Regulating 24/7 RN and Care Minutes Responsibilities

With the announcement of the closure of three aged care Homes in Sydney by Wesley Mission due to the new federal government staffing requirements being too difficult for them to meet and then a day later the Brightwater Care Group (a WA not for profit provider) announcing that it will close three of its smallest and older aged care Homes over the next 12 months, there has been discussion within the industry and media about the new requirements where there needs to be a registered nurse (RN) in aged care Homes 24 hours a day, seven days a week from 1 July 2023.

The ABC noted in its coverage of the Wesley Mission closures that the ‘Aged Care Minister  Anika Wells admitted about one in 20 facilities would not meet this target but nearly all facilities would have enrolled nurses on duty. The sector is still thousands of staff short of what it needs but the government is trying to attract more people by raising the minimum pay standard by 15% from July 2023.

Aged Care Minister said she had recently met with Wesley Mission management, who did not foreshadow the closures. She said there was support for operators who were struggling to meet the new requirement for nurses, which she said was recommended by the Royal Commission two years ago. Ms Wells defended the implementation of the changes saying the government had increased funding to the sector.’

The Aged Care Quality and Safety Commission (ACQSC) issued a letter to providers on 14 April 2023. The Commissioner advised ‘of the regulatory approach that the ACQSC will be taking to the new workforce responsibilities being introduced for residential aged care services’. The Commissioner stated that she is ‘concerned that there is misinformation circulating about our regulatory approach which is causing unnecessary anxiety for aged care residents, their families, and providers. The Commission released on 14 April 2023 the Regulatory Bulletin – Workforce-related responsibilities – including 24/7 registered nurse and care minutes – which provides detailed information on this subject’, and she ‘encouraged executive staff to read it’.

The Commissioner stated that ‘in essence, the Commission will be taking a fair and sensible approach to the regulation of the new responsibilities for every residential aged care service to have at least one RN on-site and on duty 24/7 (from 1 July 2023) and to meet care minutes targets (from 1 October 2023). We understand the challenges being experienced by many providers, and especially those located outside urban population centres, in attracting and retaining a suitably qualified workforce.’

Our Critical Success Solutions (CSS) consultants submitted questions and attended the webinar Regulating 24/7 RN and Care Minutes Responsibilities conducted by the Commission on 18 April 2023. The webinar was to assist approved providers in understanding the changes and address some of the concern which has been voiced in the sector and the media.

Speakers included:

  • Janet Anderson, Aged Care Quality and Safety Commissioner
  • Mark Richardson, Assistant Secretary, Residential Care Funding Reform, Department of Health and Aged Care
  • Peter Edwards, Executive Director Financial and Prudential Regulation, Aged Care Quality and Safety Commission
  • Dr Melanie Wroth, Chief Clinical Advisor, Aged Care Quality and Safety Commission

 
CSS has provided a summary of the webinar for those who could not attend. Download the notes at the download red button below this article.

The Commissioner in her opening remarks reiterated the letter it sent providers on 14 April 2023. She was concerned at the ‘alarmist commentary in the media. If providers are demonstrating that they are providing safe clinical care and making efforts to recruit RNs then the Commission will continue to monitor the risk. However, if there is serious risk then the Commission will be actively monitoring and escalating enforcement action if there is not safe and quality aged care and best possible quality of life. Commission will implement a fair and sensible approach.’

Mark Richardson outlined the exemption framework and he expects approximately 5% of RACFs to be exempt. The Department has contacted many smaller Homes and conducted webinars. This exemption is only until 1 July 2024 and then the Commission will develop another model. For reporting he outlined that providers only need to report the specific 30 minute periods where there was no RN. Note EN cannot replace the RN however may continue to support the RN. 

Mark discussed that if a provider is exempt from RN reporting then this does not exempt providers from the care minutes requirement. AN-ACC funding provided to fund all types of care workers. There are no exemptions to care minutes reporting. Remember that ENs care contributes to the care minutes target.

Other topics (with presentation slides) included:

  • RN 24/7 Reporting and Monitoring
  • RN 24/7 Supplement
  • Care Minutes Responsibility
  • Compliance and Regulating Workforce-related Responsibilities
  • Assessing and Monitoring Risk
  • Alternative Clinical Care Arrangements
  • Questions and Answers.

CSS also recommends that providers read the Department of Health and Aged Care Frequently Asked Questions – 24/7 RN Responsibility.

The FAQ include the exemptions, supplement, reporting, compliance and workforce management. There is also a list of programs to support growing, skilling and enabling the aged care workforce, many with a focus on support for regional, rural and remote areas, including:

  • Rural Locum Assistance Program – provides locums so that rural health professionals can attend continuing professional development or take vacation leave
  • Workforce Advisory Service – access to free, independent and confidential advice to assist services with workforce planning
  • Business Advisory Service – access to free, independent and confidential advice to help assist services with business management.
  • Aged Care Registered Nurses Payment – a payment to RNs who work for the same aged care employer for 6 or 12 months
  • Aged Care Nursing and Allied Health Scholarships – funding for a range of scholarship opportunities
  • Aged Care Transition to Practice Program – provides new aged care nurses with mentoring, training and support
  • Rural Health Multidisciplinary Training program – offers health students the opportunity to train in rural and remote communities
  • Aged Care Research and Industry Innovation Australia – translates research into practice and develops stronger workforce capability through training and growing knowledge
  • Fee Free TAFE – the Government continues to work with states and territories to provide access to free or low-fee vocational education and training courses in aged care related qualifications.

If you would like support navigating the 24/7 RN requirements or to assist you with workforce sufficiency, or would like to schedule an external review of your current systems/ processes/ governance, please email Alex@cssconsulting.com.au (Business Manager) or our office on info@cssconsulting.com.au and we will discuss your requirements and tailor assistance.

Download Notes from Commission Webinar on Regulating 24/7 RN

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