Victorian Senator Derryn Hinch is calling on the Government to introduce staff-to-resident ratios in aged care without delay.
The Royal Commission into Aged Care Quality and Safety has received widespread support but Hinch believes, “We don’t need to wait for the royal commission to improve our care of Australia’s elderly.”
The royal commission will investigate the quality of care provided to elderly Australians living in residential and aged–care homes, and young Australians living with a disability in residential aged care.
It follows more than 5000 submissions from health professionals, aged–care workers, residents, families and providers documenting cases of abuse, neglect and extremely challenging working conditions in Australia’s aged–care sector.
Operating since October, the royal commission will be conducting hearings in all capital cities and several regional centres. An interim report will be provided by 31 October, and the final report before 30 April 2020.
At the conclusion of the first hearings in Adelaide, witnesses had raised issues of surveillance, a national database, food, treatment of patients and staff-to-resident ratios. The second round of hearings is now underway in Sydney.
Currently, no federal legislation exists mandating staffing ratios in aged–care homes. In Victoria, state-run homes do specify nurse-to-patient ratios but these are not subject to federal legislation.
Hinch was balloted to receive a three-year term, not the usual six, because the election that brought him to office in 2016 was called as part of a double dissolution.
If re-elected, Senator Hinch has announced getting such staffing ratios in aged care will be high on his agenda, convinced as he is that enough evidence exists to show they are needed.
“They’ve had the information. This Government, the last Government, the one before that – they know, they know it’s wrong,” Hinch said.
“It’s shocking … I’ve heard horror stories of one registered nurse for 120 people at night–time. Now if there’s an emergency, how do you [cope]?”
Hinch, who put forward the Aged Care Amendment (Ratio of Skilled Staff to Care Recipients) Bill in 2017 said, “[Ratios] need to be implemented well before a royal commission because the RNs (registered nurses) and the midwifery union are pleading for it – and have been for several years – and it’s just falling on deaf ears.”
Australian Nursing and Midwifery Federation (ANMF) federal secretary Annie Butler explained in a press release, “Understaffing means that often just one registered nurse has to manage the care for sometimes over 100 residents … or that one carer has to feed, bathe, dress and mobilise 16 residents in less than an hour.”
A study led by registered nurse Professor Linda Aiken from the University of Pennsylvania revealed alarming statistics linking staffing levels to patient wellbeing. For every extra patient over four per nurse, there is a 7 per cent increase in failure to rescue – that is, failure to recognise and respond to a treatable complication causing death.
There is also a clear link between staffing levels and burnout, job dissatisfaction and nurse retention, with a 23 per cent increase in risk of staff burnout for every extra patient over four per nurse.
The ANMF supports Hinch’s actions and has launched a federal campaign, Ratios for Aged Care – Make Them Law Now.
The campaign features the voices of real nurses, patients and family members, and describes how the absence of mandated ratios in aged care allows for dangerously low staffing levels, placing patient lives at risk.
In the past 13 years, there has been a 400 per cent increase in preventable deaths in nursing homes, from falls, choking and suicides, according to a Monash University study.
Butler said, “Nurses and carers are struggling; they’re run off their feet. They are doing the best they can, but they can’t provide the level of care they want to. It’s just not possible.”
Hinch recalled the day a registered nurse approached him in tears admitting she had quit her job in aged care hours earlier because “[she] couldn’t do what [she] was hired to do”.
With more than 25 years of nursing experience, the woman told Hinch: “I know what I have to do [but] under the way it works in aged care now, I can’t do it. I go home at night and cry because I think I didn’t do my job today and therefore I shouldn’t be here.”
This is the reality plaguing many aged-care nurses. The ANMF is campaigning for mandated nurse-to-patient ratios and an adequate nursing skills mix. Currently personal care assistants, or PCAs – whose qualification can be earned after 22 days of study – form 70 per cent of staff. To ensure adequate care, the ANMF has put forward a staffing mix proposal of 50 per cent PCAs, 20 per cent enrolled nurses and 30 per cent registered nurses.
New research conducted by Flinders University has revealed mandated ratios and changes to the staffing mix will not only improve the health and wellbeing of residents and nurses but also bring economic benefits.
Although staffing changes would cost $5.3 billion, a cost-benefit analysis revealed any costs would be offset by tax measures, decreased staff attrition and greater staff productivity. Mandated ratios and changes to the staffing mix would allow for earlier diagnoses of illnesses, reduced hospital stays and lower mortality – significantly reducing costs.
Hinch believes, “The only difference between the elderly and us is they got there first.
“The royal commission is going to take two or three years. There are people who will die on the Government’s watch and that’s not good enough.”