Time to reward aged care workers
Royal commission lawyers call for mandatory staffing ratios, significant wage increases and a greater role for registered nurses in aged care.
Senior lawyers assisting the aged care royal commission say it is “high time” the dedication and commit-ment of aged care workers was properly rewarded.
“The vast majority are women and the low pay they receive is nothing less than the aged care system exploiting the goodness of their hearts,” say counsel assisting Peter Rozen QC and Peter Gray QC.
They argue that aged care workers “need better wages and conditions and enough colleagues to be able to complete their work safely and to the standard that they consider is appropriate”.
Rozen and Gray make the comments in a far-reaching plan to rebuild the aged care sector.
They recommend mandatory staff-to-resident ratios, significant wage increases and a greater role for registered nurses.
The recommendations are being considered by royal commissioners Tony Pagone and Lynelle Briggs, who will deliver their final report to the federal government in February.
Rozen and Gray’s 500-page submission says at least one in five residents have received “substandard care” under a system that “deprives people of their humanity”.
They cite a University of Wollongong report that on average, residents receive 180 minutes of care per day, of which 36 minutes are provided by RNs.
Some nursing homes provide far less care time, particularly from registered nurses.
Their submission says the federal government must “exercise a leadership role in planning for the future needs of the aged care workforce. The sector has not done this and cannot be relied upon to do it in the future”.
Pay needs to increase significantly
They call for nursing homes to be required by law to deliver minimum adequate care standards.
On wages, the submission notes that governments have made several failed attempts to give additional funds to providers “in the hope that they would be passed on to aged care workers by way of increased wages”.
However, “Unless aged care workers have a legal right to be paid more, they won’t be. A new approach is needed. It will only succeed if all parties – providers, unions and government – work together.”
Rozen and Gray propose a “significant increase” to award pay rates through a step-by-step process.
By 2030, staff providing personal, nursing and allied health care would be paid at “comparable levels to their counterparts working in the health and disability services systems”.
Government aged care subsidies would be tied to “an explicit policy of increasing wages and improving working conditions for aged care workers”.
On training, the submission recommends an immediate injection of funds into the sector for education and training to meet “an urgent need for skills acquisition” among aged care workers.
By 2030, all personal care workers should be registered and accredited with mandatory Certificate III qualifications as a minimum.
All staff should receive better training in dementia care, and high-level infection control overseen by trained infection control officers “will be the norm”.
Steps to better staffing
The royal commission counsel’s proposed staffing recommendation is in two parts – a first step on 1 July 2022 and a second step on 1 July 2024.
Step 1 would require providers to employ registered nurses, enrolled nurses, and personal care workers for at least 215 minutes per resident per day for the average resident, with at least 36 minutes of that staff time provided by a RN.
In addition, the “minimum staff time standard” should require each facility to have at least one RN on site for the morning and afternoon shifts (16 hours per day).
In Step 2, the minimum would range from 215 to 264 minutes per resident per day for the average resident, with at least 44 to 36 minutes of that staff time provided by an RN. An RN would be employed on every shift.
These minimum standards would result in average staff increases of 20 per cent from 1 July 2022 and 37.2 per cent from 1 July 2024.
The final report is to be handed down in February 2021.