Report calls for RNs on duty in aged care at all times

A New South Wales Government upper house cross-party committee has recommended the state mandate registered nurses in NSW aged care homes at all times at the appropriate level based on the number of residents.

The Legislative Council select committee report also calls on the Commonwealth to fund and implement appropriate mandatory staffing levels of RNs, personal care workers and allied health professionals but adds the state should investigate mandating these levels if the Federal Government doesn’t act quickly enough.

The committee was established in October 2020 to examine the Public Health Amendment (Registered Nurses in Nursing Homes) Bill 2020 and investigate how the state government could regulate RNs in aged care.

It found all aged staff play a critical role in providing holistic care, a need for increased transparency and accountability for Commonwealth funding and a need to create a stable workforce through better wages, secure employment, training and career pathways.

Committee chair Courtney Houssos said the NSW government needed to ensure safe staffing levels so residents received the care they deserve.

“The key thing that can be done is the introduction of safe staffing levels, so that means mandated levels of registered nurses, personal care workers and also allied health care professionals.

“These levels should be based on the number and on the needs of the residents and that should be the criteria for what it is,” Ms Houssos told Australian Ageing Agenda.

“The NSW Government should then advocate at a Federal level for those mandated levels for safe staffing,” said Ms Houssos, a Labor member of the NSW Legislative Council.

Elsewhere among its seven recommendations, the report calls for NSW Government to enhance laws to ensure the availability of RNs on site at all times to safely manage, procure and administer medications as required by residents, particularly with respect to end-of-life and palliative care.

It also calls on the NSW Government to analyse the cost-shifting that occurs in the state’s public health system due to aged care homes failing to have a registered nurse on duty at all times.

While the report did not seek to replicate the work of the royal commission, the committee’s recommendations mirror those of the commission, Ms Houssos said.

The report identified five key findings overall including that the NSW Government response was not best practice at Newmarch House, where 71 residents and staff tested positive for COVID-19 between April and June 2020, and 19 residents died.

Other findings include a need for aged care homes that cater to the specific needs of Aboriginal people and specialised facilities to appropriately care for residents from culturally and linguistically diverse communities.

Ms Houssos said she hoped these recommendations will improve “the shocking state of aged care in NSW.”

“The stories that we heard and the evidence that we’ve received shows that the current situation in many aged care facilities is totally unacceptable. And that responsibility lies primarily with the federal government, we accept that. But there are some things that the state government can do,” she said.

The government has six months to respond to the report, Ms Houssos said.

Other recommendations in the report call on the NSW Government to:

• urge the Federal Government to develop a clear workforce plan for aged care across Australia.
• advocate for a national register so providers can check if staff have been implicated in the sexual assault of a resident
• a review of the Serious Incident Response Scheme to ensure sexual assault incidents are classified as critical incidents.

Access the report.

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