Formal registration of aged care workers under the National Registration Accreditation Scheme could help improve working conditions in the sector, a report says.
The Improving the health of older aged care workers study, by the University of Melbourne of the Brotherhood of St Laurence, surveyed 20 aged care workers aged over the age of 50, including over 17 women and three men.
It found an “imbalance” between the interests of service providers and those employed to give care, a third of whom also had informal care responsibilities.
“This imbalance has had unintended social and economic consequences, including compromises in the quality of care and in the longevity of the workforce,” the report says.
Joining the landscape of professional carers
The researchers propose wage increases, penalty rates, minimum shift hours, minimum contract hours and paid transit between sites to improve employment conditions and the wellbeing of workers.
But they also recommend increasing the professionalism of carers “shifting the demarcations between professional and unskilled work”, which they argue can improve the quality of care and also make the roles performed by older workers more sustainable.
Registration would boost the professional status of aged care workers, the report says.
“Many of our participants reported feeling disrespected and disempowered by their place in the staff hierarchy, and that their status as ‘unskilled’ diminished care quality and job quality.
“We suggest that formal registration of personal care would improve worker health and employment conditions, and the quality of care they are able to provide.”
The report recommends aged care workers could have their own category alongside disability carers within the National Registration Accreditation Scheme, which regulates health professions including occupational therapy, optometry, pharmacy, and podiatry.
“To register in these professions, individuals need to demonstrate accredited course completion, language proficiency, clean criminal record and recent practice. Ongoing professional development is also required to maintain registration,” the report says.
“Adding personal carers to this scheme would recognise their place within the landscape of professional carers.”
Clinical supervision and the development of specialist roles across care teams – such as falls prevention, peer support and IT – could also sustain workers emotionally and build their status as professional carers, the report recommends.
“Accredited courses could be developed, and pay rates could be tiered accordingly.”
Impact of a consumer driven market place
The researchers said the study came in response to concerns about how an aged care marketplace in which consumers are empowered to make decisions has come at the cost of employment conditions.
In home care, consumer-directed care has created instability for providers, and this uncertainty has transferred to workers, they say.
The survey found most of the care workers have few spare hours and little spare money.
Home care workers often had unpaid periods between shifts and about a third received no travel allowance.
Forty per cent wanted more hours, but because their awards didn’t specify minimum hours or penalty rates they often had to be on call for potential extra shifts.
“Work in private homes is often fragmented, with short periods of work interspersed with periods of unpaid waiting or travel,” the report says. “These dynamics have been linked to widespread worker underpayment.”
The report says workers often say that caring for older people is meaningful and important to them, and money isn’t the main motivation.
“However, qualitative studies have shown that short-staffing and restricted autonomy often compromise the intrinsic rewards of this work,” it says.
The researchers say the findings of the study underline the need to improve accredited training.
“While many employers may favour in-house training, accredited training will allow workers to specialise and or to move across care industries.
We suggest that the COAG-mandated Australian Health Practitioner Regulation Agency and the Australian Industry Skills Committee need to work with care providers to build a comprehensive suite of credentials for personal care workers in aged and disability care.”
The study says employment in the health care and social assistance sector is forecast to grow by a further 16.1 per cent over the next five years and that the rollout of the NDIS is also likely to drive competition for personal care workers.