New aged care standards could threaten local facilities’ viability

While the recommendations are designed to improve services to the most-vulnerable people in our community — our elderly — the implementation presents broad and complex challenges to local services.

This follows the federal government’s release of a raft of recommendations and reforms in response to the findings of the commission, including:

- That aged care residents have access to a registered nurse in every aged care facility on-site, 24 hours a day, seven-days-a-week.

- Enable a sector average of 215 “care minutes” per resident, per day.

- Ensure better food for aged care residents.

- Provide tailored support for older people with disability.

- Increase access to culturally safe care for First Nations Elders and older Australians from diverse communities.

- Limit the amount home care recipients can be charged in administration and management fees.

- Redesign in-home aged care to meet the changing needs of older Australians.

- Empower older Australians to make informed choices.

- Introduce stronger regulation and independent oversight to protect older Australians from neglectful practices.

While many of the recommendations appear reasonable, and necessary, given the controversy surrounding the sector (especially during peak COVID-19 lockdowns), it is hard to ascertain how local government entities like the Gilgandra Shire Council will be able to adhere to these measures.

For instance, ensuring that aged care residents have access to a registered nurse 24/7 is, in principle, a beneficial arrangement for aged care providers and residents, Gilgandra Shire Council’s director of aged care and disabilities, Donna Dobson said.

However, she added, there is currently a work-force crisis and staffing shortages within the aged care sector at a critical juncture, “As a registered nurse (RN) myself I see the value for our clients having ‘RN’ staff 24/7 and welcome the change,” she said.

“However, the ongoing workforce crisis and disparities between income and expenditure in the aged care sector, make obtaining the goal of 24/7 registered nurses difficult to implement.” Recruiting, and keeping good staff in the sector, she explained, is a long-term issue with few obvious solutions.

“Gilgandra council are endeavouring to recruit suitably- trained staff to meet the requirement and have been for some time, without success,” she said.

“We are looking at all opportunities including sponsorship of immigration visa recipients, engagement of new graduates, offering above award pay rates just to name a few,” she added.

The issue will become critical, Ms Donna Dobson believes, if staff simply cannot be found to fill the new position.

“It’s unclear what the position of the Commonwealth government will be if we are unsuccessful in our recruitment.”

Strain on the sector and the demands on service providers and the staff means that none of these problems have easy solutions and it is likely to take a long time, lots of negotiations, funding, and effort, to overcome them. The difficulty to provide “tailored support for older people with disability”, is another challenge faced by council through these reforms,” Ms Dodson explained.

“With some of the changes coming from the aged care reform, it is making it difficult for residential aged care services to meet the individual needs of clients living with a disability,” she said.

“Gilgandra Shire Council are committed to our clients who we serve through Carlginda Enterprises and Orana Living, and are currently actively seeking solutions to meet the needs of the disability sector as they age.”

These issues and complications have also been raised recently by the federal member for Parkes, Mark Coulton, who has called upon the Labor government to: “immediately address whether they will require struggling aged care homes to meet rigid staffing requirements by July [2023] or risk closure.”

In a recent statement, the Parkes MP acknowledged that aged care minister, Anika Wells: “has now acknowledged that the government’s legislated policy is not deliverable, due to the impacts of the workforce crisis.

“However vulnerable aged care homes remain in a state of uncertainty about what will happen to them, if they cannot meet the current or any future deadlines imposed,” he said.

The federal government is yet to respond to pushback from state and federal MPs and the many service providers over the impact of the suggested reforms. The government has also not yet announced any concessions or changes to its position either, as the fallout from the royal commission into the aged care sector continues and the conversation turns to the potential changes between now and July 1 when they are due to be enacted.

The aged care sector across the country has struggled for a long time to meet the quantity and quality of staffing required to meet the care of the elderly residents. This issue is played out across the entire industry in all the different kinds and sizes of service providers and programs, regardless of state or territory.

This is of course one of the reasons that governments initiate reviews and inquiries into sectors. During its inquiry period between 2018–2021, the aged care royal commission unearthed examples of negligence, exploitation, while highlighting the difficulties with staffing levels within the sector.

Regional aged care facilities similar to Cooee Lodge and Jack Towney Hostel, have their own problems managing and maintaining consistent staffing levels for their residents as a result of their locations. This is a pressing and significant issue for the council. It not only means that there remain several vacant registered nurse positions, but more importantly, the capability to ensure duty of care and the professional aid required for an elderly person is not compromised.

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In trying to improve the aged care sector, is it possible that unrealistic recommendations of the Royal Commission, could make matters worse?