The Australian College of Nursing (ACN) is concerned by the finding in the latest report of the Inspector-General of Aged Care that, despite significant positive reforms to improve care in the aged care system, registered nurses are feeling "exposed" without the support of enrolled nurses in aged care settings.
ACN welcomes the Inspector General's call for greater strategic planning for the aged care workforce, and for education to boost workforce quality, but tweaking of the reforms is needed to better support the vital contribution of nurses.
The Inspector-General's 2025 Progress Report on the Implementation of the Recommendations of the Royal Commission into Aged Care Quality and Safety examines the progress in the four years since the 148 recommendations of the Royal Commission were handed down.
Among its worrying findings is that the implementation of 215 care minutes and 24/7 registered nursing requirements, as part of the Australian National Aged Care Classification (AN-ACC) care minutes requirement, has led to a significant fall in employment of experienced enrolled nurses in the aged care sector, who are being substituted for cheaper, unregulated care workers."
ACN believes the use of the full scope of nursing expertise must not come at the expense of meeting care minutes in residential aged care facilities.
"The aged care sector must think carefully about how it implements this recommendation," ACN CEO Adjunct Professor Kathryn Zeitz FACN said.
"Registered nurses provide invaluable expertise and care in residential aged care facilities, but to feel safe in their care and to deliver the best care possible, they absolutely need to be working in a team of other regulated nurses.
"Enrolled nurses must be kept in the system as key members of the care team.
"It is also disturbing to read that allied health services and lifestyle activities are being sacrificed to meet the AN-ACC care minutes. These services are critical to residents' health and wellbeing.
"Aged care service providers must ensure that they are not taking a rigid approach to the care minutes model, which fails to reflect the real-life delivery of quality nursing care.
"Further, we still don't have mandatory dementia training for aged care workers. This is unconscionable given the growing numbers of people with dementia in our care."
The report also confirms that increasingly prescriptive administrative and reporting tasks are eroding the time nurses have available to deliver personal care and support to residents.
ACN is urging the government to act on any unintended consequences of the recommendations by immediately reviewing the care minutes model to allow for appropriate skill mix, including enrolled nurses.
The government should also:
- Mandate dementia and cultural safety training in legislation, not just quality standards.
- Release the National Nursing Workforce Strategy that has been developed by the Department of Health, Disability and Ageing with Victoria as a matter of priority.
- Streamline reporting requirements to reduce the administrative burden on nursing staff.
- Invest in retention strategies, particularly for rural and remote areas.
"ACN understands that the aged care sector is going through a significant transformation," Adjunct Professor Zeitz said.
"But we must make sure that the rollout of recommendations is fine-tuned to ensure residents' wellbeing is at the centre of the reform process."
