Older Australians’ lives depend on a well-resourced, functional aged care system.
And despite the royal commission providing a number of recommendations, an ideal system seems far out of reach, with limited capacity to respond stemming from workforce shortages and government budgets that are failing to keep up with inflation.
Michael Maher, an aged care compliance and credentialing specialist and founder of One Passport, an app that helps to store compliance-related data, describes the situation as a “downward spiral”.
“COVID was the straw that broke the camel’s back,” he says.
“All the staff — but especially the carers — are pulling to do their job as best as possible, but you just can’t do it at 50 per cent capacity.
“So that then drives more people wanting to leave the industry.”
Maher notes that while a small number of “bad actors” may be wilfully turning a blind eye to this, most aged care managers are desperate to address these concerns, but are unable to overcome tightening budgets.
“They really do want to pay them more, but unless they get an increase from the Government in that time, they can’t pay them more.”
With aged care subsidies indexed at only 1.7 per cent this new financial year, expanding the workforce is looking like an even tougher prospect for providers.
“There isn’t some magic other place where they can charge from,” Maher says.
Training and compliance process needs streamlining
Maher says that most commonly, working Australians are not transitioning from other forms of employment to aged care.
Instead, aged care recruits are often drawn from unemployed jobseekers, referred through a job active provider.
But not all would-be aged care candidates see the process through; with the procedure onerous and unsupportive of the difficulties faced by the average person seeking employment in aged care, often a middle aged woman of a culturally and linguistically diverse background.
“So you want to make it as simple as possible regarding things like compliance,” Maher says.
“Higher pay would be great, but there are lots of other small things that can be done, such as tying up the three parts of the entry point [to aged care work].
“You go from Centrelink, to an RTO to do your Certificate III, and then [from the] RTO into a provider… Now that’s a really loose relationship.”
In fact, training placements do not necessarily lead to job offers, a demoralising experience that drives many would-be aged care workers away from the industry for good.
“A lot of the homes like that four-week placement, because it’s a ‘try before you buy’… Some won’t get a job offer from that placement, so they resign [from the industry] and go back to Woolworths.”
Maher suggests the uptake of a registry like that of the Post Graduate Medical Council of Victoria’s (PMCV) Allocation and Placement Service, which ensures graduates are provided best possible access to employment options.
“It’s a centralised system that connects all the universities that have nursing classes, nursing school … so hospitals can go shopping and everybody gets a job, making it easier to make sure we don’t have leakage.”
Once a worker is in the industry, Maher also suggests that training and accreditation — including police checks — should be better centralised, a benefit to workers and providers alike.
“You’ve got small providers who are tight on money … and they’re paying for their carers to come in and sit there for half a day to do subjects they’ve done down the road [at another facility].
“If you’ve got 100 staff and you pay for an extra couple of police checks at $50 a pop — that’s quite a bit of money that can be used on better food, and more staff members.”
“And from a worker’s point of view, they might have arrangements for childcare or an elderly parent that may be affected, they may have to come in on their ‘day off’, which is not really a day off, because they have a second job down the road, so it’s affecting their pay.”
A need for providers to take matters into their own hands
Amidst the crisis, some providers are trying to invest in ‘on the ground’ solutions.
Giovanni Siano, co-owner of Geelong home care provider Home Instead, tells Aged Care News that his company, became a Registered Training Organisation (RTO) in response to the difficulty in recruiting new workers.
“One of the main issues for the industry is attracting the workforce … especially highlighted with the not-so-good news that, due to the pandemic, there are 65,000 people that have left the industry.
“With these shortages leading to poor conditions for residents, that environment that workers are restricted in, it is no surprise that there is this massive detraction from the industry.”
In response, Siano says that he and his co-owner, wife, and registered pharmacist, Giselle Siano, are hoping to rebuild the culture of aged care organisations from the ground up to improve the appeal of the industry.
Currently, Home Instead Geelong employs just over 200 workers, but the Sianos hope, that by 2025, they are able to scale their team up to 1000 workers.
“To do that, it’s our responsibility to create an incredibly supportive environment where people feel safe, and that they have the support they need,” Siano says.
“One of our missions is to change the face of ageing… We’re trying to elevate the role of aged care worker to a profession, in order to attract people from all walks of lives to join our organisation.”
In-house training has been a key focus of Home Instead’s approach.
Caitlynne Allen, a former residential aged care worker of seven years, at present works as a trainer and assessor for Home Instead Geelong, after being given the opportunity to upskill with a Certificate IV in Assessment and Training.
“I grabbed [the opportunity] with both hands and I’ve loved every single day of it,” she tells Aged Care News.
A vital point of difference, she says, it that her office has designated trainers that are available to attend on site, to assist new workers when they’re unsure or intimidated by a situation.
“Yes, [home care assistants] are working alone, but it’s about making sure that they have resources in us, for there to be an office with more than one person there, so that one of us can pop out and actually assist and guide them.
“I’ve got an amazing team. I’ve got Deb as an assistant in training and Emma our caregiver coach, and they’re both amazing.
“On Monday, one of our of carers was a little bit nervous about doing a shower with someone, so Emma said ‘I’ll meet you there’ and headed off to assist her.
“She never takes over, she just assists them, gives them words of encouragement and that sort of thing.”
Siano says that those training through educational institutions most commonly volunteer their labour to satisfy the work experience component of their Certificate III.
In contrast, Home Instead allows workers to earn money from day one, a necessity for working Australians considering a transition in careers.
“If the cultural alignment is there, they can start from day one, working with us, as we give them all the tools to be able to study and practice as they earn a wage,” he says.
However, workers may be on the job before totally completing their Certificate III, but Allen notes that they never go into the field unprepared.
“Everyone that comes onboard to Home Instead gets a link to what we call our Empower Accounts… and they have six modules to complete before they can attend orientation,” she says.
“Then there are four modules that we have left in orientation: workplace health and safety, manual handling and technology.”
Furthermore, new workers are assigned low-skill work tasks to begin with, with higher care tasks delegated to experienced staff only.
“They’re going to typically start with basic tasks, with more lower level needs clients… a bit of shopping, some meal preparation, companionship, all with clients without dementia,” Siano says.
“As an older person deteriorates, they will be assigned a higher level package, in which case they will be assigned to our staff who are more experienced and qualified to help them.
“But since our caregivers are gaining experience and getting qualified at the same time, it could potentially be the same person staying with the client on their journey.
“We’re big on continuity of care.”
Lisa Hinton began working for Home Instead Geelong in February, after previous stints in both home and residential care.
She tells Aged Care News that despite the ensuing battle for fairer wages and conditions, she wouldn’t dream of leaving the industry.
“I love the dynamic of home care and seeing people be their best selves, because they’re in their own home environment.
“I wish I found this vocation years ago, because I feel like it’s my calling.
“What I’ve found as a mother is that once the kids are a little bit older, maybe teenagers or adults, you lose that sense of self, that identity as a nurturing person.
“So this work is a perfect way of reinventing who you are and having another sense of purpose.”
The Home Instead academy, she says, has helped enrich her career prospects as a care worker.
“One of the selling points for me was you could actually study individual support whilst working, and do your placement while getting paid.
“Not only is that validation for me and certification, but it will also increase my pay and, long term, it allows me to then do further training if I want to specialise in something.”
Allen notes that the average Certificate III takes 12 months to complete, but that it can be fast-tracked or extended, depending on a worker’s ability and commitments outside of work and study.
“Everyone has their own pace … it’s all about making sure that we’re accommodating for people’s learning abilities.
“It’s all about making sure that we’re there for them, and that’s what I love about it, the simple fact that everyone in our office is so dedicated to our caregivers.”