EN contribution deserves to be recognised in care minute totals

Earlier this month, the Aged Care Quality and Safety Commissioner Janet Anderson, released a statement highlighting the early signs of success for mandatory care minute targets. 

Government data revealed that, on average, residential aged care homes were providing 194 care minutes per resident per day, including 37 minutes of Registered Nurse (RN) time. While neither target is at the mandated level of 200 care minutes or 40 RN minutes, many providers have exceeded requirements even if the industry average is not yet where it needs to be.

The 24/7 RN requirement was also highlighted with the industry average finding that an RN was on-site and on duty 98% of the time, or for 23.5 hours per day.

But the ongoing focus on RNs at the expense of Enrolled Nurses, Personal Care Workers (PCWs) and allied health professionals, continues to have an impact. This is detrimental to providers achieving their care minute requirements and the EN workforce, explains Rachel Wassink, a Registered Nurse and the Director of Social Care and Health at RMIT University.

“When you’re leaving out or not adequately including a workforce such as the Enrolled Nurse workforce that could have an impact on the sustainability of care minutes as we move forward,” Ms Wassink told hello leaders.

“There was some recent news around more aged care providers going bust and not being able to service their residents and with the increase in care minutes and the increased requirements solely on the RNs, seeing more aged care providers closing their doors would be an unintended consequence to the quality of care and the access to care for our ageing population.”

There are widespread concerns across the industry regarding the treatment of ENs and how their contribution to aged care is recognised by the Government. Speaking to hello leaders earlier in the month, Fronditha Care CEO Faye Spiteri said not including ENs in the 40-minute quota alongside ENs was “counterproductive to investing in staff and their career paths”.

This is also where Ms Wassink acknowledged the largest impact could be felt as the EN workforce is suddenly underappreciated for the important role it plays alongside RNs. 

“ENs are a high-value part of our healthcare system and we need to debunk some of the myths around how much they contribute to the high quality of care they provide working in consultation with a Registered Nurse,” she explained.

“The Government has heavily invested in the training and upskilling of people into the role of the Enrolled Nurse, now it just seems like they’ve been left out.”

Alongside her role as Director of Social Care and Health at RMIT University, Ms Wassink is the CEO of Happy Helpers Home Care, a Victorian-based home care service provider launched in 2023. 

Without care minute requirements for in-home care services, there’s scope for that part of the aged care sector to benefit from ENs looking for greater recognition. It may not come to fruition as more industry leaders call for ENs to be specifically included in the reporting, but Ms Wassink explained that the growth in home care services could have an influence.

“We are seeing the ageing population stay in their home for longer which is going to increase the requirement to have more nurses in the home care industry. As we increase the care minute requirements in residential aged care and people are trying to stay at home for longer, we may see a flow-on effect to the availability of both ENs and RNs in that specialised space of keeping people in their homes.”

Further workforce losses could occur if ENs are not prioritised by employers in favour of PCWs who can provide care at lower wages. In a worst-case scenario, the loss of opportunity for ENs in aged care could see them move into other sectors if the Government no longer invests in them for aged care.

Not including allied health in the care minute requirements has also been viewed as a significant misstep as their skillset would directly benefit residents if prioritised further by the Government. 

Ms Wassink acknowledged the importance of prioritising nursing care minutes but she said to leave out all-encompassing roles filled by allied health professionals was a missed opportunity for promoting holistic care.