One of the most significant outcomes from the aged care royal commission was the federal government’s commitment this year to mandate minimum staffing levels in residential aged care homes by 2023.
Our study, published today, shows only a tiny fraction of aged care homes would already comply with the new requirements.
Substantial increases in staffing will be needed across the sector, placing even more pressure on an industry already struggling to meet the needs of a growing number of Australians.
What are minimum staffing standards?
Minimum staffing standards are designed to ensure all aged care homes have sufficient staff to meet their residents’ care needs. This type of regulation already exists in several countries, including the United States, Japan and Germany.
Japan and Germany both prescribe minimum staff-to-resident ratios. In the United States, homes must have a certain number of staff on site each day and many states regulate the minimum time staff spend with residents. Also, while some countries mandate requirements for all care staff, others target specific roles, such as licensed nurses.
In Australia, licensed nurses include both registered nurses (RNs), who have at least a bachelor’s degree, and enrolled nurses who have completed a two-year diploma.
However, most aged care is provided by unlicensed personal care workers, who don’t need formal qualifications.
Australia’s new staffing standard has three requirements that will be mandatory from October 1, 2023:
These requirements are stated as industry averages with each home’s requirements adjusted based on the relative complexity of their residents’ care needs.
The royal commission heard evidence that more than half of all Australian residents in aged care (57.6%) live in aged care homes with inadequate staff.
In the final report, it stated:
all too often, and despite best intentions, aged care workers simply do not have the requisite time, knowledge, skill and support to deliver high quality care.
For example, the commission heard testimony from families of residents at an understaffed home in Victoria, where staff didn’t have time to help residents go to the toilet or eat meals, or attend to their clinical care.
The commission also heard about the dangers of not having enough trained nurses. One witness described a regional home where three nurses had to look after up to 80 residents on weekends.
The witness’ father, a resident living with dementia, had been neglected and hospitalised on several occasions due to falls that occurred while left unattended.
Our study of historical staffing levels found few aged care homes (3.8%) had staffing above all three requirements of the new standard.
While many homes (79.7%) would meet the requirement to have an RN on site, few had levels above daily requirements for total direct care (10.4%) or RN care (11.1%).
The homes that fell short of these two requirements will need to increase staff time by an average of 43 minutes of total care per day and 18 minutes of RN time per day.
We also found evidence the new standard is likely to cause different pressures for homes across the sector. The homes most at risk of non-compliance are likely to be larger with more residents to care for, located outside metropolitan cities and run by small providers.
Interestingly, while smaller homes were more likely to meet the two requirements about daily minutes, they were much less likely to have an RN on site for two shifts.
The new minimum standards are a crucial piece of regulation to ensure Australian aged care homes provide sufficient staff to deliver quality care to residents.
However, this requires a substantial expansion of a workforce already under strain. Workforce shortages are already a problem due to the COVID-19 pandemic, with low immigration and additional work demands, such as infection control and handling family requests.
A report published in August by the Committee for Economic Development of Australia suggests even without the minimum standards, Australia’s aged care workforce needs to grow by an additional 17,000 workers per year between now and 2030.
Our study highlights areas requiring urgent action. For example, the new requirements will likely cause a dramatic increase in demand for RNs. While training and retention initiatives announced in the recent federal budget will help, much more will be required, such as improved working conditions and pay, to arrest the decline of RNs in the sector.
In addition, targeted government support will likely be required to help homes outside the major cities, and those smaller in size, to attract appropriate care workers to fill shortfalls.
Such measures will be required to enable a fair transition towards compliance with the minimum staffing standard within the sector.
Nicole Sutton, Senior Lecturer in Accounting, University of Technology Sydney; Deborah Parker, Professor of Nursing Aged Care (Dementia), University of Technology Sydney, and Nelson Ma, Senior Lecturer, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
I don’t believe the statistics quoted, our facility for example has a minimum of 72 Registered Nurses hours around the clock. In addition there is a clinical manager, education officer etc. There’s probably a minority of homes less than this but you should call Canberra Aged Care Facility ACT 26473988 and get the care you need and deserve.
These standards will not be achieved without complete transparency about what happens to the billions of taxpayer $ that go to aged care.
We can then focus on training and good careers for locals in aged care. Immigration has become a short cut for poorly managed providers that lack commitment and competence.
Spot on Max!!
Aged care should never be used as a money making venture. This is a scourge and needs to be eradicated. Strict laws should come down on aged care owners that do this.
It is nonsensical to mandate staffing levels in the absence of staff to fill the positions. Last week there were 7,000 vacant NDIS roles in Victoria and 28,000 nationally. Home Care is equally short of staff. When I left public hospitals in NEW South Wales 17 years ago, at a large tertiary referral hospital we had no AINs and only 17 ENs. Public hospitals are now significantly staffed in ward areas with AINS. This nursing crisis has not just emerged, it has been evolving for years. It went under the radar because the nursing workforce has been significantly supported by immigration. Now with the pandemic, and the drop in immigration, we are seeing the effect of this. Neither State or Federal governments have a plan. Nursing Unions do not have a cohesive plan either. When you combine the comparative pay rates with the treatment of nurses across all industries why would anyone want to undertake this work?
So true. Our governments have been blindsided by this importation of everything from cheap whitegoods and clothes to immigrants doing what Qualified ENs did years ago. All to save money. All we have now are too many people living in our cities across the world where alot of people can’t get a job to pay their bills resulting in immigrants and Aussies now working 2 or 3 low paying jobs to keep their heads above water. Doesn’t make sense to have so many brought over here where so many live on the poverty line or on welfare. Some will never work not to mention the Australians pushed out of so many other industries including care work where business and governments work hand in hand to stomp on their own creating generations of Australians now with little hope in blue collar employment that refuse to pay better wages soon to be made worse for all by Climate Emissions Targets propaganda.
What about personal support workers to resident ratios? Private aged care don’t use AINs as a job position because they have to pay as AINs they usa PSW or PCW. Even though we do all the works. Many of the cases we make facilities aware about residence health even when rn and en goes to see them for medicine and don’t even observe well..
We work 10 is to 1 ratio. 10 Resident to one carer, in which some are 2 assist so are bariatric residents who need 3 to 4 staff to assist them. Some are abusive but still facilities just run after money. If we get injured its our fault because we didn’t protect ourselves if we protect ourselves and didn’t do the job then also our fault because we didn’t do the care.
Important aspect is look at the funding the facility recieve and mandate them to allocate the staff.
Spot on David!
you wont more staff working in aged care homes then give them a descent pay rate
that’s one bit reason why its hard to get staff
Spot on David!
Do you know whay would go a long way in increasing the workforce in aged care?
Pay us better.
It’s hard to retain staff when they are offered a barely livable wage. Burn out is rife in an already emotionally taxing environment but when you couple that with a very low pay rate, the only way to survive financially is to run yourself into the ground making up enough hours to keep food in your families bellies and a roof over your head. A higher pay rate would certainly go a long way in attracting and retaining staff