The question of having mandated fixed staffing ratios for aged care facilities was first muted by Senator Derryn Hinch back in late 2016 following the outcomes and horrific stories coming from the Oakden facility in South Australia. Since then there has been significant debate, high level analysis by the productivity commission, political parties and of course industry and consumers. The Royal Commission into Aged Care will also no doubt cast a value statement across the issue. With the federal election just 3 weeks away, Aged Care Management Australia is hosting an open forum to discuss the issue openly, rationally, and constructively. Key industry players have been invited to have their input into the debate and the community is invited to have your say as well. For me, this is an issue of governance that is forged in a business model controlled by the commonwealth government. Aged Care providers have very limited control over their income streams, even more limited opportunity to be competitive in an open market. Without exception aged care providers and their representative peak bodies will tell you that there is insufficient funding to have mandated fixed staffing ratios, and still generate sufficient income to make a profit.
Personally I am not sure that is entirely true. The reason I say this is that there are many providers who will have already met what could be established as a minimum staffing level per head of residents, and are still generating a healthy operational surplus. My question is where does the subsidy funding get spent by other providers. Notwithstanding that, aged care is a commercial business and no provider operates to make a loss. So it is reasonable that any changes in staffing requirements must be affordable and it is inevitable that the $60 Million per day currently spent by Government is set to increase.
The question as to what is a suitable staffing ratio is an extremely complex one, and arm chair strategists and aged care experts are hugely divided on the answer. For mine, it is not a matter of having raw numbers per head of resident population. Though numbers will be part of the solution. Skill mix is the critical factor and having flexibility within a funding framework that can respond to changes in resident acquity is critical. Access to trained and untrained staff will become critical as the current workforce is about to experience a planned mass exodus as those RN’s and Carer’s who are reaching their 60’s are set to retire, leaving a significant void in numbers, skills, knowledge and experience.
The coming debate on the 13th of May will address the issues of mandated levels, plus meeting future training needs and the role of the Nurse Practitioner in aged care. Lets have the discussion