Staff crisis puts aged care ‘at risk of failing’

The aged-care system is in danger of failure if the workforce system isn’t reformed, the royal commission has heard.

Inadequate education and training has limited workforce capability to deliver quality clinical care, the inquiry has heard.

Australia’s aged-care system is in serious danger of failure if the workforce system isn’t fundamentally reformed, yet there is no sense of urgency and the commonwealth appears “missing in action” on the issue, the aged-care royal commission has been told.

Counsel assisting the commission Peter Rozen QC offered a blistering critique of the state of the aged-care workforce on Friday in summing up a week of evidence that included stories of abuse, ­neglect, underfunding, staff shortages and stalled reform.

“The workforce is too small,” he said. “The bare minimum has ­become the norm. It is unsustainable. Further, the current workforce does not have the right skills mix. The evidence suggests skills deficits across the sector, exacerbated by time-poor staff and threadbare rostering practices. Inadequate education and training has limited workforce capability to deliver quality clinical care. On current trends, the entire system is under serious threat. And without fundamental change, we’re concerned the system will fail.”

Mr Rozen told the commission that building an appropriately skilled and remunerated workforce to service the growing number of older Australians required leadership in the public and private sectors. “The commonwealth appears on the evidence … to be missing in action,” he said. “It needs to demonstrate the leadership and commit the resources necessary to build industry competence and to ensure delivery of an aged-care system that meets community standards. And it needs to act quickly.

“There appears to be a lack of leadership and expertise about aged care within the Department of Health.”

Noting the number of past ­reviews of aged care, Mr Rozen said the time had come for action.

“What is lacking is sustained and co-ordinated action. There doesn’t appear to be any sense of urgency,” he said.

He said an appropriate “blueprint” for reform of the workforce had already been produced in the work of John Pollaers’ Aged Care Workforce Strategy, provided to government more than a year ago. “However, the actions are not all being implemented and, where they are, we are concerned the structures established to drive ­reform will be ineffective without assistance.

“On the basis of current progress … there must be real concerns about whether the strategic ­actions can be achieved in the three-year time frame set down by Professor Pollaers.”

Mr Rozen said both clinical skills and holistic care were needed in the care of older Australians, who were entering residential care at ever higher levels of acuity.

“Aged care must deliver both quality of life and quality clinical care. The two are not mutually ­exclusive,” he said. “Unfortunately the current system appears to be failing on both fronts.

“We need more staff in residential aged-care facilities and a better mix of staff. The decline in the employment of nurses in aged care must be addressed and reversed.

“In both residential and home care, staff must be allowed the time to engage with those they care for and to undertake their duties properly and compassionately.”

Mr Rozen called on the commissioners to consider recommendations to address low pay, a registration scheme for personal care workers, and closer connections between training and care.

The commission reconvenes next month to examine the issue of aged care in rural areas. Its interim report is due on October 31.