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What happened?

The lawyers who help the Royal Commission, known as the counsel assisting, have made 124 recommendations for the Royal Commission to consider in its final report due on February 26 due next year.

A full link to the 124 recommendations in the 475-page report is available here.

What are the headlines?

The counsel assisting the Royal Commission made sweeping recommendations that cover almost all aspects of home care and residential aged care.

If the recommendations are adopted they could greatly improve conditions for aged care workers across the country, with recommendations covering:

  • A mandated minimum staffing level to improve the quality of care.
  • A recognition that aged care wages are too low and wages need to rise.
  • Improved training.
  • Registration of workers.
  • New duties on providers to report their performance.

What happens next?

The recommendations are NOT the recommendations of the Aged Care Royal Commission.

We have to wait until the Royal Commission decides next year what recommendations they will adopt.

After that, the Royal Commission report goes to the Federal Government, and the Federal Government decides what recommendations from the Royal Commission they will accept.

More below

What does your union say?

Your aged care workers’ union broadly supports many of the proposed measures, particularly around adopting a mandated staffing model.

With other proposals, the devil will be in the detail.

For example, the proposed ways to increase wages are bureaucratic and clunky.

Also, your aged care workers union believes beneficial changes should be adopted as soon as possible rather than waiting, in some cases until July 2024.

However with the poor track record of the Federal Government in aged care it is likely aged care workers will have to fight to see the most beneficial – and most expensive – recommendations implemented.

What’s the fine detail?

The need for staffing levels in residential care:

  • There is a recommendation to introduce mandated minimum staffing time. In the first stage from July 2022 the minimum staff time standard of care should provide:
    • At least 215 minutes per resident per day for the average resident, with at least 36 minutes of that staff time provided by a registered nurse. (Currently across Australia on average, residents receive 180 minutes of care per day.)
    • Plus there should be a nurse in attendance at each facility for the morning and afternoon shifts (16 hours a day).
  • In the second stage from 1 July 2024 the minimum staff time standard of care should provide:
    • At least 215 minutes per resident per day for the average resident, with at least 44 minutes of that staff time provided by a registered nurse, OR
    • At least 264 minutes per resident per day for the average resident, with at least 36 minutes of that staff time provided by a registered nurse.
    • Plus there should be at least one registered nurse on site at a residential aged care facility at all times (that means, for every shift).

The first stage increase is designed to meet the US CMS 3 star rating, and the second stage increase is to meet the US CMS 4 star rating.

A call for worker registration

  • By 1 July 2022, the Australian Health Practitioner Regulation Agency should establish a National Board and a registration scheme for personal care workers, with Cert III as a minimum qualification.

A call for better reporting by providers

  • By 1 January 2022 the Aged Care Act should be amended to require providers to make an annual report, including information on staffing levels, qualifications, hours worked, employment status, and turnover.
  • By 1 July 2022 providers must report on a quarterly basis in standard reports total direct care staffing hours provided each day at each facility they conduct, broken into different employment categories.

The need to improve wages

  • The counsel assisting recommended a joint union/employer/government approach to a work value or ERO case is recommended for aged care awards covering aged care workers. In addition the Aged Care Pricing Authority should tie government aged care subsidies to an explicit policy of increasing wages and improving working conditions for aged care workers. The first two steps will take a while to do, so in the meantime, the counsel assisting recommends the Australian Government and providers should support substantial increases to the aged care awards in the Annual Wage Review.

The need for better training

  • A recommendation that the Australian Government should make additional funding tied to an increase in targeted staff training available immediately. The recommendation calls for a two-year scheme commencing on 1 July 2021 to improve the quality of the current aged care workforce. Providers would be reimbursed for the cost of education of the direct care workforce to receive a Cert III in Individual Support or Cert IV in Ageing Support, or for continuing education and training courses relevant to direct care skills such as dementia and oral health.

The need for better scrutiny of funding to providers

  • There should be independent determination of the subsidies to be paid to providers and of prices they may charge for services through a separate body, the Australian Aged Care Pricing Authority. The Aged Care Pricing Authority would need to take quality care, staffing levels and staff remuneration into account.