workforce
Without a minimum standard , you run the risk of not having enough staff on hand , or you don ’ t have enough staff that are licensed nurses , and that can lead to some of the problems that we saw on display at the Royal Commission .
What are your thoughts on the new staffing standards brought on by the Royal Commission ? I think they ’ re positive . From 2023 , all aged care homes will be required to ensure that each resident receives on average at least 200 minutes of direct care per day , and of that , 40 minutes should be provided by a registered nurse . The third component is that there should be a registered nurse on site for the morning and afternoon shifts .
If a home has a lot of residents that have much more complex needs , they ’ ll actually have to have higher levels of staffing , and a home that has residents with lower care needs will have less .
It ’ s going to require a significant stepchange in the number of staff in aged care homes in Australia . If you look at the recommended levels that come from the US or our own researchers in Australia , this still is short of the top five staffing levels .
It is a significant change and a significant increase , but I don ’ t think it ’ s unrealistic . It ’ s within the ballpark of the levels that are going to be required to ensure that all residents are able to enjoy adequate staffing levels to ensure both quality of life and quality of care .
Your recent co-research paper found that only 3.8 per cent of Australian homes would meet these new standards . How did you find that out ? We were really interested to discover how close Australian residential homes are now . We looked at the existing staffing levels within a sample of aged care homes , representing about half the industry . We looked at their staffing characteristics , compared them to the standards that are coming in , and we looked at the degree to which they cleared each of those three hurdles individually , and then all three at once .
That 3.8 per cent is the small percentage of homes that are able to meet all three requirements .
Then we unpicked which of the requirements are the ones that are going to cause the most problems . Almost 80 per cent of our sample were able to meet the requirement about having an RN on site for those two shifts , but it drops dramatically in terms of the percentage that could meet the requirements around daily care . It was about 10 or 11 per cent for both – having the 200 minutes of daily care and the 40 minutes of RN care .
Why do you think so few are able to provide the full scale of care ? If you think about the way the standard is formulated , having an RN on site is actually quite difficult for a small provider . It ’ s quite a significant cost , but for most larger homes having an RN on site is much easier to accommodate .
The two requirements around daily care minutes are going to require the big change in staffing , because it ’ s the one where you need to have enough care workers – personal care workers , enrolled nurses , and RNs – and it goes up by how many residents you have . I think that ’ s really exposing where the shortages are in terms of raw numbers and in terms of licensed nurses .
What are the biggest obstacles stopping homes from complying with these new standards ? We have an issue in terms of staffing numbers : just actually having enough aged care workers , and being able to recruit and retain a sufficient number of personal care workers , enrolled nurses and registered nurses .
A report from the Committee for Economic Development of Australia has projected that we need to be growing the aged care workforce by 17,000 workers every year between now and 2030 . So it ’ s just the big challenge of getting enough aged care workers and hanging onto them .
The second issue is getting enough staff members that are qualified nurses . The standard around having an RN on site and RN care minutes is going to require a significant increase in the number of registered nurses in aged care . The pockets of the industry that are probably going to struggle most with that are regional and rural homes , who potentially have less access to registered nurses .
We can ’ t forget the other staff that are in aged care homes . One of the dangers we know from international evidence is that when you regulate to have a certain number of particular staff , you might
“ Having an
RN on site is actually quite difficult for a small provider .
create a disincentive or have to deprioritise the staff you have in other roles .
We ’ re concerned that potentially aged care organisations that need to increase the number of care workers may have to deprioritise social support , housekeeping and allied health – those roles that are not part of the standards – and we would hate to see that substitution effect , because those staff are really important for quality of care as well .
What kind of policy measures do you think we need to ensure that providers do have enough resources ? In terms of staffing numbers and hanging onto staff , clearly wages and working conditions are an immediate priority . There are two cases around lifting the award rates for aged care workers before the fair work commission , which I think is important because there ’ s quite a gap between the amount aged care workers are paid compared to similar roles in other care industries , such as disability support . Ideally we ’ ll see at least aged care pay rates become on par with those other sectors so you ’ re not losing staff .
A lot of workers have indicated that they are actually in one sense under-employed , so there is scope to ensure that the people who are working are getting enough shifts and working the hours that they want to . The government announced in the budget earlier this year there will be more funding to pay for staff as the new funding model rolls out . One thing we want to make sure is that there ’ s sufficient money in that funding model to pay for both wages and training . We need to update the qualification framework within aged care to make sure it provides a clear career path for workers , and opportunities for them to progress and get more responsibility matched against opportunities for training and development .
How urgent do we need to see some of these changes being made ? It ’ s critical . Obviously the bricks and mortar are important , but it ’ s people that are providing the care to the residents . And it ’ s about making sure there ’ s enough staff that are qualified and enough registered nurses and enrolled nurses there . Otherwise , all we will see is a repeat of the sorts of instances that we saw at the Royal Commission . ■
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