Workforce strategy: what the aged care sector is telling taskforce
Establishing a code of practice, pay and conditions, and better recognising personal care workers are among the issues that sector stakeholders have raised with workforce taskforce, says chair John Pollaers.
Establishing a code of practice, pay and conditions, and better recognising personal care workers are among the issues that sector stakeholders have raised with workforce taskforce, says chair John Pollaers.
I have long been concerned that as a society we treat ageing as a problem, a sign of weakness.
Australia has the opportunity to reframe this thinking so older people and their families and carers feel inspired and equipped, not helpless and confused.
Ageing well, with dignity and independence, is something everyone deserves.
Expectations of the aged care sector are understandably high. Everyone wants their family members to be treated with dignity and respect. But equally, we all want an aged care industry that the community values, which attracts and retains a workforce that’s proud of its contribution to society, and is recognised and rewarded accordingly.
The Aged Care Workforce Strategy we are developing views the aged care sector as an economic contributor, not an economic cost, to the community and nation more broadly.
This strategy is based on extensive consultations and engagement with consumers, their families, workers, employers, health professionals, volunteers and informal carers.
The strategy will be shaped around five “imperatives” – leadership, organisation of work, skilling, innovation and the practical application of research and technology.
I’m keen to make sure this strategy is more than words on a page. It needs to reflect the views, challenges and vision of the sector. And it must be owned by consumers, the workforce and industry as a whole, as these are the people who’ll bring it to life.
The taskforce is making real progress in identifying the many challenges and issues facing the sector, and, most importantly, coming up with a strong vision for the future.
Early feedback from sector
During the past few months I’ve heard in detail about the real issues the workforce strategy will need to address, such as the impact of massive demographic change, disparity between providers, the need for new skills and knowledge as the nature of work changes, and supply and retention of the workforce.
I have also heard the feelings of a sector that wants Australia to understand why it matters to the future of us all.
For many, accessing aged care is far more difficult and burdensome than it need be.
We need a whole-of-government, industry and community effort, across the health, education and training, human services and employment portfolios, with a focus on the needs of the consumers of aged care. It isn’t about fitting consumers within the current system but rather it’s about enhancing their lives.
Based on the consultations so far, some clear actions are emerging.
Qualifications and pathways
Education and training is an area requiring change, especially boosting the competencies and skills of the existing workforce, with a focus on practical skills and known competency gaps. Notably, the job title of “personal care workers” needs to be reassessed so people working in the industry see themselves as professionals, and the full range and value they provide is better recognised.
Similarly, there’s the need to reform education and training offerings provided for the industry through the vocational education and training system and higher education. This includes examining entry-level qualifications, and career pathways, along with recognition of the full range of competencies required as we move toward living well models of care and recognise the benefits of integrated care.
Care planning
Another emerging area is care planning and profiling people to inform models of care. For residential aged care, this includes planning care over days, night and weekends. These models of care need to emphasise the relationship between staff and consumers, with a focus on quality of life, rather than purely clinical care.
We need to think more about the consumer journey, and improving connections between home care, residential care, primary care, sub-acute care, functional health and financial and retirement planning. Workforce planning and skills mix modelling is emerging as an industry-wide competency that can be strengthened to ensure clearer line of sight between existing and emerging business models, their consumer profiles, individual/aggregate care plans and the workforce decisions being made.
Dementia, palliative care
It is no surprise that equipping the workforce to respond to dementia, mental health, and end-of-life are also areas that have been raised. The workforce are at the frontline, dealing with death and dying every day, and we need to look after their health and wellbeing and give them support and recognition. These issues are appearing across the aged care, primary care and acute care systems – all part of the aged care workforce and each requiring a renewed focus.
Pay and engagement
Pay and conditions includes benchmarking pay against comparable industries and understanding the variations in pay across the industry in addition to the other factors that are equally important as part of employment arrangements. There needs to be a better alignment of employee engagement factors to help attract and retain people to the industry.
Using evidence
Another area that’s been raised is the importance of using research and data about care outcomes to inform best practice and improve the transparency of the industry. We need a change in mindset, where the industry shares best practice and focuses on accountability and transparency of data.
Establish a code of practice
For me, transparency is paramount and there is a clear opportunity for the industry to step ahead of community expectations and establish its own code of practice. This could define standards of quality and safety in a “living well context”. By focusing on aspirational expectations of the industry it could go beyond matters of compliance in addressing consumer-led approaches, community engagement, board governance, best practice sharing, industry benchmarking and workforce accreditation.
Supporting research, technology
We’re hearing feedback about improvements to government funding approaches to research and the need for a fresh look at the ecosystem required to support academic, industry and government partnerships in the translation of research and technology into new models of care and practice.
Diverse settings
We’ve also heard about the need for the workforce strategy to cover the specific circumstances applying in rural, remote and very remote settings. We also know that increasing recognition of the diversity in the aged population will drive demand for a greater diversity of services in the sector.
Sharing our insights and successes will be important as we execute the strategy and bring it to life. I encourage all stakeholders to take the time to contribute to this vital work over the next few months.
Online consultations are open until March 16. Information about face-to-face community and industry consultations and the second phase of public consultations is available here.
Professor John Pollaers is chair of the Aged Care Workforce Strategy Taskforce.
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In our report on the national evaluation of the TRACS program, the uptake of workforce education was significant with over 6,000 workers participating in programs offered by TRACS. Interestingly, in open ended feedback workers repeatedly used the term ‘hungry for it’ in describing the demand for training with a focus on developing care and clinical skills. To me, it said so much about a system that has not invested in workforce education. A copy of the report can be found at https://agedcare.health.gov.au/sites/g/files/net1426/f/documents/08_2016/final_nationaltracsevaluation_wiser_finalreport_for_website_publication_march_2016.pdf
I am struggling to see how a change of name for PCWs will make them more professional. Professionalism comes with such things as education, qualifications, a code of conduct and a membership council/body. Older people in RACFs are frail with complex care needs – no longer is the setting “homelike” and the care provision needs to move alongside the complexity of care needs. Such a situation needs gerontologically trained RNs over seeing and providing the care – not concentrating on funding. CEOs must no longer be able to direct the funding to their salary package – aged care funding must be used for the care and treatment of older people.
To be fair, this is the best assessment to date of the gaps and possibilities moving forward. The Strategy aims to improve the industry and workforce as a whole particularly in relation to education around the complexities of care. However, I will point out that there is a whole range of other supports in the sector (like counsellors) who can be part of the workforce. Let’s broaden workforce to a diversity of experiences and supports in this system of care.
In planning for aged care in the future we must not forget the informal carers, particularly with the number of older people being cared for at home (with or without a package) increasing considerably. Education is extremely important for those in the paid workforce but informal carers need training as well. Their task exists 24/7, often with little or no respite. The transfer of knowledge into practice should not cease at the paid workforce level.
Community programs of “home visits” by volunteers who have attended a peer education course could be a possibility if the extension of the Key worker program was not a viable economic proposal.
Those of us in the later stages of life should not have to worry about becoming a burden or fear that place in a residential aged care facility cannot be arranged if the three key criteria (area in which you live/availability of vacancy/affordability) are not satisfied.
Older people in care have multiple conditions and need multidisciplinary teams that know how to provide person centred care together. There is no room for professional boundaries. There is an urgent need for easy access to geriatricians. Many GPs hate going to aged care facilities and this can be addressed with available Nurse Practitioners who can refer directly to specialists. PCAs can do a great job with the right leadership. Continuity of care is essential and the skill set and rostering needs to take this into account. The clinical skills of RNs and ENs must be developed and tested. Screening tools with alerts would assist PCAs to do a lot of care but they need responsive ENs and RNs. All nursing should be guided by NPs. There must be incentives to encourage GPs to really be engaged in the team.
I witnessed an online discussion where people were discussing the cheapest and shortest course to get them employment in aged care. They said 8 weeks with a 3 week placement.
Would we allow people with such inadequate training to look after any other segment of society, let alone some of our most vulnerable, frail and high needs people.
I support your comments Rhonda – this is our experience in our rural public residential care facility. I wish we had a NP to facilitate & lead so incentives for GPs to be engaged in the multidisciplinary team is challenging due to their competing priorities. However with support of Aged care peak bodies and PHNs I remain optimistic we can work collaboratively towards just such.
There must be regulation on the profits generated by the Aged Care Institutions so that more of these funds are actually used to better care for residents and their Carers (staff). Short-staffed, harassed workers are presently unable to deliver the critical care often needed by residents who have sold their homes and paid huge amounts for their care. No wonder they and their families are so unhappy! A much-need pay rise to say $40 per hour would still be inadequate reward for how hard these people work, but would, hopefully, attract dedicated staff getting enough money to live on, and ensure our care facilities are properly staffed.
What about Staff to Consumer ratios? When staff are overworked and do not have time to enjoy the work they love, which involves engaging with older people they become frustrated, under appreciated and extremely stressed. By providing adequate staff:consumer ratios staff are able to enjoy the work they love and actually encourage older people to be active participants in their own live. Care for older people does not always need to be task orientated when there are adequate staffing levels.