Participation in the National Aged Care Mandatory Quality Indicator Program (QI Program) has been a requirement for all approved providers of residential care services since 1 July 2019. The QI Program requires quarterly reporting against eleven quality indicators across crucial care areas: pressure injuries, physical restraint, unplanned weight loss, falls and major injury, medication management, activities of daily living, incontinence care, hospitalisation, workforce, consumer experience and quality of life.

The workforce indicators have traditionally focused only on service management, nursing, and the care and support workforce.

The Department of Health and Aged Care is working on expanding the QI program to include indicators for enrolled nurses, allied health professionals, and lifestyle services (activities coordinators); AHAs were omitted from the changes. A consultation process is underway for these proposed changes. AHANA has provided feedback on the Expansion of the National Aged Care Mandatory Quality Index Program: Consultation Paper, advocating for the recognition of the AHA workforce in the QI Program, and outlining the benefits of utlising the AHA workforce in aged care.

Here is an excerpt of the feedback we provided:

How do the varying levels of resident needs and care complexities in different residential aged care settings influence the staffing hours per resident per day provided by ENs, allied health professionals and lifestyle officers?

Residents requiring reablement (e.g., after a fall/ surgery/malnutrition) compared with residents who require maintenance level of care/therapy. Appropriate ratio levels of staffing are most beneficial depending on resident functional needs within the facility e.g., an allied heath assistant (AHA) within a residential aged care facility can focus on resident functional practice to reduce ongoing physical load on other care workers assisting with transfers.

Are there other professions that would need to be considered to ensure a comprehensive assessment of care quality in residential aged care settings?

The AHA role needs to be identified as a specific workforce in the quality indicators. AHAs work in delegation from and are supervised by allied health professionals. Together, these two workforces deliver allied health services in collaboration with the broader RAC workforce. Ideally an AHA should be a specific role to be added to every residential aged care facility to assist with consistent allied health interventions within the centre. For the most efficient use, employing an MDT AHA (across physio, OT, and POD or SLP) would be ideal to provide the best use of a single staff member. Current aged care facilities only offer group exercise class and individual exercises twice a week. OT is not consistently utilised in this sector yet improvements in functional tasks of mobility within the bedspace and bathroom, personal ADLs and common daily activities like dressing, feeding and food prep would also be key skills beneficial for repetitive practice. Utilising an AHA to practise tasks across these disciplines can improve resident outcomes, improve functional ability and reduce dependency and burden on the existing healthcare staff.

We encourage the Commonwealth Department of Aged Care to utilise the work of AHANA and implement our defined scope of practice as the preferred scope to be used throughout this sector. We also provided a singular need to recognise the role of an AHA and provided several examples of differing titles within the residential aged care space that still encompass the roles and responsibilities of an AHA. These titles include: leisure and lifestyle assistant, physiotherapy aide, and therapy assistant.