Here’s what workers think could help improve the aged care system in Australia

Senior man with carer

There has been a $100 million royal commission, which has resulted in 148 recommendations being made to the government. In turn, the government has committed more than $17 billion to the industry and has committed to supporting many of those recommendations.

And yet, we still hear reports of neglect and abuse in aged care, and many are concerned the government’s recent funding boost doesn’t address some of the most fundamental problems facing the sector.

As the royal commission said in its report on the various inquiries over the years, “The overarching question that arises is why, after all these reviews, the aged care system still fails to support an appropriate quality of life for the most frail and vulnerable members of our community.”

HelloCare is fortunate to have many aged care workers reading our pages. Recently, a member of our Aged Care Workers Support Group on Facebook asked members how they thought the sector could be improved.

The answers provide telling insights into the problems aged care workers face every day – but they will not surprise those who closely follow the sector. These suggestions are nothing new.

The question now is, when will the reforms begin to show real improvements on the frontline? When can staff begin to feel more supported? And when will we see higher standards of care broadly across the sector?

Here are the ideas proposed by aged care workers to ‘fix’ the aged care system.

Better pay and conditions for aged care staff

  • Higher pay
  • Mandated staffing numbers and skill ratios
  • Permanent jobs, either full-time or part-time, and fewer casual and contract staff
  • Aged care staff who know a resident given priority to work with that resident, rather than a new staff member every day
  • Realistic workloads
  • Greater rewards and recognition for good staff
  • More respect shown to aged care staff
  • Aged care recognised as a specialisation and profession
  • A union or workers’ association just for aged care workers
  • Stamp out bullying in the aged care workplace

Improved management

  • Highly skilled and professional management
  • Listen to staff working on the floor
  • Open and honest communication
  • Aged care staff given more input into operational decisions
  • Management to provide more support to aged care staff
  • All materials needed to deliver care supplied in appropriate quantities
  • Management to spend time working on the floor
  • Improved communication and collaboration between management and staff, including team meetings

High quality training

  • Better training, including dementia training
  • Aged care traineeships
  • Buddy shifts, and more training of new staff by experienced staff
  • Ensure training colleges don’t offer poor quality courses

Improvements at the bedside

  • Greater emphasis on person-centered care
  • More staff employed just to help serve food and help residents with eating
  • Smaller aged care homes
  • Ensure residents who ‘lash out’ receive the level of care they need
  • Ensure staff can communicate with residents, for example, by ensuring they speak the same language

Broad sector changes

  • Improved transparency in how government aged care funding is spent
  • More positive media coverage of aged care

What do you think could make aged care a more appealing career and improve outcomes for residents in Australia’s aged care system?

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  1. While this article and some others continue to quote the $17.7 billion in funding the reality is that residents only gained $10 per day increase.
    The vast majority of the funding increase went to either home care or regulatory bodies.
    The wage increases, much deserved, will swallow up half of the $10 increase. The wage increase is overdue and was supported strongly by the royal commission but at this time the increase is unfunded by the government.
    A government that has failed it’s duty of care to provide sustainable and adequate funding for the delivery of safe and reliable care in facilities.

  2. The surprising thing about these suggestions is no mention of technology. Clearly the current methodology does not work and and throwing more money at it will not fix the underlying problems and failings. Take falls for example. Most falls occur in the bedroom at night and most go unreported. Residents can go for days or weeks with injuries that are not recognised as the resident is unwilling to self report or they do not remember. Handing out pendants does not solve the problem. Nursing staff do not get to know each resident to be able to observe the daily decline in residents. Passive monitoring can detect, prevent and predict adverse events very reliably. Why isn’t this a major focus to provide better care?

  3. I think the above recommendations cover everything I could hope and pray for in Aged Care.
    It would be wonderful if they were implemented but I don’t have much faith in it ever happening.

  4. I agree with what was said in this article, all aged care facilities should not be judged by only a few that aren’t up to scratch. More pay for skilled workers will help as most only stay until they find a better paying job or place which gives permanent/part time contracts, as for respective all aged care staff should get, as a EN working in aged care I am proud to say I enjoy this sector of work as u deal with a verity of different things in one day, but all you hear is negative things about aged care.
    If you pay staff the correct wages you will be able to keep the RN’s, EN’s and other qualified staff most use aged care as a stepping stone until they find something better.
    The nurses award 2010 is which some nursing homes pay, there staff from needs to be looked at as EN’s and RN’s pay rates are appalling, this is another reason for qualified staff not staying and going to work in the hospitals.
    1 staff to consumer ratios
    2 better pay
    3 more training available to staff

  5. Agree with all the above especially increased staffing levels with the ability to provide meaningful activities 24/7. The aged care sector needs to invest in more homely, smaller environments with consistent staffing that are environmentally designed for ageing and dementia which provide more ‘normalised’ environments. Education should include mentoring whilst on the job by experienced and competent workplace coaches who are supernumary. Appropriately qualified and knowledgable staff must be assessed for competency before working with older people and people living with dementia. The funding system should reward aged care organisations for excellent care, not penalise for maintaining independence.
    Aged care services should observe and celebrate positive care and compassion using observational tools like Sit&See which will assist with team building and building morale within the staff team and encourage self reflected practice. Managers need to be person centred in their approach towards their staff and implement staff recognition schemes that align with career advancement.People living in aged care services and their families should be empowered and have opportunities to be involved in staff recruitment and strategic planning and/ or business planning. Care planning should reflect the persons needs and handovers should allow more time to review each resident.
    IT should provide staff with the information they need, where and when they need it including alerts that register changes to the persons care. Call bell systems should be silent. Language needs to change, particularly funding language and language adopted in dementia care to reflect person centred care. Innovation should be rewarded. And I could go on……

  6. Here’s a suggestion on what could ‘improve aged care in Australia’…bloody well turn up for work when you are rostered on!!!
    My wife, who works at an aged care facility just 2 minutes from our home and is known as ‘the girl who can’t say No’, and when I refer to her as ‘the girl’, she’ll be 68 in October, is constantly being called at 5.45am asking if she can come in and do a 7am to 11am, etc. etc. etc., because someone has decided she doesn’t want to do her shift. Invariably, my wife then has to back up and do her regular 3pm to 10pm shift. Fortunately for the residents, she is also known as one of the most compassionate, empathetic carers who always goes far beyond the call of duty. Maybe seeing her Dad die of Alzheimers has something to do with it.
    Finally, if the government doesn’t pull their finger out and make Covid vaccination compulsory, and with flu shots, then each facility should have the guts to do it, there’s been far too many, unnecessary deaths amongst vulnerable residents in aged care.
    Thank you for the opportunity to contribute.

  7. In the nursing Home I work in staff a not supported when complaints a made against aggressive family members, and a staff member who bullies certain staff was.recently promoted, even after complaints were made against the person.

  8. This report has all the things l have been concerned about. Well done and hope it can all be
    implemented with speed as our aged deserve nothing but the best…

  9. Number 1 is better trained, English speaking staff appropriate mandated staff to resident ratios, Palliative and Dementia care training needs to be improved and ongoing,better pay and quality management, smaller facilities where person centred care is a REAL PRIORITY not just false advertising and where our elders are RESPECTED not a number aligned to profit!

  10. Qualified staff with minimum ratios. That means employing registered nurses with aged care qualifications or equivalent at award wages. Not employing unskilled, untrained staff with minimal language skills (dependent on the the residents needs). Ensuring there are quality, safety and infection control specialists on site every day.
    Expert geriatrics medical staff available 24/7 and regular inspections to ensure the most vulnerable are receiving the care they need and deserve.
    The sector is corrupt and run for money rather than care. It’s an embarrassment to our society.

  11. I have worked in an aged care nursing home for 39 yrs . It is one which I consider to be one of the better ones, but still falls short! What do we need , to improve the care for these beautiful elderly clients?

    Well we need a higher ratio of carer to residents, how can rushing to get through your workload provide dignified care ?

    We need to ensure all shifts are covered, staff often work with sick staff shifts unable to be covered.

    We need to make the job more enticing by increasing the wages to reflect on the care and constant training we have to do to be eligible to work with these fragile people.Then maybe we’ll have more people willing to take up the challenge to be a nurse/carer worker in aged care !

    More paper work for the nurses does not make for better care….we need more carers on the floor and nothing will change until we are heard !

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