Staff leave in their thousands, data shows

In all, more than 10,000 staff left their aged care workplace during July-September last year.

Almost 10,000 nurses and care workers left their residential aged care service between July and September 2023, the latest quality indicator report shows.

Published quarterly online by the Australian Institute of Health and Welfare, the latest data is the first to feature the six new QI categories introduced on 1 April 2023:

  • activities of daily living
  • incontinence care
  • hospitalisations
  • workforce
  • consumer experience
  • quality of life.  

A deeper dive into the workforce statistics – which assessed the turnover of 169,180 employees at 2,520 aged care homes – shows 2,308 nurse practitioners or registered nurses and 854 enrolled nurses stopped working at a service during the period. Providers also report losing 6,556 personal care staff or assistants in nursing and 355 service managers during the quarter – 10,073 workers in all.

For the purposes of the QI program, a staff member has “stopped working” after not working at the service for at least 60 consecutive days in the current quarter; a person is considered staff when they worked at least 120 hours the previous quarter.

Source: Australian Institute of Health and Welfare
Professor Denise Jepsen

“Losing 10,000 workers in one quarter is tough, and on track to lose 25 per cent over the year,” Macquarie University’s Ageing and Aged Care Researchers Network chair Professor Denise Jepsen told Australian Ageing Agenda. “The service loses all that memory, not just the institutional memory of how the employing organisation works, but employees’ memories about their residents’ likes, preferences and idiosyncrasies.”

Shortages resulting from staff departures can present other consequences. “They impact on quality and continuity of care provided to residents, increased workloads and stress for remaining staff and, of course, difficulty for organisations to meet their regulatory requirements such as quality standards and care minutes,” Professor Jepsen said.

“And the cost of replacing staff is huge – including advertising, agency fees, internal screening and interviewing time and resources, onboarding and training costs, let alone the agency and/or overtime costs to backfill,” she added.

Professor Jepsen told AAA she’d like to see a study of the destinations of these workers who leave. “Where do they go after they resign, how many of them go to another provider or re-enter the sector a little later after a break, or are they lost from the sector forever? I’m sure there’s a lot we can learn from such a study.”

As providers look to recruit replacement staff through multiple channels, Professor Jepsen suggests they consider boomerang employees. “That is, rehiring former employees who left on good terms. Providers able to manage an alumni of former staff have an advantage of being able to tap into a network of skilled and experienced brand ambassadors who may refer potential candidates.”

Four in five residents report positive experience

Meanwhile, in better news, more than 100,000 residents reported a good or excellent consumer experience – or 81.8 per cent of the 128,000 residents assessed at the 2,516 aged care homes that submitted data for this quality indicator.

Source: AIHW

Those residents reporting a good or excellent quality of life stood at 92,612 – or 72.5 per cent of those assessed.

Analysis of the new clinical indicators shows 38,258 of those assessed for activities of daily living experienced a decline in their ADL score (21.3 per cent); the number of care recipients with incontinence was 151,907 (78.7 per cent); while the number of emergency department presentations and hospitalisation admissions for the quarter were at 30,253 (14.7 per cent).

The other clinical indicators show as follows: 11,378 residents (5.9 per cent) had one or more pressure injury, on a par with the previous quarter.

The number of residents physically restrained during the period was 32,902 (17.4 per cent), down slightly from 18.1 per cent the previous quarter.

Significant unplanned weight loss affected 12,781 residents during July-September ’23 – 7.8 per cent compared to 7.7 per cent the quarter before.

Falls totalled 67,326 (32 per cent); falls that resulted in a major injury 3,584 (1.7 per cent). The previous quarter recorded 32.1 per cent and 1.9 per cent.

Analysing medication management data in residential aged care, the QI report shows the number of residents who were prescribed nine or more medications was 65,386 (34.4 per cent), down from 35.8 per cent.

The number of residents who received an antipsychotic drug was 33,808 (17.4 per cent), compared to 18.1 per cent the previous quarter.

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Tags: australian institute of health and welfare, denise jepsen, quality indicator report, workforce turnover,

4 thoughts on “Staff leave in their thousands, data shows

  1. Staff leaving residential aged care – I have interviewed a number of these care staff and their answers are all similar.
    1. Too little time to complete their personal care duties
    2. Too little time for required documentation
    3. When issues arise and an RN or EN is required to address them, they are unable or have inadequate time to do so properly.
    4. Too little remuneration, given their responsibilities.

    Re RNs –
    1. Too much responsibility for too many residents – not enough time to properly carry out their responsibilities.
    2. Management often do not listen to their issues and respond appropriately.
    3. They leave RAC because it is too hard and they can obtain easier jobs elsewhere.

  2. Staff turnover in aged care has been a major issue for a long time and it is expensive and exhausting trying to recruit and retain. This leads to managers burning out and becoming frustrated, especially during accreditation visit where staff are not able to answer everything due to still being green. I know a lot of the EN/RNs go to the hospitals where the pay is much better and there are set ratios. Not sure what the long term answer is to stop the tide turning, with cost of living the way it is-money certainly talks.

  3. Staff turnover could be dramatically reduced with better interaction, partnerships and cooperation with respected education providers.
    by partnering there would be less chance of new workers being disillusioned, less chance of new workers not having the required skills and knowledge to complete tasks.

    if aged care providers worked in partnerships with educators as an example:
    aged care facility X location 1
    6 groups of 10 students per year = 60 workers, if trained adequately prior to attending placement
    120 hours per student x 60 students = 1600 hours of additional care
    1600 hours of care at $29 per hour average = 46400
    if your organisation has 3 locations then it would multiply accordingly. ($139,200)
    you would also save on recruitment costs approx. $300 cost of acquisition.
    you could also reasonably charge $150 per student for access and require
    the educator to provide the supervisor for at least 3-4 visits during the required placement to minimise floor staff responsibility.
    $1500 access
    supervisor time saved 15 hours @40

    so with good structure and workforce planning, each organisation could reasonably save 50k to 150k and have a larger workforce for no additional cost.

    Wont stop staff leaving but would assist with the workload.

  4. Yes, it would be interesting to find out where staff go after they resign, as per Professor Denise Jepsen, and exit interviews remain an important source of valuable information (if executed correctly).
    It would also be interesting to uncover the original recruitment source of the staff who left versus those who stayed. In my work, I have noticed an ongoing strong (over)reliance on sourcing care staff via online job boards yet it appears that many of these active job seekers confirm the “revolving door” notion many recruiters are aware of in the sector. There are several mediators for retention (coping, person-fit, org-fit, expectations met etc), many of which are influenced by the original recruitment source someone was hired through, with “internal sources” associated with increased tenure compared to “external sources”.
    Google Weller, Ingo, Agnes Michalik and Daniel Mühlbauer, “Recruitment Source Implications for Organizational Tenure” for more detail on this.

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