Aged care hours should double
A groundbreaking study has recommended the hours of care and skill mix needed for safe care of the elderly.
Aged care residents should receive an average four hours and 18 minutes of care per day – almost double the 2.84 hours they currently get.
The minimum skills mix needed to ensure safe care is registered nurses (RN) 30 per cent, enrolled nurses (EN) 20 per cent and assistants in nursing (AiN) or personal care workers (PCW) 50 per cent.
Inadequate staffing is the main cause of incidents of missed care, which are common across all aspects of care.
These are the main findings of the first Australian study aimed at finding a method of determining both the number and mix of qualifications of aged care nursing staff.
Called the National Aged Care Staffing and Skills Mix Project, the study was done by the Australian Nursing and Midwifery Federation (ANMF) in conjunction with the ANMF’s South Australian branch and researchers from Flinders University and the University of South Australia.
The union carried out the study due to the “monumental failure” of governments to establish-evidence based staffing levels and skills mix in aged care, said ANMF Federal Secretary Lee Thomas.
Over the past two decades, the number of residential aged care places nearly doubled from 134,810 in 1995 to 263,788 in 2014.
Successive governments have failed older Australians
Productivity Commission reports and Senate inquiries have consistently recommended the need to establish a method of determining safe staffing levels and skills mix in aged care.
“Despite these recommendations, there has been a monumental failure of successive governments to establish and legislate evidence-based staffing levels and skills mix that provide a minimum safe standard of quality care to vulnerable older Australians,” Lee said.
“The current Aged Care Act 1997 indicates the numbers of care staff should be adequate to meet the assessed care needs.
“However, it provides no parameters on what the volume or skill mix of workers must be based on to safely meet the needs and care requirements of residents.
“The report’s findings reflect feedback from ANMF members working on the ground in aged care and are consistent with stories from members about the increasing difficulty they experience in providing decent care to residents, many with dementia and other high-complex needs.
“As the report shows, missed care is a regular occurrence in residential aged care.”
Report now in the hands of the senate
The ANMF has given the report to a Senate inquiry into the aged care workforce, which has also heard
evidence from the NSWNMA.
Nursing unions hope the Senate committee will use the report’s
evidence to recommend legislation to establish minimum staffing levels and skills mix in residential care.
Recommendations from the committee are due in April 2017.
Meanwhile, the NSWNMA will join unions from every state and
territory at a national meeting of age care campaigners in February 2017.
The meeting will help draw up a campaign to promote the report’s recommendations.
The study adds to a growing body of national and international research showing that inadequate levels of qualified nursing staff lead to an increase in negative outcomes for those in their care, which results in increased costs.
In acute care, the implementation of safe mandated minimum staffing
has been shown to prevent adverse incidents and outcomes, reduce
mortality and prevent readmissions, thereby cutting health care costs.
“It is widely agreed that the same improvements could be achieved in the aged care sector – but this is reliant on appropriate number and mix of skilled and experienced staff,” Lee said.
“There has been a monumental failure of successive governments to establish and legislate evidence-based staffing levels and skills mix that provide a minimum safe standard of quality care to vulnerable older Australians.” — Lee Thomas, ANMF Federal Secretary.
1 A staffing methodology be adopted for aged care facilities.
2 A methodology for staffing facilities needs to incorporate the time taken for both direct and indirect nursing, and personal care tasks and assessment of residents; it also needs to reflect the level of care required by residents.
3 An average four hours and eighteen minutes of care per day, with a skills-mix requirement of RN 30 per cent, EN 20 per cent and AiN 50 per cent is the evidence-based minimum care requirement and skills mix to ensure safe residential and restorative care.