Publishing staff-to-resident ratios in aged care is a positive first step for increasing transparency but it’s not enough for consumers to make informed decisions, according to a parliamentary inquiry.
The House of Representatives Standing Committee on Health, Aged Care and Sport tabled its final report into the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018 and presented it to Parliament last week.
The inquiry was launched on 14 September following the introduction of a Private Member’s bill by South Australian Centre Alliance member for Mayo Rebekha Sharkie on 20 August (read our backgrounder here).
The bill proposes that aged care providers publish full-time equivalent staff-to-resident ratio by qualification, such as registered nurse, enrolled nurse, personal care attendant or allied health staff, on My Aged Care every quarter (read more here).
The committee said in its report that while it supported the publication of quarterly staffing ratios it did not believe the data alone would allow consumers to make informed decisions.
However, it will increase the amount of information available to consumers, the report said.
“It may only be a minor step, but it is a first step,” the report said.
The committee “urges the Department of Health to continue to work with the aged care sector to develop a rating scheme for residential aged care facilities,” according to the report.
“Reported staffing ratios need to be accompanied by additional data, in order to enable consumers to make like-for-like comparisons between facilities,” the committee’s report said.
The bill also requires providers to notify the Government within 28 days if staffing ratios change by more than 10 per cent, which may create “unnecessary regulatory burden” particularly among smaller and rural facilities, the report said.
The report made the following six recommendations:
- the staffing ratio bill should be passed by Parliament
- the Department of Health should publish data so consumers can consider resident acuity levels when comparing facilities
- the bill should be monitored to see whether there is a need to report staffing ratios after business hours and whether this creates a reporting burden on smaller facilities
- the National Aged Care Quality Indicator Program should be mandatory for Government-funded providers
- the Government should legislate to ensure providers have at least one registered nurse on site at all times and monitor the correlation between the standards of care and staffing mixtures
- the Government should review the effectiveness of publishing staffing ratios on improving transparency after 12 months.
Provider peaks say reporting cuts care time
When the bill was introduced provider peaks raised concerns that publishing staff-to-resident ratios could be problematic and an ineffective indicator of quality.
Leading Age Services Australia CEO Sean Rooney said while it was important give consumers appropriate information on the quality of aged care facilities it is “unclear how the Sharkie Bill would support these objectives.”
“Reporting staff to care recipient ratios may provide the general public with information that is hard to interpret, not readily comparable across facilities and services, and potentially misleading,” Mr Rooney told Australian Ageing Agenda.
“Any additional reporting also creates extra administrative and cost burdens at a time when the industry is already under significant staffing and financial pressure,” Mr Rooney said.
He said the Australian Aged Care Quality Agency’s consumer experience reports and the quality rating system used in the United Kingdom were among better ways to measure quality of care.
Fellow peak the Aged Care Guild supported the inquiry, however CEO Matthew Richter said the bill would only be effective if it provided meaningful information that is readily available to consumers.
“Bearing in mind recent reforms and likely outcomes of the royal commission, Government needs to be conscious of the regulatory burden for service providers as every minute directed to administration is a minute that could be spent on care,” Mr Richter told AAA.
In its submission to the inquiry, the Guild recommended the Government work with both providers and consumers to ensure the bill is “fit for purpose,” Mr Richter said.
Aged & Community Services Australia also supported the inquiry, but CEO Pat Sparrow said there were risks with comparing providers.
“There are several challenges and risks associated with metrics that attempt to allow comparisons between different aged care services using simplified data that may or may not accurately compare like with like,” Ms Sparrow told AAA.
“As the bill currently stands, we do not believe it will necessarily achieve this.”
Ms Sparrow said other factors including leadership and different models of care also contributed to quality care.
She said the aged care royal commission would likely consider staff-to-resident ratios and that it “would be more appropriate for this matter to be examined as part of the overall aged care system design and financing to meet community expectations.”
Calls for bill to be passed
National Seniors Australia chief advocate Ian Henschke welcomed the recommendations and said this information should have always been available to consumers and families.
“The bill offers a common-sense approach to the issue of residential aged care and, if passed, will give consumers and their families more understanding about the capacity of an aged care home to look after older people’s needs,” Mr Henschke said.
Similarly, Australian Nursing and Midwifery Federation federal secretary Annie Butler commended the committee for recognising the need to increase transparency in the sector, however, said the Government needed to act now.
“The Government cannot continue to wait for the royal commission, when Parliament resumes in the new year, it must act on the committee’s recommendations and start fixing the crisis in aged care,” Ms Butler said.
Federal member for Mayo Rebekha Sharkie also called on the Government to pass the bill as part of measures to improve the sector.
“It is not the only way to increase transparency in the sector but given that the industry has consistently resisted transparency when it comes to staffing numbers and qualifications, I do believe it will help,” Ms Sharkie said.
Access the bill here.
This article has been updated to include comments from ACSA.
See related coverage: Committee told more detail required in proposal to publish staffing ratios
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