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Mass exodus of aged care staff expected: Survey


Matt Woodley


16/08/2022 3:30:00 PM

Half of the sector’s workers are reportedly planning to leave in the next three years due to low pay and stress, with 64,000 set to quit by June 2023.

Stressed aged care nurse
Forty-three per cent of the more than 1100 respondents to a new aged care workforce survey ranked ‘stress’ as their main reason for wanting to leave the industry.

Up to 139,000 aged care workers are planning to leave the sector by the end of 2026, a new workforce survey suggests.
 
The CompliSpace Aged Care Workforce Report, which surveyed 1110 staff from 300 services across the country, also indicates two-thirds of Australia’s current 280,000-strong workforce are unlikely to still be working in aged care in five years’ time, with the job’s demands increasingly taking a toll.
 
In addition to pressures resulting from the COVID-19 pandemic, many fear that proposed reforms set out by the aged care royal commission cannot be realistically implemented, as the sector struggles with a lack of qualified aged care staff.
 
One of the proposed reforms causing the most concern, according to the report, is the introduction of a mandatory 200 minutes of personalised care per resident per day from October 2023, which will rise to 215 minutes in 2024.
 
Fifty-seven per cent of respondents said the targets are ‘impossible’ to reach within the required timeframe, while 37% believe they will be difficult to achieve.
 
Dr Sachin Patel, founder of Aged Care GP, told newsGP the findings are in line with his own experiences, warning that the sector is on the precipice of a ‘workforce disaster’.
 
He believes many of the recommendations have been made by people who do not have a realistic understanding of the current pressures facing workers.
 
‘The problem is … you’ve got people who are far removed from the reality making decisions,’ he said.
 
‘Those who are best placed to give the solutions are too busy doing the actual work, to contribute to things like a royal commission.’
 
In his opinion, the level of paperwork has become too onerous for many aged care workers and is preventing them from caring for residents, while at the same time is contributing to the high numbers of people looking to leave – and the mandatory care requirements will only make it worse.
 
‘It just turns people off because the meaningful part for people who want to do this work is the connection with the residents,’ he said.
 
‘These types of rules coming in are great, in theory. The problem is those who are on the shop floor will tell you the reality does not match the theory.
 
‘You’re going to get this situation where people are spending time filling out paperwork when they should be spending with the residents – but they can’t, because they’ve got to do the paperwork to prove they’ve spent the time.
 
‘There’s accountability. And then there’s “tick-box” micromanagement.’
 
Associate Professor Paresh Dawda, a director at Prestantia Health, which provides primary care services to people living in residential aged care facilities (RACFs), told newsGP while the regulatory framework is ‘well intentioned’, it is resulting in a culture of ‘compliance rather than commitment’.
 
‘The compliance regime is leading to a mountain of paperwork with the goals of satisfying the regulation and losing sight of the reasoning behind the regulation,’ he said.
 
‘Whilst a degree of turnover is expected it does seem high and this adds to the recruitment and training costs for providers.’
 
Most respondents (79%) reportedly have no confidence that the reforms will improve outcomes for residents, while 84% anticipate that the aged care homes that they work for will need to make major changes to systems and processes to cope with regulatory changes in 2022–23.
 
Rather than regulatory reform, attracting new workers appears to be their greatest priority, with 90% saying that the addition of new staff over the next 12 months would be ‘very beneficial’.
 
To this end, Federal Aged Care Minister Anika Wells recently committed to a ‘significant, meaningful’ pay rise for workers, but also warned that it may need to be spaced out over several years.
 
‘The number one issue that everybody wants to talk to me about in aged care is workforce shortages,’ she recently told Sky News.
 
‘We need to do something to value aged care workers better and that starts with a pay rise.’
 
More than two-thirds (69%) of workers reportedly believe that they should receive an annual pay increase of more than 20%, including 47% who indicated that the pay rise should be more than 25%.
 
The Federal Government has committed to paying any wage increase approved by the Fair Work Commission, which is expected to report later this year, or in early 2023. A 25% pay increase would cost government an estimated $4 billion a year, on top of the $26 billion it currently funds.
 
Meanwhile, a recent study from the University of Technology Sydney found that more than 60% of RACFs are operating at a loss, while 26% of home care services are experiencing decreased financial performance compared to last year, limiting their ability to pay staff more.
 
Dr Patel believes providing an environment that allows workers to focus on caring, rather than administration, would have an even greater impact.
 
‘Giving more money might make people stay a bit longer, but it’s not going to make people stay in the long term,’ he said.
 
‘We need to find ways to make it meaningful for people again, that means they need to be able to feel like they’re growing and making a difference.
 
‘At the moment I think many would tell you that they have to show that they’ve looked after people at the expense of actually looking after them.
 
‘You’ve got to turn it back into actually caring for people.’
 
Among respondents to the CompliSpace survey, 43% ranked ‘relationships with residents and families’ as their top reason for staying in the industry, while 89% included it in their top three reasons for staying.
 
Meanwhile, one quarter ranked ‘job satisfaction and fulfilment’ as their top reason for staying, whereas only 8% of workers ranked remuneration as their top reason for staying.
 
For Associate Professor Dawda, the significance of workers feeling valued ‘cannot be underestimated’.
 
‘Pay is a factor, but equally important, if not more, is for people to feel valued and a sense of belonging,’ he said. 
 
‘Unfortunately, working in aged care is perceived by those outside as the “Cinderella” of the workforce – having colleagues respect aged care workers is an important aspect of feeling valued.’
 
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Dr Leah Curtis   16/08/2022 7:12:30 PM

The government and health Dept need to develop and share programs, policies and procedures and similar documentation with aged care facilities that are simple and quick to use, subsidise computer software and hardware etc. Each facility I visit spend huge amounts of time creating unique forms (chemical restraints a classic example), policies etc which creates a burden to them but also to GPs who have to do things differently every place we go. Many places can't afford computerisation (clinical and medication) and those that do make it hard for the GP to share info between that system and our software (need for record keeping etc). The paperwork and red tape involved in aged care is a tipping point for me.


Dr Peter James Strickland   17/08/2022 2:09:35 PM

The problems with aged care are going to definitely worsen. What are the problems? Too much bureaucratic nonsense by government, too little pay and care of the carers, too little input by many families to help their loved ones in social and financial ways, and too little incentive for GPs to visit nursing homes. Over about 40 years plus I spent 50% of my NH time doing unpaid work --writing referrals, writing scripts, admitting the NH patients to hospital etc. Governments want control, but don't want to spend the money. The best assessors of NH functioning are GPs who visit --they can see the clinical state and nutrition etc of their patients --I did it all the time--not some arbitrary public servant trying to justify their pay, and going by some often impractical set of standards that are often unrealistic in the real world, and do not benefit anyone. Same applies to GPs rebate relations with Medicare---massively inadequate, and inexperienced public servants interfering!


A.Prof Christopher David Hogan   17/08/2022 9:51:36 PM

Problems affecting Aged Care include
• Ridiculously low remuneration for working in Aged Care ( a traffic management officer earns much more for much less skills & responsibility)
• Excessive paperwork & inappropriate regulation affects all staff working in aged care.
When you read as many resident histories as I did you wonder if there is any assessment of the literacy of staff
o Current estimates are that 20% of the aged care workforce has literacy & numeracy difficulties ( for those educated in Australia).
• The poor health literacy of the population leads to inappropriate expectations by relatives & friends of residents resulting inappropriate & even vexatious complaints against staff & even violence against staff.
• There is no obligation for ongoing staff education (Certainly there is no protected time & adequate funding to facilitate this)