In the face of a deregulated home care market, supporting and empowering the direct care workforce will be more important than ever, write Nicki Doyle and Roshani Manouchehri.
Good support workers are the key to winning over consumers in a deregulated consumer directed care environment. It is vital that providers overhaul their human resource approaches to attract and retain talent, and empower employees to build a sustainable competitive advantage. The workforce challenge for providers today is balancing this investment against cost competitiveness and change weariness, while dealing with recruitment challenges brought about by an ageing workforce, expansion of the older population, and disruptive e-marketplace models.
It’s all about the support worker
In the rapidly changing world of home care, there is an increased expectation on providers to customise services to consumer preferences and special needs, including various languages, cultures, religions and lifestyle preferences. In addition, care planning is goal-directed incorporating wellbeing, reablement and enabling approaches.
In essence, this means that the role of the support worker will transform into a complex mix of a companion, personal trainer, care specialist, cook, cleaner, pet groomer, driver, finance assistant, and more. Support workers must also understand and reflect customer service values, and have the skills and autonomy to be flexible while performing services for the consumer.
However, this is easier said than done. Support workers generally represent the largest and lowest paid workforce in home care service. Many are casual or part-time, with limited interaction with each other, or with the organisation. They work when rostered and as directed by the care coordinator, with little input or say into how they deliver their services.
Some providers have also moved down the path of brokerage to minimise employment costs and service delivery downtime. Increasingly, we see providers brokering higher-end services such as nursing and allied health. While this strategy may deliver cost efficiencies, the fact that the provider does not own the key resource under this model creates risks around quality and reliability.
This situation presents a conundrum for providers – a logical solution would be to invest in building a workforce with well-trained, empowered and high quality support workers; however, the current focus on cost competitiveness and need for a flexible workforce to manage demand uncertainty in a deregulated environment makes this a difficult decision.
Secondly, many providers are dealing with change weariness brought about by multiple waves of reforms impacting not just community aged care, but disability and residential aged care. Functions such as assessments and intakes have been taken away from providers, while significant new responsibilities such as budgeting and reporting have been added. Further changes are anticipated, such as the transfer or minimisation of care planning and coordination, as more customers choose to self-direct and manage their own supports.
Thirdly, providers have to deal with the recruitment challenge in aged care. Data from research firm McCrindle into aged care supply and demand shows that in March 2014, the median age for community direct care workers was 50 years, making it the sector with the highest median employee age in Australia. It is anticipated that half of the current home care workforce will retire in the next 15 years. Over the next decade, providers across Australia need to recruit an additional 650 aged care workers every month to keep up with the ageing population, in addition to replacing the 668 retiring staff per month. This creates an impending war for care talent, and the need to attract younger workers.
Taking the first steps
The strategic opportunity exists for providers to build up their human resource practices to attract and retain quality support workers. It’s not enough to just pay a support worker more. Strong values, flexible HR policies and smart technology will be far more effective and cost efficient in the long run. However, building a great culture takes time, good planning, vision and strong values-based leadership. This includes:
Investment in empowering and enabling support workers
For support workers to be responsive to consumer needs, they must first be empowered to do so. This requires providers to give their support workers the right tools and information, such as direct access to consumer information, clear frameworks of action, approval discretions, and escalation points, so that a support worker can autonomously and consistently respond to consumer questions and requests. This will require investment in staff training, and a workplace culture that encourages and rewards initiative, compassion, a spirit of service and independence.
Building a desirable culture and identity
Employees join organisations that they feel share their values. For example, if a provider wishes to attract and retain flexible and creative support workers, they in turn should implement HR systems and tools that feature those same qualities, such as encouraging consumers and support workers to collaboratively set their hours, or encourage innovative goal setting. Similarly, providers that wish to attract culturally and linguistically diverse support workers should ensure a strong culture of respect and tolerance for various cultures, including language proficiencies.
Celebrating the role of a support worker
Don’t just advertise your brand name or the services you offer on your website – put the spotlight on your support workers. Acknowledge them for the challenging work that they do and encourage them to shine by capitalising on their talents, interests and strengths. Engage with consumers to give active feedback on their experiences with the support workers and reward those who do well. This will translate to loyalty and employee satisfaction.
Preparing for the future
Strengthening your workforce with quality support workers is vital for building a sustainable competitive advantage, particularly in the face of deregulation. The disruptive e-marketplace models show just how powerful a platform can be when a support worker gets to showcase their skills, talents and interests; exercise choice in consumers they wish to work with; choose their own hours; receive direct feedback on performance; and be incentivised for it.
The portability of home care packages from February this year is the next home care reform. If Australia follows the path of the United Kingdom, we may see the direct payment of subsidies to consumers, the implications of which are yet to be realised. The UK model of personal budgets puts both funds and responsibility to employ support workers directly in the hands of the consumer where they may flexibly and legally employ family, friends, neighbours or care service providers, while a government-appointed national organisation, HomeCareDirect, provides the administration support and training to the chosen individuals, such as police checks and care planning.
If a similar model is fully adopted in Australia, the greatest challenge to continued viability will not just be competition from other providers, but also whether organisations can deliver a consumer-centric model and convince consumers that they are better off choosing a provider’s support workers instead of someone the consumer already knows and trusts.
Every support worker on your team has the potential to shine. Give them the right training, leadership and opportunity and you may create a sustainable competitive advantage as well as a great workplace and service quality outcomes to remain a key market player.
Nicki Doyle is a director and Roshani Manouchehri a manager with the health, ageing and human services division at KPMG Australia.
This article appears in the current edition of Community Care Review magazine.