After almost 30 years of ANMF members campaigning for safe staffing levels, all private residential aged care facilities are now required to provide an average of 200 care minutes per resident per day.
The new legal direct care staffing requirements came into effect from 1 October 2023 and require 40 minutes by a registered nurse with the remaining time by enrolled nurses and in the private sector – personal care workers.
The mandatory care-minutes targets were a result of national ANMF campaigns for ratios in aged care. The care-minutes mechanism came from an aged care royal commission recommendation.
ANMF public aged care facilities have had per shift ratios since 2001. ANMF understands the new care minute staffing requirements will also apply to ‘low care’ beds and hostels in public aged care, some of which have previously been exempt from Victoria’s Safe Patient Care Act.
ANMF (Vic Branch) Secretary Lisa Fitzpatrick said ‘ANMF and its members have campaigned for minimum staffing levels for almost three decades and the introduction of care minutes will mean more nurses and carers on every shift and more time to care.
‘Members should feel positive about the care-minutes reforms, but also feel reassured that ANMF will be watching implementation closely and working with you to ensure you can provide safe clinical care for aged care residents.’
What are the care minutes and what is the implementation timeframe?
From 1 October 2022: residential aged care facilities start receiving funding to voluntarily meet the daily average 200 care minutes per resident target. This comprises a minimum 40 minutes by a registered nurse and the remainder by enrolled nurses and in the private sector, personal care workers. This allowed providers an important 12 months to prepare for the mandatory target.
From 1 October 2023: residential aged care facilities are legally required to provide a daily average of 200 care minutes per resident, comprising a minimum 40 minutes by a registered nurse and the remainder by enrolled nurses and in the private sector, personal care workers.
From 1 October 2024: the minimum average daily care minutes will increase from 200 to 215 minutes, including 44 minutes by a registered nurse and the remainder by enrolled and in the private sector, personal care workers.
How will the care minutes work?
Care minutes relate to direct care staff only – registered nurses, enrolled nurses and in the private sector, personal care workers.
Allied health and lifestyle services are excluded from the daily average 200 care minutes and are funded separately.
Each aged care provider has specific care minute targets set based on their permanent residents’ assessed needs via the Australian National Aged Care Classification funding model and respite assessments. They are required to meet the targets set in the previous quarter. This means targets for October to December 2023 are based on the residents that were in care between June and August.
Aged care providers must report on the care minutes delivered each quarter.
What are the care minute requirements for my workplace?
You can find the targets for your workplace on the Federal Department of Health and Aged Care’s website.
What was the royal commission recommendation?
The Royal Commission into Aged Care Quality and Safety’s final report and 148 recommendations were released on 1 March 2021. Recommendation 86 recommended:
From 1 July 2022, the minimum staff time standard should require providers to engage registered nurses, enrolled nurses, and personal care workers for at least 200 minutes per resident per day for the average resident, with at least 40 minutes of that staff time provided by a registered nurse. (The former Morrison federal government delayed implementation by 12 months.) From 1 July 2024, the minimum care time staff provision should be 215 minutes per average resident, with 44 minutes provided by a registered nurse. (The former Morrison did not agree to this increase.) A registered nurse should be on-site at all times. (The former Morrison government agreed to implement a registered nurse for the morning and afternoon shift only or 16 hours a day.)
The Albanese Federal Government gave ANMF members a 2022 election commitment to deliver the royal commission’s staffing recommendation in full.
Additional funding for nurses and carers
The Australian National Aged Care Classification (AN-ACC) funding model has replaced the Australian Aged Care Funding Instrument (ACFI).
The Albanese Federal Government is providing additional funding to support aged care providers employ additional staff and pay higher wages:
- $5.4 billion over four years for the additional registered and enrolled nurses and personal care workers that providers will need to employ. Aged care providers started receiving this funding 12 months ago from 1 October 2022
- a further $10.1 billion in AN-ACC funding over four years with an increase to the AN-ACC price from $243.10 from 1 July 2023 is included in the 2023-24 federal budget
- an additional $1.9 billion allocated to cover the costs of additional nurses and carers when the care minutes increase in 2024
- a further $743 million over three years from 2024-25 is allocated to cover award wage increases and the additional staff required for the increase to 215 care minutes.
What staffing mechanism are the daily care minutes replacing?
The introduction of care minutes is the first time the private residential aged care sector has had mandatory minimum nursing requirements since the Howard Coalition federal government’s Aged Care Act 1997 came into effect. Victoria had nurse/resident ratios in private aged care until the regulations were abolished in 1995 by the Kennett Liberal Victorian government.
For more than 20 years this Howard-era legislation only required providers to ‘maintain an adequate number of appropriately skilled staff to ensure the care needs of care recipients are met’. An ‘adequate number’ or ‘appropriately skilled staff’ was never defined or enforced.
These terms remain in the Aged Care Act 1997, but the aged care providers care minute legislative obligations and requirements are detailed in the amended Quality of Care Principles 2014 made through the Aged Care Legislation Amendment (Care Minutes Responsibilities) Principles 2023 and the Aged Care Quality Standards.
What about workforce issues?
Residential aged care providers have been funded to employ additional staff, or roster existing staff additional shifts, to provide an average daily 200 care minutes per resident since October 2022.
ANMF has also secured significant wage increases for private aged care nurses and personal care workers. Following ANMF’s successful private aged care work value case in the Fair Work Commission, nurses and carers received a 15 per cent Award wage increase on 30 June. After considerable ANMF lobbying those nurses and carers on higher enterprise agreement pay rates received the dollar equivalent of the 15 per cent Award wage increase. ANMF has prepared a campaign in the event any aged care provider is not passing on all of the $11.3 billion in federal funding for this wage increase.
In addition, as part of the Fair Work Commission’s annual review, the Australian Council of Trade Unions secured an additional 5.75 per cent increase from 1 July for workers earning award wages including some aged care nurses and carers. This effectively gave aged care nurses and carers on award wages a 21.6 per cent wage increase overnight.
Under the Andrews/ Allan Victorian Government, the diploma of nursing has been free since 2019 as part of a plan to build a robust enrolled nurse workforce. Victoria has 21,729 enrolled nurses compared to 14,906 in New South Wales and 14,886 in Queensland. There are also a number of programs and scholarships to encourage people to study the bachelor of nursing and encourage former registered and enrolled nurses to return to practice.
The Federal Department of Health and Aged Care understands some aged care providers may be facing workforce issues affecting their ability to employ enough staff to meet the new 24/7 RN and daily average care minutes per residents. However, providers are expected to take all reasonable actions to recruit and retain registered and enrolled nurses and personal care workers and be able to provide evidence of this work. In some circumstances aged care providers, who do not have enough nurses and carers, will have to demonstrate their ability to provide alternative care that meets residents’ clinical care needs.
Residential aged care providers have been funded to employ additional staff, or roster existing staff additional shifts, to provide an average daily 200 care minutes per resident since October 2022.
ANMF has also secured significant wage increases for private aged care nurses and personal care workers. Following ANMF’s successful private aged care work value case in the Fair Work Commission, nurses and carers received a 15 per cent Award wage increase on 30 June. After considerable ANMF lobbying those nurses and carers on higher enterprise agreement pay rates received the dollar equivalent of the 15 per cent Award wage increase. ANMF has prepared a campaign in the event any aged care provider is not passing on all of the $11.3 billion in federal funding for this wage increase.
In addition, as part of the Fair Work Commission’s annual review, the ACTU secured an additional 5.75 per cent increase from 1 July for workers earning award wages including some aged care nurses and carers. This effectively gave aged care nurses and carers on award wages a 21.6 per cent wage increase overnight.
Under the Andrews/ Allan Victorian Government, the diploma of nursing has been free since 2019 as part of a plan to build a robust enrolled nurse workforce. Victoria has 21,729 enrolled nurses compared to 14,906 in New South Wales and 14,886 in Queensland. There are also a number of programs and scholarships to encourage people to study the bachelor of nursing and encourage former registered and enrolled nurses to return to practice.
The Federal Department of Health and Aged Care understands some aged care providers may be facing workforce issues affecting their ability to employ enough staff to meet the new 24/7 RN and daily average care minutes per residents. However, providers are expected to take all reasonable actions to recruit and retain registered and enrolled nurses and personal care workers and be able to provide evidence of this work. In some circumstances aged care providers, who do not have enough nurses and carers, will have to demonstrate their ability to provide alternative care that meets residents’ clinical care needs.
Residential aged care providers have been funded to employ additional staff, or roster existing staff additional shifts, to provide an average daily 200 care minutes per resident since October 2022.
ANMF has also secured significant wage increases for private aged care nurses and personal care workers. Following ANMF’s successful private aged care work value case in the Fair Work Commission, nurses and carers received a 15 per cent Award wage increase on 30 June. After considerable ANMF lobbying those nurses and carers on higher enterprise agreement pay rates received the dollar equivalent of the 15 per cent Award wage increase. ANMF has prepared a campaign in the event any aged care provider is not passing on all of the $11.3 billion in federal funding for this wage increase.
In addition, as part of the Fair Work Commission’s annual review, the Australian Council of Trade Unions (ACTU) secured an additional 5.75 per cent increase from 1 July for workers earning award wages including some aged care nurses and carers. This effectively gave aged care nurses and carers on award wages a 21.6 per cent wage increase overnight.
Under the Andrews/ Allan Victorian Government, the diploma of nursing has been free since 2019 as part of a plan to build a robust enrolled nurse workforce. Victoria has 21,729 enrolled nurses compared to 14,906 in New South Wales and 14,886 in Queensland. There are also a number of programs and scholarships to encourage people to study the bachelor of nursing and encourage former registered and enrolled nurses to return to practice.
The Federal Department of Health and Aged Care understands some aged care providers may be facing workforce issues affecting their ability to employ enough staff to meet the new 24/7 RN and daily average care minutes per residents. However, providers are expected to take all reasonable actions to recruit and retain registered and enrolled nurses and personal care workers and be able to provide evidence of this work. In some circumstances aged care providers, who do not have enough nurses and carers, will have to demonstrate their ability to provide alternative care that meets residents’ clinical care needs.
How will the care minutes be monitored and enforced?
Aged care providers must report care minutes delivered in a quarterly report, which will be measured against their care minute targets. This reporting will also be used to ensure additional care-minute funding is appropriately used.
Care-minute reporting will also be used to calculate residential aged care services’ Staffing Star Ratings, which include staffing levels and average care minutes including enrolled nurse care minutes.
Providers that submit late reports or don’t submit a report will be referred to the Aged Care Quality and Safety Commission.
According to the Federal Aged Care Quality and Safety Commission’s regulatory bulletin (June 2023), aged care providers must ‘demonstrate a willingness to comply with their responsibilities’. This willingness and any risk to residents will be considered when determining action.
Where an aged care provider is not complying, the Commission will take action proportionate to the issues identified and risks posed to residents. This may include:
- a caution letter
- directions to take specified action
- a non-compliance notice and setting out the required action to comply
- a notice of requirement to agree to certain matters setting out actions a provider must take to comply
- sanctions if the aged care provider’s response is insufficient and/or there are sever and immediate risks to consumers. Sanctions may include restricting payment of federal subsidies or suspending approval to deliver aged care
- revoking a provider’s status.
The Commission’s compliance decisions and actions will be published via:
- its Non-compliance register, and/or
- the My Aged Care Non-compliance checker
ANMF will be monitoring compliance and enforcement.
Are there any exemptions?
The department has limited exemptions from the 24/7 requirement for small rural and remote residential facilities. Facilities must apply for the exemption, which does not remove obligations under the Aged Care Act 1997 or the Aged Care Quality Standards.
These providers with an exemption must still deliver the mandatory registered nurse care minutes, which is different to the 24/7 registered nurse responsibility, and they must submit a monthly RN 24/7 report. These facilities will not receive the 24/7 RN funding.
How do the care minutes work with the 24/7 RN legislation?
As part of the aged care reforms all private aged care providers were required to have a registered nurse on site 24 hours a day, seven days a week from 1 July. This is in addition to the care minutes.
It is important to note that prior to 1 July, ANMF (Vic Branch) had negotiated a 24/7 RN clause in the majority of our enterprise agreements. This was not the case in some other states and territories.
By the end of August, the Federal Government was reporting that 87.48 per cent of facilities across the country had a registered nurse on site 24/7. Minister for Ageing Anika Wells says this figure is expected to improve every month.
Members can read the or see a summary via the Department of Health’s registered nurse coverage in aged care dashboard.
Member inquiries
Members with concerns about the implementation of care minutes in their workplace can submit a member assistance form via anmfvic.asn.au/memberassistance
