A way forward for aged care

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Judith Kiejda, Acting General Secretary

If we want to have an aged care sector that has the capacity to care for older Australians to the standards the community expects then a good place to start is with an understanding of what the staffing requirements are to deliver that care.   

Over the last two decades, numerous Productivity Commission reports and Senate Inquiries have consistently highlighted the need for a method of determining safe staffing levels and skills mix in the aged care sector.

Incredibly, despite the interminable debate about aged care staffing there has been no empirically-based research to determine how to establish those staffing levels.

As my colleague Lee Thomas, Secretary of the ANMF, has said: “There has been a monumental failure of successive governments to establish and legislate evidence-based staffing levels and skills mix that provide a minimum safe standard of quality care to vulnerable
older Australians” (see p.8).

The Productivity Commission recognised the difficulty in attracting and retaining a workforce in the sector for a myriad of reasons including a lack of competitive wages, poor management of facilities and lack of career opportunities.

Its timid response was limited to addressing education and training opportunities.

This crisis in the aged care workforce will undoubtedly be exacerbated by recent budget cuts by the Federal government that will reduce funding to the sector.

It is obvious that much bolder initiatives are needed especially a methodology for aged care that considers both staffing levels (the right number) and skills mix (the right qualification).

The ANMF Federal Executive recognised this critical gap and commissioned and funded the National Aged Care Staffing and Skills Mix Research. The evidence-based tools that have been established by this research will inform staffing and skills mix in aged care.

Now, thanks to the ANMF (with the support of all its state branches including the NSWNMA), and in collaboration with researchers at Flinders University and the University of South Australia, we finally have a national aged care staffing and skills mix model which can provide a platform to take the sector forward.

IMPORTANT QUESTIONS ANSWERED

The project is a first for Australia and provides important answers to questions about what needs to be done to provide appropriate,
safe care for older Australians.

The research was comprehensive and involved focus groups across the country with aged
care nurses, a “Misscare” survey with over 3,200 participants and the imput of 102
invited experts.

Key recommendations coming from the research include:

  • an average four hours and eighteen minutes of care per day,
  • a skills mix requirement of RN 30 per cent, EN 20 per cent and AiN 50 per cent.

This is the minimum care requirement and skills mix to ensure safe residential and restorative care.

The Misscare survey threw up some alarming results – only 8 per cent of aged care nurses thought staffing was always adequate. The survey identified inadequate staff numbers
as the most common reason for missed care.

76.8 per cent indicated they could not request additional staff. Only 10 per cent indicated that extra staff were provided when requested.

The status quo is clearly failing older Australians. Successive governments and aged care providers have prioritised budgets and profits over standards of care.

The ANMF and the NSWNMA will not stand by and allow this to happen. The point of departure in any discussion about how aged care should go forward should be: What are
the care needs of older Australians?

We now have a clear idea of what the staffing requirements of the sector are and the next step of our campaign will be to fight for their implementation.