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General Submission from COTA Australia (With Substantial Input from Member Cotas and from Consumers Through Them and Directly)

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General Submission from COTA Australia (With Substantial Input from Member Cotas and from Consumers Through Them and Directly) Submission to the Royal Commission into Quality and Safety in Aged Care General Submission from COTA Australia (with substantial input from member COTAs and from consumers through them and directly) Prepared by COTA Australia Late 2019 early 2020 Submitted July 2020 About COTA Australia COTA Australia is the national consumer peak body for older Australians. Through its own networks and those of the State and Territory COTAs (Councils on the Ageing) around Australia we represent more than 1,000 seniors’ organisation members - which jointly represent over 500,000 older Australians - and around 40,000 individual members and supporters, COTA Australia focuses on national policy issues from the perspective of older people as citizens and consumers and we seek to promote, improve and protect the circumstances and wellbeing of older people in Australia. Information about, and the views of, our constituents and members are gathered through a wide variety of consultative and engagement mechanisms and processes. COTA Australia has been in the forefront of aged care reform for many years, both in its own right and as a leading member of the National Aged Care Alliance. In preparing this document COTA Australia has drawn on the work of the COTA Federation over a significant period, and during time the Royal Commission has been operating, discussions at our National Policy Council, and material arising from extensive, recent and relevant consultations with members and stakeholders on many of the issues before the Commission. We submit it in order to contribute to the deliberations of the Royal Commission. Principally authored by: Phillipa Brennan Aged Care Royal Commission Policy Officer Assisted by: Mary Swift, Policy Officer, Aged Care Reform Judy Gregurke, (Formerly) National Manager, Aged Care Reform Sophia Petrov, National Manager, Aged Care Reform Corey Irlam, Deputy Chief Executive Ian Yates, Chief Executive Various members of the COTA Federation Authorised by: Ian Yates AM Chief Executive COTA Australia Suite 9, 16 National Circuit Barton ACT 2600 02 6154 9740 www.cota.org.au Page 2 of 90 Preface This “General Submission” from COTA Australia is one of a number of substantial inputs from COTA Australia to the Aged Care Royal Commission, commencing with the tendering to the Commissioners, before the formal commencement of its proceedings, of many of our submissions to the Federal Government, the Productivity Commission, the Legislated Review and the Carnell/Paterson Inquiry. We also tendered National Aged Care Alliance (NACA) documents that we thought were particularly relevant and reflected strong COTA positions. We discussed some of this material at meeting with Commissioner Briggs and Commission staff and Consultants in Adelaide late 2018. We have since provided a Witness Statement for the appearance by COTA Australia’s Chief Executive, who presented for most of the first formal day of Hearings in Adelaide in February 2019. We have subsequently participated in several Roundtables, provided numerous briefings to Commission staff and Counsel, and appeared at the February 2020 Roundtable and then the Adelaide Workshop Hearing on Redesign of the Aged Care system, on which we also made a submission. We have recently completed a submission on Governance, and Submission 1 on Lessons to be learned from the COVID-19 experience (we will make a second submission by the new deadline of 4 September). We are finalising a submission on Financing Aged Care which will be submitted on 4 August. This General Submission has been prepared over the latter part of 2019 and early 2020. It was intended to be submitted in March 2020 but got delayed by COVID-19 developments in which COTA Australia has been heavily involved. In preparing this submission COTA Australia has drawn on its own earlier work, the work of the other members of the COTA Federation over a significant period; and, during the time the Royal Commission has been operating, discussions at our National Policy Council, discussion with members of the Consumer Organisations Forum of the National Aged Care Alliance (NACA); and material arising from extensive, recent and relevant consultations with members and stakeholders on many of the issues before the Commission. The submission has been reviewed and updated prior to submission now, but due to continuing time constraints may contain some information, comment or views that have been superseded by events or revised policy decisions. These, if any, should not detract from the overall richness of this consultative input. COTA positions in the System Design, Governance and Financing Aged Care Submissions take precedence. However, this submission covers a very wide range of issues from our consultations with consumers and their representatives, many through State and Territory COTAs, that are not covered in any other material and which warrant the attention of the Royal Commission. We submit it in belief it will make an important contribute to the deliberations of the Royal Commission. Ian Yates AM Chief Executive 31 July 2020 Page 3 of 90 Table of Contents About COTA Australia ............................................................................................................. 2 Preface………………………………………………………………………………………………………………………………… 3 WHAT IS COTA’S VIS.ON FOR THE FUTURE OF AGED CARE? ........................................................ 8 Community Expectations ........................................................................................................ 8 Aged Care Reforms ................................................................................................................. 9 Historical Reforms ....................................................................................................................... 9 Recent quality and safety reforms ............................................................................................ 1 1 Reforms not yet implemented but identified in earlier enquiries ............................................ 13 How do consumers prepare for and engage with their aged care? ......................................... 14 Assessment of eligibility for aged care services ..................................................................... 16 Provision of aged care services ............................................................................................. 17 How are consumers with different needs supported? ............................................................. 17 How do we make dementia care core business throughout the system? ............................... 18 What care is available? ............................................................................................................. 19 Who provides care? .................................................................................................................. 21 Who pays? ................................................................................................................................ 22 How will the formal and informal workforce be supported? ................................................... 24 How will quality be achieved? .................................................................................................. 26 Increased Human Rights for older Australians ...................................................................... 27 Need for broader human rights protections beyond aged care ............................................... 28 Disempowerment ..................................................................................................................... 28 Institutionalisation .................................................................................................................... 28 Rights of older people to self-advocate .................................................................................... 29 Ageism....................................................................................................................................... 30 Elder abuse ............................................................................................................................... 32 Quality and the cost of care .................................................................................................. 33 What does aged care funding cover? ....................................................................................... 33 Definition of quality and safety ................................................................................................ 34 CHSP and HCP comparative fees .............................................................................................. 34 Measuring Aged Care Quality and Safety ................................................................................. 36 Need for Broader Toolkit of regulatory penalties ..................................................................... 38 ACCESS AND SERVICES ............................................................................................................. 39 Page 4 of 90 My Aged Care ....................................................................................................................... 39 Enhancing My Aged Care .......................................................................................................... 40 Screening and Registering with My Aged Care ...................................................................... 41 Call response times ..................................................................................................................
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