Aged care experts and advocates say they feel let down by a much-anticipated royal commission review into the sector’s handling of the pandemic.
A special report released on Thursday afternoon said the federal government’s efforts to prepare the sector were “insufficient” in some respects, but the commission also emphasised it was “not the time for blame”.
The government has accepted all its recommendations, some of which include publishing a detailed national plan for Covid-19 and deploying infection control experts into nursing homes.
Prof Joseph Ibrahim, the head of the Health Law and Ageing research unit at Monash University, told Guardian Australia the report was “pretty benign in terms of an investigative approach”.
“The public should understand this was a fact-finding mission not a critical analysis,” said Ibrahim, who gave evidence at the commission.
“The terms of reference specify that … They were meant to find out how to do things better.”
That explained why the commission had made reasonable recommendations but had not addressed what Ibrahim suggested were wider problems.
“The recommendations are sensible, they could have been stronger and they could have been more detailed,” he said.
The government and the sector have come under fire for their response to the pandemic, which has seen more than 650 deaths, most during Victoria’s second wave.
During the pandemic, Guardian Australia has reported how residents have been confined to their rooms for long periods without fresh air breaks or visits from family.
In homes that have been struck by the virus, in particular, there have been shocking allegations of neglect, and some facilities in Victoria are now facing legal action.
In addition to a published Covid plan and infection control experts in homes, the commission also recommended the creation of a national aged care advisory body and said major outbreaks should also be investigated independently.
It also called for the government to “immediately fund providers that apply for funding to ensure there are adequate staff available to allow continued visits” to residents.
Annie Butler, the federal secretary of the Australian Nursing and Midwifery Federation, welcomed the recommendations but said a failure to be specific about staffing levels was a “large part of the reason we got into this problem in the first place”.
“There has been chronic understaffing for years because the Aged Care Act just says providers need to provide ‘adequate numbers of staff’,’” she said.
The sector has faced criticism for having varying visitation rights, despite a voluntary code established by the government at the start of the pandemic.
The commission made no call to make the code mandatory and Ibrahim said the fact it was “still running” was damning.
“There’s no way of enforcing it, assessing it, and there’s no way of ensuring equity between homes or families,” he said.
Experts and unions have said while extra funding was provided to ensure staffing levels, some operators reduced staff hours when they went into lockdown.
This occurred despite the commission saying last year that 57.6% of all Australian aged care residents lived in homes that are understaffed.
Critics have also raised concerns about a lack of transparency about how funding is spent.
The peak bodies for the non-profit and for-profit aged care sectors both welcomed the commission’s report.
The Leading Age Services Australia chief executive, Sean Rooney, said the report made “protecting and maintaining the physical and mental health of older people in care the end game, not a blame game”.
Maree Bernoth, an aged care and nursing expert at Charles Sturt University, questioned why infection control standards that would be adhered to by the experts deployed to homes would be determined by the new advisory body.
“We’ve already got standards that nurses have to meet [in hospitals],” she told Guardian Australia.
“Why would we set standards by an advisory body who, chances are, will be dominated by industry? Are older people not deserving of the standards of the general community?”
Lynda Saltarelli, the founder of the advocacy group Aged Care Crisis, said the industry’s response had been telling.
“The industry seemed to be thrilled with the report, that says it all,” she said.
“I know the report is not to lay blame, but families we spoke to are really disempowered,” she added. “To us [the response to the pandemic] was a very inhumane response.”
She also questioned why there was not greater scrutiny of the regulator, the Aged Care Quality and Safety Commission, in the report.
“There were so few visitors, there were so few sanctions, even when there were the deaths,” she said.
Ibrahim said his view was the regulator should “never have been asked to manage the pandemic”.
The RMIT professor Sara Charlesworth, who researches the aged care workforce, welcomed that the commission had acknowledged many workers had been “traumatised” by the pandemic.
“It shines a light on the very real damage that has been done to workers who have been invisible,” she told Guardian Australia.
