Outcome 4: Aged Care and Population Ageing > Outcome Performance Report

Major Achievements

• Implemented significant reforms in the funding of residential aged care resulting in better matching of funding to care needs and targeting of funding to residents with higher care needs.
• Provided support for the establishment and operation of the Ministerial Conference on Ageing which will ensure better coordination of jurisdiction policies, and programs to include older people in discussion.
• Helped ensure the safety and security of people receiving care through the investigation of complaints made to the Aged Care Complaints Investigation Scheme.
• Made arrangements for cash bonuses to be paid to eligible nurses to attract qualified nurses back into the residential aged care workforce.

Key Strategic Directions for 2007–08 – Major Activities

Reform of the Residential and Community Aged Care Sectors to Ensure a Fair and Sustainable Aged Care System

Residential Aged Care Funding Reforms

In 2007–08, the Department implemented significant reforms in the funding of residential aged care resulting in better matching of funding to care needs and targeting of funding to those residents with higher care needs to improve access to and the quality of care for people with high needs. These reforms included a new fairer income test, a new accommodation supplement that provided for more equitable treatment for all residents and a new funding instrument.

Throughout the development and implementation of the new Aged Care Funding Instrument, the Department worked with an industry reference group whose membership included provider, worker and consumer representatives. This new system has three funded levels for personal care and includes two new funding supplements. The new supplements will better target funding towards residents with dementia and challenging behaviours, and residents who have complex health care needs, including those who need palliative care. The Aged Care Funding Instrument measures residents’ needs for care rather than care being provided. This is a more objective measure of resident care needs. The instrument has been designed to reduce the amount of documentation, and can now be claimed online directly through Medicare Australia.

Top of page

Reforms to the Community Care System

The Department worked in partnership with State and Territory Governments and the sector to commence reforms to the community care system outlined in A New Strategy for Community Care – The Way Forward. This initiative aims to strengthen community care by streamlining administrative arrangements and creating a nationally consistent and fairer way to help frail, older Australians and people with disabilities to live in their own homes for as long as possible.

Common arrangements, built upon the individual arrangements already in place in each state and territory, were implemented. Each of the states and territories progressed these common arrangements during 2007–08.

The Council of Australian Governments’ agreement in 2006 endorsed the efforts already underway identifying two priorities, including more timely and consistent assessments for frail older people by Aged Care Assessment Teams, and simplified entry (Access Points) and assessment processes for the Home and Community Care Program. Specific achievements included the signing of the Home and Community Care Review Agreement between the Commonwealth and each state and territory, confirming national agreement to the implementation of the reforms by 2010–11, and the development of nationally consistent approaches to intake assessment of clients and carers (known as the Australian Community Care Needs Assessment and the Carers’ Eligibility and Needs Assessment).

Access Point Demonstration Projects established in each jurisdiction streamline entry arrangements, eligibility testing, assessment, and referral processes, including the use of the Australian Community Care Needs Assessment and the Carers’ Eligibility and Needs Assessment. They help people and their carers to navigate the community care system, and to be initially assessed and referred to appropriate services for their needs.

Other achievements included a set of draft principles and framework for a national fees policy. Seven draft quality standards and associated performance criteria have also been developed for pilot, together with a reporting tool and guidelines for assessors and service providers. This is to ensure that the community care reform work strategically aligns with and supports Council of Australian Governments and other Government directions which emerged during 2007–08.

Top of page

Ministerial Conference on Ageing

The Department acted as the interim Secretariat to the Ministerial Conference on Ageing which met for the first time on 13 June 2008. The Ministerial Conference provides a forum where Commonwealth, State and Territory and local governments can cooperate to ensure that policies and programs are focused on the inclusion of older people. Ministers at the conference agreed to establish an expert group to advise governments on the challenges of psychogeriatric care, and to support a forum with States, Territories and local government on aged care planning and allocation processes.

Ensuring the Safety and Security of People Receiving Care

Aged Care Complaints Investigation

The Department’s Aged Care Complaints Investigation Scheme completed its first year of operation in May 2008. Through the scheme, the Department has the ability to investigate potential breaches of an approved provider’s responsibilities under the Aged Care Act 1997. By 30 June 2008 the Complaints Investigation Scheme had received 11,323 contacts and investigated 7,496 cases. The remaining contacts were addressed either through the provision of information or were out of scope of the scheme. In investigating the 7,496 cases, the scheme conducted 4,768 site visits. There were 930 instances where a breach was identified. Of these, 214 Notices of Required Action were issued to address the breach and in the remainder of cases, resolution was achieved either through conciliation or the approved provider had already undertaken remedial action to address the problem.

From 1 July 2007, compulsory reporting requirements were introduced for incidents or allegations of sexual or serious physical assault in residential aged care with protection for approved providers and staff that make these reports. In 2007–08, the Department received 200 reports of alleged sexual assault and 725 reports of alleged physical assault. The police are responsible for investigating the assaults and the Department is aware of charges being laid in six cases during the reporting period. The Department checks that the Approved Provider has made a referral to police and organised suitable arrangements to protect residents in the aged care facility.

Top of page

Aged Care Commissioner

Approved providers and other parties affected by decisions under the Aged Care Complaints Investigation Scheme have a right to seek an examination of those decisions by the Aged Care Commissioner. Parties can also request the Commissioner to examine the handling and investigation of a complaint by the scheme. During 2007–08, the Commissioner reviewed 88 examinable decisions and provided her recommendations to the Department. After the Department receives a recommendation from the Commissioner about an examinable decision, the Department must, taking into consideration the recommendation, reconsider the decision. In 2007–08, the Department completed a reconsideration of 78 of the 88 Commissioner recommendations. Of those 78, in all but 10 instances the outcome of the Department’s reconsideration was consistent with the Commissioner’s recommendation. The outstanding 10 recommendations which were not considered by the Department in 2007–08 will be reconsidered in 2008–09.

Police Checks

Under the Aged Care Act 1997, certain staff and volunteers need to undergo a police check and assessment for suitability to work in aged care. In 2007–08, the Department obtained a one-off statement from all approved providers in respect of 4,468 services regarding their compliance with police check requirements. The Department also commenced strengthening police check criteria by expanding the requirement for aged care staff to undergo police checks. This will mean that staff who have both supervised and unsupervised access to people receiving care will be required to undergo a police check.

Financial Security for Aged Care Residents

Following the insolvency of Lifestyle Care Providers Pty Ltd, the Department acted to protect residents that had paid lump sums for their entry to its residential care service. The refunds of those lump sums that were accommodation bonds were made under the Accommodation Bond Guarantee Scheme, while the remainder were made as ‘act of grace’ payments. In total, nearly $970,000 was paid out to residents and the Department is currently pursuing Lifestyle Care Providers Pty Ltd to attempt to recover this amount.

Ensuring an Adequate and Well-trained Workforce

The Department funds a number of vocational education and training programs and scholarships for aged care workers in residential and community care settings. In January 2008, the Prime Minister announced the commencement of the Bringing Nurses Back into Aged Care program, which aims to encourage up to 1,000 nurses to return to the aged care workforce. The Department has appointed the Royal College of Nursing Australia to administer the aged care nurses incentives.

Top of page

Improved Access to Care for People from Culturally and Linguistically Diverse Backgrounds

Community Partners

The Department approved 72 projects under the Community Partners Program to improve access to aged care services for older people from a culturally and linguistically diverse background. This was an increase from 35 projects during the previous year. Funding was provided to organisations representing older people from over 16 language groups and 14 projects targeted multiple culturally and linguistically diverse communities. The funded organisations include community based and charitable, local government and State and Territory Governments. For example, activities funded under the program included information dissemination activities, translated materials relating to aged care, cultural briefings for aged care providers and the establishment of partnerships with aged care services.

Training in Culturally Appropriate Care

The Department also funded an organisation in each state and territory under the Partners in Culturally Appropriate Care Program to train aged care service providers in culturally appropriate care. The organisations also undertook a new role in 2007–08 to assist in the coordination of activities, the reduction of duplication, and to assist projects funded under the Community Partners Program to achieve required objectives and outcomes.

One of the many achievements of the Partners in Culturally Appropriate Care Program in 2007–08 was the development of a training program for aged care service providers who are managing older people suffering from the effects of past trauma. This program has been developed in Western Australia in partnership with the Association for Services to Torture and Trauma Survivors Inc and will be rolled out nationally in partnership with state and territory members of the Forum of Australian Services for Survivors of Torture and Trauma.

Transition Care

The Department also developed an approach to implement an additional 2,000 transition care places over the next four years. Transition Care assists older people after a hospital episode by providing additional therapies and support, so that they can regain their functioning and independence. In 2008–09, the Department will continue to work collaboratively with the states and territories to ensure appropriate access to transition care by Aboriginal and Torres Strait Islander people.

Top of page

Supporting Older Australians to Have Healthy, Independent and Active Lives

Ambassador for Ageing

The Department provided secretariat support for the Ambassador for Ageing, following the appointment on 12 April 2008 of Ms Noeline Brown. The Ambassador is involved in a range of activities and events across Australia promoting positive and active ageing and encouraging recognition and respect for the continuing contribution made by older Australians. In May 2008, the Ambassador attended several regional functions to celebrate the work of older volunteers, addressed the National Community Care Conference and spoke to a Council on the Ageing Forum.

Provision of Information

The Department also provided a range of information for the community and the aged care industry through print and other media to communicate its programs and services. The Aged Care Information Line (1800 500 853) continued to be popular with the public, with the number of calls increasing from previous years. In 2007–08, there were 99,039 calls, compared with 94,634 in 2006–07 and 90,286 in 2005–06. The helpline is listed in all White Pages directories, with additional mention in the Age Page at the front of each White Pages directory. More than 8.6 million print items, including the Aged Care 5 Steps booklet and Carer Information kits, were distributed by the Department’s storage and distribution contractor, National Mailing and Marketing. The Department also sponsored a number of awards and events that supported positive ageing. The new year will mark the tenth year of the Department’s sponsorship of the Senior Australian of the Year Award.

Support for People with Dementia

To provide support through better consumer and health professional integration, the Department managed programs that provided training and education support for people living with dementia and their carers. The Department implemented Dementia Behaviour Management Advisory Services nationally, a further round of the Dementia Research Grants Program to promote and support the growing need for dementia-focused research, and a Dementia Caring Pilot which provided skill enhancement activities for carers. The Department also supported the formation of the Minister’s Dementia Advisory Group to provide advice to the Minister for Ageing on issues relating to the monitoring, evaluation and future directions of the dementia-related initiatives.

Continence Management

Under Phase 3 of the National Continence Management Strategy, the Department provided funding to the Pharmacy Guild of Australia to provide community pharmacists and pharmacy assistants with the information and skills to better inform the public of continence assistance available. Pharmacists and pharmacy assistants also encouraged individuals to seek readily accessible, appropriate and discreet information about their condition or symptoms. This included encouraging people to seek appropriate professional assessment and providing access to information resources on how to better manage their condition.

Eye Health

The Department supported 12 new projects under the second round of the National Eye Health Demonstration Grants Program. These grants are to trial and evaluate innovative methods of eye health promotion and service delivery. For example, funding was provided to The Royal Victorian Eye and Ear Hospital to evaluate shared care arrangements for glaucoma, diabetic retinopathy and macular degeneration. Another supported project was the development of skills and knowledge in Aboriginal Eye Health Workers by the International Centre of Eye Care Education.

Top of page

Table 2.3.4.1: Allocated and Operational Aged Care Places per 1,000 Persons Aged 70 Years and Over at 30 June 2008 ¹

	Ratio of Allocated Places				Ratio of Operational Places
	All Residential	Community Care	Transition Care	Total	All Residential	Community Care	Transition Care	Total
New South Wales	99.9	22.9	1.1	124.0	87.2	22.8	1.0	111.0
Victoria	99.5	23.1	1.1	123.6	88.0	23.0	1.0	112.0
Queensland	98.0	22.3	1.1	121.4	85.4	22.2	0.9	108.5
South Australia	100.9	23.1	1.1	125.1	95.2	22.9	1.0	119.1
Western Australia	97.0	23.5	1.0	121.5	83.4	23.4	0.9	107.7
Tasmania	93.1	24.0	1.3	118.4	85.9	23.7	1.1	110.7
Northern Territory	111.4	127.4	3.6	242.4	95.0	127.4	2.6	225.0
Australian Capital Territory	105.9	28.7	1.6	136.2	76.8	28.6	1.5	106.9
Australia	99.2	23.3	1.1	123.6	87.3	23.2	1.0	111.5

¹ The places in Table 2.3.4.1 include flexible care places. The higher levels of provision in the Northern Territory address the care needs of Aboriginal people aged 50 years and over.

Table 2.3.4.2: Allocated and Operational Places by Region per 1,000 Persons Aged 70 and Over at 30 June 2008²

	Ratio of Allocated Places				Ratio of Operational Places
Aged Care Planning Region	Residential Care	Community Care	Transition Care	Total	Residential Care	Community Care	Transition Care	Total
New South Wales			1.1				1.0
Central Coast	93.9	24.4		118.3	83.3	24.4		107.6
Central West	93.3	22.6		115.9	91.3	22.4		113.7
Far North Coast	95.4	22.2		117.6	79.9	22.1		102.1
Hunter	97.8	22.2		120.0	84.6	22.2		106.8
Illawarra	100.6	23.5		124.0	78.9	23.5		102.4
Inner West	118.8	22.4		141.2	112.8	22.4		135.2
Mid North Coast	98.5	22.6		121.1	78.8	22.4		101.2
Nepean	94.1	22.0		116.2	91.6	22.0		113.7
New England	96.2	23.5		119.8	85.0	23.5		108.5
Northern Sydney	104.4	22.1		126.5	98.5	22.1		120.6
Orana Far West	95.1	26.9		122.0	93.2	26.2		119.5
Riverina/Murray	97.4	22.0		119.5	81.6	21.8		103.5
South East Sydney	95.6	22.4		118.0	78.2	22.4		100.6
South West Sydney	102.0	23.1		125.1	85.1	23.1		108.1
Southern Highlands	104.3	23.9		128.2	89.2	23.9		113.1
Western Sydney	101.4	23.8		125.2	89.3	23.8		113.1
Victoria			1.1				1.0
Barwon-South Western	98.6	24.4		123.0	91.9	24.4		116.4
Eastern Metro	98.1	24.8		123.0	86.6	24.8		111.4
Gippsland	93.0	21.3		114.3	82.8	21.3		104.1
Grampians	96.8	18.2		115.0	87.7	18.2		105.9
Hume	101.6	24.5		126.1	92.2	24.5		116.7
Loddon-Mallee	97.6	21.1		118.7	90.7	21.1		111.8
Northern Metro	99.5	18.5		118.1	81.3	18.5		99.9
Southern Metro	102.0	20.7		122.7	90.7	20.7		111.4
Western Metro	101.7	33.9		135.6	89.8	33.6		123.4
Queensland			1.1				0.9
Brisbane North	106.1	26.7		132.8	101.0	26.3		127.3
Brisbane South	100.2	24.2		124.4	90.0	23.7		113.7
Cabool	93.0	19.1		112.1	81.6	19.1		100.8
Central West	123.7	57.8		181.5	123.7	53.8		177.5
Darling Downs	95.6	18.3		113.9	88.2	18.2		106.4
Far North	92.7	26.9		119.5	80.5	26.9		107.3
Fitzroy	98.3	24.0		122.3	92.8	23.8		116.6
Logan River Valley	98.1	17.1		115.1	85.9	17.1		103.0
Mackay	87.3	23.7		111.0	82.9	23.7		106.6
North West	93.6	103.8		197.4	93.6	103.8		197.4
Northern	95.3	20.5		115.8	94.5	20.5		115.0
South Coast	99.4	18.7		118.0	76.0	18.7		94.6
South West	107.4	62.4		169.7	105.5	62.4		167.8
Sunshine Coast	100.5	20.3		120.8	78.3	20.3		98.6
West Moreton	95.3	18.4		113.7	83.1	18.4		101.5
Wide Bay	92.6	22.4		115.0	73.7	21.9		95.7
South Australia			1.1				1.0
Eyre Peninsula	96.2	29.0		125.1	96.2	24.7		120.9
Hills, Mallee and Southern	91.5	25.5		117.0	81.0	25.5		106.5
Metropolitan East	125.0	31.4		156.4	123.6	31.2		154.9
Metropolitan North	101.8	17.9		119.6	93.7	17.9		111.5
Metropolitan South	102.8	22.1		124.9	93.7	22.1		115.7
Metropolitan West	88.4	18.7		107.1	87.2	18.7		105.9
Mid North	79.0	27.8		106.8	76.1	27.8		103.9
Riverland	93.2	17.5		110.8	82.5	17.5		100.0
South East	91.0	24.9		116.0	85.5	24.9		110.5
Whyalla, Flinders and Far North	92.5	38.1		130.6	87.9	38.1		126.0
Yorke, Lower North and Barossa	95.4	21.1		116.5	91.0	21.1		112.1
Western Australia			1.0				0.9
Goldfields	107.2	26.2		133.4	107.2	26.2		133.4
Great Southern	88.6	24.4		113.0	82.8	24.4		107.2
Kimberley	172.0	75.6		247.7	172.0	75.6		247.7
Metropolitan East	108.9	20.8		129.7	88.5	20.8		109.3
Metropolitan North	91.2	22.8		114.0	80.5	22.8		103.3
Metropolitan South East	109.6	25.0		134.6	101.7	24.3		126.0
Metropolitan South West	89.3	20.5		109.8	71.1	20.5		91.6
Mid West	84.3	35.3		119.6	68.4	35.3		103.7
Pilbara	129.7	92.4		222.0	105.3	92.4		197.7
South West	100.1	22.6		122.7	79.4	22.6		102.0
Wheatbelt	76.2	28.4		104.6	75.7	28.4		104.0
Tasmania			1.3				1.1
North Western	87.4	19.9		107.2	81.3	19.2		100.5
Northern	96.9	24.3		121.2	90.3	23.8		114.0
Southern	93.5	25.9		119.4	85.5	25.9		111.4
Northern Territory			3.6				2.6
Alice Springs	146.1	182.2		328.3	146.1	182.2		328.3
Barkly	105.0	232.0		337.0	105.0	232.0		337.0
Darwin	94.9	88.8		183.7	70.6	88.8		159.4
East Arnhem	85.2	420.5		505.7	85.2	420.5		505.7
Katherine	183.5	181.4		365.0	183.5	181.4		365.0
Australian Capital Territory			1.6				1.5
Australian Capital Territory	105.9	28.7		134.6	76.8	28.6		105.4

² The ratios in Table 2.3.4.2 are based on estimates of the population aged 70 years and over as at 30 June 2008 from small area projections prepared by the Australian Bureau of Statistics. The places in Table 2.3.4.2 include flexible care places. The higher levels of provision in the Northern Territory address the care needs of Aboriginal people aged 50 years and over. In this table, community care places include Community Aged Care packages and Extended Aged Care at Home packages. Some aged care planning region boundaries have changed since they appeared in the Annual Report for 2006–07, to align with Australian Bureau of Statistics changes to Statistical Local Areas.

Top of page