INSIDE QUALITY: EDITION THREE
When we ask a provider how they know their workforce is skilled and sufficient, the answer we hear most often is a roster.
But sufficient and skilled are two different tests, and we consistently find one is being measured and the other is being assumed. A fully rostered shift tells you the numbers add up. It does not tell you whether the people on that shift were the right people for the residents in front of them.
Read other editions of our Inside Quality series:
Edition 1: Good Governance isn’t about meeting minutes. It’s about decisions.
Edition 2: What we look for first: The Standards Transition.
Edition 3: What we look for first: Skilled & sufficient workforce.
Edition 4: What we look for first: Complaints & Feedback
What we look for before we open a single roster
Is the skill mix matched to acuity, or just to headcount?
A shift can be fully staffed and still be the wrong shift, if a wing with several residents requiring complex wound care or behaviour support has the same staffing ratio as a wing with lower needs.
Do agency or casual staff know the residents they are caring for?
A skilled worker who has never met the person they are supporting starts the shift at a disadvantage no qualification can fully close.
Can staff explain why they are doing something, not just what to do?
Competency that has only been trained, not embedded, tends to show up as staff following a process correctly without being able to explain the reasoning behind it.
Three documents we ask to see
The workforce strategy and skills matrix.
Not whether one exists, but whether it identifies the specific skills and competencies each role actually needs against the residents in that service. A skills matrix that has not been revisited since the resident profile changed is measuring the workforce against yesterday’s needs.
Pre-employment and competency records, not just training completion.
Training completion tells us someone attended. It does not tell us they can do the task.
The plan for workforce shortages, not just the roster that resulted from it.
Every service experiences shortfalls. What separates services is whether there is a deliberate strategy for absorbing them versus an ad hoc scramble that happens to work out.
The conversation that tells us the most
We ask frontline staff: “If you were short-staffed tonight, what would you do first?”
Strong answers describe a clear sequence. Weaker answers describe hoping it does not happen. The second answer usually means the organisation has not built a real plan, and the worker is left to improvise one under pressure.
The pattern we see most often
The common gap to close is treating workforce sufficiency as a rostering question and workforce skill as a training question, when assessors increasingly treat them as one connected standard. A fully rostered shift staffed by people without the right skill mix for that day’s acuity is not a sufficient workforce. It is a present one.
We reviewed a service where agency utilisation looked fine on paper. On the floor, agency staff were being handed a resident list at the start of the shift with no orientation. One conversation with the rostering team and a simple briefing checklist changed that within a fortnight. The numbers had never been the problem.
If an assessor walked onto your floor tonight, unannounced, would they find a workforce that is sufficient on paper, or one that is genuinely matched to the people it is caring for?
Mathew Brincat
Chief Clinical Officer
Inside Quality is a regular series from Provider Assist exploring governance, leadership and clinical quality through practical observations from across aged care. Our aim is not to explain compliance. It is to encourage a different way of thinking about quality.
