3 strategies to resource your care minute target

By Petra Awad, Manager

Much has been publicised about the 35,000 per year projected workforce gap expected over the next decades if systemic issues are not addressed. Many of these concerns are macro-level and must be configured across the entire sector, such as the growing global competition for care workers, lags in migration processing, the need for higher pay across the industry, and the public perception of careers in aged care.

Workforce Australia and the Department of Health and Aged Care are currently implementing sector-wide workforce strategies[1], investing $402.2 million over 2022-25 to grow the clinical care workforce of nurses and allied health professions by removing barriers to entry, upskilling the workforce with training and qualifications that will enhance the quality of care delivered, and strengthening the workforce nationally, including in rural and remote locations. These programs include:

• Workforce Bonus Payment
• Care and support regulatory alignment
• Clinical placements
• Rural Health Multidisciplinary Training
• Care Together – Cooperative and Mutual Enterprises

However, with this October’s mandatory care minutes deadline looming, what are some practical steps you can take as a provider to support and grow a sustainable workforce that meets your obligations? The commission recently indicated it would monitor recruitment efforts for providers that are failing to meet their 24/7 RN and care minute targets as an indication of genuine efforts to comply.

In this article, we focus on residential aged care Registered Nurses (RNs), Enrolled Nurses (ENs), and Personal Care Workers (PCWs). Acknowledging each region has a unique set of workforce challenges and opportunities, state-based initiatives such as Crest NT and the rural locum assistance program offer some localised interventions. The Federal Government has also launched the Home Care Workforce Support Program to increase the size of the PCW workforce by 13,000. Reach out to us if you would like assistance identifying state-based and home care opportunities.

Maximising Minutes in your Existing Pool

The 2021 Care Workforce Labour Market Study showed that a very high proportion of the direct care workforce is employed in part-time or casual positions, with PCWs (61%) and RNs (59%) more likely to work part-time. Approximately 30% of the residential aged care workforce say they want to work more hours and around 11% hold multiple jobs. Reasons for this vary greatly, including system settings, historical arrangements, and changing business models. The mismatch may also be due to a gap between employee preferences and provider needs which presents an opportunity to increase the relatively low average hours and underemployment in your workforce by tailoring solutions to fit the individual. Some solutions may include:

• More flexibility in rostering and workforce planning, including the availability, timing, and location of shifts
• Removing barriers to working across facilities
• Addressing training and skills gaps

Approximately 30% of the workforce does not hold a relevant aged care qualification. While there are currently no minimum standard qualifications for entry-level care and support workers, as we know, many providers do hold a minimum Certificate III requirement for their PCW staff.

Are there currently unqualified staff across your facilities that may be interested in a side-step into carer positions? What about ENs that can retrain as RNs?

If barriers to participation in education and professional development are addressed, the existing workforce could have a greater capacity to meet the growing demand for services. Again, this requires a flexible and tailored approach for each staff member, with a focus on measures such as mentoring, reimbursing, or subsidising expenses like study and childcare, and ensuring they can learn while staying gainfully employed. Some initiatives to explore with staff include:

• The Department of Health and Aged Care has made fee-free and subsidised TAFE places available for new aged care workers
• Aged Care Transition to Practice Program supports EN or RN staff at the beginning of their career or those re-entering aged care from another sector
• Scholarship opportunities are available through the Australian College of Nursing for PCWs, nurses, and allied health professionals working in aged care
• For general upskilling, the University of Tasmania has made several free, short, online learning modules available.

Staff Retention Strategies

While government retention bonuses such as the Aged Care Registered Nurses’ Payment may help to keep RNs in-house for set periods, there is much more that can be done to improve the value proposition to your employees. Workforce turnover has been linked to several factors such as high workloads, work pressure, inadequate staffing, working conditions, and pay.

Professionals aged under 30 and nurses were ranked most likely to intend to leave the aged care sector in the next year or two[2]. Additionally, exits from the workforce are most likely to occur within the first few years, indicating the need for tailored retention strategies for early career cohorts. Good leadership, supervision, and support, as well as training and skills development, are vital for this group.

A large factor in workforce attraction and retention is the availability of opportunities for employees to grow and progress their careers. The Human Services Skills Organisation has been piloting better-defined career pathways, linked to stackable training, allowing staff to build their skills throughout their career and advance to higher level roles. At higher skill levels, career paths are more clearly articulated and structured, so a focus on mirroring similar professional development pathways for floor staff – leading to higher pay and responsibility – is vital to workforce longevity. The benefits of accumulating more skills through additional training at this level are normally focused on regulation and compliance and not clearly linked to career progression, which is a commonly cited reason for people considering leaving the sector.

The median age of PCWs and ENs is 40-49 years and for staff in older age groups, the work can be physically demanding and may impact their desire to remain in the sector. Strategically investing in innovation and new technologies can address multiple workforce challenges including:

• Reducing the high labour intensity for floor staff
• Improving quality of care
• Streamlining administrative tasks
• Freeing up capacity to spend more time with residents

Ultimately, this can lead to overall job satisfaction and wellbeing. The Aged Care Research and Industry Innovation Australia grants provide funded opportunities to partner with research institutions and implement an array of innovative solutions for the aged care sector, including new technologies.

A natural add-on to innovation is ensuring staff have the appropriate digital literacy training to ensure they are competitive and empowered to continue performing in a more technologically augmented workplace.

Workplace culture is another important aspect of retention and often the hardest to get right. However, it can also be an inexpensive way to keep valued staff within your organisation. Some simple tactics include:

• Regularly and publicly recognising and rewarding efforts, perhaps through gifts and bonuses
• Organising social events
• Ensuring there are avenues to welcome staff suggestions and constructive criticism
• Prioritising staff wellbeing and implementing practices to avoid burnout
• Communicating openly and honestly with your employees and checking in regularly with them
• Increasing the visibility of managers on the floor

Many staff highlight manager engagement and leadership as key to career satisfaction and being able to spend time with and support older Australians remains the biggest driving factor for staff valuing work in the aged care sector. Any combination of proactive tactics you use to retain staff will ultimately bring people back to this central tenant and improve the day-to-day culture.

Recruitment Pipeline

We have looked at building training and career pathways for existing workers but we also need to ensure a consistent funnel of skilled staff coming in at entry-level. Innovative partnerships with tertiary providers will backfill those retiring or leaving your organisation and create a supplementary workforce that can bolster the work of more experienced staff.

Australian Apprenticeships is a government initiative to get more trainees into the sector. In 2021, there were over 1800 completions, 4500 in training, and 2300 commencements in the personal carer category. A new wage subsidy commenced in July 2022 to incentivise employers and there is a dedicated service, the Australian Apprenticeship Support Network, to help providers identify the right training options, find candidates, claim incentives, and complete the associated admin. Importantly, partnerships with training providers also help influence the course curriculum and integrate the knowledge and competencies you would like to see in your future workforce.

Diversification of the employment pool is another area to consider. The aged care workforce is up to 90% female – while this needs to be sustained and grown, are there unique value propositions that can be incorporated in your marketing that would attract more male applicants?

Only around 2% of care workers are Aboriginal and/or Torres Strait Islander – what are the local community organisations you can work with to understand how to engage First Nations staff and identify people with the right skills to transition into aged care? Having a culturally and linguistically diverse workforce also improves cultural competency across the organisation and the experience of residents.

Another underrepresented group would be people with disability – reach out to your local NDIS Disability Employment Services to understand and fund the supports their jobseekers need to enter the aged care workforce.

Currently, about 30-40% of the aged care workforce is made up of migrants. In addition to existing employer sponsorships, the Pacific Australia Labour Mobility (PALM) scheme will allow eligible aged care providers to hire workers from nine Pacific islands and Timor-Leste to plug the gap in local supply. The pilot scheme enables workers to complete their Certificate III in Individual Support (Ageing) and expressions of interest are currently being sought from existing PALM scheme employers in the aged care sector to participate in the expanded pilot.

Addressing barriers to participation for a more diverse workforce, including providing career pathways and mentoring, will be critical to attracting a new range of workers. Other existing initiatives and strategic partnerships to tap into are:

• Workforce Australia provides employment services and connects job seekers with employers
• The $2 billion JobTrainer Fund supports training places for job seekers and young people in areas of skills need
• Launch into Work initiative is for businesses who want to use a pre-employment project to fill entry-level roles
• Referrals from existing staff are highly effective. An informal event where existing staff can refer a friend may be a good way to attract potential employees who may find the traditional application process daunting

System-wide, there also needs to be a coordinated effort by employers, unions, and Federal Government to increase award wages and consider remuneration structures that enable career progression. The industry and government should review and revise conditions like minimum shift lengths, paid travel time, and cancellation of shifts under relevant awards to offer more flexibility and attract new workers.

These are just some avenues you can explore as an employer that are within your control. The above initiatives show steps are being made in the right direction to decrease the gap between supply and demand in the sector. Although some may not see immediate results and do require long-term investment of your time and resources, it is vital that workforce restructuring is implemented longitudinally as the benefits will continue to grow.

If you would like to discuss any of these workforce strategies, please contact us:

[1] A Matter of Care: Australia’s Aged Care Workforce Strategy https://www.health.gov.au/resources/publications/a-matter-of-care-australias-aged-care-workforce-strategy and National Care and Support Workforce Strategy https://www.dewr.gov.au/workforce/resources/national-care-and-support-workforce-strategy

[2] Aged Care Workforce Industry Council https://acwic.com.au/factsheets/

We can work with you to undertake a gap analysis, embed processes, and support your team through the aged care reforms.