RNs needed in nursing homes - inquiry finds

Thursday, 29th October, 2015

Registered nurses are essential in aged care, Senate inquiry finds.

FEDERAL Government legislation is not sufficient to ensure aged care residents receive the highest possible standard of care delivered through adequate staffing, a NSW Senate inquiry has found.

Seniors groups have welcomed the inquiry on Registered Nurses in Aged Care's recommendation to support retaining the state's requirement for registered nurses to be on duty at all times in nursing homes.

The inquiry considered more than 160 submissions over four month before handing down its report earlier today.

Combined Pensioners and Superannuants Association senior advisor Charmaine Crowe called on Health Minister Jillian Skinner to adopt the report in full immediately and end uncertainty on the issue.

The committee handed down 11 wide-ranging recommendations, including a call for the State Government, through the Council of Australian Governments, to push for the nationwide adoption of minimum staffing ratios in aged care.

It also recommended that COAG urge the Commonwealth to ensure its new aged care quality framework includes genuinely unnanounced inspection visits, assessment of all 44 accreditation outcomes at each visit and a greater emphasis on resident experience.

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Committee chair Jan Barham says Federal legislation is not enough to guarantee high standards of aged care.

"The committee acknowledges that the Commonwealth has jurisdictional responsibility and funds aged care across the country, but ultimately we were not convinced that the regulatory framework at that level adequately ensures that a high standard of care is delivered to residents in aged care facilities through its staffing standards," committee chair Jan Barham wrote.

It said the definition of "nursing home" under the legislation should be based directly on the assessed needs of residents rather than the type of facility.

Providers who could demonstrate the provision of high quality care would be able to apply for exemptions from the registered nurses requirement on a case-by-case basis.

The State Government is yet to announce a decision on whether it will retain the requirement after changes to Federal legislation removed the distinction between high care and low care facilities, rendering the definition of a "nursing home" under the state's Public Health Act outdated.

Major providers argued retaining registered nurses under the new system could be costly and difficult, particularly in rural and regional areas.
HammondCare said residents with high care needs did not always require nursing support.

"While some facilities with 'high care' residents will require a registered nurse on duty at all times, others will not," its submission said.

"HammondCare believes that it is appropriate to have a registered nurse on duty at all times in aged care homes with high proportions of residents who have complex health care needs that require technical clinical interventions, such as complex pain management, wound care and the administration of catheters."

Mission Australia said the requirement for all aged care homes to have a registered nurse on site would be "counterproductive".

Senior nursing lecturer Dr Maree Bernoth said as people entered aged care with higher needs it was increasingly essential for facilities to have registered nurses who were skilled in aged care and had the experience to recognise and deal with problems appropriately.

Combined Pensioners and Superannuants Association senior advisor Charmaine Crowe said the report's findings were welcome.

"The report is clear - the NSW Government must continue its role in mandating registered nurse staffing in nursing homes because the Commonwealth regulations governing nursing home staffing are totally inadequate," she said.

"CPSA also welcomes recommendations regarding improving transparency about nursing home staffing and complaints, improving data collection, providing better training for aged care staff and strengthening the risibly ineffective accreditation system.

"More broadly, this report exposes the failings of the Australian Government's regulation of nursing homes.

"In the interest of resident safety, the Australian Government must mandate that nursing homes across the country have at least one registered nurse on staff 24/7 where there are residents with high care needs."

NSW Nurses and Midwives Association general secretary Brett Holmes said more than 24,000 people had signed a petition seeking the retention of registered nurses in the state's aged care homes, and the inquiry's report gave further impetus to calls for the government to retain the requirement.

"The volume of evidence supporting the minimum requirement for registered nurses to be on duty around the clock in facilities with high care residents speaks for itself, and the committee has diligently outlined how it can be retained and strengthened at the Commonwealth level," he said.

"We also welcomed the recommendation for the government, through the Council of Australian Governments, to address the wage disparity between registered nurses in aged care and their counterparts in the public health system."

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