This week in politics


07 Nov 2018


Provider groups appearing at the Inquiry into the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018 on 26 October highlighted that publishing staffing ratios is much more complicated than it might appear at face value. Many of those appearing were in agreement saying that while they supported increased transparency, there are many more indicators of quality than just staffing levels alone. While we await the tabling of the report and recommendations some evidence provided at the Inquiry is below.

ACSA’s Pat Sparrow said that publishing a ratio on its own isn't going to tell the consumer about the quality of care they can expect in any particular home because it doesn't take account of so many different variables that impact on staffing, including service models and types, the resident acuity mix, staffing sometimes for specialist services, building design and things like use of technology.  Concerns were also raised about how regional, rural and remote services would cope, and particularly the need to regularly publish and to revise data. Pat went on to outline some alternative approaches that need to be explored such as linking staffing numbers to resident acuity as defined by the funding providers receive.

Other issues raised integral to the quality of service provision in aged care included: training and development of staff, processes of recruitment, availability of end-of-life and other programs, support infrastructure to assist workers maintain their skills, and connectivity and development in the system. Also, complexity is different among consumers.

CHA raised that the public disclosure of staffing data would be of limited use to consumers for different services and may be potentially misleading, and, that there is no conclusive evidence that clinically-based staff ratios as an input measure are a reliable indicator of the quality of aged care:  “Staff ratios can be expected to vary for good reasons that are not always obvious to consumers—for example, the design and layout of the aged-care home; the size of the aged-care home; models of care being employed, including the use of outsourcing, particularly at allied health homes; each home's residents' profile; and, importantly, the care funding they attract under ACFI. A service with an average daily ACFI payment of $160 a day per resident will have a very different staffing profile to one of a similar size with and ACFI payment of $190.”

COTA discussed their recent report, Keep fixing Australia's aged care system which has a research summary of staff ratios concluding the “jury is still out”.  “Some of the international research shows that, when minimum staff ratios were introduced, the services and facilities that had above the minimum level reduced their staff and, for some consumers, care levels dropped...  COTA strongly believes that some way of categorising … by care needs, so that staffing matches the needs of the residents, is the critical factor … whether it's the ACFI … indicating the care needs of residents and also the broader needs of residents, such as special language needs, palliative care needs, dementia care needs.”

Further information on the Bill and the inquiry is available here


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