In recent years, Australia’s aged care sector has grappled with meeting new care minute targets designed to enhance the quality of life for older Australians.
Despite increased funding and extensive recruitment efforts, the latest reports show that aged care facilities across multiple states are still struggling to reach the required levels of staff-resident interaction, particularly in New South Wales, Victoria, Queensland, and South Australia.
This crisis is attributed largely to an ongoing shortage of qualified staff, with over half of aged care homes consistently falling short of these benchmarks.
In response to recommendations from the Royal Commission into Aged Care Quality and Safety, the Labor government introduced reforms mandating an average of 215 minutes of care per resident per day, including 44 minutes of direct care by registered nurses.
The aim is to ensure that elderly Australians receive adequate support, companionship, and medical attention, all essential for their wellbeing. However, despite these ambitious goals and a 58% increase in government funding since September 2022, many providers are still unable to fulfil these requirements.
According to the latest quarterly data, from April to June, a substantial number of facilities fell short. In New South Wales alone, six out of ten aged care homes failed to meet the care minute targets. Similarly, more than half of the aged care facilities in Victoria, Queensland, and South Australia did not meet the set standards.
The primary hurdle preventing facilities from achieving their care targets is a nationwide shortage of registered nurses and aged care staff. Aged care facilities, especially those in rural or remote areas, face intensified competition from hospitals and other healthcare sectors, which offer higher wages and more appealing working conditions.
Facilities have had to go to great lengths to attract staff, often hiring through agencies that offer substantial incentives like gift cards, travel allowances, accommodation, and hourly rates reaching up to $150 for nurses. Some providers have even flown staff in from other regions or countries to address critical gaps.
The crisis is not limited to rural or remote facilities; metropolitan areas, where workforce constraints are expected to be less severe, have also been affected. For instance, Victoria’s Wintringham Gilgunya Village in Coburg reported a significant shortfall in registered nurse care minutes, though it managed to meet its total care minute target.
Facilities that do exceed care minute requirements, such as Talbot Place Aged Care in Ballarat and Aldersgate Aged Care in South Australia, are increasingly rare examples in an industry struggling to keep pace with demand.
The challenges are so pronounced that some aged care administrators have taken on multiple roles to attract and retain overseas staff.
For example, Jenny Deer, CEO of a small aged care facility in Booleroo, South Australia, has not only recruited nurses internationally but has also provided accommodation in her own home, acted as a driving instructor, and even served as a taxi driver.
These efforts reflect the lengths providers are going to in order to secure staff, but they also underscore the severity of the staffing crisis.
For many aged care facilities, these measures remain insufficient. Providers, particularly those with fewer resources, cannot afford the high costs associated with recruiting and retaining international staff, leaving a significant number of facilities unable to deliver the expected care minutes.
Adding to the difficulties, some aged care providers report challenges in interpreting and adhering to the care minute reporting standards.
Misreporting has led to instances where facilities appear non-compliant despite meeting the target. Dr. Tanvi Dalal, CEO of FicusBridge, which supports Graceland Manor in Elsternwick, Victoria, noted that some facilities are still uncertain about the reporting requirements, which has led to inadvertent errors.
With Australia’s population ageing and demand for aged care services growing, the outlook for the sector remains challenging. Current projections indicate that by 2035, an additional 79,473 nurses will be needed to meet aged care demands.
However, with international recruitment and retention both costly and complex, there is mounting concern that facilities will continue to fall short of meeting care minute targets.
In response to these challenges, Minister for Aged Care Anika Wells recently issued a statement urging providers to improve their performance.
Despite the additional funding and recruitment initiatives, sustained effort and significant changes may be necessary to build a workforce that can adequately support Australia’s aged care population.
To combat the challenges, aged care advocates stress the need for a multifaceted approach. This could include offering better incentives to attract young Australians to the sector, expanding training programs, and reducing the administrative burdens that discourage providers from hiring locally.
While international hires have helped alleviate immediate staffing shortfalls, long-term solutions are needed to build a resilient, qualified workforce capable of meeting the sector’s growing demands.
Looking in from the outside one wonders why the minutes may not be used by skilled professionals other than registered nurses. There are a range of other professionals from different disciplines who are trained in eliciting narratives from clients and who are also skilled in understanding the developmental continuum of aging and how it is unique to each individual. Counsellors, social workers, psychologists and allied health workers are client centred, focused on enablement, and have a deep understanding of the needs of people as they age.
Registered nurses in aged care have an enormous load to carry, and often it is the unmet psychosocial needs of older people which result in depression and anxiety, especially following the separation crisis of relocating into a residential facility. In order to support them in their caring work we should be able to reduce their load with some professional transdisciplinary support that has a strong evidence base to complement their role.