Vicious cycle: use of casual staff can worsen aged care workforce issues, says study

Many aged care facilities are turning to casual staff to fill workforce shortages but new research shows this reduces job satisfaction among permanent personal care workers and increases their intention to leave.

Many aged care facilities are turning to casual staff to fill workforce shortages but new research shows this reduces job satisfaction among permanent personal care workers and increases their intention to leave.

For permanent personal care workers, an increasing proportion of casual staff in a facility is linked to increased job stress as well as a perception they are less able to use their own skills and abilities and are less respected, the research found.

The study, by academics at Flinders University and Mid Sweden University, found that without acknowledging the role of casual staff in workforce dynamics their employment “could well exacerbate, rather than help resolve, problems affecting workforce sustainability.”

In contrast to previous findings, the research also suggests it isn’t so much the presence of casual staff but rather the proportion of them that creates issues for retention of permanent staff.

The research used the data in the 2012 National Aged Care Workforce Census and Survey, drawing on information from 2,481 organisations and more than 5,000 employees.

The study found that employing casual workers may increase dissatisfaction and intention to leave for permanent personal care workers but did not have a significant impact on nurses.

Using casuals to fill shortages

Despite of years of debate and various policy initiatives, skill shortages remain a pressing concern in the aged care sector.

More than three quarters of aged care facilities reported skill shortages in 2012, of which a third were for registered nurses and a further third were for personal care workers.

“More than half of facilities responded to skill shortages through the greater use of agency staff, second only to requiring the existing workforce to work longer hours,” the research noted.

The study found that agency staff were “a significant proportion of the direct care workforce, comprising nearly 10 per cent of all direct care workers in the survey fortnight.”

Personal care workers were the largest group of casual staff, as they are among the permanent residential workforce, while casual nurses worked a higher number of shifts per worker than other occupations, the research found.

Increased workload and stress

Where casual staff lack organisation-specific knowledge, research has found that internal workers take on higher workloads and informally supervise casuals, thereby increasing workload and stress, the study said.

It also noted that previous research has shown the presence of casual staff can generate negative feelings among permanent employees and diminish relations between co-workers, as well as between workers and management.

“Ultimately, this has a negative impact on internal employees’ job satisfaction,” it found.

If organisations intend to use casual staff as a strategy to quickly overcome skill shortages, the findings suggest they may get caught up in a vicious circle, the study said.

It concluded:

“The ‘quick fix’ of utilising [casual staff] runs the risk of increasing internal employee turnover and, as such, of perpetuating a cycle of skill shortages.”

Given the relatively high proportion of external workers in the aged care workforce, the results of the study highlight the need for these workers to be incorporated into both industry-wide workforce development strategies and the aged care policy and regulatory framework, the authors said.

The study, by Debra King, Sven Svensson and Zhang Wei has been published in the Journal of Industrial Relations.

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Tags: casual staff, debra-king, flinders-university, National Aged Care Workforce Census and Survey, nurses, personal-care-workers, recruitment, retention, slider, Sven Svensson, workforce, workforce shortages, Zhang Wei,

6 thoughts on “Vicious cycle: use of casual staff can worsen aged care workforce issues, says study

  1. Not only does the use of casual carers, whether from agencies or other parts of the organisation, affect other workers but it also affects and causes additional stress to residents that they take care of. This is especially where some disability exists and knowing the routine and needs of the resident is essential for the best provision of care. When casual carers are used, it is then up to the resident to instruct the carer in their routine and needs, causing stress to the resident, which then overflows to the permanent carer. Often a resident has to repeat this multiple times a week with successive new carers, who may never be seen again.

  2. I realise that casuals are an important part of the work force , however problems can occur in home care of the aged, especially if those being cared for are living with dementia..
    If service providers rotate staff too often the aged person can become confused and sometimes aggressive . Life can become even more difficult for the primary carer .

    I imagine that the situation would be similar for residents in a residential facility. So too many casuals can mean a less happy group of residents as well as an unhappy permanent workforce

    A calm stable environment is a necessity for the wellbeing of those in care either at home or in a facility.

  3. The government is moving to increase subsidised care in the individual home in the future and has already begun in that direction. Currently Providers of this care employ mainly part time casual workers and there is a large turnover of staff. Clients find it quite stressful dealing with agencies and carers when carers are not assigned to one client for long. Clients have to “regularly train new carers ” who do not know the client’s needs or requirements or even what service they are providing to the client before they arrive at the client’s house. This is because most of them do not bother to check this out even when the information has been supplied to them. Due to the high turnover of staff the client carer relationship is so brief that the client can feel like a number instead if a human being. Many older clients are quite isolated and lonely and cannot form any kind of relationship with a carer because they are so transient and their very nature has to have objectivity. Travel requirements for these carers is unrealistic given the distances they are required to travel and the associated traffic conditions like roadworks everywhere. Add the poor pay and it is no wonder that the aged care system is greatly impeded by these factors. Moreover, placing the need for profit (with For Profit Providers) above the welfare of the frail aged is morally corrupt.This is a sytem that has chaotic components that need to be remedied. It is welfare and care for the frail aged. It should not be a business that is focussed on profit for shareholders. Aged Care Companies do not ethically belong on the Stock Exchange as vehicles for profit. If companies want profits they should not be at the exoense of the vulnerable frail aged. They should go into a different business. I do not expect the sector to change until all providers are not for profit, the government provides more training and makes licencing a requirement for carers, and establishes a decent minimum wage for carers.

  4. My mother suffered from dementia, and for a time was cared for at home. The staff turnover was high, meaning that mother was frequently faced with complete strangers asking for access to her home. She became frightened and even more confused, and we had to place her in residential care, which she hated. She wanted to stay in her own home, and could have done so if, and only if, she could be cared for by the same team for extended periods (years, not weeks). As it was, care in the home worsened her quality of life and I’m sure contributed to her worsening condition. Part time and temporary staff should not be employed in aged care.

  5. A really valuable piece of research and with the current and growing skills shortage more time and expertise needs to be expended on better understanding the issues and the levers for change.

    This issue effects all aspects of Aged Care, and with the current Aged Care Reforms there is also an impact in the assessment, planning and coordination of care as many organisations are hesitant to employ permanent roles while they realign their business to support the exciting new changes to the Aged Care sector which are more client focussed and really challenging the past norms of what we have been delivering.

    Some of the long term contracts being offered to skilled aged care professionals are underdone and concerning when you compare these nimble staff and their role in the change and transformation of the sector. Many are up to date with the changes, energetic and adaptable however they are often working with professionals in permanent roles who are not adapting and evolving with the current changes. How the change makers are being valued and activated will have an impact on how we maintain skilled, passionate and dedicated staff across the skills and professions required.

    Let’s keep talking, researching and trialling to get better outcomes for the mix of staff working in this field, ensuring that they work collaboratively and to ensure the good outcomes for older people, ultimately that is what we are all working in this field for…outcomes for people accessing services and supports.

  6. aged care facilities employ very many permanent but casual part time workers. These hardworking care workers often work in more than one aged care facility . They have family to support and mortgages. Should they be covid compromised what a dilemma they face as there seems to be no government nor employer system in place to compensate them for staying at home. And what a problem for the aged care sector and covid control

    they encounter covid

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