The Aged Care Royal Commission and COVID-19 have revealed some glaring gaps in the aged care system, a major one of which is the lack of consistency across facilities when it comes to minimum staffing levels. In Australia, there is no legislated, mandated staff ratio – most facilities operate on a consumer-directed care model, meaning that they have enough staff to care for individual people. It is becoming evident that many people have very complex care needs and require more care than is currently being provided to meet their clinical and everyday living care needs.
As is recommended by the counsel assisting the Royal Commission into Aged Care, minimum staffing should be legislated to ensure that all residents receive the care they need. Rather than a concrete number of staff, it is recommended that the minimum staffing levels are essentially just that and these staffing levels should increase as the complexity of resident’s care needs change over time.
Having a Division 1 registered nurse on site 24 hours a day, and appropriate staffing of enrolled nurses would be an appropriate resourcing minimum. We also recommend the upskilling of PCA nurses and increased training across the board. It is not enough to only have minimum staffing levels – staff should also be appropriately trained, with a minimum of a Certificate III or IV. Training should be continuous, with supplementary engagement, opportunities to upskill and clear pathways for career progression. Increased training around common conditions such as dementia is necessary to ensure care staff are equipped with the appropriate knowledge to care for residents. Overall, we need more staff in aged care facilities and continual training to ensure the staff have the appropriate skills to look after our most vulnerable residents.
All caregivers need to be diligent, skilful and insightful, engaging with residents on a personal basis and fostering ongoing caring relationships. Having minimum staffing levels at facilities will mean that staff have the time and skills required to invest in creating these caring relationships to ensure residents receive the quality of care they deserve.
Recent studies show that over half of Australian aged care residents are in homes that have unacceptable staffing levels and that to raise the standards for all residents to receive a good level of staffing, an increase of 37.2% in staffing will be required. There are also further considerations when it comes to the needs of culturally and linguistically diverse residents, and staffing levels in regional and rural facilities.
We support the introduction of legislated minimum staff ratios, but this will only be effective if combined with enhanced training to give residents access to the highest quality care in line with requirements.
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