Inquiry recommends minimum RN requirement, funding review

A parliamentary inquiry has called for legislation to ensure aged care facilities have at least one registered nurse on site at all times and a review of funding to assess its adequacy to meet residents’ needs.

A parliamentary inquiry has called for legislation to require aged care facilities have at least one registered nurse on site at all times and for the government to monitor the link between care standards and staff mix to inform future staffing requirements.

The inquiry into the quality of residential aged care services also recommends reviews of the Aged Care Funding Instrument and its penalties and Medicare rebates for doctors visiting facilities to ensure they are adequate.

The House of Representatives committee on health, aged care and sport began its examination of the delivery and regulation of the aged care system and the prevalence of mistreatment in December following a referral from Minister for Health Greg Hunt (read more here).

The 173-page report, which was released on Monday, makes 14 recommendations including for an independent review and parliamentary inquiry of the incoming Aged Care Quality and Safety Commission after two years of operation.

The inquiry drew on the findings of other recent investigations including the Tune Review of aged care reform, the Australian Law Reform Commission report on elder abuse and the Carnell-Paterson review of aged care quality regulation.

The committee has made a number of similar recommendations to those inquiries including for the mandatory participation of a quality indicators program, unannounced and out-of-hours accreditation visits, a consumer rating system for facilities, and greater transparency about complaints against individual facilities.

The parliamentary inquiry received 123 submissions and 33 exhibits and held seven public hearings in five capital cities.

Committee chair Trent Zimmerman said they received submissions from many residents and family members that outlined harrowing examples of mistreatment.

“This is not good enough for a nation like Australia,” he said.

Stakeholder reaction

The aged care royal commission, which was called toward the end of the inquiry, is welcomed by the committee, but should not delay the implementation of improvements recommended in this report and other recent reviews, Mr Zimmerman said.

This sentiment has been repeated by provider and industry peak bodies including the Australian Medical Association, which welcomed the report and particularly its recommendations around staffing.

Dr Tony Bartone

AMA President Dr Tony Bartone, who appeared before the inquiry in May, said the recommendations in the report largely aligned with AMA policy and suggestions to improve the care of aged care residents.

“The AMA has been advocating for a registered nurse-to-resident ratio that aligns with the level of care need, and ensures 24-hour registered nurse availability,” Dr Bartone said.

Requiring by law that all aged care facilities provide at least one registered nurse on-site at all times is a good first step, but it must be recognised that one RN will not be enough in many facilities, he said.

Provider peaks Leading Age Services Australia and Aged & Community Services Australia also welcomed the report.

Sean Rooney

LASA CEO Sean Rooney said the report provided a constructive contribution to aged care reform and he particularly welcomed the focus on adequate funding for ACFI, and Medicare rebates to better support GP visits to facilities.

He also noted the inquiry’s focus on improving safety and quality and said workforce development and the implementation of the Aged Care Workforce Taskforce’s strategy was vital to achieving this.

“Part of this is the development of a strong evidence base to inform optimal aged care staffing models across a range of care settings to meet the care needs of individuals and deliver best possible outcomes,” Mr Rooney said.

However any new regulatory requirements must do not divert limited resources away from providing direct care, he said.

Pat Sparrow

ACSA CEO Pat Sparrow said she welcomed the report’s concern for the future of quality aged services and its contribution to the public conversation underway.

“As the report touches on many of the areas that will be considered as part of the terms of reference of the royal commission, we believe it will make a useful contribution to the national discussion we all want to see occur.”

Access the report here.

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Tags: acsa, Aged & Community Services Australia, aged care quality, ama, australian-medical-association, lasa, leading-age-services-australia, parliamentary inquiry, pat-sparrow, Sean Rooney, slider, tony-bartone, trent-simmerman,

5 thoughts on “Inquiry recommends minimum RN requirement, funding review

  1. It is timely that the rebate for GP visits has come into consideration. yesterday i heard that a resident in a facility needed a GP around 2pm. however as the facility did not have a GP they could call, the resident had to wait for a call to be made to a radiodoctor service -the call was made at 7pm and doctor arrived about 10pm. Very few doctors are willing to leave their surgeries and do home visits or facility visits..

  2. Let’s not forget that the NSW Government voted against a bill mandating 24/7 RN coverage despite the 2016 parliamentary inquiry’s recommendation to retain the regulation.

    And let’s also not forget that LASA and ACSA made submissions against 24/7 RNs at that inquiry.

    Mr Rooney and Ms Sparrow are not the type of advocates consumers and aged care workers need. Just read their submissions supporting the ‘robustness’ of the quality agency’s processes or using the quality of care inquiry to lobby for more money (again) and a marketing campaign to promote just how rosy things are in the sector. You cant read the RN submissions…they’ve been mysteriously removed from their websites.

    There are quite a few of us who look forward to seeing these peak bodies squirm in front of the Royal Commission.

  3. The education provided for personal care assistants is not sufficient. They are at the coal face of care and need to be aware of signs and symptoms from a biopsychosocial perspective.
    Many are not aware of signs of pain, many are in too much of a hurry to spend time with a patient because of the high workload expected.

  4. What kind of RACF that advertises it’s specialist dementia care and in house experts can’t manage the behaviour of an almost 80 year old woman with dementia who is bedridden? The GP only suggestion was to send her to the ED Dept. More trauma, more drugs and after ruling out acute injury or infection nothing they can do either.

  5. There are several nursing home businesses in Tasmania that base one RN at a single facility and expect them to cover another home as well. This means that at night, one of each pair of facilities has no qualified staff on at all, and if a drug needs to be given, or there is an emergency, the RN needs to abandon their base facility to attend.
    Laws mandating one RN per shift per facility would overcome this problem

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