Efforts to increase direct care staffing levels in aged care homes are working but a new study raises a critical question: is this enough to improve quality of care for older people?
Led by Flinders University researchers from the Registry of Senior Australians (ROSA) Research Centre, based at SAHMRI, the team analysed data from over 2,000 aged care homes across Australia, looking at how well care staffing targets were being met, and whether this impacted residents’ experiences and quality measures.
“Since October 2022, Australia has set individual targets for total care and registered nurse minutes for aged care homes, based on the assessed care needs of their residents,” says lead author Associate Professor Stephanie Harrison, a researcher in Flinders’ Caring Futures Institute and SAHMRI.
“These targets are a positive step, but these are the minimum levels of care that homes should be providing, and it remains unclear whether they are sufficient to drive meaningful improvements in care quality.”
Looking at data from January 2023 to March 2024, the study found that the proportion of aged care homes meeting or exceeding their total care minutes target rose from 41% to 53%. Government-run facilities were more likely to meet their targets, compared to for-profit and not-for-profit facilities, with metropolitan and smaller facilities also performing better.
“The data suggests that location and facility size play a crucial role in the ability of an aged care home to provide adequate staffing levels,” says Associate Professor Harrison.
“Government-run facilities were also more successful in meeting and exceeding care minute targets. As smaller, government-run facilities are replaced by larger, for-profit services, this is an important area to monitor.”
Despite the rise in care staffing levels, the authors found no association between care minutes and residents’ experiences or quality measures.
“This challenges the assumption that simply increasing staffing will automatically improve care quality,” says Associate Professor Harrison.
The researchers emphasise that high-quality care depends on more than just staff numbers, as it requires a skilled, well-supported workforce with strong clinical leadership.
The findings highlight the complexity of aged care reform and the need for further research to understand the right balance of care minutes, skill mix and models of care to enhance care quality and resident safety.
“A holistic view to care quality is needed, beyond just meeting staffing targets. Adequate training, staff retention strategies, and tailored models of care that meet individual resident needs are all important for policymakers to consider,” says Associate Professor Harrison.
“Improving care means investing in workforce development, especially in rural and remote communities where staffing challenges are more pronounced. Recent initiatives to support the provision of aged care staff in rural and remote areas should be monitored to see if this helps to improve equitable access to care in these regions.
“Monitoring staffing levels in aged care homes remains essential, it provides vital data, but to truly improve the quality of aged care, we must also strengthen the evidence base and address the ongoing challenges facing the sector.”
The paper ‘Long-term care staffing: associations with facility characteristics, residents’ experience and quality measures’ by Stephanie L Harrison, Dylan Harries, Hoi Man Fu, Gillian E Caughey, Tracy Comans, Megan Corlis and Maria C Inacio is published in the Journal of the American Medical Director’s Association. DOI: 10.1016/j.jamda.2025.105686
The Registry of Senior Australians (ROSA) Research Centre is supported through the Australian Government Medical Research Future Fund (PHRDI000009) and its partners (SAHMRI, Flinders University, ECH Inc, Silverchain, Bolton Clarke). Prof Maria Inacio is supported by a NHMRC Investigator Grant (GNT119378). Prof Gillian Caughey is supported by an NHMRC Investigator Grant (GNT2026400).