Feb 24, 2020

Industry body prefers benchmarks to royal commission’s mandated staff ratios

The Royal Commission into Aged Care Quality and Safety is proposing major changes to the way aged care facilities are staffed in a bid to attract more workers to the sector and ensure staff are able to perform their jobs properly.

Counsel assisting the royal commission, Peter Rozen QC, told the royal commission on Friday, “We submit that if the goal of this Royal Commission is to make recommendations to achieve high quality, safe and person-centred aged care services, as it must be under the terms of reference, then the time for real action on staffing numbers and mix, skill levels, remuneration, conditions of work and registration of the unregulated portion of the aged care workforce is now.”

“Staff must be cared for and valued”

On Friday, Mr Rozen outlined proposed changes for staffing in aged care, including:

– approved aged care providers should have to meet mandatory minimum staffing requirements;

– registered nurses should make up a greater proportion of the aged care workforce;

– all aged care workers should receive better training;

– unregulated aged care workers should be subject to a registration process;

– unregulated aged care workers should have a minimum mandatory qualification as an entry requirement; 

– the aged care workforce should be better paid and should work in safe workplaces; 

– the organisations for which they work should be better managed and governed; and

– the government should provide practical leadership to the sector.

He said the royal commission recognises “that numbers alone will not guarantee high quality care. As well as the right number of staff there needs to be the right skill mix to provide the care needed by particular residents.”

“The quality of the staff must also be high. Staff with the right aptitude but also the right attitude to provide the relationship based care that is person-centred. They are the hallmarks of quality aged care, according to the evidence that this Commission has heard. 

“Finally, the staff must themselves be cared for and valued. 

“The evidence in this Royal Commission is that if all of those features are in place care, that is of a high standard and is safe should follow,” Mr Rozen said.

LASA prefers benchmarks to mandatory requirements

Leading Age Services Australia issued a statement saying Mr Rozen’s recommendations “reflect” its own wishes for more staff, better skills and appropriate remuneration in aged care.

However, LASA CEO Sean Rooney said using “benchmarks” to determine staffing levels were a more suitable method than mandatory requirements, and that providers should be urged to explain “if not, why not” when benchmarks are not met.

“‘If-not-why-not’ benchmarks provide guidance on staffing for a given mix of residents’ care needs and models of care, and would require aged care providers to explain any deviations from the benchmark,” Mr Rooney said.

Recommendation calls for 37% increase in staffing: ACSA

Aged and Community Services Australia said the royal commission’s recommendation that staffing must be sufficient to achieve a 4-star rating under the United States’ CMS staffing rating system (adjusted for Australian conditions) would require a staffing increase of 37.2 per cent.

“We believe greater transparency is important, but even more important is having enough staff to begin with,” said ACSA CEO, Patricia Sparrow.

“Additional resourcing is required to achieve this increase in staffing,” she said.

“What we know now is that aged care simply isn’t funded to provide the level of care people expect and deserve. 

“A new direction like this could be exactly what we need to force a rethink and set up Australia for our ageing population and the decades to come,” Ms Sparrow said.

“Better wages, training, regulation will improve beleaguered workforce”

The Australian Nursing and Midwifery Federation welcomed Mr Rozen’s recommendations, especially that requiring that a registered nurse be on duty at all times.

ANMF Federal Secretary, Annie Butler, said, “As we’ve heard from our members in aged care and in the harrowing evidence from residents and their families, workforce issues, particularly inadequate staffing levels, have been the cause for much of their pain and suffering.

“The ANMF supports Mr Rozen’s recommendations to mandate the minimum numbers of nurses and qualified care staff that would be rostered, ensuring better, safer, continuity of care for residents.

“Better wages, training and regulation, would also improve the retention and recruitment of the beleaguered aged care workforce.”

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