The royal commission’s recommendation to regulate the personal care workforce through registration will create barriers for new and existing staff, an organisational psychologist tells Australian Ageing Agenda.

The aged care royal commission made 148 recommendations to overhaul the aged care system including for government to create a national registration for personal care workers by July 2022.

Key features of the proposed scheme include a mandatory minimum Certificate III qualification, ongoing training, minimum levels of English language proficiency and criminal history screening.

The commissioners also propose a code of conduct and power for the registering body to investigate complaints into breaches of the code and take disciplinary action.

Commissioners Lynelle Briggs and Tony Pagone said the commission heard “harrowing stories of abuse in aged care perpetrated by care workers”.

“We also heard of the anguish of the families of the victims that there is nothing currently in place that enables the perpetrators to be excluded from the sector. A registration scheme will enable those who are not suited to care work to be excluded from the sector,” the commissioners said.

For existing personal care workers who do not meet minimum qualification requirements, the commissioners recommend transitional arrangements that allow them to apply for registration based on their experience and prior learning.

“It needs to be sector wide and the whole thing needs to be bipartisan… Without those increased wages, nothing’s going to move.”

Professor Denise Jepsen

Macquarie University’s Ageing and Aged Care Researchers Network chair Professor Denise Jepsen said a registration scheme would create issues for new and existing staff.

“We’ve got such big shortages and while registration will help to give the impression of career opportunities, we still need to get more entrants into the sector. We don’t want registration to act as yet another barrier to entering the sector,” Professor Jepsen told AAA.

Professor Denise Jepsen

 “We’ll lose some people who won’t want to go into the registration level, if they’re not committed enough to bother with registration,” said Professor Jepsen, an organisational psychologist.

There are also quite a lot of workers who work in aged care on and off around raising children or taking care of family, she said.

“I am concerned that some of that opportunity to come back might be lost by putting in registration.

The definition of disciplinary action in the recommendation is also unclear, she said.

“If a care worker has been reported because somebody ended up with a bruise, then does that mean it’s the end of their career? Does that mean they’re going to have a strike or something on their record?”.

Professor Jepsen said the cost of the registration was an issue for aged care workers who are already struggling with low wages and a minimum qualification could deter new entrants or trainees.

“There should be a balance to allow new entrants to trial [aged care] and not provide this huge barrier that they can’t come into our sector,” she said.

The commissioners also made recommendations to lift award wages to reflect the work value of aged care employees and to ensure equal remuneration for men and women for work of comparable value.

Professor Jepsen welcomed the recommendation for increases in award wages and said better pay was “absolutely fundamental” to reform.

“It needs to be sector wide and the whole thing needs to be bipartisan… Without those increased wages, nothing’s going to move,” she said.

Professor Jepsen said she would have liked to have seen the commissioners recognise the intensity and emotional burden of aged care work in their recommendations, and more opportunities for personal care workers to work with allied health professionals.

Staffing key to quality

Annie Butler speaking at the LASA Aged Care Transformed virtual event

Australian Nursing and Midwifery Federation federal secretary Annie Butler said it was clear from the report that workforce and staffing levels were critical to improving aged care quality.

“It acknowledges that there are many ingredients in enabling high quality and safe care across the aged care sector. But unless you get the staffing right with the right numbers, the right skills, and most importantly time to care, you’re not going to achieve that high quality,” Ms Butler told Leading Age Services Australia’s Aged Care Transformed virtual forum on Wednesday.

Health Services Union Gerard Hayes said the government needed to get worker conditions like remuneration right before the sector could attract and retain the right people.

The broader community’s perception of aged care also needs to change, he said.

Gerard Hayes

“People have a mindset that’s not true if you work in aged care. We need to be able to deal with that in a public forum and be able to promote the attraction of aged care,” Mr Hayes told the forum.

To address staff shortages, Ms Butler said provider should start by identifying aged care staff who want more hours including those who have more than one job.

“We saw that revealed during the pandemic where we found out how many workers have multiple jobs because they need to make ends meet. They would want to work more hours,” she said.

These are the people we need to go to first to get staffing right, Ms Butler said.

“We need to assess what we’ve got first, what we can do with the pool available to us, and then look at the strategies we need to build supply,” Ms Butler said.

The LASA Aged Care Transformed forum took place on 9 – 10 March.

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6 Comments

  1. While I absolutely agree that care workers need to be able to speak English competently and confidently if their native language is not English, I am concerned that the proposed level of proficiency will serve as a barrier to staffing. To attain the required level will be time consuming and costly for people who are already poorly paid. Some people who are wonderful, caring people may be excluded because they are unable to attain this level.

  2. Workers registration was an issue raised many years ago and should not be feared. This should not be just about aged care workers names on a list – this could and should indeed be the first strong community message that aged care work is a professional that deserves to be recognised for the substantial contribution it makes. Many professions have registration requirements, along with a gradated career progression recognition [Associate – Member – Associate Fellow – Fellow et al] opportunity to which everyone in the industry could aspire should they choose to. Imagine centralised education records including the maintenance of Continuing Professional Development and eliminating the need to manually record education and CPD experience to send through to other professional bodies. The models for such registers and memberships already exist and could be readily licensed and adapted. If we do this right it will be a boon for employment in the industry and recognise formally the amazing work done for so many by so few.

  3. I agree that staff across all of the aged care system need to have minimum of Cert III training as well as Manual Handling training to support them. Employers are responsible for the quality of care provided and need to invest in staff they want to retain.

  4. Thank you for this very insightful article. Staffing is not just about recruitment. It’s a combination of successful workforce planning and retention programs at the operational level. Rostering staff need to be strong customer service champions. Know their internal teams need for more hours. The hidden costs of recruitment are high costing organisations millions. Retention and constructive culture are key to slowing the revolving door.

  5. We need more workforce in Aged Care, but we have to have more skilled responsible staff to deliver the care. PCA’s do a wonderful job at the basic care level but extended education and assessment for them would mean better outcomes for our Aged Care industry.

  6. I agree that all care staff need to be registered, at the moment they are not accountable in any legal form.
    All providers who educate Certificate 111 and up should be on the same page, there are to many providers and the course content and how it is taught is to varied.
    It should only be provided as a TAFE certificate at a minimum.
    The course requires more hands on time, education in time management and seeing residents as human beings rather than just a task.

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