Aged care homes don’t need ‘evidence’ on food spending to receive government funding, with a third still spending less than $10 a day

by Anne Connolly

Aged care operators will receive an extra $3 billion in government funding to improve food, but have been told they do not need to provide “spreadsheets or evidence” of how much they are spending in order to get the cash.

Instead, providers have to answer two questions each quarter regarding how much they spend on food prepared on and off-site.

The first public report on the scheme shows that two-thirds of operators said they are spending on average $14 a day per resident on food while a third — or 883 operators – said they spent less than $10 a day.

Two per cent of operators said they continued to spend less than $6 a day.

But the providers do not require any proof of their spending, with the Department of Health telling providers: “We are not asking you to provide us with spreadsheets or evidence that supports your answers. You are expected to keep a record of how you calculate the information you provide us.”

“I don’t think without a clear audit trail, without the spreadsheets and so on, you can be fooled that they actually did spend the money on this,” said Stephen Duckett, health economist and former secretary of the Department of Health.

A spokesperson for Aged Care Minister Richard Colbeck said the mechanism to report spending on food will be expanded when the new aged care funding system is introduced.

A plate of peas, mashed potato, pumpkin and gravy on a plate.
Despite the funding increase, many nursing homes are still providing inadequate meals.(Supplied)

Celebrity chef Maggie Beer, whose foundation advocates for better food in aged care, said it was not possible to provide three meals and snacks for $10 a day.

Pasta, beans and mashed potato on a plate.
Five per cent of aged care homes spending less than $10 a day on food were audited by the Aged Care Quality and Safety Commission.(Supplied)

“We have a responsibility to look after those in aged care, those that are no longer able to look after themselves in that way,” she told the ABC’s 7.30.

The government announced its plan to give an extra $10 per day, per resident in the 2021 Budget, just months after the Royal Commission into Aged Care Quality and Safety’s damning report into the sector.

When the federal government increased its funding, it said it was to support “aged care providers to deliver better care and services to residents, with a focus on food and nutrition”.

Greater transparency needed

Composite image of a meat and three veg meal, some fruit, and fried fish with beetroot.
Two-thirds of aged care operators say they are spending $14 a day on food.(Supplied)

One of the royal commission’s many criticisms of the federal government and the aged care sector was the lack of transparency on how taxpayer dollars were spent.

Treasurer Josh Frydenberg told 7.30’s Leigh Sales on Budget night last year that the regulator, the Aged Care Quality and Safety Commission, would make sure the extra money was spent on residents.

“There’s going to be new powers for the regulators, a more coordinated system to ensure that the money being spent is getting to the residents.”

The Department of Health said the 883 aged care homes spending less than $10 a day had been referred to the regulator for monitoring.

But 7.30 can reveal the Aged Care Quality and Safety Commission audited 41 of the homes, or 5 per cent. It found three had failed food standards.

A spokesperson for the regulator said: “Decisions are still pending for some of the 41 services.

“Therefore, the number of decisions of non-compliance with this requirement may change.”

A plate of mashed peas, potato and sauce.
A photo sent to 7.30 showing the quality of food at a nursing home.(Supplied)

Mr Duckett argues the regulator should have performed unannounced audits on all those facilities.

“We don’t want our grannies and so on to be given awful food, and the government cannot guarantee us that that actually is no longer happening,” Mr Duckett said. 

The CEO of Leading Age Services Australia, Sean Rooney, said the Basic Daily Fee in residential aged care is designed to cover the costs range of “hotel services”, including meals and refreshments, laundry, cleaning, social activities, basic toiletries, and help in emergencies.

He said figures showed that 60 per cent of aged care facilities were operating at a loss.

The Department of Health said it would not be releasing the next two Food and Nutrition reports of providers until after the end of the financial year.

Photos reveal no improvement in food standards

Staff, dieticians and families around the country have sent photos to the ABC showing that after the funding increase, food has not improved in their nursing homes.

Dietician Anne Shneyder from Nutrition Professionals Australia said she is still seeing the same problems that she saw more than 20 years ago.

“I see things like … the evening meal, where cheaper or low-protein items are served,” she said. 

“Things like little pies and pasties, things like fish patties with not much fish in them … dim sims, tinned spaghetti.”

A woman wearing glasses looks into camera with a serious expression.
Julia Davis was so worried about the food being served to her mother, she relocated so that she could cook for her.(ABC News)

Julia Davis, whose mother Barbara was a resident at Castlemaine Health in Victoria before she died earlier this year, had relocated so she could be close to her mum and cook meals to take to her. 

Ms Davis felt that the food her mother was receiving was so poor in quality that “[mother] would have starved” if she hadn’t been there. 

She said she did not see any improvement in food when the supplement came in and despite her complaints, the regulator found the nursing home passed all food standards.

Castlemaine Health said the regulator found that “most consumers enjoyed the food” and that it was a suitable quantity and quality, however it declined to say how much it spent per day.

Composite image showing various fried foods on a plate.
Examples of the food served to Barbara Davis at her aged care facility after the extra $10-a-day supplement came in.(Supplied)

Lack of training of cooks in aged care another issue

To improve food quality in nursing homes, in 2019 the federal government gave a grant from a dementia fund totalling almost $600,000 to the Maggie Beer Foundation to produce a series of online training videos for chefs and cooks in the sector.

Last month, the foundation released the online training videos, which many in the industry believed would be available free of charge.

Instead, 11 modules cost about $480 – or $44 per half-hour video.

Mr Duckett said he thinks most Australians were under the impression that all aged care homes would be able to benefit.

“So I think, unfortunately, what I think the public thought was going to help everybody is probably not actually what the business model is.”

Three mini sausage rolls on a plate with tomato sauce.
Dietician Anne Shneyder says cheap, low-protein meals are still being served in aged care homes.(Supplied)

Maggie Beer said the foundation received only a portion of the money, which paid for a moderator for an online forum available to those who completed the training modules.

She said the majority of the money would go to Altura Learning, who produced the videos.

“I would love to think that we had the support to make them free to everyone in aged care, but we have to deal with the economic issues of Altura’s business,” she said.

Altura Learning is owned by aged care provider Bolton Clarke, and told 7.30 it charges a small fee to stream and host the lessons.

Other dieticians and chefs in the sector have also raised concerns that the online videos are too advanced for cooks working in aged care who have no training.

They say some of the ingredients are not readily available or too expensive.

“I think the videos are fantastic for somebody who is really trying very hard already to do a good job and would like to further improve their practice,” Ms Shneyder said.

Maggie Beer standing between two women at cooking workshop
Maggie Beer has previously run classes for cooks who work in aged care facilities.(ABC North Coast: Samantha Turnbull)

Maggie Beer disagrees.

“Following the online modules will give the cook or the chef the basic skills,” she said.

“Some of the ingredients are optional. For instance, if you’re making a fish soup, and we have saffron in it, saffron is optional.

“There are people and there are homes where food is so important. They don’t want it dumbed down.

In 2020, the Maggie Beer Foundation received another grant from the Department of Health of almost $300,000 for a two-day national congress on aged care food, nutrition, and the dining experience.

Labor has also pledged to invest $5 million through the iconic chef’s foundation to develop new food standards and more training programs for chefs.

Mr Duckett said enlisting Maggie Beer to the cause made Australians believe food standards in aged care had improved.

“She has a tremendous reputation, and I think the Maggie Beer Foundation saying it’s going to do this actually gives the government a lot of credibility, and I think that’s what they want,” he said.

“The public thought it was going to fix everything and I think the government traded on that and was not as clear with what they’re actually doing.”

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