There is no case for fixed staffing ratios in Australian residential aged care, a leading industry consultant has told the royal commission.
Aged care advisory firm Ansell Strategic recently made a submission to the aged care royal commission about its investigation into the practical application of fixed staffing ratios in residential facilities.
The investigation involved extensive consultation with aged care operators and clinical leaders, examination of international research and literature reviews, said Ansell Strategic managing director Cam Ansell.
“We found that it’s not a system that is suitable for Australia,” Mr Ansell told Australian Ageing Agenda.
“We completely appreciate and recognise why people are looking for answers, but in answering a very complex problem, it is a simple solution we feel is more likely to make the situation worse and unsustainable,” he said.
Ansell Strategic found that fixed ratios in Australian aged care facilities are not appropriate because:
- there is a variability in resident needs and staff skills
- it would lead to an overinvestment in clinical resources
- models of care are evolving
- there are a scarcity of registered and enrolled nurses
- it would create economic and administrative burdens
- it would negatively affect consumer choice.
As part of the investigation, Ansell Strategic examined the assumptions used by the Australian Nursing and Midwifery Federation and Flinders University in its modelling of costs and benefits of the ANMF proposal to meet recommendations of minimum nurse staffing and 4.3 hours of care per resident per day by 2025.
The Flinders University report found the $5.7 billion cost of implementing the increased workforce and skills mix recommended by the ANMF would be offset by indirect and social benefits (read more here).
Ansell Strategic said in its submission that the ANMF and Flinders University modelling did not substantiate the assumptions underpinning the benefits forecast and that the regime proposed would undermine the flexibility needed for care delivery.
However, it said that the ANMF accurately articulated that the workforce was under-resourced, inadequately trained and undervalued.
“It is undisputed that resident outcomes are enhanced through improved skills mix, training and recognition.
“Delivering on this will require a substantial investment, not only in the workforce, but in the reallocation of our sector’s resources between residential aged care and home care,” Ansell Strategic said.
Ansell Strategic has proposed the following solutions:
- improve the focus and resourcing of home care and reduce pressures on residential aged care
- improve the training, education and recognition of the aged care workforce
- realign the relationship between aged care stakeholders to create a unified partnership.
Mr Ansell said the first point was critical and supported David Tune’s recommendations for a modest increase in means testing and the introduction of level 5 and 6 home care packages.
“If we were to means test properly then we could pay for a stronger staff complement,” he said.
If there is a better balance between user payments and taxpayer contributions the industry will explode, which will improve competition, choice and innovation, Mr Ansell said.
Access the submission here.
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