Keeping Aged Care Reform on Track

BY DANIEL PRENTICE, QNMU PROFESSIONAL RESEARCH OFFICER

The final report and recommendations of the Royal Commission into Aged Care Quality and Safety (the Royal Commission) released in 2020, along with a total of 148 recommendations, have provided the opportunity to significantly improve the Australian aged care system.

However, like any reform process, the best of intentions are no guarantee of good outcomes. This is why the QNMU and our national body – the ANMF –are spending considerable time and resources making sure the interests of our members and the older Australians they care for, are represented at every opportunity in the reform process.

The aged care reform process is extensive and daunting, and it will take time to achieve a high quality and safe aged care system for all who use it. The Royal Commission final report recommendations ranged over 20 aspects of aged care services and included everything from the need for a new Aged Care Act as the basis of reform, to workforce planning, recruitment and retention, standards of care, funding, regulation, and governance, as well as reporting by providers. There is a lot to do.

While a change of federal government in May 2022 has given the QNMU more confidence that the full range of recommendations from the Royal Commission will be implemented, it is imperative the QNMU, and ANMF nationally, continue to focus the government, regulators, policy makers, aged care providers, members and the public, on the many issues that remain in need of improvement.

There are a number of issues the QNMU/ANMF is focussed on.

RN 24/7

Quality of care

In a move to ensure at least a minimum level of care, from 1 October 2022 aged care providers have been required to set a target of an average 200 minutes of care per resident per day with 40 minutes of RN time. Those targets will become mandatory from 1 October, 2023. In addition, from 1 July this year each facility must have an RN on site and on duty 24/7. Minutes of care requirements will increase to 215 minutes of care and 44 minutes of RN time from 1 October, 2024.

While welcome, these requirements are only the start. The ideal arrangement is one in which care mandates reflect the actual level of care required.

Another development has been the introduction of a new aged care funding model (the Australian National Aged Care Classification or AN-ACC) that replaced the ACFI funding model on 1 October last year.

A focus of the QNMU/ANMF has been to ensure this funding model reflects the actual cost of care.

As a recommendation of the Royal Commission, a Star Ratings system for all nursing homes came into effect from December 2022.

This scheme assigns facilities a star rating of between 1 and 5 for the following four areas; compliance, quality measures, residents’ experience and staffing, with ratings made publicly available. While it is early days yet, a number of organisations, including the ANMF, have questioned the accuracy of the first set of ratings. The QNMU/ANMF will be watching this scheme closely.

Workforce

One area of concern has been the role of Enrolled Nurses (ENs) in aged care. While the Royal Commission made specific recommendations