Occupational therapists welcome final report of the Royal Commission into Aged Care Quality and Safety

The peak body for Australian occupational therapists has welcomed the release of the final report of the Royal Commission into Aged Care Quality and Safety, noting that many of its recommendations are in line with those made by the profession.

Chief Executive Officer of Occupational Therapy Australia (OTA), Samantha Hunter, said the Royal Commissioner’s report amounted to a call for a complete change of culture around the delivery of aged care.

“Whether older Australians are in Residential Aged Care Facilities (RACFs) or are ageing in their own homes, the Royal Commission has made it clear that there needs to be sweeping changes to the manner in which care is delivered, the oversight and measurement of that care, the skillset of those delivering it, and the governance and funding of care providers,” Ms Hunter said.

“The fact that the two Royal Commissioners have offered differing visions with regard to some matters of governance and funding should not, I believe, take from the great good sense reflected in the recommendations concerning the day-to-day delivery of aged care, the vast majority of which enjoy the support of both Royal Commissioners.”

Ms Hunter noted that a number of the Royal Commission’s recommendations align with those made by OTA in its submissions to the Royal Commission.

Among these are:

• Recommendation 29 (Commissioner Briggs), which calls for the engagement of a workforce of personal advisers to older people, to assist older people seeking aged care services;
• Recommendation 36, which calls for those ageing in their own homes to receive allied health care appropriate to their needs;
• Recommendations 37 and 38, which call for arrangements which ensure the delivery of allied health services, including occupational therapy, to residents of RACFs and the ‘strict monitoring’ of the level of these services;
• Recommendation 47, which states that no younger people should be in RACFs;
• Recommendation 61, which calls for short-term changes to the Medicare Benefits Schedule, enabling the delivery of services by mental health practitioners, including occupational therapists, to residents of RACFs until June 2024, at which time an aged care allied health funding arrangement will have been established (funding for this recommendation was made available in last year’s federal budget); and
• Recommendation 86, which will ultimately require at least one registered nurse on site per RACF at all times.

“In addition to these specific recommendations, numerous parts of the Royal Commission report echo concerns raised by OTA,” Ms Hunter said.

“These include the identification and regular review of aged care quality standards, something the Royal Commissioners recommend become a responsibility of the Australian Commission on Safety and Quality in Health Care, which would be renamed as the Australian Commission on Safety and Quality in Health and Aged Care.

“Recommendations 25 to 28, which would see all existing home care programs amalgamated, includes a provision that multi-disciplinary teams be involved in the assessment process, which is to be welcomed.

“OTA also welcomes recommendation 39, which calls for an immediate increase in the number of Home Care Packages available, so as to address the existing waiting list,” Ms Hunter said.

“Of particular interest to occupational therapists is recommendation 34, which calls for the government to implement an assistive technology and home modifications category within the aged care program that provides goods, aids, equipment and services that promote a level of independence in daily living tasks and reduces risks to living safely at home.

“Also of interest is recommendation 45, which calls for the improved design of RACFs, an area in which occupational therapists have specific expertise.

“Recommendation 58, which envisions the establishment of multi-disciplinary outreach services to support people in their own homes is a promising idea, and OTA notes the inclusion of allied health practitioners in these teams.

“OTA also commends the Royal Commissioners for their careful consideration of the rights and needs of those aged Australians with disability who are ineligible for the support of the National Disability Insurance Scheme (NDIS). We support the Commissioners’ finding that these Australians should receive supports equivalent to those that would be available under the NDIS to a person under the age of 65 years with the same or substantially similar conditions,” Ms Hunter said.

“The Royal Commissioners have recognised the challenges involved in the delivery of aged care services in rural and remote parts of the country, and have suggested means by which these might be addressed.

“We also endorse the Commissioners’ observations around the culturally appropriate provision of aged care services to Aboriginal and Torres Strait Islanders. We particularly welcome the call for targets for the training and employment of Aboriginal and Torres Strait Islander people across the full range of aged care roles.

“Finally, OTA notes with great interest chapters 13, 14 and 15 of the report, which relate to issues of governance, quality, and the collection of aged care data. Chapter 15, in particular, aligns with observations made by OTA about the fundamental importance of data collection to the delivery of evidence-based aged care.”

Ms Hunter thanked the Royal Commissioners, the Hon. Tony Pagone QC and Ms Lynelle Briggs AO, for their dedication to a vast undertaking, which it is hoped will be of lasting value to the Australian community. She noted that the fate of the Royal Commission’s recommendations, and by implication the future of Australia’s aged care system, rests now with the Morrison Government, which is due to respond to the Royal Commission by 31 May.

The Royal Commission’s final report is available here: https://agedcare.royalcommission.gov.au/publications/final-report

OTA’s submissions to the Royal Commission are available here:    

• Royal Commission into Aged Care Quality and Safety
• Royal Commission into Aged Care Quality and Safety Interim Report