Minimum staffing and registered nurses needed in aged care: royal commission told

Aged care royal commission hears recommendations for sweeping staffing changes in nursing homes

Aged Care Royal Commission
Submission by Counsel Assisting the aged care royal commission calls for mandatory staff-to-resident ratios in nursing homes.

Submission by Counsel Assisting the aged care royal commission calls for mandatory staff-to-resident ratios in nursing homes.


Submission by Counsel assisting the aged care royal commission seeks mandatory staff to resident ratios


Mandatory staff-to-resident ratios and a registered nurse on all shifts are two staffing recommendations to the aged care royal commission.

In a submission Counsel assisting the commission Peter Rozen proposed a number of changes designed to improve the safety of residents and conditions in nursing homes.

The recommendations include:

  • mandatory minimum staffing levels
  • a greater proportion of the care workforce made up of registered nurses, including nurse practitioners and a registered nurse on every shift
  • better training for care staff
  • unregulated care workers subject to a registration process with a minimum mandatory qualification (certificate 111) as an entry requirement
  • better pay and safer workplaces for care staff
  • quarterly public disclosure of staffing levels by providers

"Reform is needed in many aspects of the system including regulation, governance and funding to name a few," said Mr Rozen.

He remarked on the similarities between the child care sector and aged care.

"It's a care-based sector where those receiving care are vulnerable, in that case because they are young, of course, rather than old. It's also a system that's heavily reliant on government funding and we note that for some years now there have been minimum mandatory staffing requirements imposed in the early childhood sector. And one's starting position may well be that if it's good enough for the young, why isn't it good enough for our old."

Mr Rozen said mandatory staffing levels could not be achieved under current funding arrangements.

The recommendations have been welcomed by the Australian Nursing and Midwives Federation.

"As we've heard from our members in aged care and the harrowing evidence from residents and their families, workforce issues, particularly inadequate staffing levels, have been the cause for much of their pain and suffering," said Federal Secretary Annie Butler.

"Better wages, training and regulation would also improve the retention and recruitment of the beleaguered aged care workforce," she said.

Leading Aged Services Australia chief executive Sean Rooney said more staff, with overall improved qualifications, was a top priority for the care of older Australians but this couldn't be done without more funding.

"Our dedicated workforce is the lifeblood of care and we need more staff who are valued, supported and accountable," he said. "Having more nurses also responds to the rising complexity of residents' needs.

"We agree with Counsel Assisting's observation that realising more staff in aged care is not possible under the current funding system.

"The problem is that the average aged care operator struggles to cover their costs at existing funding levels. We have long advocated for funding for good quality care be linked to cost of delivering good quality care including a reasonable financial margin, to maintain viability," said Mr Rooney.