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Ratios for Aged Care - Make Them Law Now

The ANMF calls on the Morrison Government to urgently respond to the Royal Commission into Aged Care Quality and Safety Final Report’s recognition that staffing levels in aged care are too low and that staff ratios should be introduced to ensure that there are sufficient nursing and other care staff present at all times in residential aged care.

The ANMF has long-campaigned for the introduction of safe staffing laws - to stop the suffering of elderly Australians living in residential aged care facilities. We thank the Royal Commissioners, the Honourable Tony Pagone QC and Lynelle Briggs AO, for acknowledging the importance of the right numbers of the right types of staff in guaranteeing safe, dignified care for every older Australian.

“This Government and many previous Governments, have done nothing to address ever-increasing shortages of registered nurses and qualified carers working in aged care. Without adequate staffing and skills mix, with minimum standards for care workers, nursing home residents have suffered terribly, as a result of inadequate levels of care."

“The Morrison Government must now act; every day the Government delays taking action to address dangerous understaffing in nursing homes and community care, is another sad day, that vulnerable residents will continue to suffer.”

Workers demand Action for Aged Care

The unions representing aged care workers and the ACTU have launched a comprehensive plan to fix our broken aged care system, protect workers who have been at the front line of the fight against the virus and provide better quality care to older Australians. The HSU, ANMF and UWU represent workers who do invaluable work in incredibly difficult conditions but have been let down by a Government who has ignored critical issues in aged care.

Secure jobs for workers in aged care means better quality care for older Australians.

The document calls for the following essential changes:

  1. Mandated minimum staffing levels and required mix of skills and qualifications in every residential facility, over every shift.
  2. Transparency and accountability for Government funding.
  3. Mandated training requirements (including infection control and ongoing professional development) accessible to all staff and paid by employer.
  4. Government funding is required to be increased, linked to the provision of care and the direct employment of permanent staff with decent pay and enough hours to live on.

ANMF National COVID-19 in Aged Care survey

Australia’s aged care sector is indisputably understaffed and the workers who are there are in many cases doing the best they can with little support, few resources, and limited recognition by providers and more broadly within the public domain.

  • Many aged care providers need to increase their staffing levels and skills mix to deliver safe quality care for vulnerable residents and clients.
  • Higher levels of staffing and better skills mix with greater numbers of registered nurses and enrolled nurses would provide better infection control and health care as well as greater support to nurses, care workers, and other staff.
  • Workloads in aged care are often unmanageable and have been intensified by the COVID-19 pandemic across the sector.

The Aged Care COVID-19 Survey conducted from 15 April to 6 May 2020 aimed to assess aged care workers’ sense of their employer’s preparedness to deal with the COVID-19 pandemic and the strategies that had been put in place as well as identify the key challenges and major gaps in the aged care sector’s response to COVID-19 from the perspective of those providing direct care to older Australians.

Aged Care Royal Commission COVID-19 report

The Royal Commission into Aged Care Quality and Safety delivered a special report on the COVID-19 pandemic in aged care, tabled in the Australian Parliament on 1 October 2020, ahead of its Final Report. The report is the result of a hearing of the Royal Commission into Aged Care Quality and Safety into the impact of COVID-19 on aged care, which was held in Sydney from 10 to 13 August 2020.

The Australian Government accepted and has acted on all six recommendations of the Royal Commission into Aged Care Quality and Safety on COVID-19. The Australian Government’s response to these recommendations was tabled in Parliament ahead of the 1 December deadline. The Implementation Progress Report on the Royal Commission into Aged Care Quality and Safety report – Aged Care and COVID-19 – a special report is available on the Department of Health’s website.

Aged Care and COVID-19

Updated online information for aged care during COVID-19

The Department of Health have recently published updated and improved COVID-19 advice for aged care providers, aged care workers and people who receive residential or home care on their website. Information includes:

  • The National COVID-19 Aged Care Plan
  • How to prepare for and respond to a COVID-19 outbreak
  • Advice for older people, carers, workers and services
  • Visitor restrictions

View the Advice on aged care during COVID-19 page

PPE usage and sourcing

Consistently and safely wearing PPE is an essential measure to protect your health, and the health of the older Australians in your care. All aged care workers and providers are reminded of the need to ensure you are consistently following Commonwealth guidance, and state and territory government requirements and directions on PPE use. Depending on the incidence of COVID-19 in individual jurisdictions and localised areas within jurisdictions, states and territories may implement more stringent requirements on when to use PPE. It is important you remain up to date with the latest Commonwealth guidance and state/territory requirements.

If you urgently need PPE and cannot source it please submit an online application. The Commonwealth is prioritising requests for PPE from the National Medical Stockpile to aged care services that are most in need.

Residential and in home aged care services across Australia who are in a priority category can request surgical masks and P2/N95 respirator masks from the National Medical Stockpile. Requests for other PPE, will be assessed on a case-by-case basis and prioritised where there is an outbreak in a residential aged care facility.

National Aged Care Emergency Response Program

The Commonwealth Department of Health has partnered with the aged care industry to develop the National Aged Care Emergency Response (NACER) Program. The initiative mobilises aged care staff from areas across Australia not experiencing community transmission, to assist in caring for people in aged care facilities impacted by COVID-19. While the initial focus is on supporting Victoria, it is a national program that can be expanded where and when it is needed.

Support for aged care workers in COVID-19 grant

The Support for Aged Care Workers in COVID-19 (SACWIC) Grant Opportunity is designed to minimise the risk of infection to aged care workers, residents and other consumers of aged care services. The Grant Opportunity was initially available to providers located in, or with staff located in, Greater Melbourne and Mitchell Shire until 26 October 2020. The Government has now agreed to further extend the grant period to 30 November 2020.

Approved providers can apply for funding up until 30 June 2021 to cover the costs of supporting eligible workers during the period to 30 November 2020:

  • who normally work at multiple residential aged care facilities, but will be working solely at the facility being applied for
  • who are not to work because they have been experiencing COVID-19 symptoms, have been diagnosed as COVID-19 positive, require testing or are subject to self-isolation or quarantine requirements
  • to undertake training in the event a skills gap arises from where existing workers are not to work due to experiencing COVID-19 symptoms, or are subject to self-isolation or quarantine requirements.

You can view the Grant Opportunity and documentation at Support for Aged Care Workers in COVID-19 (GO4215) Program.

Mental health support for aged care workers

While the pandemic has changed so much about the way we live and work, maintaining good mental health is very important, particularly so for workers in aged care. There are a range of resources available to support the aged care workforce.

Living well in the COVID-19 pandemic

As restrictions are easing at different rates in NSW and Victoria, older Australians are reminded to take a risk based approach to social outings. It is recommended that older Australians consider their own risk factors, along with the number of COVID-19 cases in their area, and assess what activities are important to them and how much risk those activities carry. Resources are available to support these decisions.

Older persons COVID-19 support line

The Older Persons COVID-19 Support Line has been set up to provide information, support and connection for older Australians during the period of social distancing measures in response to the COVID-19 pandemic. COTA Australia, National Seniors, Dementia Australia and the Older Person’s Advocacy Network have banded together to deliver this service, supported by funding from the Australian Government.

In November, the Minister for Aged Care and Senior Australians, Richard Colbeck announced a $2.5 million investment to extend and expand the Older Persons COVID-19 Support Line until 30 June 2021 to ensure senior Australians get the services and assistance they need during COVID-19.

Older Australians, their families, friends and carers can FREECALL 1800 171 866 if they:

  • would like to talk with someone about the COVID-19 restrictions and its impact on them
  • are feeling lonely or are worried about a loved one
  • are caring for someone and need some information or a listening ear
  • need help with questions or concerns about residential aged care, visitation or home care services
  • need help to access new care services or essential supplies such as shopping
  • are concerned about themselves, a friend or family member living with dementia
  • would like to arrange a one-off or regular wellbeing check for themselves, or someone else.

Home care service providers can also use the number and dial option 1 to refer home care clients who would like a call from an independent organisation to check on their wellbeing.

Six Steps to Stop the Spread
The ‘Six Steps to Stop the Spread’ resource is available to remind aged care workers, families and visitors of the simple things they can do to prevent COVID-19 outbreaks in residential aged care facilities.

Information Sheets - These information sheets explain the six steps that aged care workers, aged care residents and families and visitors can follow to stop the spread and keep safe.

Supporting older Australians

This poster provides ways we can support older Australians through coronavirus (COVID-19).

Providing aged care services during COVID-19 - Resources and advice for aged care providers and workers who deliver services in residential aged care and in-home care settings. Find out when you must not go to work, getting coronavirus (COVID-19) testing, identifying symptoms in older people, and protecting yourself and the people you care for. View page on the Department of Health website here.

Royal Commission into Aged Care Quality and Safety
In September 2018, the federal government announced a Royal Commission into the aged care sector. The announcement came ahead of a damning two-part Four Corners investigation into elder neglect and poor conditions in aged care, as well as years of campaigning by the ANMF to fix systemic issues preventing nursing and care staff from delivering safe best practice care.

For more information about the Royal Commission into the aged care sector and updates from the ANMF including our own submissions, go to our Royal Commission into Aged Care Quality and Safety update page here.

Australia should be a world leader in aged care delivery

That’s why nurses and doctors have joined forces in calling for aged care ratios.The ANMF, the AMA, RACGP and ANZSGM published a letter in The Australian newspaper calling on Prime Minister Morrison to legislate minimum staffing ratios that will enable the delivery of the holistic care plans needed to ensure safe and best practice care for all elderly Australians. Read the full letter here.

Aged Care Ratios Make Economic Sense
The Australian Nursing and Midwifery Federation (ANMF) has released compelling evidence which outlines how mandated minimum staffing ratios in aged care can be implemented to bring improvements in care outcomes for elderly nursing home residents while also providing economic benefits. Independent economic analysis, undertaken by the Flinders University’s Australian Industrial Transformation Institute (AITI), not only outlines the financial benefits of implementing mandated minimum staffing levels for the care of the elderly but also warns of the ‘significant costs’ of not mandating the minimum levels of nursing and care hours in nursing homes.

About the Campaign

Australia's elderly die in care with no laws to protect them

Over the last 13 years, chronic understaffing has seen a 400% increase in preventable deaths of elderly Australians in aged care with hundreds dying from falls, choking and suicide. They are our parents and grandparents, people who looked after us and loved us, but now many of them, especially those in need of high care, are left unfed, unwashed and even in soiled nappies for hours.

Hard-pressed nurses and care staff do the best they can in impossible circumstances, but they are run off their feet and can’t provide the care they want to. And while our nurses and care staff struggle because there is simply not enough of them, last year*, owners of Aged Care facilities racked up over $1 billion in profits while cutting staff.

Australia has strict staff ratios for childcare, which is as it should be. But there are no ratios for aged care and no laws to ensure our elderly get the care they need.

It’s a crisis that shames us. Our Aged Care system has been ignored by governments for far too long.

*that all indications from major for-profit and non-profit company reports continue to show further increases in profitability in the 2016-17 financial year.

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Aged care providers putting profits before their responsibility to care

Australia’s top six aged care providers, some with foreign ownership, posted enormous profits whilst taking advantage of AUD $2.17 billion in Australian taxpayer funded subsidies, using various loopholes, corporate structures and discretionary trusts to avoid paying their fair share of tax, according to a new report examining tax avoidance in the rapidly-growing aged care sector. The report, Tax Avoidance by For-Profit Aged Care Companies: Profit Shifting on Public Funds, was prepared by Jason Ward from the Tax Justice Network, on behalf of the ANMF. View the full report: http://bit.ly/anmf-taxavoidancereport

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Authorised by A.Butler, Federal Secretary, Australian Nursing and Midwifery Federation, Level 1 / 365 Queen St, Melbourne, VIC 3000.