Care minutes – how we’re dealing with continued non-compliance
In this post I talk about residential aged care providers and their obligation to meet care minutes targets. We’re closely monitoring and supervising providers that are demonstrating continued non compliance with this obligation.
Care minutes is the minimum target all providers must meet for how much care each resident receives each day. I want to make it clear that this is a minimum target.
The care minutes targets draw attention to how important it is to have enough aged care workers to deliver good quality care. Recognising this important relationship, the Royal Commission into Aged Care Quality and Safety recommended introducing minimum care minutes, along with other workforce related recommendations.
In a large number of residential aged care facilities there are not enough workers to provide high quality and safe, person-centred care. We have heard this from people receiving aged care, their family members and the staff members and managers of aged care providers. Their views have been supported by those of many independent experts. (page 371, Final Report Volume 3A)
Without the right number and mix of staff, the care that’s delivered can be rushed. Residents’ needs can end up not being fully met. This causes quality and safety issues for residents. We know from speaking to workers that this is also stressful for them. They feel that they’re not able to give the people they care for the time and attention they deserve.
Through daily contact with providers across the country, we know that the majority of providers are trying their best to meet their care minutes targets. They are showing us evidence of the work they’re doing on this, and many who have a shortfall are making progress on addressing it.
However, there are providers with residential services that are a long way from meeting their minimum care minutes targets. These providers aren’t able to show that issues with workforce availability or financial viability are major contributing factors to their continued non-compliance. These are the providers that we regard as requiring increased supervision. That is, providers:
- who have ongoing large care minutes gaps, and
- have made little if any progress to closing those gaps, and
- are located in areas where neighbouring services have a much smaller gap or no gap at all.
We are also looking more closely at providers whose spending on care is low compared with the funding they’re getting. We’re using information reported to the Department of Health and Aged Care to target these providers.
Providers in this situation are being moved under Active Supervision to manage their non compliance. Where these providers cannot demonstrate compliance, we are initiating action to compel their compliance through an Enforceable Undertaking or Non Compliance Notice. We’re also doing onsite visits to residential services run by these providers. We need solid evidence that they are doing everything they can to meet the care minutes targets while also managing the risks to residents.
Our options to regulate these providers
- Where providers can provide evidence of their efforts to meet their care minute targets including through implementing a suitable workforce strategy, they will have the opportunity to offer the Commission an enforceable undertaking. We’ll then monitor them against the commitments they make in their undertaking.
- If we won’t accept an enforceable undertaking from a provider – we’ll issue a Non Compliance Notice.
In both cases, from that point on, we can impose a sanction on the provider if they don’t meet their commitments in the agreed timeframe. Also, if at any stage we find that a provider is deliberately avoiding meeting their obligations, our enforcement team will investigate to see if they have breached the Code of Conduct. If they have, we may impose a penalty.
I want to make two points about this regulatory approach. First, it’s consistent with our provider supervision model in our Regulatory Strategy. We’ll work with providers to give them an opportunity to resolve issues as quickly as possible. But if there are unexplained delays, the intensity of our supervision will increase. We’ll also use other regulatory tools. It should also be understood by everyone that we will not hesitate to act quickly and decisively where older people are at immediate and severe risk of harm.
My second point is that the care minutes targets weren’t a surprise. We and the department communicated them to providers well in advance. Extra funding was provided to support providers to reach the targets well before care minutes became mandatory in October 2023.
Under our provider supervision model, we expect that if we take regulatory action against a provider, that provider will be able to meet their agreed commitments under the enforceable undertaking or other regulatory notice. This then avoids the need for us to impose a consequence. We’re more interested in the outcome than in increasing how often we use a regulatory tool.
In the case of providers who are falling well behind in meeting their care minutes targets, we want to make sure that they’re doing everything possible, as soon as possible, to recruit and retain the minimum number of workers they need to comply.
A provider that complies with their care minute targets is much more likely to protect and improve residents’ safety, health, wellbeing and quality of life. And that’s a goal that everyone shares.
Until next time…
