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June 27, 2022
  • THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
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residential aged care

Make providers accountable for funding, commission says

April 7, 2021 by Rayan Calimlim Leave a Comment

The royal commission says transparency and accountability should be embedded in the new aged care system.

The aged care royal commission has put forward recommendations to make providers more accountable for the expenditure of taxpayer funds.

It says residential care providers get about $11.7 billion in federal government care subsidies.

“However, there is no specific requirement on residential aged care providers to spend any portion of the money they receive on care,” it points out.

It recommends that all residential care providers should report, on a quarterly basis, the “total direct care staffing hours” provided each day at each facility they conduct.

Reports should specify the different employment categories, including personal care workers/AiNs, enrolled nurses, registered nurses and allied health care professionals engaged in direct care provision.

The commission wants the government regulator to assess the reports against minimum staffing     requirements and take action if providers don’t meet standards.

The commission also wants greater transparency by home care providers.

At present, they are paid subsidies for each month in advance, regardless of the services actually provided.

“This means the Australian Government is wholly reliant on approved providers for accurate financial reporting and reconciliation of funds,” the commission points out.

“This arrangement has several undesirable effects, including the accumulation of ‘unspent funds’ and a lack of clarity regarding what services are delivered.”

To increase “efficiency, transparency and accountability” the commission recommends that home care providers be paid from home care packages after services have been delivered or after “liability to deliver them has been incurred”.

Providers cry poor – but no transparency

Owners of some rural and regional aged care facilities recently told an NSW Upper House inquiry they will “go out of business” if they are required to have a registered nurse on site 24/7.

Inquiry chairperson Courtney Houssos asked Charles Sturt University Associate Professor Maree Bernoth, an NSWNMA member, to respond to the claim.

Professor Bernoth asked, “How do we know that, when there is no transparency required of aged care facilities?”

“Except for those in Queensland, I believe these facilities do not have to share with us their financials. We do not know how much they are spending on staff.

“We do not know how much they are spending on equipment. We do not know where our taxpayer money is being used.

“That lack of transparency … means that the aged care facilities cannot claim that they are going out of business. We need to see where their money is being spent, and then maybe we can make some comment, but until then we cannot.

“Secondly, if that is so, why do we have so many aged care facilities in rural areas that are doing very well? There are quite a few aged care facilities that have registered nurses and are doing very well.”

Persons with Alzheimer’s disease have a higher risk of head injuries

January 20, 2020 by Nurse Uncut Editor Leave a Comment

Persons with Alzheimer’s disease have approximately 30% higher risk of head injuries, and 50% higher risk of traumatic brain injuries than persons without Alzheimer’s disease, a recent study from University of Eastern Finland shows. The results were published in Journal of Epidemiology and Community Health.

This is the first study that has assessed the incidence of head and traumatic brain injuries among persons with Alzheimer’s disease. Falls are the most common cause of head injuries in older adults, and persons with Alzheimer’s disease are known to have a higher risk of falling. The findings of this study highlight the importance of fall prevention, as head injuries can shorten the life expectancy and deteriorate a person’s functional capacity. For persons with Alzheimer disease, head injuries may lead to the loss of activities of daily living and independence, and to the need of residential care even at early stages of the disease.

This study was conducted in the nationwide register-based MEDALZ cohort which included all community-dwelling persons who received an Alzheimer’s disease diagnosis in Finland 2005-2011. From the overall cohort, 67,172 persons without a previous head injury were selected to the study. For comparison purposes, a matching person with neither Alzheimer’s disease nor a previous head injury was identified with respect to age, sex and university hospital district.

NSW government: nursing homes don’t need RNs    

March 4, 2019 by Rayan Calimlim

The NSW Liberal–National government attempted to turn its back on professional advice and public opinion.

By abandoning the requirement for nursing homes to have a registered nurse on duty around the clock, the state government ignored appeals from a wide range of nursing, seniors and health advocacy groups.

It went against the views of 25,000 citizens who signed an NSWNMA petition.

It even went against the unanimous recommendation of a parliamentary inquiry supported by the government’s own MPs.

In 2015, the NSW government proposed that it would withdraw its legislation requiring RNs 24/7 for licensed nursing homes because the federal government holds responsibility for aged care.

Federal regulations do not specify the number and skill mix of staff in aged care facilities and therefore fail to ensure safe staffing levels for frail residents and workers.

As former Greens MP Jan Barham pointed out: “Some of these facilities have over 300 residents. Now there’s no guarantee they’ll have a registered nurse on site during the day, overnight or on weekends.”

“Without 24/7 registered nursing, residents can wait for hours or days for pain relief or to have a catheter changed or have the specialised care that recognises symptoms of an emerging condition.”

In an open letter, 15 organisations called on the state government to keep the requirement for RNs.

They included the Council on the Ageing, Cancer Council NSW, Alzheimer’s Australia, National Seniors, the Australia and New Zealand Society for Geriatric Medicine and the Combined Pensioners and Superannuants Association (CPSA).

Dr Lyndal Newton of the Australian & New Zealand Society for Geriatric Medicine said registered nurses were integral in providing skilled, clinical care to nursing home residents with complex, high level needs.

“The roles of a registered nurse and director of nursing in nursing homes with high care residents are vital to the NSW health system,” Dr Newton said.

“We cannot rely on industry self-regulation for our most vulnerable Australians. Though many service providers will do the right thing, we need to make sure that they all do.”

NSWNMA General Secretary Brett Holmes agreed.

“The removal of the 24/7 registered nurse requirement would only lead to increased profits for nursing homes. But it would come at a high cost to elderly residents and their families,” he said.

“Nursing homes would have no choice but to transfer residents to already overwhelmed hospital emergency departments for basic treatment if there wasn’t a nurse on duty.”

“The legislation continues to exist only as a result of our campaigning but is limited to certain nursing homes not all aged care facilities.”


Where the parties stand on RNs in aged care

 LIBERAL-NATIONAL COALITION

The Liberal–National Coalition parties used its numbers in state parliament to defeat a Bill supported by Shooters, Fishers and Farmers’ party requiring nursing homes 
to have registered nurses on duty 24 hours a day.

 NSW Greens

Voted in favour of requiring aged care facilities to always have a RN on duty.

 NSW LABOR

Labor supported the 2017 proposals of Shooters, Fishers and Farmers’ party to ensure aged care facilities have an RN on duty at all times.

  SHOOTERS, FISHERS & FARMERS

  • Supports RNs 24/7.
  • Proposed a Bill to make it law.

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