Why can’t the NSW Government lead the way with aged care reform?
If adopted, the astute recommendations of a NSW parliamentary report into staffing at residential aged care facilities will enhance the care delivered to older people in NSW.
But according to Associate Professor in Nursing Maree Bernoth in the Charles Sturt University School of Nursing, Midwifery and Indigenous Health, the dissenting statement by some committee members may impede the full adoption of the recommendations by the NSW Government.
On Thursday 10 June 2021 the NSW Legislative Council release the report of the Select Committee on the Provisions of the Public Health Amendment (Registered Nurses in Nursing Homes) Bill 2020.
The document contains seven recommendations relating to staffing and aspects of residential aged care in NSW, with the focus on the safety and dignity of residents.
The recommendations include that the NSW Government urge the Australian Government to implement staffing ratios in residential aged care facilities in the state.
Further recommendations include that the Commonwealth Government provide funding to support the implementation of staffing ratios.
The report also mentions the cost shifting that occurs between aged care which is funded by the Commonwealth and hospital acute care funded by the state.
The recommendation is that the NSW Government analyse how cost shifting occurs, especially in relation to the absence of the requirement to have a registered nurse in residential aged care facilities at all times.
The significance of the absence of registered nurses in residential aged care facilities is twofold:
- Firstly, it means that a resident in hospital-based acute care with complex care needs is delayed in their transfer back to the residential aged care facility.
- Secondly, the absence of a registered nurse has implications for reliance on ambulance services, and the unnecessary transfer of a resident to acute care.
In relation to registered nurses, the recommendations recognise the specialised role they play in the care team and that a registered nurse be on duty at all time.
This is to ensure the safe administration of medications and the provision of complex support, such as palliative care and dementia care.
The report asks for increased transparency and accountability in the way Commonwealth money is spent and the provision of information to families about the staffing levels.
Of significance is the recognition of the specific needs of First Nations Peoples, as well as the recognition of older people from culturally and linguistically diverse (CaLD) backgrounds.
The report expresses concern for the number of sexual assaults in residential care and recommends the creation of a register to assist residential aged care facilities to identify staff who have been implicated in the abuse of an older person.
Unfortunately, the report does not have the full endorsement of all committee members.
Panel members from the Liberal and National parties have included a dissenting statement in relation to mandatory staffing mix for registered nurses, personal care workers and allied health staff.
This statement recommends that NSW waits for the changes in the Aged Care Act, but these are not due for another two years.
NSW led the way in managing the response to COVID-19 and in keeping the people of NSW safe from the virus.
Why then can’t the NSW Government demonstrate its commitment to our older citizens and lead the way with aged care reform? This especially applies to staffing, recognition of First Nations Peoples, and ensuring safe and culturally respectful support for those who need it.
12 June 2021.