Nursing and personal care in aged care homes

How do I know if a home provides enough nursing and personal care staff for residents?

Each aged care home reports on the overall amount of care its staff delivered to residents, as well as the amount of care time each resident receives from a Registered Nurse.

Providers have a target for the overall minutes of care and a separate target for the minutes of Registered Nurse care that they need to provide to residents at each aged care home.  The Registered Nurse target may include up to 10% of the target provided by Enrolled Nurses.

You can see how an aged care home is performing on their Find a provider profile, under Staffing. Their performance in relation to the care minutes targets informs the Staffing rating, which is part of the Australian Government’s Star Ratings for aged care homes.

How is nursing and personal care time measured?

Since October 2022, all aged care homes have been required to record and report the amount of care that was provided to their residents by:

• Registered Nurses
• Enrolled Nurses
• Personal Care Workers, or
• Assistants in Nursing.

This includes time spent on help with daily tasks and other care activities such as updating care plans and arranging medical appointments. This is known as ‘care minutes’.

This information is reported to the Department of Health, Disability and Ageing on a quarterly basis through the Quarterly Financial Report.

What do Personal Care Workers and Assistants in Nursing do?

Personal Care Workers and Assistants in Nursing support residents with their activities of daily living. Their responsibilities can include:

• monitoring and reporting residents’ condition
• providing interventions, treatments and therapies from resident care plans
• helping residents with their activities of daily living
• providing residents with social and emotional support
• working in multidisciplinary teams.

The Staffing rating

In December 2022, the Australian Government introduced Star Ratings for aged care homes. Star Ratings provide simple information about the quality of care an aged care home delivers and how they compare to others.

Staffing is one of the 4 key areas of performance that make up the overall Star Rating. The Staffing rating is assigned based on whether the aged care home has met or exceeded their targets for:

• the total amount of nursing and personal care time a resident receives from Registered Nurses, Enrolled Nurses, Personal Care Workers and Assistants in Nursing, and
• the care time a resident receives from Registered Nurses, which may include up to 10% of the target provided by Enrolled Nurses. 

Providers that deliver care to their residents over and above their care minutes targets will have a better Staffing rating.

The table below displays the different rating levels and the number of homes nationwide that have received each rating.

Staffing rating		How many homes in Australia currently have this rating?
	Excellent	11%
	Good	12%
	Acceptable	48%
	Improvement needed	27%
	Significant improvement needed	1%

* Percentages may not equal 100% due to rounding.

	Overall Care Minutes Target
	Less than   90% of target met	Between 90% and less than 100% of target met	Between 100 and less than 105% of target met	Between 105% and less than 115% of target met	Equal   to  or more than 115% of target met
Registered   Nurse  Care Minutes  Target
Less than 75% of target met
Between 75% and less than 100% of target met
Between 100% and less than 115% of target met
Between 115% and less than 125% of target met
Equal to or more than 125% of target met

The Staffing rating is updated every 3 months using care minutes information reported by the aged care home.

Under certain circumstances, some providers may not display a Staffing rating. You can read more about why a rating isn’t shown.

The 24/7 Registered Nurse target

The Royal Commission into Aged Care Quality and Safety identified that having a Registered Nurse on-site and on duty is critical to the quality of care in aged care homes. The Australian Government has taken action based on these findings.

Every aged care home is now required to have at least one Registered Nurse on-site and on duty 24 hours a day, 7 days a week.

This ensures that residents will always have access to qualified and experienced care staff. Registered Nurses can identify and address potential risks. They can also manage some medical issues and emergencies, which can prevent unnecessary trips to the hospital.

Learn more about the responsibilities of 24/7 Registered Nurses on the Department of Health, Disability and Ageing website.

How are the care minute targets calculated?

Care minutes targets are based on the care needs of people who have lived in the home over the previous 3 months.

Across all aged care homes, the nationwide target is currently an average of:

• 215 minutes of personal and nursing care (from a Registered Nurse, Enrolled Nurse, or Personal Care Worker/Assistants in Nursing) and
• 44 minutes of nursing care (from a Registered Nurse) per resident; this can include up to a maximum of 4.4 of care contributed by an Enrolled Nurse.

This means, on average, people who live in an aged care home will get 215 minutes of care each day, including at least 44 minutes from a Registered Nurse.

However, each aged care home has their own care minutes target, which may be different to the nationwide target.  

Generally, homes with mainly higher needs residents will have higher care minutes targets and need to deliver more care time than a home with mainly lower needs residents.

As care minutes targets are an average for all residents across the home, it also means some people may receive more care time than others, depending on their individual care needs.

You can find out the current target for your home on the Department of Health, Disability and Ageing website. Showing the targets as an average amount of care per resident makes it easier to understand the amount of care you might receive.

Temporary 24/7 Registered Nurse requirement exemptions

For some smaller aged care homes in rural areas, finding and hiring Registered Nurses to be on-site and on duty 24 hours a day, 7 days a week can take time.

Some of these homes have been temporarily exempted from the 24/7 Registered Nurse requirement for up to 12 months. This is to allow them more time to find and hire more Registered Nurses. However, this doesn’t remove their other obligations under the Aged Care Act 1997 and the Aged Care Quality Standards to make sure that all residents at the home receive safe and quality care.

Aged care homes with an exemption must still submit a 24/7 Registered Nurse report each month. They also have to inform their residents about the exemption and the duration of it, including the alternative care arrangements in place while they are looking for more Registered Nurses.

Learn more about aged care home 24/7 Registered Nurse exemptions on the Exemption from the 24/7 RN responsibility, Australian Government Department of Health, Disability and Ageing page.

For a list of current exempt providers from 24/7 RN requirements please visit Department of Health, Disability and Ageing website.

What if an aged care home is showing no 24/7 Registered Nurse data?

There are a few reasons why a provider may display a ’No data’ label in their Find a provider profile. 

This may be because the aged care home:

• is a new provider
• is operating under new ownership
• has recently reopened after major repairs or renovations
• has failed to submit their data in the required time period
• is experiencing issues that have stopped them from being able to report on time, such as technical (IT or data) issues.

It could also be for other reasons outside of their control, such as a natural disaster.

Where can I find more information?

You can read more about care minutes on the Department of Health, Disability and Ageing care website.