Managers from New South Wales nursing homes have come together to brainstorm how their embattled industry can bounce back, amid fears of a mass exodus of "demoralised" staff.
A recent union survey revealed one in five aged care staff were considering leaving the sector in the next 12 months.
The figures were no surprise to nursing home CEOs who recently gathered in Sydney to discuss a way forward.
Viv Allanson runs the Maroba nursing home in Newcastle and was worried about how staff were coping after years of dealing with COVID and the fallout from the Aged Care Royal Commission.
"I've seen people leave the sector, they're not only burnt out, they're demoralised," she said.
Ms Allanson was also worried about succession planning.
"I look over my shoulder and I see no one chasing me for my job and that is terrifying," she said.
Paul Sadler is the chief executive of peak body Aged and Community Services Australia and said the regulator needed to do more than call out bad behaviour.
He said the Aged Care Quality and Safety Commission should also be helping to lift standards.
"We know the regulator needs to call out poor practice and intervene where providers are doing a really poor job," he said.
"But we need positive engagement so we're not focused solely on the things that go wrong, which can be really disempowering for our staff.
Individual approach a success
To that end, aged care providers have come together to organise tours of nursing homes to see what was working and how they could emulate success.
The first tour was at a nursing home in the Sydney suburb of Paddington, where manager Leigh Bryson explained how the dementia unit was avoiding the use of mood-altering drugs to control aggression.
Ms Bryson said they instead used the residents' "life story" to inform the structure of their day.
"We have one gentleman who ran a successful medical organisation," she said.
"He has a desk in his room and a computer, we give him papers and he writes up 'reports', in the way he would have done at work.
"You might have someone who worked night shifts all their life, then ends up with dementia and suddenly people expect them to go to bed at 8 every night.
But Ms Bryson said the regulator's focus on penalties and punishment had created a difficult relationship with providers.
"I always feel on edge because I know we're coming up for accreditation, I feel like it's a bit of a bullying culture from the regulator," she said.
"But if our families and residents are happy, we must be doing something right."
The ABC has contacted the Aged Care Quality and Safety Commission for a response.
Staff 'churn rates' rising
Recruiters for the sector described the last two years as the 'perfect storm' for staffing.
Alex McDonald is the managing director the Orchard Talent Group and said the pandemic had exposed staffing weaknesses in the sector.
He described the number of aged care staff leaving their job each year as concerning.
"Executive or board level churn rates are close to 40 per cent for the last 12 months," he said.
"Now that's a very large challenge and it's cascaded down the organisational structure.
"Middle management is 40 per cent, and frontline staff around 50 per cent, so we're seeing a significant shift in the workforce."
But Mr McDonald remained optimistic about the future.
