The Australian Government is determined to deliver reforms to Australia’s aged care system that improve the care provided to older Australians and has implemented the first two years of an $18.8 billion five-year Aged Care Reform program from 2021 to 2024 (postponed to 2025) in response to the Royal Commission into Aged Care Quality and Safety Final Report: Care, Dignity and Respect (Royal Commission).
The aged care reforms will put older Australians first, improving quality, safety, and choice in Aged Care to create a sector that:
This reform has already started with some changes, such as the Code of Conduct for Aged Care, Serious Incident Response Scheme (SIRS), etc. It will continue with other changes that will be introduced by July 2025. In more detail, we have summarised some of the most significant changes relevant to the providers below. As the changes will be made gradually, this blog will be updated accordingly to the best of our knowledge.
More than 50 of the 148 recommendations of the Royal Commission require the introduction of supporting legislation. The new Act will put older Australians and their needs at the centre of the legislative framework and underpin generational reform of aged care in Australia. The Royal Commission also highlighted that the current regulatory framework is no longer suitable. Current regulatory framework constraints include, but are not limited to:
The new regulatory model has four foundations:
The design of the new regulatory model is being undertaken concurrently and collaboratively with related activities and reforms in the aged care sector, such as the new Aged Care Act, Reforming in-home aged care, and aligning regulation across the care and support sectors, such as aged care, disability support, and veterans’ care sectors.
In response to the Aged Care Royal Commission, the Australian Government will invest $26.7 million to develop and introduce a new Act to underpin the fundamental and generational reform across aged care.
It includes the rights and principles and addresses significant structural changes within the Aged Care system. It also resolves many technical issues and ambiguities, such as the different definitions of a staff member and worker as an example. When writing this blog, the Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2022 (No. 34, 2022) is in force. As an amendment of the Aged Care Act 1997.
The new Aged Care Act will replace the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018. At the moment.
The new Aged Care Act establishes new requirements for aged care providers through 9 measures that respond to the Royal Commission into Aged Care Quality and Safety. Four of these measures directly relate to the regulation of Aged Care:
The Serious Incident Response Scheme (SIRS) is already in place for residential care services and settings, but from 1 December 2022, It also applies to home care and flexible care, including short-term restorative care in a home care setting, multi-purpose services and transition care, as well as the Commonwealth Home Support Programme (CHSP) provider.
They should review their Incident Management System (IMS) to ensure that it will continue to support them in improving the management and prevention of incidents.
They must also notify the Aged Care Quality and Safety Commission when reportable incidents occur as part of the Serious Incident Response Scheme (SIRS). Notifications must be made using the SIRS tile on the My Aged Care Service Provider Portal.
It applies from 1 December 2022 to approved providers of residential, home, and flexible care, including short-term restorative care, multi-purpose services, and transition care. The Code of Conduct does not apply to the Commonwealth Home Support Programme (CHSP) and National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) as they are not approved providers under the Aged Care Act; however, these providers are still required to provide safe and respectful care and behave in a way that aligns with the Code. It is expected that similar provisions will be extended to all Commonwealth-funded aged care services as part of the planned introduction of a new aged care Act.
The Code includes eight elements that require the providers to:
The Code is also consistent with the NDIS Code of Conduct with a focus on the individual’s right to receive quality care, but the Aged Care Code of Conduct has additional requirements, and the Aged Care providers must take reasonable steps to make sure workers (including employees, volunteers, and contractors)and governing people understand and comply with the Code.
The Commission has access to various compliance and enforcement actions to respond to different situations. In severe cases, actions may include banning a current or former worker or governing person from working in the aged care sector or, in the case of approved providers, applying a sanction or revoking their approved provider status.
The Government’s Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2022 implements nine measures to improve accountability and transparency and responds to 17 recommendations of the Royal Commission into Aged Care Quality and Safety.
From 1 December 2022, there are new governance responsibilities for all approved providers. Additional responsibilities will commence on 1 December 2023 for providers approved before 1 December 2022. They apply to approved residential, home and flexible care providers, including short-term restorative care, multi-purpose services and transition care, but Commonwealth Home Support Programme (CHSP) and National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP). This does not apply to state/territory or local government authorities (which may be some MPS services).
These new requirements include:
Additional legislative amendments were made through the Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2022. These further strengthened consent requirements to address gaps in state and territory legislation on the use of restrictive practices in residential aged care.
The Quality of Care Principles has been amended to include a hierarchy of persons/bodies who can consent to the use of restrictive practices on the care recipient’s behalf. This can only be used when:
The hierarchy will only be in place until 1 December 2024. A new mechanism will be included in the new Aged Care Act.
This will ensure restrictive practices are only used with the appropriate consent to protect the health, rights and dignity of older Australians in residential aged care.
In March 2021, the Australian Government announced an urgent review of Quality Standards. This was in response to the Royal Commission into Aged Care Quality and Safety Final Report: Care, Dignity and Respect (Royal Commission).
The Aged Care Quality standards are revised to make them:
In the revised standards, There are more details on what older people expect from their providers. It provides clear and details actions (142 actions) to help providers understand the requirements to achieve the desired outcome.
The requirements are more measurable and less subjective for a better assessment by the Aged Care Commission.
A new term, “older person/older people” will be used instead of the term “Consumer(s)” that is used in the current standards.
The term “Consumer” in the current standard
The following table summarises the differences between the current and revised standards drafted for public consultation:
|Current Standards||Revised Standards (Draft)||The Outcome of the Revised Standards|
|Standard 1: Consumer dignity and choice||Standard 1: The Person – I am valued and have choice over the life I lead |
The revised Standard 1 is almost similar to the current Standard 1
|Standard 2: Ongoing assessment and planning with consumers||Standard 2: The Organisation – I have confidence in my service provider |
The revised Standard 2 draws on the current Standards 6, 7 and 8
|Standard 3: Personal care and clinical care||Standard 3: The Care and Services – My care is based around who I am and what is important to me |
The revised Standard 3 draws on Standard 2 and parts of Standards 3 and 4
|Standard 4: Services and supports for daily living||Standard 4: The Environment – I feel safe and supported where I live |
The revised Standard 4 draws on Standard 5 and parts of Standard 3
|Standard 5: Organisation’s service environment||Standard 5: Clinical Care – I get the right clinical care for me |
The revised Standard 5 draws on parts of Standards 2, 3 and 8
|Standard 6: Feedback and complaints||Standard 6: Food and Nutrition – I enjoy tasty and nutritious food every day |
The revised Standard 6 expands significantly on parts of Standards 2 and 4
|Standard 7: Human resources||Standard 7: The residential Community – I contribute to the community I live in |
The revised Standard 5 draws on parts of Standards 3 and 4
|Standard 8: Organisational governance||The revised Aged Care Quality Standard does not include Standard 8||Not Applicable|
Current Aged Care Quality Standards apply to all providers regardless of the risk profile of the provider or the service type. It could lead to the over-regulation of some providers and the under-regulation of others. The new system has taken the modular concept of NDIS into consideration and is structured based on the type of services delivered by the providers. According to the revised standards, the Registration Categories and Registration Obligations for providers are summarised in the table below:
|Registration Category & Service Types||Registration Obligations||Registration Process and Period|
|Category 1: Home and community services || || |
|Category 2: Assistive technology and home modifications || || |
|Category 3: Social support || || |
|Category 4: Clinical and specialised supports || || |
|Category 5: Home or community-based respite || || |
|Category 6: Residential care || || |
Currently, the Commission is conducting a pilot to test the assessment process in 2023.
In-home aged care services such as the Home Care Packages (HCP) and Commonwealth Home Support Programme (CHSP) Program support almost one million senior Australians. Research shows that senior Australians want to remain at home for as long as possible before entering a residential aged care facility. More than 1 million Australian rely on aged care in their home today. With more than $9.5 billion in funding this financial year (FY 2022-23) going toward the in-home care program. Additional $40000 home care packages will be available this financial year.
In-home aged care reform seems to be needed:
The support At Home program that was introduced in January 2022 will replace Commonwealth Home Support Programme (CHSP), Home Care Packages (HCP) Program, Short Term Restorative Care (STRC) Programme, and Residential Respite. This model can be summarised in the followings:
This new program is structured as:
As the next step, after further consultations, It is expected to release the Government decision about this program sometime in Mid-2023 that give a 12-month for transition and implementation by July 2025.
In the meantime, the current CHSP and HCP are still available. No one will lose any in-home aged care services they currently have in place through the Commonwealth Home Support Programme or Home Care Packages Program.
There are some other changes and new programmes running in parallel with the ones mentioned above, such as
The Aged Care reform will be continued with other changes, such as having nurses on-site 24/7 in Residential Care. Power of setting a cap on the administration and management fee for Home Care providers and mandatory reporting requirements, including financial information.
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