Response to the Royal Commission Final Report: Care, Dignity and Respect on behalf of CALD community and PICAC Alliance

The PICAC (Partners in Culturally Appropriate Care) Alliance is a unified national body comprising of state and territory specific PICAC funded organisations. The alliance aims to be a channel and voice for information, training and resources to inform aged and community services.

The PICAC program (PICAC program; the Program) has been funded by the Department of Health (the Department) since 1997 to support the provision of culturally appropriate aged and community care for older people from culturally and linguistically diverse (CALD) backgrounds.

The PICAC Alliance has successfully engaged in promoting and enhancing the culturally appropriate care provision to the aged and community care as well as engaging with older people from CALD community in Australia. On behalf of the CALD community, the PICAC Alliance would like to respond by urging action on priority issues highlighted in recommendations of the Final Report of the Royal Commission into Aged Care Quality and Safety. Additionally, we would like to emphasise some key concerns and silent spaces that may not have been addressed in the report.

• The CALD community constitute a significant proportion of the Australian population with every 1 in 3 persons aged over 65 years being born overseas in a non-English speaking country. The report recommendations do not adequately address the challenges and barriers experienced by the CALD older people in accessing services/support
• The Aged Care Diversity Framework is embedded in policy. However, it needs to be better integrated into practice as well to ensure:
  • The diverse needs (social, cultural, linguistic, spiritual etc.) and goals of the CALD community are identified and consumers receive adequate support and choice in services
  • Service providers and consumers/carers are partners/co-designers in service planning and delivery
• The current aged care workforce training requirements are focused on ‘cultural safety’ and ‘trauma informed practice’ from an Aboriginal and Torres Strait Islander (ATSI) perspective. It is recommended to broaden the scope to include CALD perspective in training the aged care workforce to ensure culturally appropriate service delivery
• PICAC funded organisations in every state and territory have been working to provide training and support to aged care providers (particularly the small/remote cultural providers who rely on PICAC for training support) to ensure their workforce is competent to cater for the diverse cultural needs of CALD older people in care. The capacity of the PICAC Alliance to provide training material that is consistent across Australia is instrumental in achieving quality standards of aged care and cultural safety of all consumers. Also, continued funding for the PICAC program will ensure that the aged care providers/navigators who assist CALD older people to find support are appropriately trained regarding the cultural needs of the community/consumer they work with
• Mandated cultural competency training for the service providers under the PICAC program must be delivered as an ongoing activity and not just annually. The training must encompass key aspects of aged care like palliative care, dementia care and mental health, with CALD perspectives embedded as a core framework
• The PICAC Alliance has been instrumental in building valuable corporate and business knowledge with respect to providing culturally safe and appropriate practice in aged care. We recommend extension of grant funding for the PICAC program to ensure this body of knowledge is not lost and continues to be used effectively in designing and delivering aged care programs and services
• In the last ten years, the number of people using home care has tripled. CALD older people generally have a lower uptake of residential aged care and prefer to ‘age in place’ – in their homes and communities. From our expertise as the PICAC Alliance working with providers, we recognise that it is important for CALD older people to access services through the Commonwealth Home Support Program (CHSP) and Home Care Packages that assist them to stay independent, socially active, and ultimately delay the high-level care such as residential care. The Commission’s Final Report highlights (Recommendation 33) the importance of social support:
  • Social support services help reduce and prevent social isolation/loneliness among older people
  • These services include centre based day care and social support groups, meal delivery and transport
  • Social support services must be implemented as ‘Social supports category’ within aged care to greatest extent
• In line with the recommendation by the Commission, the PICAC Alliance would strongly urge grant funding to continue the increased funding to Home Care Packages, reduce the waiting list and to maintain the CHSP program and Social Support category in particular, in order to facilitate services to vulnerable and socially isolated older people of the Australian CALD community. Social support has an immense contribution in enhancing the wellbeing of older people especially with heightened needs during the COVID-19 pandemic.

We hope to receive the Government’s continued support and commitment towards the priority issues highlighted above.

In an effort to not duplicate the former response by peak bodies, the PICAC Alliance has also endorsed the statement by the Aged Care Consumer Organisations as well as NACA.