Home | Industry+Policy | Staff ratios won’t cost you a thing: royal commission day three
Photo: Kelly Barnes AAP

Staff ratios won’t cost you a thing: royal commission day three

Properly staffing aged care facilities with an adequate nursing skill mix and at least four hours and 18 minutes per-patient per-day care minimum would not cost the sector anything more than it currently outlays.

That’s according to a report presented to the Royal Commission by the Australian Nursing and Midwifery Federation (ANMF) federal secretary Annie Butler. The ANMF-funded, Flinders University National Aged Care Staffing and Skills Mix Project Report made a cost-benefit analysis of the paper’s recommendations and found that although it would cost $5.3 billion to implement, any costs would be offset through tax measures and other features.

Savings made by avoiding staff attrition is one such feature, which currently costs the sector $500 million.

“If you had proper staffing in the places, people would feel satisfied, fulfilled in their jobs as nurses and carers and we wouldn’t see the churn that we see,” Butler told the commission.

Staffing levels were the running theme in Butler’s testimony as well as skills mix and the pay gap between the public sector and the aged care sector.

“What we hear most often from our members now is the increasing pressure they’re experiencing with workloads. So many of them across the country describe their workloads now as unsafe. They’re untenable. They report to us that that’s why they’re leaving the sector,” she said.

These shortages affect nurses’ ability to properly attend residents in the mornings during their personal hygiene routine, during meal times and handover between shifts, Butler said. We heard a particularly disturbing account of a man, post-stroke and aphasic. He was experiencing pain in his penis and because of a poor handover he was found to have an indwelling catheter wound.

Council assisting Paul Bolster read a statement from an aged care nurse about the incident that read: “I am blown away the staff did not report the erosion as it was happening and take steps to prevent it. More educated staff had not looked at the source of his pain. He had Panadol every night.”

Nurse testimonies from ANNF surveys also highlighted their concerns about nurse hours.

One nurse wrote:

I have been a registered nurse since 1972 and worked in aged care since 1988, and for almost all of that time worked in senior management positions running large aged care facilities for the same not-for-profit organisation.

“Last year, there was a roster review at the facility I was running and the organisation made the decision to cut 16 hours per day from my care staff roster.

“I am now working as a registered nurse seven shifts per fortnight in an aged care facility for another-not-for profit organisation, and they have just reviewed their staffing hours, and are going to cut nine hours per 25 day from the care staff roster.”

It is incidents like these that led the ANMF to put forward their hourly care model and a mandated skill mix of 30 per cent registered nurse, 20 per cent enrolled nurse and 50 per cent personal care worker.

“What we think our research clearly indicates is there’s just a gaping hole in the Aged Care Act currently in terms of how you actually staff against genuine care needs in residential aged care,” Butler said.

The first witnesses are called: royal commission Monday

Ineffective advocacy, uneaten meals: royal commission day two

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  1. It is so good to see the aged care industry having the spotlight put in it! Well overdue! Lets hope this commission facilitates a much needed change to the anged
    care industry. I witnessed care to my late mother in law and work as a RN in the public health sector and know only too well the pressure that nurses work under. Makes sense to look after staff having them work with appropriate staffing levels and the flow on effect will be satisfied staff, less attrition rates and well cared for patients. It’s not rocket science and tragic that so many of our frail aged have suffered and the industry has lost so many good staff having burnt them out.

  2. “It is incidents like these that led the ANMF to put forward their hourly care model and a mandated skill mix of 30 per cent registered nurse, 20 per cent enrolled nurse and 50 per cent personal care worker.”

    I sincerely hope this is just a case of poor reporting, and that the ANMF is not actually suggesting that someone who is classified, as an example, as NNL under ACFI requires the same hourly care model and mandated skill as someone who is classified as HHH under ACFI…

    • The use of contractions here renders the remarks useless if the intention was to communicate anything important.

  3. Staff ratios scariest thing in aged care as an Enrolled nurse doing agency work very unsettling when you don’t know residents and can’t possible get around to see every resident you rely totally on carers on keeping you updated. So many great carers but with limited knowledge so a report of pain can need investigating re why time permitting not at all fair on our aged they deserve much better and leaves myself as a nurse feeling I haven’t given my best.

  4. They need to look at the way these not for profit care facilitys use the money the goverment gives money for residents .At the moment the money is given to these faciitys is not monitiored. they can spend it on what they want,It should be given stickly for the care of the residents This is the only way homes will get staff ratios with a good mix of skills.

  5. Implementing a minimum ratio of 4.3 direct care hours per resident per day (up from the current industry average of 3.06) would increase costs for aged care providers across the industry by approximately $31 per resident per day. The most recent industry benchmarks indicate providers make an average profit of $4.5 per resident per day. Its easy to talk about implementing minimum ratios, but the numbers don’t stack up in the context of current funding levels

  6. Residential facility says government has cut the funding, commission says ratio won’t cost you . This is big industry money making for everyone but who is suffering poor elderly people. When residents wants to go toilet wait is nearly 30 to 40 minutes, assistance with meals someone has to wait till it gets cold. There are too many things . And then accreditation comes all of the sudden facilities gets more staf for that time , they never come at pm and night shift , morning time facility will bring all extra staff where never exist. Reality is different it’s money making and running politics for politicians. Please don’t play money game with elderly people, bring something good for elderly people , nurses and care staff . Thank you