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Senate Bill seeks to introduce mandated ratio of skilled staff to care recipients for all Australian aged care facilities

08 Sep 2017

Senator Derryn Hinch introduced the Aged Care Amendment (Ratio of Skilled Staff to Care Recipients) Bill 2017 to the Senate this week.

The private member’s Bill seeks to introduce a mandated ratio of skilled staff to care recipients across all residential aged care facilities in Australia.

The Explanatory Memorandum to the Bill suggests that Department of Health, in consultation with the aged care sector, would determine a “safe and specific ratio” while providing for variables such as the number of care recipients, level and type of care provided, day and night shifts, and metropolitan, rural and regional areas.

This issue has been debated many times before and each time the Government has decided not to introduce a mandated staffing ratio in aged care. The recommendation to mandate minimum ratios of skilled staff to care recipients presents a potentially prescriptive and unreasonable blanket requirement for providers.

Aged care providers already have an obligation under the Quality of Care Principles to have appropriately skilled and qualified staff sufficient to ensure that services are delivered in accordance with the Accreditation Standards. This is necessarily flexible to take into account the different needs of residents and factors relating to the service, including its location.

The Bill does not contemplate the formula that would be used for the ratio and it is difficult to see how a ratio could be introduced that is truly flexible to different care needs and the resident mix in an aged care facility at any given time.

We echo the Productivity Commission’s statement in the 2011 Caring for Older Australians report:

“An across-the-board staffing ratio is a fairly ‘blunt’ instrument for ensuring quality care because of the heterogeneous and ever changing care needs of aged care recipients — in the Commission’s view, it is unlikely to be an efficient way to improve the quality of care.

Because the basis for deciding on staffing levels and skills mix should be the care needs of residents, it is important that these can be adjusted as the profile of care recipients changes (because of improvements/deteriorations in functionality and adverse events, etc).

Imposing mandated staffing ratios could also eliminate incentives for providers to invest in innovative models of care, or adopt new technologies that could assist care recipients.”

Senator Hinch has also failed to acknowledge that the sector would require additional funding and support from the Government in order to meet a mandated staffing ratio. As Senator Helen Polley commented in her Second Reading Speech, “You can't take $4 billion out of a sector and then expect the same type of care. It just cannot be delivered.

We will continue to closely monitor the progress of this Bill. 

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