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Senate proposes raft of aged care workforce measures

Lengthy inquiry recommends consideration of nursing requirements, publication of staff ratios and efforts to tackle pay in aged care.

The Commonwealth should look at introducing minimum nursing requirements for all aged care facilities, a Senate inquiry into the sector’s workforce says.

The inquiry also recommends the government require aged care providers to publish their staff-to-client ratios in order to facilitate greater choice for seniors.

The Senate’s community affairs committee, which tabled its report yesterday evening, said it was concerned that the ratio of staff to residents in some facilities “is too low and risks compromising the quality of care delivered.”

Noting the long-held arguments for and against minimum ratios, it said that “a compromise position may be to mandate a minimum number of nurses working at any one time and that there should be a registered nurse present at all times.”

It acknowledged that the sector may require “additional funding and support from governments in order to meet such a mandatory minimum requirement.”

The committee said it was concerned at the evidence presented in relation to poor working conditions and threats to workers’ health and safety, which it heard were impacted by issues including insufficient staffing levels.

“The committee considers poor working conditions an urgent matter,” it said.

Priorities for new taskforce

The inquiry, which was initiated in December 2015, also recommended that the new multi-group taskforce charged with developing a sector workforce strategy should develop industry-wide career structures and take “clear steps” to address low pay in the sector.

The committee commended those aged care providers who have established their own career structures and continuing professional development models for staff. Such models should be explored to identify best practice that could be replicated nationally across the industry, it said.

Nonetheless, the committee said it was concerned that pay and conditions for aged care workers were becoming increasingly uncompetitive with other sectors.

The move to “zero hour contracts” is making the industry less attractive for workers, it said.

The committee said it acknowledged concerns that “reductions in funding have impacted the sector’s ability to recruit and retain workers, and offer higher rates of remuneration.”

Noting the widespread concerns about the quality of courses for aged care workers, which have persisted for years in the sector, the committee recommended the workforce strategy taskforce work with the Australian Skills Quality Authority “to establish nationally consistent minimum standards for training and accreditation.”

Similarly, it recommended the taskforce work with the Australian Nursing and Midwifery Accreditation Council to ensure aged care is core within nursing curriculum and to establish dementia skills training.

Aged care worker registration

More broadly, the committee recommended government should examine consistent workforce regulation across carer sectors such as disability and ageing, which would include national employment screening or a worker registration scheme.

It would also include the full implementation of the National Code of Conduct for Health Care Workers, a recommendation in line with the findings of the Australian Law Reform Commission’s elder abuse report released last week.

Australian Greens Senator and Community Affairs References Committee chair Rachel Siewert, said it was clear that a workforce strategy was needed and that action had to be taken to address the myriad of aged care workforce development issues.

Read the Senate inquiry’s full report here

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4 Responses to Senate proposes raft of aged care workforce measures

  1. Kylie Wise June 23, 2017 at 4:02 pm #

    Why bother? The recent inquiry’s recommendation to mandate RNs 24/7 went down the gurgler, lobbied out of existence by providers and their peak bodies. There’s not much chance of these, or any other improvements that cost money, getting any traction.

    How many years have we been talking about poor wages, awful conditions and low skills in the aged care sector? The only thing we can be assured of is another study or inquiry in a few years.

    We just keep going round and round. Shame on us all.

  2. Eileen McCormack June 26, 2017 at 9:05 am #

    The costs tor people requiring residential care has increase substantially with the recent Aged Care Reforms. Aged care providers of residential care naturally expect to make a profit for their shareholders and keep wages low. The power they have in this market place is immense. It is the elderly who is the most powerless and at the mercy of others to speak for them to ensure high standards of care and support. The next most powerless is the staff. They are poorly paid, working shift work and caring for people who are often highly dependent, increasingly have a diagnoses of dementia. They require staff who are skilled, who are interested in the wellbeing of the aged; where staff patient ratios are realistic and based on level of need. Only this will ensure the elderly are able to live their lives with some level of dignity. We’re a wealthy society but we continue to devalue the work done in aged care.
    To those staff working in aged care you will remain powerless as a single voice. Your voice will only be heard as a collective. Joining a union will at least ensure you are represented in this debate.

  3. Joan Daniel July 4, 2017 at 7:08 pm #

    I personally despaired at the abysmal level of carers to residents in a really posh nursing home where my Mother in Law stayed for nearly five years; where we stopped counting changing managers; where we established a friendship with a handful of good carers whose hearts and minds were well engaged but where the incomprehensible rosters kept them mostly away from her; and we watched mum suffering as a result of poor management, regular staff turnover, poor communication with family, a non existent QA, fundamental processes not followed, neglect and a litany of unending injuries. I could go on, I can only say that reading the motherhood statements in the Roadmap were hardly reassuring. In fact, if there is no minimum carer to resident staff ratio legislated, the elderley will continue to be neglected/injured. Nursing staff are now sharing their duties with carers; agency nursing staff are totally unaware of the individual’s idiosynchrasies, there is no monitoring of the length it takes for call buttons to be answered. Basic care, ie comfort,a dry bottom, being hydrated and bathed daily was always a challenge. That is why our family was there, six days a week, for the period of mum’s stay. Apart from the very few old hands who knew how to love and care, we could not trust staff to think and do for mum.
    Nursing staff need to do just that; nurse. However, there must be sufficient carers, who come to work every day, who show intelligence and compassion in their every action caring for the elderley, especially those who are no longer mobile, cannot lift a mug and who are not strong enough to press a buzzer. If this Committee achieves nothing else, I hope it presses for 24/7 nursing staff and a ratio of carers similar to that in Child Care
    .
    NB: In Queensland, there is a mandated ratio of four children to one carer in Child Care; As children grow, they become less dependent. For the aged, the reverse applies and total dependence is the eventual outcome. But for them, if the water mug is within reach, fresh and full, if the buzzer is within reach, if the buzzer works, if it’s actually answered; these basic things make the difference between a good and bad day.
    Not too much to ask you say? Well, management might say otherwise. Excuses abound.
    Basically if the nursing home operators are left with the responsibility of staffing levels, then corporate greed will rule, as it does now.

  4. Pam Klower August 17, 2017 at 1:13 pm #

    I agree fully with Kylie, Eileen and Joan’s comments above. My twin sister in March this year at aged 65 was diagnosed with Paraneoplastic Cerebellar Ataxia which is her Immune System attacking her brain instead of attacking the cancer cells in her neck. Her Diagonis was terminal and meant she would loose all functions. But where to place her, Hospital couldn’t keep her there, not sick enough for Palliative Care Placement at that stage so the only option was a Nursing Home. After checking out several she was placed in one at Strathfield. It looked good and was close to transport so friends could visit and I was able to get a Single Room for her which she really wanted.

    She was admitted as a High Care Patient so that means the Nursing Home gets more Government Funding than they do for low care patients but the care her and other clients there received was not good due to lack of trained staff which leads to lack of care. One RN incharge and other staff who seem to be very basically trained, spoke English as a second language & some hard to understand.

    Presure Sores started to develope and I purchased a Lambskin Rug and asked for a Air Matress which took ten days to arrive by whcih time a huge bed sore had developed. The care for the bed sore was poor, 3 days I was told the dressing had been changed that day only to discover no dressing at all on sore!

    It is unbelieveable when someone becomes terriminally ill that they have to go to a Nursing Home if as my sister’s condition is not manageable at home. There was only ever going to be one outcome yet she had to be placed in a place where she did not recieve the dignity that we all should be intitled to when we become so unwell. Although she lost all her functions even the ability to speak towards the end her mind was still sharp and she knew exactly what was happening to her and hated being in a place where the standard of staff, treatment and care was not good. I finally insisted the Nursing Home call for an Ambulance and had her transfered to Concord Hospital and admitted to the Palliative Care Unit for the last 5 days of her life.

    The difference in care was unbelievable and that is what is required from Nursing Homes but as long as they are looked at as a profitable businesses and it is all about profits then patients and staff provided will always come second.

    Federal & State Governments provide alot of money to these facilities and should be held accountable if the facilities they are funding are not using it for patients instead for big profits.

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