NSW inquiry calls for staff ratios to ease ‘burden’ on the sector

In early June the NSW Legislative Committee published its final inquiry into the issue of chronic understaffing in aged care facilities. It found, as did the royal commission, that mandated staffing ratios and more registered nurses were urgently required.

When asked why aged care providers and the NSW government have yet to implement staffing ratios, despite the insurmountable evidence supporting its benefits, Dr Maree Bernoth had one simple answer

“The reason we don’t have staffing ratios is because of the power of the for-profit-sector in the aged-care industry.”

“The decisions are made based on profits, not people,” she said.

Bernoth, an Associate Professor at Charles Sturt University and a registered nurse, participated in the upper-house probe. Last year, she spoke to Aged Care Insite about the dire need to attract and retain qualified workers in the sector.

“We haven’t heard anything much after the aged care royal commission report was published,” said Bernoth.

“It’s sort of gone in the background.”

The Royal Commission gave us significant evidence as to the consequences of understaffing. Horrific stories of residents left for hours in their own faeces, excessive use of chemical and physical restraints and a slew of unreported sexual assaults rattled the nation. 

Earlier this year, the Federal Budget offered the government’s solution to the problem, a $17.7 billion-dollar package wrapped in a five-year-rollout designed to overhaul the entire system. Its fifth and final pillar being a new Aged Care Act set to debut in 2023.

Despite this, the recent State inquiry found that the “shocking” conditions faced by residents across residential homes in NSW had been worsening.

“We were told about the increasing needs of patients with complex co-morbidities, yet there has been no increase in staff,” wrote Chair of the NSW Legislative Council Courtney Houssos.

“Instead, we heard that chronic under-funding, combined with the COVID-19 pandemic, has put an increasing burden on nursing and personal care staff.

"What was clear in our inquiry was that it is getting worse, not better."

Gaps in vaccination rates between aged care staff and residents have now put hundreds of lives at risk. As of today, three residents living in a Sydney nursing home have tested positive for the virus after two unvaccinated workers attended shifts while infectious. 

One of the inquiry's most critical revelations concerned the state government’s response to a deadly outbreak in a Western Sydney facility. Last year, Newmarch House saw 71 residents and workers infected, with 19 deaths among residents.

The report highlighted that NSW Health did not dispatch crisis or surge staff and had delayed issuing personal protective equipment. It was also found that staff shortages, due to quarantine conditions and a lack of employees provided by Anglicare, had exacerbated the situation. 

According to an Anglicare surge worker, understaffing had also led to “extremely poor care conditions” for residents.

“It is very hard to train up the agency staff and look after the residents at the same time,” she told the Committee.

The chief executive of Anglicare, Grant Millard, went on to defend recent the decision to cut staff costs at Newmarch house given last year’s tragedy.

He told Committee members there was “very little else” that could have been done to ensure the organisation's financial stability.

The inquiry also determined that the role of NSW Health in supporting the facility and its workers was insufficient.

“The NSW government likes to boast about being leaders in things,” Deputy Chair Mark Banasiak told Aged Care Insite during an afternoon phone call.

“If there’s any one issue we should be leading in, it is how to look after our elderly.”

Banasiak, a member of the Shooters, Fishers and Farmers Party, introduced the Public Health Amendment bill last year. He was one of the six of nine members who voted in favour of mandated staff ratios in NSW.

“It's one of those grey areas that both the federal government and the state government like to play off each other,” he said of the ongoing stoush over who should ultimately have responsibility over the sector.

While unpacking the findings of the committee, Banasiak revealed that no government entity, including the state, had made efforts to respond to the inquiry.

“It’s also possible that they want to push it off for two years because that will push it into a new government, and then they don't have to deal with it,” he said.

Those opposing staff ratios included National Party member Wes Fang and Liberal Party members Natasha Maclaren-Jones and Taylor Martin. They did not respond to Aged Care Insite when asked to comment.

In a joint dissenting statement in the inquiry, the three contended that the issue should remain the Commonwealth’s business. 

“It is not appropriate for the NSW government to be legislating in an area of Commonwealth responsibility and should wait for their reforms and legislation to be introduced,” they wrote.

The statement read that the state should hold off for two years until the Aged Care Act is implemented, a comment which has frustrated Greens Committee member Cate Faehrmann.

“The Liberal-National members of the Committee seem determined to ignore the fact that aged care is in crisis,” Faehrmann said.

 “The safety and wellbeing of our nurses and their patients relies on adequate and safe staffing levels and this has been made clear, so there’s no reason to delay any longer.“

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