Oct 17, 2019

Five staff rostered for 100 residents, royal commission hears

Royal commission hearings into the aged care workforce continued on Wednesday, with witnesses describing alarmingly low staff numbers at a major provider, aged care staff as the “working poor”, and the acceptance of violence in the workplace as something staff had to “accept”.

Paul Gilbert, assistant secretary of the Victorian branch of the Australian Nurses and Midwifery Federation, described the low staff numbers employed at some of the country’s largest aged care providers.

One home had only five staff rostered at night for 106 residents – four personal care assistants and one registered nurse. In the morning, 19 staff were on duty, and in the afternoon 18 staff were employed.

Rushed staff contributing to assaults

He said assaults are occurring in aged care in part because staff are rushed.

“It’s a consequence of being rushed,” he told the commission. “People are rushing people to comply with their timelines and that’s creating a situation where someone who has already got issues around their mental competence is getting frustrated and angry at being forced down a path and that’s a consequence of being rushed.

“People are getting six minutes to get a resident out of bed, washed, in a chair, in a lounge room. It’s just madness,” he said.

Reforms in 1997 meant funding no longer tied to care

Mr Gilbert’s statement to the royal commission described how protections for staff pay were removed in 1997, and that funding could then be set aside for other costs and profit margin.

Prior to the reforms, approximately 70-75 per cent of funding had to be spent on care, and any of that funding not spent was returned to the government. This breakdown was closely monitored by the government.

“From this time onwards, homes were required to meet accreditation, rather than allocate protected funding to nursing,” Mr Gilbert’s statement states.

As soon as the year after the reform, operators were reporting spending on care as a proportion of funding as low as 56 per cent.

Aged care staff the “working poor”

Lisa Alcock, a representative of the Health Workers Union, said staff that are effectively the “working poor” could not be expected to provide high quality care.

She said the union regularly hears from aged care staff frustrated about their “incredibly” low rates of pay.

“I feel that you can’t have a high quality of care if you (are)… working them into poverty,” she said.

Ms Alcock said high rates of workplace violence are also a common source of frustration for aged care union members.

“The alarming rate of occupational violence… is just something you have to accept when you work in aged care,” she said.

Staff could earn more “on the checkout at Aldi”

Ms Alcock said she hears from staff who question why aged care staff are so poorly paid. One woman said she hires a man to clean her gutters for $150 and yet she is only paid $21 to clean a person which also involves providing “dignity and care and support to that person”.

Another aged care worker said her husband, who has not qualifications, earns $100,000 in an aluminium smelter, whereas she has a TAFE qualification and only earns $21 an hour, or the equivalent of $40,000 annually.

Mr Gilbert said he often hears from members who say they could earn more “working on the checkout at Aldi”.

“It’s technically true,” he said. “They see themselves as – ‘Why is my life treated as being – my – what I dedicate myself to being seen as of less worth than that position?’.

“And that’s, interestingly, what they tend to compare themselves to, because they see those jobs advertised with an hourly rate of $24, $25 and $26 dollars. Our enrolled-nurse and registered-nurse members are paid more than the personal-care-worker cohort but not by a whole lot more,” Mr Gilbert said.

The hearings continue.

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  1. Mum’s facility in Canberra has up to 108 residents and from 11pm – 7am, that’s a third of every 24 hour period, there is 3 carers spread over 3 levels. Including a 20 bed secure unit and 1 RN. No matter what the electronic call bell log says elders are not all asleep then.

  2. I believe that society see any sort of “care” of another person as menial and the sort of work “we women” (mostly) are accustomed to. It is a mindset that needs changing. If people knew what carers were exposed to every day they would be chanting “More pay more pay”! We empty catheters, stoma bags that have leaked all over the resident at times, vomit and every bodily fluid is attended to by the AINs. Not to mention physical and verbal abuse by residents. I remember a day when a dear lady died with a dark fluid coming out of every orifice and staff needing to use up to 8 towels to clean her. The odour emanating from her made staff dry reach. We carers do so much more than this. We are made to become Medication competent to take the load off of the RNs. Which means that the AINs that don’t want to do med comp are given less shifts. We have been told to assist catering staff as there are a bare minimum in aged care facilities and even put laundry on as there are not enough laundry staff to cope with so much washing, labeling of resident’s clothing etc. We are told to mop floors as they have cut back on cleaners and hours. So as you can see any decent person would surely believe AINs are incredibly deserving of a decent wage.

  3. Personal carers should be qualified at a higher level then Cert III, and then this should really be registered with a body such as AHPRA (for arguments sake). Th issue is that, many Aged Care providers in the past were only low care “Hostels”, and this confuses the debate around care, as now all providers are under the same banner.
    I absolutely agree our industry’s staff should be better remunerated for the work they do, however as a tightly regulated funding model, this can only come through increase funding streams for providers. I am not talking about providers who have low staff numbers and high profits…. who should not, in my opinion even be allowed to exist!
    As a balance to any argument we also need to not apply a blunt instrument to “how many staff” should be on duty at any time. The reason for this is all about care needs. Some homes may have 3 staff over night, including one RN to 50+ residents, however if over half of the residents are of lower care needs, then these numbers can indeed be considered appropriate. Conversely, if another home has the same numbers, but all 57 are high care needs, then you would consider this to be grossly inappropriate. This is why blunt Staff to Resident ratios won’t work. If poor providers who are consistently non-compliant are removed from the industry, this might send a clear message to those who put profits over care, yet we see (BUPA for example) the Dept “working with them” to improve…. In the meantime, small providers are roped in with these giants and the whole industry is stained with their failings…. If anyone wants to see a comparison in an industry that once upon a time had a good reputation until “Supermarket” providers were allowed in, look no further than the ABC childcare centres debacle, which destroyed many community based centres in favour of the “Big Shiny, well marketed” soulless money factories.

  4. I work as a Clinical Nurse Consultant in the community on minimum wage that Fair Work Australia says is all I’m worth and similar position in hospitals earn $20 to $30 and more than me an hour. I’m keeping people in their home and cutting down hospital presentations but I am worthless. Aged care staff are undervalued and underpaid in the name of profit.

  5. And I worked for a private company that has 1 RN to 3 HCWS for 120 beds on night shift. Government is solely to blame for this as they state shareholders must make a profit first and foremost.

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