Aged care legislation ‘not fit for purpose’: report

4 minute read

A review of the Aged Care Quality and Safety Commission is in with a boatload of recommendations to help it survive in a useful form.

A review of the Aged Care Quality and Safety Commission has made 32 recommendations to address “critical capability gaps in the organisation that require urgent attention” but stops short of replacing it with a new entity.

David Tune AO PSM conducted the review, which was established following the recommendation of the Royal Commission into Aged Care Quality and Safety that the ACQSC should be abolished in favour of a new authority. His report was released late last week.

“There are strong arguments, however, to more effectively and efficiently achieve the objectives expressed by the Royal Commission by retaining the current Commission [ACQSC],” wrote Mr Tune.

“This approach involves a less disruptive and more efficient and cost-effective approach by building on the strengths of the current Commission and the work already underway to achieve modern, world class regulation.”

Mr Tune said the ACQSC had “significant issues attracting and retaining staff” and a staff vacancy rate of 20% – “in particular, quality assessor staff are difficult to attract and retain”.

He commended the current staff and Commissioner Janet Anderson PSM, but there was a long laundry list of problems needing attention, including:

  • an urgent need to fix its organisational structure, senior leadership, and internal governance;
  • a need to change the ACQSC’s organisational structure to reduce functional silos, bring together like functions, improve accountability, spans of control and delegation of powers, and the redesign of internal strategic governance arrangements;
  • workforce and ICT systems, including a new set of internal governance arrangements, with oversight by a new Deputy Commissioner Corporate;
  • significant problems in its complaints process and Serious Incident Response Scheme;
  • the need for more openness, transparency, accountability, information sharing and engagement with providers and consumers;
  • the need for a far more collaborative approach to shaping and delivering its regulatory responsibilities and work program, partnering with providers and peaks and utilising opportunities for co-design with providers and consumers; and,
  • the need for a better understanding of the diverse needs and circumstances of aged care consumers and their communities.

“The existing aged care legislative framework is not fit for purpose and is too complicated and rules-bound,” wrote Mr Tune.

“The new Act and regulatory system must encourage ongoing continuous improvement, driving higher quality care, and the development of risk approaches that ensure that the safety of older Australians gets the right and timely attention that is warranted.”

Data would be key to improvement, he said.

“Without the right systems and capabilities – particularly robust data analysis – the vision will not come into being,” he said.

“The Commission must share much more information and data – on its own performance, but also providers, and what works, and what the key issues are. This will help drive ongoing continuous improvement and enable a more trusting and empowered sector.”

Top priority recommendations are:

  • formation of a senior level steering group to oversee implementation of an action plan based on the review recommendations;
  • establishment of a joint strategic policy and operational committee and update of its overarching memorandum of understanding;
  • strengthening leadership with a new organisational structure;
  • a robust, comprehensive and transparent corporate governance framework;
  • accelerated development and implementation of a diversity and inclusion strategy;
  • a detailed, holistic and thorough a strategic workforce plan that identifies skills gaps and focuses on all aspects of the employee lifecycle;
  • appropriately resourced ICT governance and delivery processes

Commissioner Anderson responded positively to Mr Tune’s report in a statement.

“We appreciate the thoroughness of Mr Tune’s review and his acknowledgement of the work undertaken by the Commission since its inception in 2019 to set it on an aspirational path towards becoming a world class regulator,” she said.

“[Aged Care Minister Anika] Wells has indicated that she will carefully consider the 32 report recommendations as a matter of priority.”

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