Basic medical, dementia and nursing knowledge of unqualified workers is low. Continuing training is a key to good care. Previous initiatives included the training guarantee levy, and the Residential Care Training Initiative, which has received no government funding since the new act in 1997. A concerted, continuing, compulsory education program is required. There is also matching the funding of care hours to residents' needs.
Proprietors now have full autonomy as to how funding is allocated.
Neither nursing homes nor hostels are required to provide a specified quantity of qualified staff relating to the assessed care needs of residents. Adequate staffing ratios must be established and monitored. There is also a need for specialist mental health services for older people. Another issue is the different models of residential care. The test of a nursing home or hostel is whether we would like to have our mothers live there.