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Tuesday, 4 May 1993
Page: 61

(Question No. 2456)


Senator Newman asked the Minister representing the Minister for Aged, Family and Health Services, upon notice, on 2 December 1992:

  With reference to the new Resident Classification Instrument (RCI) for nursing homes:

  (1)(a) How were the `response weightings' determined for the 14 questions in the RCI; and (b) if they were time-based, why are only questions 3 and 14 time-based in the RCI form.

  (2) How can the `response weightings' for question 3 be justified.

  (3) If the revised RCI was extensively trialled in 1990 and 1991, why do the statistics show such a high proportion of category 1 residents in the ACT.

  (4)(a) Are there different criteria for the ACT; and (b) are the guidelines interpreted differently in the ACT.

  (5) Under RCI guidelines, how is independence promoted in totally dependent residents if physiotherapy, speech therapy and occupational therapy are not warranted and good nursing care maintains the resident in a stable condition for several years.


Senator Tate —The Minister for Aged, Family and Health Services has provided the following answer to the honourable senator's question:

  (l)(a) & (2) The `response weightings' for the 14 questions in the RCI were based on responses to the questions given by Directors of Nursing during the national trials of the instrument. The ratings were then subjected to statistical analysis and from this weightings were obtained.

  (b) Question 3 and 14 are the only time-based questions in the revised RCI as time is considered a better relative indicator than frequency for these questions.

  (3) Because of the small number of nursing homes and residents being classified in the ACT it would not be expected that ACT distributions would reflect the national averages.

  In this situation any small change in the number of category 1 residents exerts a significant influence within that category, as is currently the case.

  In addition other factors impact on resident profiles, for example, demographic factors, migratory patterns and availability of alternative services.

  (4)(a) No.

  (b) No.

  (5) The revised RCI promotes independence in dependent residents by ascribing higher ratings for activities, other than therapy, which encourage greater independence in activities of daily living. This recognition of maintenance of residents in a stable condition is evidenced in all activities of daily living questions where the need for supervision and/or physical assistance is acknowledged.

  Questions from the RCI have been found to be the best indicators of relative care needs of residents. However the RCI itself does not measure the absolute needs of an individual resident.