What's your staff/resident ratios?

[Administrator]

Feel free to elaborate and post details about your staff resident ratios where you work - this may include the details on the mix of residents, and/or the total residents at your facility, usage of agency staff, etc. etc.

[Snappo]

I have been trying very hard to work out our ratios at work, but what with our chronic 'no shows' (even agency staff do no shows!!), short shifts (this means that for at least an hour and a quarter each day shift, there are 2 carers for 60 residents, actually, 10 of those residents are dementia so there has to be a carer there at all times, so make that 1 carer for 50 residents!!!), staff showing as being on the roster, but are in fact on holidays, and who knows what else, it's damn near impossible. Night shift is easier! We have 70 residents in the nursing home, and 60 residents in the hostel. The N/H has 1 RN and 3 carers overnight. The Hostel usually has 1 carer overnight, sometimes 2. This equates to 1:17.5 in the N/H, and 1:60 in the Hostel, if there are 2 carers, then 1:30. Needless to say, management lump them all together and state there are 130 residents and 5 staff, making the ratio 1:26, but in reality, this simply isn't so.

As stated above, 1 wing is dementia, so is supposed to have a carer there at all times, pretty hard to do rounds and stay in the dementia wing at the same time!

We are supposed to have 6 staff for 60 residents, 1:10, more often it's 5 staff, 1:12, but we don't just 'care', we do washing, kitchen hand, cleaning, preparation of food, serving, mopping floors, housemaid duties, bed making, table setting, rubbish and laundry removal. Then in between this(!!), we shower, peri wash, clean teeth/dentures, change pads, change clothes and into, or out of, pyjamas, soothe, calm, remove/put on ted stockings, apply cream, cut nails, observe for skin integrity, wounds, rashes, changes in behaviours, and on, and on, and on.

No wonder I come home knackered every night!!

[danielle]

I feel knackered just reading your post describing your work load and staff resident ratios!

Damn...! That's a LOT of residents to look after....

[linda_m]

I'm knackered too Snappo and Danielle! It's not just the staff/resident ratio that astounds - it is all those extra duties. Carers doing laundry and kitchen hand work? And of course what most frail people want is someone who has enough time to say a few words of comfort and cheer. Sad post Snappo!

[Snappo]

I'm actually astounded that you're astounded, I thought this was par for course. This is the 'multi skilling' I have spoken about elsewhere on this forum. Kitchen staff actually put the trays of food in the oven (everything is delivered and reheated), but they have been so unreliable that I prefer to do this myself, then I know it's done. 'Carers' then prepare salads, sandwiches, butter bread or cook toast, whatever the residents want over and above whats on the 'menu'. We set up the kitchen to serve the food, prepare the tables for the meal, get the residents to the table, serve, make a cuppa, clear the table, wash the dishes and put away, and tidy and clean the kitchen. Far more often than not, we are alone on the wing when this is occurring. There are supposed to be 2 carers in the dementia wing only, but often, due to shortage of staff, this doesn't happen either.

We change bed linen, wash the resident's personal clothing (except the dementia wing, that goes to the main laundry), dry, fold and put away the clothing. Carers always put the clothing away in the dementia wing, there can be 2 or 3 LARGE tubs, and this can take considerable time due to lack of, or poor labelling of the items.

Interestinglig, our 'duty statement' mentions none of this!! We no longer have 'buddy shifts', and often agency staff are just sent to a wing, alone, and are expected to know what they're doing!! No wonder residents are complaining.

Are there any other carers who would please share with us their evening duties?? It would be interesting to do a comparison.

[linda_m]

Snappo, the nursing home that I visit on a regular basis has laundry staff and kitchen staff. The carers don't have to make sandwiches, do the dishes or wash the residents' clothes. I think that what you are describing is appalling. It doesn't say much for any of us that we let this stuff happen. Anyone would think that old age is some kind of aberration that only happens to others. I too wait with interest to see if any other carers have to 'multi-skill' like this!!

[industrystandard]

I don't know of anywhere where carers do not do domestic tasks. It is part of their job description unlike nurses whose right to undertake just nursing tasks is law.

[Snappo]

I have worked at 2 aged care facilities, predominately in dementia. At one, we did food serving, but the food was brought up from the kitchen (yes, FRESH food) in a heated trolley. Carers served the food, then replaced the dirty dishes in the trolley for kitchen staff to wash. In the low care and extra care wings, kitchen staff brought up the food and served it, carers carried it to the residents. Then the kitchen staff took the dishes away and cleaned up the dining room, setting the tables for the next meal. The nursing home area was carried out in a similar fashion to the dementia wings

ALL washing was done in the laundry by the laundry staff, it was dried, folded, or placed on hangers, and then returned to the residents rooms and put away by the laundry staff. Carers did no washing whatsoever. The ACF my father was in had this same system, the carers did no washing, folding or putting away of residents clothes.

The only domestic tasks we performed were preparing and serving morning and afternoon teas, then cleaning up afterwards. the above mentioned tasks associated with meals, and bed making.

Mind you, we did have around 16 residents to care for, so with all the personal care, behaviour management, etc. it left precious little time for anything else.

We all understand, and accept, that a certain ammount of domestic chores are involved in aged care, but where I work now we really do do the roles of laundry and kitchen hands, not just partly, but fully, as well as the carers role. There really is no time to 'care' and give much 1 on 1 time to a resident, we are far too busy....very sad.

[Snappo]

Isn't there anyone out there who would care to share with us a normal shift for them? Preferably low care hostel work, I would truely be interested to see what carers in other facilities have to contend with.

[lisa_Nightshift]

Hello for starters because I'm new to this website. so hello to everyone, and what a fantastic website to help support not only the familys but the carers that are trying to do there job the best way we can and get penalized for it.

Of a night time at the place I work, we have 3 units, 2 high care and 1 low care. it is a 138 bed place.
In unit 1 (High care) we have 3 staff on 2 PCA or div 2 and 1 div 1, one person needs to be in the dementia lock up area all night, unit 2 (High care) there is one div 1 and a PCA or a div 2, some nights we cannot find a div 1 so we have to have a div 2 endorsed, and unit 3 (low care but some days we beg to differ) has 2 PCA's.

I mainly work in high care unit 1 and there is 15 beds in the dementia ward, and there is 30 in section 2 and 3.

During the day in unit 1 there is 1 div 1, and 1 div 2 endorsed, and 7 carers on the floor, in the afternoon there is 1 div 1 and one div 2 and 5 people working on the floor.

And now we are having the morning shift tell us that we should start to shower people in the morning, there is no way that is going to happen when I'm on. That is why they have more staff on in the morning plus it is unfair on the residents to be woken before 7am for a shower, i thought it was against the Age care act

[lisa_Nightshift]

ooo and I forgot to say that if all the care staff took there breaks at the "allocated" time there would be 1 person on the floor for almost 2 hours, it is only out of the kindness of our hearts that we come off our breaks to help our staff that for most of the residents of a night time are 2 people!

[Snappo]

Hi all, me again, with another quick question. It has just been decreed that there is to be only 1 staff member on overnight at our 'low care' Hostel. This hostel comprises of 5 separate wings with, between 10 and 15 residents in each wing (currently 61 residents all up). One of these is a locked dementia wing of 10 residents. Apart from the dementia residents, there are also 7 high care residents scattered throughout the various wings. When I first started at this facility 3 years ago, the dementia wing was NEVER to be left unattended. There were always 2 night duty staff, one stayed in the dementia wing while the other one did the rounds and answered any call bells. Now, obviously,the dementia wing is to be left unattended when the staff member attends to resident's buzzers. If a resident who buzzes has been incontinent and requires showering, bed changes, etc, this will entail the staff member being absent from the dementia wing for a considerable length of time.

Is this really 'best practice' care? Is this not an OH&S issue for the staff member on duty? Who is responsible if a dementia resident, or any other for that matter, falls during the staff member's absence? Staff have been told they are to finish with the resident they are dealing with before answering other buzzers, what if it's an emergency? I could pose dozens of queries concerning this issue, but I'm sure you get the idea!! Is this actually legal? Any thoughts would be gratefully received.

[industrystandard]

I'll let some-one else answer the OHS question and you know the answer to whether it's legal already. You know it is because 54.1 (b) says so:

The responsibilities of an approved provider in relation to the quality of the aged care that the approved provider provides are as follows: to maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met

Which would all be well and good if the Accreditation Standards didn't make providers responsible to themselves (bolding mine):

1.6 Human resource management

There are appropriately skilled and qualified staff sufficient to ensure that services are delivered in accordance with these standards and the residential care service’s philosophy and objectives.

and 1.3, 2.3, 3.3 and 4.3:

Management and staff have appropriate knowledge and skills to perform their roles effectively.


"Appropriate" is not defined anywhere and in my experience, the Team accept in-house competencies as proof of appropriate knowledge and skills.

Then add in the fact that the Aged Care Commissioner cannot examine the Team's decision to accredit a facility.

Then add in the fact that so few people can or want to litigate and even if they did, compensation is capped at 250k and even then, there's no future economic loss to be claimed when the victim is a retired person........

[linda_m]

I think reducing staff to one person for 61 residents - and having to leave people in a locked unit without any staff is just terrible. I would say it is a fire risk apart from anything else.

The nursing home I visit has just taken all the RNs off the roster. There used to be one on every shift. Now there is just one RN - who is basically in charge of the whole shebang (one 30 bed nursing home, 3 hostels and quite a few independent living units) and who will be on call if needed - and the carers will be handing out the medications. It is all getting worse and I'm not getting any younger!

[Sally]

Just like I have always said, "It's getting worse and worse and.... and it always will !!
Some people just don't value the human race, especially if they are elderly !!! (Or if they are the people who GIVE THEIR OWN LIFE TO CARE FOR THEM !!)

Sorry, sorry Sally.