Accountability Survey

Aged care depends on empathic caring relationships, concern for others and altruistic human values. It is every citizen and every community’s responsibility and those who provide it are our agents. They should be directly accountable to us. Local communities need the access and the power to make providers accountable.

The principle of decentralisation and regionalisation of management and regulation using a central reach down and support strategy to build local capacity, integrate, mentor and provide backup when needed to local community organisations and local government.

We should remove the perverse commercial pressures in the market and make it much easier to control by changing the structure of the market so that it is centred in communities and is led by them.

Regional managers and local government should encourage the formation of local community groups. Staff managing aged care locally should be drawn from the community as well as local caring professions who will advise and support. Regional managers should work closely with community groups as well as the providers of care.

We need a close alliance and close working relationship between a supporting government, regional management, providers and a steadily rebuilt and more capable civil society. This would replace the current close alliance between central government and the market in aged care.

Local communities and managers working cooperatively with local providers would be able to create a resilient system that adapts and responds to local situations and innovates to address them. They would be more receptive to alternate views and could test them.

We should avoid more endless formal reviews and inquiries and unrealistic reform agendas from people who know little about our humanity and social behaviour. We should respond directly to changing situations locally and then adopt successful practices more widely.

A central representative community body drawn from communities is needed to facilitate the spread of strategies that are found to work, keep track of data, track the record of providers and support regional member organisations. It would work with government and other central bodies in policy development and so bring the real life experiences of aged care to the table at every debate.

Probity checks are needed for new owners and providers of care in each region. These should be done by local managers and communities working together before providers are contracted or licensed to provide care in that community.

Probity checks are needed for new owners and providers offering caring services in aged care, particularly large corporations and global companies. This should be done centrally and a community representative group should be involved. Those communities where it plans to operate should be informed and given the opportunity to collect information and submit it.

Refundable Accommodation Deposits (RADs) should be phased out and ownership of facilities should be separated from providers of care. This would enable local managers and communities to readily replace any provider who is found to be unsatisfactory with minimal disruption to staff and residents.

Local regional managers working with communities and supported by reach down advice from experts should plan local services and the building of facilities. Facilities could be built independently or by a Real Estate Investment Trust (REIT) and the costs recovered through accommodation payments.

Funding should be protected from profit taking in much the same way as in the 1980s and 1990s. A separate fee should be negotiated when the provider contacts to provide that service. Providers should be paid well for providing this critically important service and managing the money in providing it.

Community groups should have representation on service providers local management committees and should have a role in the caring process in which they assist and help the providers. This would ensure supportive ongoing regulatory oversight and open disclosure. It would release local managers and staff from the perverse pressures generated by competitive markets.

An empowered community visitors scheme or equivalent should become the front line first port of call regulator. The visitors would work with residents, families, staff and local provider management, liaising with and reporting to local community organisations, local system managers and the central regulator. They would be responsible for overseeing what was happening in residential facilities and the communities. They would ensure that issues were addressed and that data collected was accurate.

Most of us have many active years after retirement. Social engagement and involvement with others in social projects builds relationships and trust so increasing social capital and the quality of retirees lives. This is their future they would be protecting. They include medical and other caring professions and are well placed to play an active and leading role in community projects like aged care.

Services to support families, residents, staff and providers would benefit from community involvement and support. Other services that would benefit from community involvement and support might include regulation, advocacy, data collection, research, funding, planning and policy development.

Largely voluntary community organisations should be supported by permanent staff funded through regional managers. Volunteers should support and work with full time employees. They would also provide community support, services and activities for older citizens.