Royal Commission update – February

Written by Ilsa Bird – Sector Support Coordinator

The aged care workforce will need to have at least doubled by 2050 to meet the projected target of 980,000 workers and three and a half million Australians who will be accessing aged care services every year, largely through community-based services.

– Mr Peter Rozen, Senior Counsel Assisting

Adelaide Hearing 3

The first 2020 Hearing was held in Adelaide on 21 February and inquired into the future of the aged care workforce including:

• staffing numbers and mix
• terms and conditions of employment
• workforce planning and the role of the Commonwealth
• education and training of the workforce
• registration of personal care workers

Submission Summary

Following the withdrawal of all witnesses at the hearing, Mr Rozen, Counsel Assisting, outlined the submission made to the Commissioners on behalf of the Counsel Assisting team relative to workforce.  The submission proposed “a package” of 11 recommendations with the goal of increasing care quality as well as improving staff attraction and retention in aged care.

Staffing numbers and mix

Recommendation 1: Staff Ratios

Residential aged care facilities should be required by law to have a minimum ratio of care staff to residents working at all times. The ratio should be set at the level that is necessary to provide high quality and safe care to the residents in its facility and should be based on the following:

1. An average case mix total care minutes are between 186 and 265 minutes per resident per day delivered by a trained workforce of nurses (registered and enrolled) and personal care workers.
2. A minimum of 30 minutes of registered nurse care time per resident per day.
3. Minimum of 22 minutes of allied health care per resident per day on average.
4. A registered nurse is present on each shift and available to direct or provide care

Mr Rozen recommended a phased or transitional implementation approach.

Recommendation 2: Transparency

Quarterly reporting by approved aged care providers about staffing levels (nursing, allied and care staff) per shift in residential facilities. It is recommended that this information be published and support provided to older people and their families to understand the information.   

Education, skills and training

Recommendation 3: minimum qualification for personal care workers

The Certificate III in Individual Support (Ageing) should be the minimum mandatory qualification required for personal care workers performing paid work in aged care (including residential, home-based, respite, restorative and palliative care).

Recommendation 4: education and training for medical practitioners

A working group should be established to:

1. review the skills required for GP’s to meet the future aged care needs of the population
2. determine the need for GPs to deliver geriatric medical services
3. review geriatric undergraduate medical education

Recommendation 5: education and training for medical practitioners

All Australian University Medical Faculties should review curriculum and work towards:

1. making geriatric medicine a core element of the curriculum
2. compulsory geriatric clinical placement in order to receive registration

Recommendation 6: Assessing the projected demand for geriatric health services

Conduct ongoing research to determine the short, medium and long term demand for geriatric servicers for older Australians.

Recommendation 7: education and training for nurses

Geriatric medicine and gerontology care modules should be added into the accreditation standards for nurses.

Recommendation 8: Scholarship programs

Scholarship program introduced with aged care return of service obligations for nurses.

Regulation of personal care workers   

Recommendation 9: establishment of registration

A registration scheme should be introduced and include:

1. mandatory minimum qualifications
2. sighting of qualification by aged care providers
3. ongoing training and professional development requirements
4. minimum levels of English language proficiency
5. criminal history screening
6. a Code of Conduct and implications for breaches

Leadership and workforce planning

Recommendation 10: workforce planning

The Commonwealth government should lead workforce planning or identify a governing body to do so. Key responsibilities would include:

1. long term workforce modelling
2. management of the training pipeline in partnership with RTO, universities, specialist colleges and professional associations.
3. Driving labour productivity
4. Ensuring the appropriate distribution of health professional and care workforce to meets population needs (particularly in rural and regional areas)
5. Facilitating the migration of health professionals and care workers to Australia to meet the needs in aged care, health and disability.

Recommendation 11: Aged Care Workforce Industry Council

The Australian Government should work in partnership with the Aged Care Workforce Industry Council and provide the financial and practical support necessary to implement the Aged Care Workforce Strategy Taskforce Report recommendations.

Conclusion

In addition to the above recommendations, Mr Rozen also proposed that the 14 strategic actions delivered in the Aged Care Workforce Taskforce final report should also be implemented. Specifically, the five actions that are directed at the Australian Government.

The next hearing will take place on 4 march in Adelaide. The hearing will inquire into aged care program redesign in response to Consultation Paper 1 released in December 2019. The paper is titled Aged Care Program Redesign: Services for the Future and can be accessed here.

Public submissions to the Royal Commission will be closing on 30 April 2020.

The full transcripts and witness lists for the hearings can be found here.

The full submission paper can be accessed here: submissions-by-counsel-assisting

For more information, please see the website: agedcare.royalcommission.gov.au