United Nations Economic and Social Commission for Asia and the Pacific, Regional Survey on Ageing 2011: Australia
IV. Ensuring Enabling and Supportive Environments
16. Has your Government undertaken any of the following measures with regard to the housing and living environment for older persons and their families?
16a. Promotion of “ageing in place” in the community, such as the promotion of affordable public housing with age-friendly and accessible housing design - Yes
Names and descriptions of policies/programmes
Livable Housing DesignThe Livable Housing Design Guidelines and Strategic Plan were launched on 13 July 2010. The Australian Government has committed $AUD1 million seed funding over three years (commencing 2011-12) to support the Livable Housing Design Initiative.
This initiative will benefit ageing Australians by designing Australian homes to meet the changing needs of home occupants. This will occur through the inclusion of key easy living features that aim to make homes easier and safer to use, specifically that homes are:
- easy to enter;
- easy to move in and around;
- capable of easy and cost-effective adaptation; and
- designed to anticipate and respond to the changing needs of home occupants.
In addition, on 11 April 2011, the Australian Government announced the establishment of a new not-for-profit organisation, Livable Housing Australia. See media release at: http://www.janmclucas.fahcsia.gov.au/mediareleases/2011/Pages/jmc_m_livablehousing_11april2011.aspx
Master Builders Association National Award for Lifestyle Housing for Seniors.
The Australian Government sponsors the annual Master Builders Association National Award for Lifestyle Housing for Seniors. This Award recognises best practice in the design and construction of affordable dwellings for Australia’s seniors, with the aim of influencing members of the building industry to consider the housing needs of an ageing population. http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-ofaa-awards-mba.htm
Social Housing Initiative
In February 2009, the Commonwealth announced the provision of additional funding for social housing under the Nation Building - Economic Stimulus Plan. This initiative will provide funding of $AUD5.2 billion over three and a half years from 2008-09 to 2011-12 for the construction of around 19,600 new social housing dwellings and a further $AUD400 million over two years for repairs and maintenance to around 80,000 existing social housing dwellings. The Initiative is being conducted in partnership with the state and territory governments and is designed to assist low income Australians who are homeless or struggling in the private rental market, including older Australians.
Housing for older people is among the priorities for funding under the Initiative. It is expected that around 95 per cent (over 15,900 dwellings) approved under Stage 2 will incorporate six minimum universal design elements to make properties more accessible to people who are ageing or live with disabilities. The Commonwealth has also set a target of achieving a higher level of adaptability in 20 per cent of the dwellings that are to be constructed through Stage 2. These dwellings should meet the Australian Standard for Adaptable Housing AS4299-1995, Class C. At present, around 35 per cent of dwellings are planned to meet this standard. Further details may be accessed at: http://www.fahcsia.gov.au/sa/housing/progserv/social_housing/Pages/default.aspx
National Urban Policy
Australian cities face the challenge of meeting the needs of a growing but ageing population. Increasingly, Australian cities will need to be planned and designed to cater for the needs of a greater proportion of older people. This can be achieved by incorporating universal design features in both residential and non residential building, transportation and in the public domain. The need to facilitate age friendly housing and match housing stock to demographic change is also a challenge.
In 2009, the Council of Australian Governments agreed a national objective for cities, which includes ensuring cities are liveable, socially inclusive and well placed to meet future challenges and growth. Following consultations and research, the Australian Government released Our Cities, Our Future - A National Urban Policy for a productive, sustainable and liveable future. The policy outlines the principles, objectives and actions necessary to help Australian cities achieve these goals, for example, to support mixed income housing and improved housing affordability which is linked to accessible public transport.
The principles of the National Urban Policy will also inform the Australian Government’s continuing investment into road, rail and public transport infrastructure to ensure these meet the needs of older people. State and Territory governments are responsible for legislative instruments and regulatory frameworks which guide the design and use of public amenities, transport infrastructure and vehicles which promote the mobility of older and disabled people. The Australian Government works closely with State, Territory and local governments on matters where responsibility is shared, such as appropriate design and regulations guiding the use of motorised mobility scooters. Further details are at: http://www.infrastructure.gov.au/infrastructure/mcu/urbanpolicy/index.aspx
Older homeless people
Capital funding is being made available for the construction of specialist residential aged care facilities for homeless older people. Proposals for funding are considered through the annual, competitive Aged Care Approvals Rounds. To date, there have been two grants allocated for a new 60 bed facility and for the rebuilding of a 72 bed facility. At least one additional capital grant will be considered through each of the 2009–10 and 2010–11 Aged Care Approvals Rounds. Further details may be found at:
The Road Home - The Australian Government White Paper on Homelessness http://www.fahcsia.gov.au/sa/housing/progserv/homelessness/whitepaper/Pages/default.aspx
Older homeless people are also given practical assistance through the Assistance with Care and Housing for the Aged Program (ACHA). Commenced in 1993, ACHA helps low-income frail older people who are in insecure housing or homeless, by linking them with services able to provide more permanent housing and other community support and care.
In 2010-11 the ACHA program assisted 3858 people. The average age of the older homeless people supported through the program is 68. ACHA Program Guidelines may be accessed at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-commcare-acha-guidelines.htm
16b. Improved availability of accessible and affordable transportation to improve older persons’ mobility - Yes No
Names and descriptions of policies/programmes
See above, Q16a, National Urban PolicyAs noted in the Context at the beginning of this response, the states and territories are largely responsible for transport. The Australian Government provides practical assistance to seniors through support for travel concessions and for community transport services.
Older people who hold a Commonwealth Seniors Health Card have access to travel at concession rates. Subject to an income test, the Seniors Health Card is also available to senior Australians of pension age who do not receive income support.
The Home and Community Care Program funds community transport services to assist eligible clients to maintain independence, reduce social isolation and remain actively engaged within their local community.
17. Has your Government undertaken any measures to develop training programmes for formal and informal caregivers, including an accreditation system? - Yes
Names and descriptions of policies/programmes
Encouraging Better Practice in Aged CareThe Encouraging Better Practice in Aged Care (EBPAC) initiative aims to improve clinical care for recipients of Australian Government subsidised residential and community care by improving staff skills to support the uptake of evidence-based practice.
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To date there have been 13 evidence-translation projects funded under two funding rounds. Projects require the establishment of a consortium including residential aged care homes, researchers and educators to implement up-to-date, evidence-based clinical care in a specific area of practice for residents of aged care homes. A total of 108 aged care homes from all states have participated in an EBPAC project. Project activities have included developing and delivering training programs to formal carers as well as, developing information resources, improved communication procedures, assessment tools or management policies and protocols. A brief outline of each project as well as links to more detailed summaries and project websites are available at http://www.health.gov.au/ebpac. The Better Oral Health in Residential Care resources are available at http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-publicat-download-ordfree.htm.
National Carer Strategy
On 3 August 2011 the Australian Government launched the National Carer Strategy. The Strategy is the Government’s long term commitment to better respond to the needs of carers, and to ensure that carers have the opportunity to take part in all aspects of society, including the chance to participate fully in work, community and family life.
The National Carer Strategy includes six priority areas for action. Under each of these priority areas, policy directions and areas for future action in the shorter term have been developed. The fifth priority area relates to education and training and is about ensuring that carers have the skills to undertake their role and opportunities to participate in formal education and training. The Government has agreed to:
- examine and identify gaps in programs and services that support carers to gain the skills they need to commence, maintain and cease their caring role;
- work with the Community Services and Health Industry Skills Council to identify ways to address the skills development and needs of carers; and
- consider the needs of carers in reforms to education, training and skills development initiatives.
18. Has your Government undertaken any measures to establish standards and monitoring mechanisms to ensure the quality of elderly care services? - Yes
Names and descriptions of policies/programmes
Community Care Common StandardsUnder the Aged Care Act 1997 (the Act), approved providers of packaged community care and residential care are required to meet standards to ensure that quality of care and quality of life is provided to all care recipients.
Community Care Common Standards came into effect on 1 March 2011 replacing the quality standards that had applied to community aged care programs. The Common Standards help reduce the administrative burden for service providers while still ensuring services for care recipients are of a suitable quality. There are three Common Standards that apply to community packaged care, National Respite for Carers Program (NRCP) services, and Home and Community Care. While the NRCP is not funded under the Act, providers are required to meet the Common Standards under contractual arrangements.
All community aged care service providers are required to complete a quality report at least once during a three year cycle and to regularly update their improvement plans. If an organisation is not meeting its responsibilities, follow up action is taken including the imposition of sanctions where appropriate.
The Community Care Common Standards Guide may be accessed at http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-commcare-qualrep-standards.htm
Residential Aged Care Accreditation Standards
There are four Standards and 44 outcomes that all residential aged care services are required to meet under the Act. The Standards cover a comprehensive range of care outcomes for residents, from health and personal care through to considerations about behaviour management, the physical environment, and the safety of the residents and staff.
The independent Aged Care Standards and Accreditation Agency Ltd (the Accreditation Agency) provides ongoing monitoring of the residential aged care Accreditation Standards in Commonwealth subsidised aged care homes. As well as accreditation site audits, which for the majority of homes occur once every three years, the Accreditation Agency conducts at least one unannounced visit to each aged care home each year. This provides the Accreditation Agency with an opportunity to assess the home’s performance against the accreditation standards at any time, without prior notice. The Accreditation Agency also conducts support visits and operates a program to regularly monitor the progress homes are making towards continuous improvement.
The accreditation standards and principles may be accessed at: http://www.comlaw.gov.au/Details/F2011C00126. The Accreditation Agency’s website is at: http://www.accreditation.org.au/
19. Has your Government undertaken measures to address neglect, abuse and violence against older persons? Yes
Names and descriptions of policies/programmes
Australia takes the right to liberty and security of the person very seriously. The Australian Government has instituted a number of measures to protect older persons receiving Australian Government subsidised aged care services through the Aged Care Act 1997 (the Act).The Act aims to ensure that aged care providers are accountable for the services they provide and that recipients of residential and community aged care receive services appropriate to their needs, whilst observing their rights as care recipients and also as citizens of Australia. In addressing this aspect of aged care, the Act includes charters of rights and responsibilities for recipients of residential and community care (see, below, Aged Care Complaints Scheme).
National Aged Care Advocacy Program
The National Aged Care Advocacy Program (NACAP) provides a free and confidential service promoting the rights of people receiving residential and community aged care services. Advocacy services are available to people who are, or may become aged care recipients or representatives of care recipients.
Advocacy services can provide:
- information and advice about rights and responsibilities;
- support to be involved in decisions affecting residents’ lives;
- assistance to resolve problems or complaints in relation to aged care services; and
- assistance in promoting the rights of older people to the wider community.
Aged Care Complaints Scheme
In addition to the existing criminal law framework, the protection of older persons against violence and abuse in Australian Government subsidised aged care services, including residential aged care homes, community aged care packages and flexible care, is governed by the Act. Amongst other aspects of care, the Act clearly sets out the responsibilities of approved providers in relation to the provision of a safe and comfortable environment where care recipients can expect to be treated with dignity and respect and to live without exploitation, abuse or neglect. These rights are common to recipients of residential and community care and are provided for by the following Charters created under the Act.
Charter of resident rights and responsibilities
Amongst other resident rights, The Charter of Resident Rights and Responsibilities states that people living in aged care homes have the right to:
- live in a safe and secure environment;
- be treated with dignity and respect;
- live without exploitation, abuse or neglect; and
- complain and take action to resolve disputes.
Amongst other rights, The Charter of Rights and Responsibilities for community care states that people receiving community care packages have the right to:
- be treated and accepted as an individual, and to have individual preferences respected;
- be treated with dignity, with their privacy respected;
- receive care that is respectful of the care recipient, their family and home;
- receive care without being obliged to feel grateful to those providing care;
- full and effective use of all their human, legal and consumer rights, including the right to freedom of speech regarding their care; and
- be treated without exploitation, abuse, discrimination, harassment or neglect.
The Scheme is a free service available to anyone who wishes to raise a concern about Australian Government subsidised aged care. The Scheme can be contacted via telephone, mail or the Internet. If a person (or their friends or family) in an aged care service is concerned about possible or actual abuse they are encouraged to contact the Scheme to discuss the situation and options. Any information provided can be done so anonymously or confidentially.
Once in receipt of information or concerns for a resident of Australian Government subsidised aged care, the Scheme can examine concerns and can take action under the Act where approved providers fail to meet their responsibilities. This may involve authorised officers visiting the home and interviewing management, staff and residents and their families and other relevant individuals and reviewing relevant documentation. If the Scheme is not satisfied that an approved provider is meeting its responsibilities under the Act, the Scheme can require an approved provider to demonstrate how they have met or will meet their responsibilities under the Act. Alternatively, the matter can be referred for consideration of compliance action which may result in the imposition of sanctions.
Compulsory Reporting
Compulsory reporting and protection requirements commenced on 1 July 2007 following amendments to the Act. The Guidelines that are in place explain the compulsory reporting requirements for approved providers as follows.
All approved providers of Australian Government subsidised residential aged care must encourage staff to report alleged or suspected reportable assaults to enable approved providers to comply with their responsibility under the Act. This requirement recognises that in many cases, it may be staff who first notice assaults. The legislation therefore requires that approved providers not only give staff information about how to report assault, but also to actively require staff to make reports if they see, or suspect, an assault on a resident.
The Act requires that, except in very specific and sensitive circumstances, all approved providers of residential aged care must report all allegations or suspicions of reportable assaults. The discretion not to report applies to circumstances involving residents affected by an assessed cognitive or mental impairment, and where there are repeated allegations of the same assault. An approved provider should not wait until an allegation is substantiated – the fact that a person has alleged that someone has assaulted a resident is sufficient to trigger the reporting requirements.
Reports must be made to both the police and the Department within 24 hours of the allegation being made or the approved provider starting to suspect on reasonable grounds, that a reportable assault may have occurred. These tight timeframes ensure that alleged assaults are acted upon immediately. An allegation usually requires a claim or accusation to have been made to the approved provider and can be associated with physical evidence or the witnessing of an assault. Reporting suspicion allows reports to be made where there is no actual allegation or where an actual assault may not have been witnessed and where staff observe signs that an assault may have occurred.
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When incidents of alleged assault are reported, investigation of the incident is the responsibility of the police. The police will determine whether the incident is criminal in nature and what further police action is required. Only the police should investigate criminal activity.
When an alleged or suspected assault is reported, the Department will undertake the following key steps:
- Establish the details of the alleged or suspected assault, including when it took place (and if it has been reported within 24 hours);
- Establish if the alleged or suspected assault has been reported to the Police. If it has not, the Department will make a referral to the relevant state/territory police service;
- Advise any staff member or approved provider who makes a report of the protections in place, and whether and how the discloser qualifies for protection;
- Establish that residents are not at further risk from the alleged perpetrator; and
- Undertake an investigation to ensure that the approved provider has met its responsibilities under the Act. This includes ensuring appropriate medical care and support for the victim and notifying legal representatives or family members if required. If an approved provider fails to meet compulsory reporting requirements, the Department may take compliance action.
Accreditation
In addition, the Act requires approved providers of residential care to meet the accreditation standards and accreditation process to ensure that quality of care and quality of life is provided to all residents (see, above, Residential Aged Care Accreditation Standards). Specifically, standard 4 requires approved providers to provide residents with a safe and comfortable environment to live that ensures the quality of life and welfare of residents, staff and visitors. This includes ensuring that there are systems in place to actively ensure the safety of residents.
Approved providers must also ensure that there are adequate numbers of appropriately skilled staff to meet the individual care needs of residents and have in place arrangements for the ongoing development of staff skills and expertise to ensure residents’ quality of life and care.
Police Checks
Under the Act, approved providers are responsible for having robust recruitment practices to ensure protection for older Australians receiving care. All staff and unsupervised volunteers of residential, community and flexible care services funded under the Act are required to undertake a police check every three years to determine their suitability to provide aged care.
Persons with convictions for murder or sexual assault, or assault for which a prison term was imposed, are not eligible to be employed in aged care.
Approved providers have an overarching responsibility to ensure the health safety and well being of their care recipients at all times, and need to have transparent policies and procedures in place to demonstrate suitable management and monitoring of the compulsory police checks.
The police check legislation was implemented in 2007 and strengthened in 2009 as part of the Australian Government's ongoing commitment to ensure the health, safety and well being of our vulnerable aged care recipients.