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Aged care has received more than its fair share of bad press in recent years, owing largely to revelations from the Royal Commission (RC) into Aged Care Quality and Safety. In rural Australia, many of the issues exposed within the RC were pronounced, with the final report calling for greater funding and equitability of access in rural, regional and remote areas. Almost one year since the report was published, what is the current state of play within rural aged care?

Dr Rachel Winterton, Senior Research Fellow at the John Richards Centre for Rural Ageing Research, said that despite some positive reform, many of the challenges exposed within the RC remain since its completion. 鈥淭here are still issues in terms of equity of access and service availability in rural Australia. At this point, we have only seen marginal improvements in that respect,鈥� she said.

Meanwhile, the government鈥檚 viability supplement has not been enough to cover the lagging occupancy rates within some venues, particularly throughout COVID where some homes were forced to place a ban on new resident intakes. This has left many grappling with an ongoing financial deficit and the secondary challenges that brings.

A survey of 1200 nursing homes across Australia revealed that 69% of rural and remote aged-care homes were losing money in March 2020, a figure that dropped聽鈥� but remained high at 52% 鈥� by March 2021¹. The statistics were similar in inner regional centres, decreasing from 62% to 56% over the same period¹.

As a result, many facilities have struggled to meet the challenges inherent in delivering high-quality care within areas of geographical remoteness. Alongside the sector鈥檚 viability challenges, rural Australians have statistically poorer health than those that live in major cities, with 20% higher rates of chronic disease². This exacerbates the issue of weak nurse-to-resident ratios聽鈥� one of the key sticking points exposed by the RC, with more than half of Australian aged-care facilities (57.6%) classed as inadequately staffed³.

鈥淭he current funding and supplements rarely stretch far enough to cover recruitment and retention, so it is still difficult for rural providers to access the workforce they need,鈥� Dr Winterton said.

Leading the way

Despite the challenges, Winterton highlighted that the sector is pushing new boundaries in its quest to improve standards.

St. Catherine鈥檚 aged-care home in Bathurst, New South Wales, provides one high-definition example, having taken matters into its own hands to drive positive resident outcomes throughout the pandemic.

Like many homes, St. Catherine鈥檚 grappled with staff shortages during the crisis聽鈥� given the restrictions on aged-care personnel working across multiples facilities聽鈥� but upheld positive resident and worker reviews throughout. It even saw former employees returning to their roles, having previously departed to work in other higher paying sectors, including disability support. Manager Angela Stocks attributed this to the centre鈥檚 strong workplace culture.

鈥淥ur team members have been the unsung heroes during this crisis. They have worked incredibly hard under challenging circumstances: long hours, wearing full PPE, amid high levels of risk,鈥� she said.

鈥淭hey have also made tremendous personal sacrifices. When there was a COVID outbreak in the local jail聽鈥� where some of our employees鈥� partners worked聽鈥� they moved out of their own homes and had no contact with their families, so as not to pose a risk to residents.鈥�

Despite the long overtime hours and personal sacrifices, St. Catherine鈥檚 staff evaluated their workloads as 鈥榝air鈥� in annual appraisals conducted during the pandemic. 鈥淚 really believe the onsite camaraderie and team environment is a key reason behind this outcome,鈥� Stocks said.

Feedback from 鈥榖oomerang employees鈥� who sacrificed higher salaries in other sectors to return to their aged-care roles at St. Catherine鈥檚 also supported this theory. 鈥淩eturning staff have told us they love the environment here and get more satisfaction from their day-to-day work than they do in other support roles,鈥� she said.

Looking ahead

While additional funding for recruitment is on its way to rural centres聽鈥� via the Rural Health Outreach Fund (RHOF)聽鈥� the St. Catherine鈥檚 story points to an alternative approach for the sector: increasing the 鈥榮um of its parts鈥�, not just its staff numbers.

鈥淎dditional geriatricians and medical specialist services [as per the RHOF] will always be welcome within aged care, but I really believe the best way to get results is to create a supported environment where people are willing to come into work and go the extra mile when they get there,鈥� Stocks said.

Dr Winterton agreed noting, 鈥淚n rural areas especially, where there are fewer opportunities, people want jobs they can comfortably stay in.鈥�

It may be a way to go until the sector is 鈥榙eficit free鈥�, but with homes like St. Catherine鈥檚 paving the way, there is increasing hope.

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Image credit:聽漏stock.adobe.com/au/godfather