Better pay, more training, same job: nursing homes under Labor

Residents are going to love the better meals, getting the bell answered on time and not having to go
off to hospital in the middle of the night.

Staff will be over the moon about finally getting a fair-days pay, and providers will be pretty happy that they get a lot more money for not much effort, innovation or change in their business model. Although they might be upset about having to account for it.

But I hope no one thinks that people are going to like living in nursing homes more, or even that
they might be more satisfying to work in. Throwing a lot of money at nursing homes might make us feel better, and patches up the worst of the problems, but they will never be your home. And that’s where frail older people want to be because that’s the place where you can continue to be the person you’ve always been.

The substantial growth in home care packages helps here. But we need a mindset change from
providers and government, that aligns with older people - that nursing homes are a last resort, not a
first resort.

That means we also need all kinds of housing plus care options; higher-level packages; rehabilitation
re-enablement and convalescence; enjoyable respitem not nursing home rehearsal; support to
transition to a frail life; a re-orientation to preventative health and preventative dementia, and a
a community conversation that grows our view of frailty as a life stage to be maximised in its own
special way.

Nursing homes are a bottomless pit. It doesn’t matter how much money you tip into them they always
need more, and until we imagine and invent ways that frail people can live elsewhere, it doesn’t matter how many you have, you always need more.

Training packages, qualified staff, higher standards, care times per resident, and accountability for
this are all about getting the basics right, and so we should. But there is no end to this, and they
never address life quality.

As one study showed no amount of person-centred care training and improved standards could overcome the unrelenting institutional messages to treat everyone the same. This impacts staff wellbeing and engagement almost as much as the residents, as we kept hearing in the royal commission.

There’s a limit to how much staff will stand by the suffering and losses of residents, knowing that the system causes much of it. Paying staff more is the right thing to do, but don’t count on it to increase workforce numbers or quality, if we don’t go beyond the basics.

So, Labor's 5 point plan importantly sustains nursing homes, but risks sustaining them for longer
than we might want most of them.

They will continue to be bottomless pits, and not the best or preferred option for most older people who live in them, or staff who work in them.

Mike Rungie specialises in the intersection between good lives and aged care. He is a member of a number of boards and committees including ACFA, Every Age Counts, Global Centre for Modern Ageing and GAP Productive Ageing Committee.

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