On Friday, Senior Counsel Assisting Peter Rozen QC made a number of suggestions to the Commissioners about the aged care workforce, including mandatory minimum staffing levels.
These suggestions were made after hearing from one overseas expert, who said minimum staffing levels can have a huge impact on quality care in aged care facilities, as well as other witnesses from last year's hearings.
Other recommendations from Senior Counsel Assisting included having Registered Nurses available at all times on shift, public disclosure of staffing levels by providers, minimum qualifications for personal care workers and a national staff registry, plus a social change campaign to encourage more people into the care profession.
Industry peak body, Leading Age Services Australia (LASA), says that their calls for more staff, better skills and improved remuneration in aged care were reflected by the Counsel Assisting recommendations to the Commissioners.
LASA Chief Executive Officer (CEO), Sean Rooney, believes more staff and improved minimum qualifications should be a top care priority for older Australians.
“Our dedicated workforce is the lifeblood of care and we need more staff who are valued, supported and accountable. Having more nurses also responds to the rising complexity of residents’ needs," says Mr Rooney.
“We agree with Counsel Assisting’s observation that realising more staff in aged care is not possible under the current funding system. The problem is that the average aged care operator struggles to cover their current costs at existing funding levels.
"We have long advocated for funding for good quality care be linked to cost of delivering good quality care, including a reasonable financial margin, to maintain viability.”
Mr Rooney adds that the key change is a recommendation for a 25 percent plus increase in staffing, which would require adequate funding to support more staff in facilities.
In LASA's submission to the Commission last year, the organisation suggested staffing numbers to be aligned to the "If not, why not?" benchmarks, which they consider to be better than mandated minimum staffing ratios.
Mr Rooney says, "‘If-not-why-not’ benchmarks provide guidance on staffing for a given mix of residents’ care needs and models of care, and would require aged care providers to explain any deviations from the benchmark."
"The Royal Commission has emphasised the value of innovative care models, however, inflexible ratios may make that more difficult.”
LASA intends to examine the recommendation from Friday and see how that will work within the proposal on program design that was recently released in the Royal Commission's consultation paper.
Peak body for non-profit aged care providers, Aged and Community Services Australia (ACSA), also responded to the Royal Commission's Counsel Assisting recommendations.
ACSA CEO, Patricia Sparrow, says, "On the issue of Friday's comments at the Commission, we believe greater transparency is important, but even more important is having enough staff to begin with.
“We know that more staff are needed to deliver the quality of care we want to deliver and that the community expects. ACSA supports a star rating system in principle, provided it doesn’t create a two-tiered system.
"The proposed system includes a range of staff and occupations and acknowledges that residents have different needs which require different levels of support and skill combinations, which will also better reflect and support the increasing acuity of residents.”
ACSA noted that to reach at least a four star level rating, suggested by Counsel Assisting, it would require an overall 37.2 percent increase in total care staffing.
The peak body also supports additional resourcing to achieve an increase in staffing.
“What we know now is that aged care simply isn’t funded to provide the level of care people expect and deserve. A new direction like this could be exactly what we need to force a rethink and set up Australia for our ageing population and the decades to come,” says Ms Sparrow.
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