Current workforce arrangements are not delivering the quality of care older people deserve and expect, consumers have told a Senate inquiry into the aged care workforce.
National Seniors said it is concerned that the proportion of direct care staff is declining, which is at odds with a resident cohort that increasingly has complex care needs.
“Staff are time-constrained and have limited resources and skills to deliver high quality care, especially for residents with dementia and palliative care needs,” chief executive Dagmar Parsons told the inquiry’s Canberra hearing last week.
The peak called for greater attention to be paid to the sector’s workforce issues, including the need for better staffing levels and skill mix, and career pathways to incentivise professional development.
As Australian Ageing Agenda has reported, the inquiry by the Community Affairs References Committee is examining the composition of the aged care workforce, future requirements and challenges in attracting and retaining staff (read that story here).
Ms Parsons told the inquiry that National Seniors supported moves to develop a comprehensive workforce strategy to attract and retain qualified staff in the aged care sector.
Similarly, Aged & Community Services Australia told the inquiry that it was committed to the development of an industry-led workforce strategy, “with close cooperation between government, industry and all relevant stakeholders.”
Pat Sparrow, chief executive of ACSA, said that key factors impacting on workforce included changing models of care, the need for multidisciplinary care, changes in industry structure, the ageing of the workforce, and the changing nature of consumers.
Leading Age Services Australia CEO Sean Rooney told the inquiry that the current aged care workforce needed to expand and change composition in order to meet demand for services.
“We have to rethink the types of work that will be carried out by our aged care workforce because our future workers will be delivering more than just personal care – they will need to engage with smart technologies and work across residential and community settings,” said Mr Rooney.
Both the workforce and the regulations overseeing it needed to be more flexible if providers are going to be able to deliver the changing models for delivery of care, he said.
Mr Rooney said that a workforce strategy needed to consider rural and regional aged care workforces and special needs groups such as indigenous, LGBTI and culturally and linguistically diverse older Australians.
Both ACSA and LASA told the inquiry that certainty of funding was essential to ensure workforce challenges can be met, citing the ongoing dispute with government over the cuts to the Aged Care Funding Instrument.
In addition to the ACT, the inquiry has so far held hearings in Western Australia, the Northern Territory and Tasmania. It is due to report by April 2017.
Related coverage: Senate workforce probe hears quality of RTOs should be priority
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It’s all about funding!
In response to the above comments from National Seniors CEO Dagmar Parsons that “the proportion of direct care staff is declining”, ACSA would like to point to the June 2016 StewartBrown Aged Care Financial Performance Survey (survey results from 850 residential facilities across the country), showed the average direct care hours worked per resident per day has been on an upward trend since 2011 (3.07 in 2011 to 3.81 in 2016). This includes all direct care staff, including care management and allied health employees. The StewartBrown Report also found that the number of registered nursing hours worked per resident per day has also increased again in the most recent data.
More information on this Report can be found at stewartbrown.com.au.
Fact check: Witham is quoting misleading figures that StewartBrown (SB) staff have been posting on social media and to the senate inquiry into the workforce. There are two identically labelled Direct Care(DC) charts showing hours per resident per day on the June 2016 report. Ch 28 is the way SB has reported since 2007 comprising nursing 2.71 + Therapy .09 + Care management 0.1 = 2.9. Chart 7 includes Hotel services 0.66 + Maintenance 0.08 + Admin 0.16 + Quality & Education 0.02 = 0.91hrs (55min) add 2.9 = Witham’s 3.81. SB offers no explanation for adding 0.91 hours that are not care to the more obvious Chart 7. SB reported actual DC has barely moved from 2.5 in 2008 to 2.9 in 2016. The average nursing time has never been above 2.9 hours of actual nursing time. Studies in the USA reveal that below 2.9 hours of nursing, most residents are at risk of harm. This is what is happening in Australia and why there is so much growing anger. Dagmar Parsons is on the ball. Prior to 1997 integrity, trust and social responsibility were prerequisites for the sector. This was enshrined in probity regulations repealed in 1997. How far will industry go to maintain the illusion? Please explain or retract Heather.
The main reason is that ratios of nurses and carers are poor due to either fund cuts or private nursing homes owners wanting to still make a good profit although many are saying they are making a lose .
Due to poor staff ratios and heavy work loads good workers are burning out ( that have many years experience) and new ones coming in with little experience and needing further training due to crash courses .
Often also many nursing homes often work short staffed due as their casual bank being poor and also see a huge turnover of staff.
The government should increase funding and implement compulsory better staff / resident ratios and better pay ,that would keep all the good staff in aged care.
I find the time ratio amazing – I don;t know I am a fairly basic coal face worker caring for this nations most vulnerable like many others, who is expected to “care” for people with time restrictions on how much time is spent with each person – really? Why? This is back breaking work and it is manual labour. Residents are entering Aged Care with higher care needs most require x2 people to assist in their most basic of care – showering, toileting, dressing, undressing, assist in feeding them their meals. It is regimented with the allusion of a home, where it is dressed up as Hotel style services. RTO trainers have alot to answer for too – their training does not assist in readying people for the role at hand – funding cut to the sector – more and more paperwork to be done that must be done prior to going home after a long day and yes using the latest technologies but you still need the worker on the ground to input that information and write daily charts and progress notes. Don;t get me wrong – I love the people I care for – I wish I could spend more quality time with them, not a quick few minutes to check that they are OK. I only wish the ratio was decent. Come on – ratio’s you are talking about is 2 to 15 sometimes 20 odd people. You are the smart ones, do your maths on how much time in a shift that we can spend quality time with people. Oh I would love the opportunity to sit with one or two for half an hour and ease their agitations, their fears. The rate of pay sucks too – $19.00 something to enter the workforce, then that rate goes up to $20.00 or there abouts. Some groups are paying above the pay rate but not by much – for the amount of responsibility that we have the pay does not reflect the work we do. The abuse we receive from family members who are suffering from guilt is not warranted. There is an incredible amount of turn over of people in the care sector. I read about career pathways – not everyone goes into nursing. What other pathways are there – realistically. Funding cuts – this is basically interfering with the bottom line of some groups and as such will cut staff ratio’s thus putting more pressure on the ones working. That is the reality of aged care and a whole lot more.
Michael is correct in that Chart 7 refers to Total Hours (direct care + hotel + maintenance + support) and Chart 28 refers to Direct Care Hours. This detailed information of hours worked by resident per day (direct care and other) has been consistently included in the SB quarterly reports and individual facility reports since well before 2007, and there has been no change in the data methodology and analyses. Heather is correct in stating that the average direct care hours worked per resident per day has been on an upward trend since 2011. This is the case for direct care hours (average 2.30 in 2011 and 2.90 in 2016) and total hours (average 3.07 in 2011 and 3.81 in 2016). It is also important to note that the hours quoted above are the average of all residential facilities (including those with a lower resident acuity mix) whereas the Band 1 (high care) direct staff hours were 3.16 hours per resident per day for 2016 (total Band 1 hours per resident per day for 2016 was 4.08 hours)
Thank you Grant for responding so promptly to my concerns about the document you co-authored at StewartBrown. Very briefly you have not “confirmed” in so many words that the figures you are referring to include Hotel services, Maintenance, Admin Quality & Education. That is the key issue here. Please confirm. The second issue here is that a reputable organization has used the same words for two very different sets of data without clearly labelling on the graph and in any text exactly what the difference was. If I did that at a scientific meeting or in a scientific paper without clearly specifying the difference on the graphs and explaining this fully in the text I would be accused of fraud and be fired. Please explain how the same words can be used with different meanings in this way.
Dear Michael Wynne, as you have never once communicated directly with myself over the last 21 years of the aged care benchmark survey (the survey being initiated by me), nor sought any specific explanation from me in all that time, it is disappointing that you resort to such emotional language in your replies to Heather and myself. My response did make it very clear as to what was included in Chart 7 (total hours) and Chart 28 (direct care hours). The reports are on our website and the reporting of the staff hours data has not changed over the previous years. I am also aware that you recently had any of your concerns satisfied by Patrick Reid of SB. Essentially, as stated in my earlier response, like it or not, the data facts are that the direct care hours and total hours delivered per resident per day have been on an upward trend from 2011 to 2016. I have nothing further to add to your posts.
Some more clarity: In regard to Heather Witham’s comment that “the average direct care hours worked per resident per day has been on an upward trend’. ANMF figures indicate that the percentage of high care residents increased from about 70% in 2010 to about 83% in 2014 and when assessed in the same way to about 87% in 2016. During the same period the actual figures for nursing care without the added hotel services, maintenance, administration etc. added, first fell from 2.5 in 2010 to of 2.3 and 2.42 in 2011 and 2012 before rising slowly to 2.9 in 2016. This is an increase of only 0.4 hours (24 min) per resident per day since 2010. The issue is whether this increase is sufficient to meet the increased needs created by an increase in the acuity of residents. I suspect not. This argument should not draw attention away from the woefully inadequate levels of nursing care revealed over the years when these nursing figures from 2007 to 2016 are compared with a minimum recommended level in the USA of 4.1 hours and studies that indicate that levels below 2.9 hours pose a risk to most residents. I hope this brings some clarity. See https://www.insideagedcare.com/aged-care-analysis/widely-contrasting-views/minimum-staffing-levels
Grant Corderoy is correct in that the data that is in dispute has been reported by StewartBrown for years. It has been called “Total staff hours”. It included almost an hour of what MyAgedCare website and others call non-direct staff time and specifically exclude from their use of the term “direct care”. In the same tables, StewartBrown recorded “Total care hours” which comprised what others in Australia have called “direct care”. The issue is that StewartBrown has, as far as I am aware, for the first time in 2016 produced two charts almost identically labelled as “direct care” from two very different sets of data that are not comparable and that is not acceptable. Only one comprises what others in Australia call direct care. There has clearly been a failure to understand the confusion it would cause when what others consider non-direct care was promoted under the heading of direct care on social media and used to counter critics who were clearly concerned about inadequate direct nursing care when they used that term. Calling the messenger “emotional” to hide discomfort when challenged does them little credit.
Our parents deserve respect. If you dont want to spend money on them, let them die in dignity. At the moment aged care homes are averaging $80.000 per year per patient. That is a bucket load of money. You pay a miserable $20.00 per hour for a carer. Then that carer only spends 2 hours max per day. Do the ratio of 5 patients per carer with 2 floats on each ward and you will save enormous amounts of money with NO pressure sore, falls and less severe illness. Its a win win. Private buisness making huge profits out of the elderly. Shameful.
Staff ratios dire…making and delivering breakfast 1 1/2 hours. Serving lunches and clearing over 1 1/4 hours plus feeding residents. 1/2 hour liunch break 10 minutes only in the morning. That’s 3 hours plus out of my care time because they make us into food service assistants …I only do a 6.5 shift and have a staff ratio of 9 residents to 1 person …profit before care……diabolical…..if this was child care there would be an uproar……no one wants to take this on…cowards…
Good on Victoria for a least making sure there is always a nurse on site 24/7, however only in public centres. There needs to be a staff to resident ratio brought in by law, for all aged care facilities. It’s a disgrace to leave our frail and elderly with such low levels of assistance, it puts them at very high levels of risks. (Not criticising the workers on the ground, as they do the best they can under pressure) however we need to up their numbers. Shameful situation, makes my blood boil