New research published in the Medical Journal of Australia reveals that close to 60 per cent of Australian aged care residents are living in facilities with ‘unacceptable’ staffing levels when compared to international staffing benchmarks.
The Royal Commission’s Interim Report highlighted evidence showing that aged care workers often experience excessive work demands and that these pressures had a negative impact on their ability to deliver person-centred care.
Researchers found the five-star rating system used in the US to be the most relevant international system for judging care in Australia, and the following MJA research was requested by the Royal Commission to better inform them as to how Australian staffing levels compare to aged care homes overseas.
The research found that the majority of Australian aged care homes would be classified as either one or two-star rated homes due to low staffing numbers and that any facilities that are rated below three-stars are should be deemed as having inadequate staffing levels for aged care homes in Australia.
The research shows that aged care residents in Australia receive on average 188 minutes of care per day. This care is comprised of 36 minutes by registered nurses, 8 minutes by allied health professionals (mostly physiotherapists), and 144 minutes by personal care assistants.
It was also noted that anecdotally, registered nurses, and allied health professionals are required to spend a disproportionate amount of time on paperwork for funding purposes, leaving even less time to spend on care.
Using the five-star metrics, a little over a quarter (27.0%) are in RACFs that have three stars, 14.1% of residents are in RACFs with four stars, and 1.3% are in RACFs with five stars, which are considered best practice from an international standpoint.
Staffing levels in Australian nursing homes rate poorly when compared to staffing levels in the US where the majority of aged care residents live in homes that are rated three-stars or above.
Australia also fails to meet the standards of countries like Germany and Canada despite staffing legislation in both Queensland and Victoria.
Statistically, bringing all Australian aged care homes up to adequate staffing levels would require an average staffing increase of 37.3% in those RACFs currently rated one or two stars, which would result in an overall increase of 20% in total care staffing across Australia.
The needs of aged care residents have increased in recent decades, as residential aged care is now primarily home to people who are too vulnerable to live independently in their own homes.
This new report also provided a significant snapshot of the frailty of Australian aged care residents as only 15% of the 5,000 residents who were independently assessed were deemed independently mobile.
The other 85% of residents either required mobility assistance or were not mobile at all.
Communication issues and mental health problems are rife in Australian aged care homes including agitation which is the most prevalent problem (43%), followed by depression (35%) and irritability (35%).
There has been more than enough research done over the last two decades that clearly indicate the lack of staffing in aged care has resulted in poor outcomes for older Australians and their increasingly complex needs.
Despite this clear evidence, both the Australian Government and provider-focused peak bodies have done everything in their power to avoid legislation that would enforce a minimum standard of staff ratios and skill mix.
Older Australians deserve a model of care that fulfills both their social and clinical needs.
Achieving this will require a government that is willing to make a significant financial investment and a level of transparency that requires providers to disclose how they are using their funding to ensure that people are taking precedent over profits.
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