Aged Care Royal Commission 2020: Statistics and Government Actions Summary

Established in October 2018, before the Covid-19 pandemic swept the globe, the Australian Royal Commission into Aged Care and Safety delivered its final report in October 2020. The recommendations of the Royal Commission have been, in large, accepted by the Government and changes will be made to provide greater care, and access to care, for senior Australians.
Below is a summary of statistics and outcomes cited from the ‘Royal Commission into Aged Care Quality and Safety, Final Report Volume 1’

Changing Landscape

• It is projected that the number of Australians aged 85 years and over will increase from 515,700 in 2018–19 (2.0% of the Australian population) to more than 1.5 million by 2058 (3.7% of the population).
• In 2018–19, aged care services were delivered to around 1.3 million people. The most commonly used service in 2018–19 was the Commonwealth Home Support Programme (about 841,000 people), followed by residential aged care (about 243,000 people) and Home Care Packages (about 133,000 people).

Funding

• In 2018–19, which is the last year for which all data is currently available, a total of $27.0 billion was spent on aged care, including $19.9 billion by the Australian Government.
• In 2019–20, the Australian Government’s expenditure on aged care programs administered by the Department of Health was $21.2 billion.
• In 2019–20, the Australian Government’s expenditure on aged care programs administered by the Department of Health was $21.2 billion. Older people are required to contribute to the costs of their care and accommodation if they can afford to do so through co-payments and means tested fees. People receiving aged care services contributed $5.6 billion to the cost of their aged care in 2018–19.
• By 2030–31, aged care will account for 5.0% of all Australian Government expenditure compared to 4.2% in 2018–19.

Workforce and providers

• The most recent National Aged Care Workforce Census and Survey found there were around 366,000 paid workers (84%) and 68,000 volunteers (16%) in the aged care sector in 2016.
• The Aged Care Financing Authority reported that in 2018–19, there were over 3000 providers of aged care services. This included 873 residential aged care providers, 928 home care providers (as at 30 June 2019) and 1458 Commonwealth Home Support Programme providers.
• According to the Aged Care Financing Authority, approximately 31% of home care providers and 42% of residential aged care providers reported an operating loss in 2018
• The Aged Care Financing Authority has suggested that the pandemic may increase pressure on the sector, particularly for providers in regional, rural and remote Australia.

Accessing Care

• Most older people want to remain living in their own homes, rather than moving to residential aged care. However, in the current aged care system, older people often wait too long to get access to care at home. For example, in 2018–19, the waiting times between being assessed as eligible for a Home Care Package to being assigned a package ranged from seven months for a Level 1 package to 34 months for a Level 4 package.
• As at 30 June 2020, 102,081 older people were waiting for a package at their approved level.
• A survey found that in 2018–19, only 2% of Home Care Package funding was spent on allied health. Under the Commonwealth Home Support Programme in 2018–19, while 29% of people received services categorised as allied health and therapy services, more than half of the people received fewer than five allied health services per year.

Access to health care and disability services

• More than 1000 younger people with a disability were admitted to residential aged care in the year to 30 September 2020. Residential aged care is inherently unsuitable for younger people.

Abuse & Routine Care Extent of Substandard Care

• In 2019–20, residential aged care services reported 5718 allegations of assault under the mandatory reporting requirements of the Aged Care Act.
• Studies have revealed that as many as 68% of people receiving residential aged care are malnourished or at risk of malnutrition.
• 71% of people in residential aged care have experienced incontinence.

Extent of Substandard Care

• Commissioner Briggs concludes that at least 1 in 3 people accessing residential aged care and home care services—or over 30%—have experienced substandard care. Among the data, she notes the following disturbing themes:
  the incidence of assaults may be as high as 13–18% in residential aged care
  • there is a clear overuse of physical and chemical restraint in residential aged care
  • in residential aged care, some 47% of people have concerns about staff, including understaffing, unanswered call bells, high rates of staff turnover, and agency staff not knowing the residents and their needs
  • in home care, one-third of people have concerns about staff, including continuity of staff and staff not being adequately trained
  • in respite care in residential facilities and in the Commonwealth Home Support Programme, about 30% of people have concerns about staff, including understaffing, continuity, training and communication
  • substandard care has become normalised in some parts of the aged care system, such that people have low expectations of the quality of their care.

Government response and actions 

Visitors and Quality Of Life

• The Government advised that it delivered $450 million in 2020 to residential aged care providers to support preparedness and response to COVID-19, including visitation to aged care facilities by families and friends. On 14 October 2020, the Minister for Aged Care and Senior Australians, Minister Colbeck, wrote to all providers reinforcing expectations with regard to visitation, noting that the Australian Government agrees with our emphasis on ensuring aged care residents are able to see their loved ones. In addition, updated Australian Health Protection Principal Committee Visitation Guidelines for Residential Aged Care Facilities were issued on 20 November 2020.

Allied Health

• The Australian Government accepted the recommendation and created two new Medicare Benefits Schedule items at a cost of $47.6 million for mental health and allied health services for residential aged care residents. The items commenced from 10 December 2020.

Infection control expertise and personal protective equipment

• The Government provided funding of $217.6 million to residential aged care providers in October 2020 to be used for COVID-19 preparedness and response, including to support the costs of engaging an Infection, Prevention Control lead. The Government also agreed that residential aged care providers will be required to demonstrate, as part of the accreditation process, evidence relating to Infection Prevention Control leads. The Aged Care Advisory Group advised on training parameters.
• The Government increased its contribution under the National Partnership on COVID-19 Response from 50% to 100% for activity by the States and Territories to support aged care services, particularly infection and prevention control training, and co-ordinated preparedness and response.

Source - Royal Commission into Aged Care Quality and Safety Final Report Volume 1
https://agedcare.royalcommission.gov.au/publications/final-report-executive-summary