Mable Background: Response to Royal Commission Recommendations

The human rights principles and framing for a proposed new aged care act is laudable and overdue.

However, many of the proposed recommendations from the Counsel Assisting the Royal Commission relating to home care do not clearly reflect human rights principles, nor do they put older people at the centre of their care and support. In many respects what is proposed is the existing system with some positive improvements and more investment. Providers remain at the centre, with more regulation at more cost. Regulation is seen as the key driver of better outcomes and keeping people safe, rather than people being at the centre of services and decision making ,living their best life. Surprisingly, consumer directed care and self-managed approaches are not mentioned in the recommendations.

If people were genuinely at the centre of a new proposed Aged Care Act, there would be recognition that many older people have the capacity and desire to make decisions about their lives, their care and support, and what is important to them, they also have support people around them to assist in their decision making. There would be clear recognition that ageing isn’t solely about frailty, decline and end of life, where everyone is ‘vulnerable’ and by definition, needs to become dependent on heavily regulated aged care providers in the later part of life.

Self-management and genuine choice over who supports you (i.e. the people who support you in often personal and intimate ways) and how you are supported, critically needs to be an option for Australians in older life. The recognition of decision-making capacity of older people and their equal right to make decisions needs to be fully incorporated into the aged care system framework. This is essential and central to a human rights-based approach.

In regard, the Recommendation 10, for care finders to assist older people accessing the system and finding services, who are engaged by the Government, is a welcome step. However, another important recommendation would be for people to have access to registered case managers who are independent of service providers, so older people can access advice and planning support that is impartial and tailored to their needs. 

Our main comments regarding specific Recommendations are below:

Recommendation 1.1(c) enable people entitled to aged care to exercise choice and control in the planning and delivery of their care
We support this in principle. However, Mable is concerned that other recommendations in the Submission undermine this principle as it’s not clear people have the option to self manage and choose the people who support them, how they are supported and when.
Recommendation 8.1.(e) genuine choice accorded to each individual over how their aged care needs are to be met (including choice of provider and level of engagement in managing care, and appropriate and adapted supports to enable people from diverse backgrounds and experiences to exercise choice)
Mable supports “genuine choice” but  believes a person’s choice should not be limited only to the choice of provider and then having to accept the services they offer.  You should be able to choose the people and services that are right for you.
Recommendation 5.1.(d) [From 1 July 2022, the Australian Government (and, from 1 July 2023, the Australian Aged Care Commission) should implement a social supports category within the aged care program that:] is grant funded
Mable believes that Grant funded social support programs, even in CHSP, are not necessarily person-centred and that this does not reflect Consumer Directed Care or the diversity of preferences people have for how they spend their time and who they want to connect with. Social support should be funded individually in home care packages. In addition to individualised funding for social support, we believe there is merit in Group funded support via grants to communities and different mainstream organisations rather than allocated to Providers, to enable community connection and diversity of interests to be met. Consumers only get to mix with the cohort of consumers who use that Provider for social support and this is less likely to meet their connection and individual needs than, for example, attending a culturally appropriate knitting group.  There is an assumption that CHSP consumers wish to go to Centre-based activities rather than to reconnected to their own communities of choice. To deliver this form of support through a grant-funded, provider based model, is a system centred response where a person’s social needs have to sit within an allocated program of services, despite language, cultural and community requirements.

Have your say

The Royal Commission is seeking responses to the recommendations which will guide the final report that is handed down in early 2021. Any responses must be made by 4:00pm (AEDT) on 12 November 2020. Your response can be submitted as a Word Document or PDF attachment and emailed to ACRCfinalsubmissions@royalcommission.gov.au. You can read more about this process here.

Your submission should include your name, email address, phone number, postcode, as well as whether you’re receiving aged care services yourself or you’re a family member.