Leaving allied health professionals out of the recommendation for minimum staffing ratios is a “serious failing” of the aged care royal commission, a health academic has told Australian Ageing Agenda.

The Royal Commission into Aged Care Quality and Safety’s final report including 148 recommendations was tabled in Parliament on Monday.

Royal commissioners Tony Pagone and Lynelle Briggs found aged care staffing levels or skill mixes are unregulated.

“The evidence is compelling that overall staffing levels in aged care are linked to quality of care, and that registered nurse members are particularly important,” the commissioners said in their final report.

Research undertaken by the Australian Health Services Research Institute at the University of Wollongong for the royal commission analysed national staffing levels with international benchmarks including an American five-star rating system.

It identified that more than half of Australian aged care residents were in homes with one or two-star staffing levels.

The commissioners recommended that residential aged care meet a minimum staff time quality and safety standard for registered nurses, enrolled nurses and personal care workers to bring the sector to a four-star minimum in two stages.

Starting July 2022, residents should have 200 minutes of care per day including at least 40 minutes from a registered nurse to achieve a three-star rating and one or more RNs on during the morning and afternoon shift.

From July 2024 this should increase to 215 minutes per resident per day and at least 44 minutes from a registered nurse to reach a four-star rating and an RN on site at all times.

Professor Kathy Eagar

Australian Health Services Research Institute director Professor Kathy Eagar said while she is “thrilled” the commissioners have taken on board their recommendations, she is “disappointed” they did not include allied health professionals in the staffing ratio.

“We made recommendations about staff ratios in allied health and the royal commission did not recommend that for allied health. We think that was a serious failing,” Professor Eagar told AAA.

The commissioners recommended other measures to improve access to allied health including funding for aged care homes to engage allied health professionals via a blended funding model to provide services according to individual care plans. Commissioner Pagone recommends requiring providers have arrangements with allied health professionals to provide these services while Commissioner Briggs recommends providers employ or otherwise retain one of more of each type of allied health professional.

 Professor Eagar said the commissioners have left allied health in the lurch by excluding them from the ratios because while they may think they have put them in another way, that won’t necessarily happen.

“In the long run, if you’re going to have staff ratios and public reporting, and if you don’t include allied health, then they’re left out. It’s as simple as that,” she said.

Timeframe achievable, but more staff required

Professor Eagar said the commissioners’ goal of July 2024 is achievable but requires work to attract and retain staff.

This could firstly happen by offering the thousands of former aged care staff who left because they hated the conditions and low pay a better deal, Professor Eagar said.

“If we’re to attract the workforce we need, we need to be able to attract that workforce back into the aged care sector and that means we need to treat them better than they were treated the last time they were here,” she said.

Professor Eagar said the second was it to attract new people to the sector and particularly out-of-work service industry professionals.

“The one silver lining from COVID is that there are lots of people who have a service industry background and who are good at customer service and who could come and work in this sector if they are given training. That cohort, we need to attract them. We need to train them and we need to retain them.

“That’s all possible. But it requires both sufficient funding and sufficient will.”

Continue to follow us here and see the forthcoming edition of Australian Ageing Agenda magazine for our in-depth reporting on the royal commission’s final report and recommendations.

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5 Comments

  1. Not only was Allied Health left out but in my opinion the most troubling issue was that an entire allied health profession was NOT included at all when listing allied health services. That is Diversional / Recreation Therapy this is very troubling as without Diversional Therapy ( university trained leader) and a team of leisure and lifestyle staff ( diploma or cert 4 trained) consumers do not and will continue to not have trained staff to assess, program, plan and implement leisure and recreation activities, community outings, entertainment, maintenance of cultural activities, events and celebration of cultural events, Maintenace of religious services, events , organisation of animal assisted therapies, integenerational programming, meaningful engagement and most importantly the choice and creation of opportunities for residents to choose and enjoy how they spend their time….. This MUST be addressed immediately as stated in this article if it is not suggested or stated it simply won’t happen. We already see poor numbers in this area with staff to resident ratios of 1:40 and in some cases 1:80/100 residents and with staffing hardly any facilities have access to a degree trained DT and many facilities do not have all leisure staff appropriately trained with a minimum of cert 4 in leisure and health. As we know nursing staff support the residents to be physically well, physio staff support the residents to be mobile but Diversional and Leisure and recreation staff provide the reason, the will to live, by providing opportunities to maintain their lifestyle, create new opportunities, promoting choice, promoting meaningful engagement , supporting social connectedness and supporting the resident to live and do what they want.

  2. The Royal Commission has produced the Final Report that is incompetent and highly damaging not only to the Aged Care industry*, but for the principles of democratic governance in Australia.

  3. I believe we need to broaden the description of allied health or complementary supports in aged care. The report is disappointing from the perspective of Counsellors who are also skilled professionals. If we can have aged specific OTS, physios and speech therapists, we can also embrace counsellors with a passion for working with older adults. Let’s be open to the diversity of professions to support rather than limit. Certainly, regulation is possible, one being that talk therapists are registered, qualified and engage in relevant PD. I’ve stopped waiting for people to support me and now on a journey to raise the profile of counsellors in aged care through PACFA.

  4. Absolutely agree with Caroline above, social workers, psychologists, counsellors entirely left out – which is shocking when mental health and wellbeing is such an issue for older people.

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