To ensure quality care, management in aged care services must be committed to person-centred, high-quality care and services must have adequate numbers of skilled, qualified staff.
A robust aged care sector workforce is a critical element in the provision of quality services and this workforce must be available in the future in sufficient numbers and at a high-quality, yet there are currently significant threats to the availability and quality of the future aged care sector workforce in Australia.
As the prevalence of dementia increases in our community, it is critical that all aged care services are well-equipped and motivated to provide safe, high-quality care for people with dementia, as part of their core business.
Although much greater numbers will be needed in the future, the current workforce is itself ageing, and services are already experiencing difficulty in filling vacancies.
At a time when the number of people needing access to aged care services is increasing, and the acuity of care required is also increasing, ratios of direct care staff to residents in aged care services are often decreasing, and the number and proportion of qualified nursing staff positions in aged care, particularly residential care, has fallen dramatically.
Dementia Australia has raised these concerns and the impact these trends are already having on the quality of care offered to some of the most frail and vulnerable people in our community.
The potential for the situation to worsen in the future as demand pressures increase has also been highlighted, by Dementia Australia, in a submission responding to the Senate Community Affairs References Committee Inquiry into the Future of Australia’s Aged Care Sector Workforce.
The prime consideration in developing strategies relating to the aged care sector workforce must be the role of the workforce in ensuring access by older people, including people with dementia, to high-quality community and residential aged care services.
The workforce must have the appropriate education and training, skills, and attributes to provide quality care for older people, including people with dementia, who frequently have complex care needs.
To attract and maintain the right workforce, improved pay and conditions and appropriate career paths will be needed and funding arrangements must support the delivery of quality aged care by an adequate and appropriately educated and skilled workforce, and fostering of leadership development will be vital in ensuring positive care cultures amongst aged care providers.
Dementia Australia made the following recommendations in relation to Australia’s aged care sector workforce:
- A focus on ensuring access to high quality, appropriate aged care services by older people, including people with dementia, must be the primary consideration in all strategies relating to the future of Australia’s aged care sector workforce across the range of care environments including all forms of community and residential care.
- A comprehensive aged care workforce strategy is required to identify and address current and future workforce supply and quality issues. The strategy should include consideration of new models of care and innovative uses of technology.
- To ensure quality and safety in residential aged care, mandated minimum ratios of staff to residents, and mandated minimum levels of qualified nursing staff, are required; including a requirement for all stand-alone residential aged care facilities to have a Registered Nurse on site at all times. Funding arrangements for aged care should support appropriate staff ratios and skill mix.
- A cohesive, structured and integrated national approach to dementia education and training is needed, including minimum standards for education and training for those working with people with dementia. This approach should include a focus on leadership and cultural change at organisational level, to maximise opportunities to translate learning into improved practice. The approach should be supported by government and by the aged care industry, and focus on achieving sustainable changes to practice which lead to better outcomes for people living with dementia.
- Given that the values, attitudes, and behaviours of direct care staff are critical in ensuring a culture of commitment to high quality, person-centred care, education and training for aged care personnel should go beyond the technical, to embrace social, emotional, and cultural values, and foster emotional intelligence.
- Remuneration for all staff in the aged care sector should be aligned with that for similar roles in other sectors including acute health care; and clear career paths should be developed and implemented for nurses and other workers in the aged care sector. Funding arrangements for aged care should support appropriate remuneration and career paths.
These recommendations align with the recommendations of the National Framework for Action on Dementia 2015-2019, which include the provision of person-centred care for people with dementia and their families and carers, delivered by a skilled and knowledgeable workforce. They focus the provision of high-quality, comprehensive and flexible support to consumers, in line with the Government’s focus on consumer-directed care and choice.
You can read Dementia Australia’s full submission in response to the Senate Community Affairs References Committee Inquiry: the Future of Australia's Aged Care Sector Workforce.