‘The system has failed’: Study highlights shocking under staffing in aged care

The aged care system is failing the country’s most vulnerable, experts have claimed, as new research reveals the shocking extent of staff shortages in facilities across the country.

Researchers from the University of Wollongong have slammed the industry in a new report published in The Medical Journal of Australia, claiming inadequate staffing is putting Australia’s elderly at serious risk. The team were specifically tasked by the Royal Commission into Aged Care Quality and Safety to conduct a review of staffing levels in residential aged care facilities (RACFs) — and the results are shocking.

Of the thousands of people who currently reside in aged care homes around Australia, the study found more than half are in facilities with inadequate staffing levels. Meanwhile, only 1.3 per cent are in facilities with staffing levels considered to be best practice.

By using the five-star rating system used in the US by the Centers for Medicare and Medicaid Services (CMS) to judge aged care in Australia, the researchers found a 20 per cent increase in staffing is needed to bring facilities up to adequate levels. And staffing would need to increase by almost 50 per cent to reach best practice levels across the board.

Currently, more than half of all Australian aged care residents (57.6 per cent) are in RACFs that have inadequate staffing levels (one or two stars). Meanwhile, 27 per cent are in RACFs that have three stars, 14.1 per cent are in facilities with four stars and just 1.3 per cent are in RACFs with five stars.

Professor Kathy Eager, director of the Australian Health Services Research Institute at the University of Wollongong, said it’s clear the existing system has “failed to ensure residents uniformly receive quality care” and that while some residents receive excellent care, too many others don’t.

“It’s no longer acceptable to describe RACFs simply as a person’s home or for advocates to argue that what’s required is a social model of care delivered with a wellness philosophy,” she said. “While on the surface it sounds attractive and in line with what consumers want, the evidence from the Royal Commission is that these arguments are now being used as a justification for inadequate care.”

Eager said residents in aged care facilities in Australia have a right to be safe and receive clinically competent and adequate care, but sadly this isn’t what’s happening throughout much of the country.

“This care needs to be provided within a non-institutional environment that’s respectful of individual choices and affords every resident the opportunity to be meaningfully engaged to the extent possible,” she said. “There doesn’t need to be a trade-off between social model of care and a clinically competent model. Aged care residents have a right to both and don’t have the time to wait.”

The latest research comes months after experts backed calls to increase patient-staff ratios at aged care facilities across the country, claiming it’s the top priority for improving the care of Australia’s elderly. Earlier this year, Counsel assisting the Royal Commission into Aged Care Quality and Safety put forward a series of recommendations to improve the sector. This included mandatory minimum staffing levels, minimum qualification requirements for care worker and the appointment of registered nurses for every shift.

Peter Rozen QC recommended an average total care per resident of 186 and 265 minutes per day, a minimum of 30 minutes of registered nurse time for each resident every day, and at least 22 minutes of allied healthcare. Describing the “poor and sometimes unsafe conditions” of aged care homes, he said with a lack of staff there’s simply not enough time to do the work, putting elderly lives at serious risk.

“Any redesign of the aged care system that doesn’t remove the incentive that presently exists for providers to reduce the number of nurses they employ to cut their costs will necessarily fail,” Rozen said.