Aged care: Change is afoot

Professional Update

Nurses and care workers working in aged care understand firsthand the desperate need for change within the sector to improve care delivery and working conditions.

The ANMF has been campaigning for decades to improve the visibility of the long-standing issues in aged care and improve care delivery. The Royal Commission into Aged Care Quality and Safety publically reinforced these issues and made many recommendations. Two years on and what has really changed? Here’s a snapshot of the significant changes made to date and reform still to come.

Changes implemented

AN-ACC – on 1 October 2022, a new funding model was introduced for residential care. The evidence based Australian National Aged Care Classification model (AN-ACC) provides funding to aged care providers based on an independent assessment of an older person’s health needs and requirements.

IHACPA – the former Independent Hospital Pricing Authority who sets the funding price for hospitals in the country was expanded to include aged care. The Independent Health and Aged Care Pricing Authority (IHACPA) now has the responsibility of providing independent advice to Government about the costs of care for future funding. IHACPA has recently commenced a large costing study for residential aged care.

Medication management – The Department of Health and Aged Care released their Guiding Principles for Medication Management in Residential Aged Care Facilities late last year. The guiding principles provide evidence based parameters and procedures for medicine management in aged care facilities. It describes 15 principles and outlines the roles and responsibilities in medication management to achieve quality use of medicines. Guiding principle 15: Administration of medicines by nurses detail the essential role nurses undertake in administration of medicines and specifically states that ‘registered nurses and enrolled nurses, are responsible for the administration of medicines in RACFs’.1 Translation of these principles into practice is the next step.

Code of Conduct for Aged Care – the Aged Care Quality and Safety Commission implemented the Code of Conduct for Aged Care on 1 December 2022. Its intention is to improve safety for people receiving care. It consists of eight behaviour statements that are expected of aged care workers, including nurses and those governing aged care services. Concerns about a workers conduct who may not be meeting the expectations of the Code will be managed by the Commission and for nurses could also involve the Nursing and Midwifery Board of Australia. An Aged Care register of banning orders was also implemented with the Code.

Pay increase – The ANMF along with the HSU made applications to the Fair Work Commission (FWC) and sought a 25% pay increase for all classifications including nurses and care workers. On 4 November 2022, the FWC decided that more work needed to be done but in the interim granted a 15% increase for all direct care workers to be implemented from 30 June 2023. The union is concerned the full increase will not be passed on by some aged care providers and is  urging the Albanese Government to ensure that the pay rise is past on to aged care workers.

Changes to come

Registered nurses 24/7 – from 1 July 2023 nursing homes must have a registered nurse on site and on duty 24 hours per day.

Care minutes – from 1 October 2023, nursing homes will have to ensure that there is an average of 200 care minutes (registered nurse, enrolled nurse and care workers time) per day, per resident, which will include a minimum of 40 minutes of registered nurse time. From October 2024, this will increase to an average of 215 care minutes, with a minimum of 44 minutes of registered nurse time.

Other changes to come include the review of the Aged Care Act, a new home care delivery model and the implementation of the new quality standards.

We have achieved significant reform in aged care and when fully implemented, it will improve care delivery and working conditions but there is still much to do. The ANMF will continue to lobby strongly to ensure that we have a leading voice in influencing the extensive reform agenda and that the implemented changes make a real difference to care and to you.

For more information on the work of the ANMF in aged care head to the ANMF Federal Office website.

1 Commonwealth of Australia (Department of Health and Aged Care) Medication management in residential aged care facilities – Guiding Principles, 2022.

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