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Originally published in Australian Ageing Agenda on May 10, 2024

“Mandatory and coordinated accreditation would allow workers to have their skills recognised, boost job satisfaction and make the industry more attractive as a long-term career.

“The Aged Care Royal Commission has been crystal clear about the need for these reforms. It’s beyond time to deliver them.”

An aged care worker registration scheme including minimum education and ongoing training requirements is the missing piece of current aged care regulatory reforms addressing workforce problems. Without this, there is a risk too little progress will be made on developing the care workforce and improving the status of aged care work. Yet progress is critical to building a sustainable aged care workforce that can meet current and future care demand.

Increases in award minimum pay rates and current reforms to aged care regulation are moves in the right direction. However, more needs to be done to ensure Australia has an appropriately skilled and qualified aged care workforce able to provide safe and high-quality care.

The recent Fair Work Commission decision to award significant pay increases to direct care workers recognises the long-standing undervaluation of aged care work and the skills required to perform the work. The industrial tribunal awarded benchmark pay increases of around 23% to properly reflect the value of the work, including the exercise of ‘invisible’ skills. This decision provides important formal acknowledgement that the characterisation of aged care work in our industrial system has been blind to the skilled nature of personal care work.

Decent pay is incredibly important for a skilled sustainable workforce. It is vital for the economic security of workers and for the dignity and respect they are afforded. It matters for making aged care work a viable employment option and it matters for quality and safe care. However, this recognition of skill need to be accompanied by other mechanisms to consistently engage and support workers in ongoing training and development.

The Royal Commission into Aged Care Quality and Safety recommended a care worker registration scheme with requirements for a mandatory minimum certificate III qualification and ongoing training. In its current form, the new aged care regulatory framework is only a partial response to the Royal Commission’s recommendations and to those of earlier inquiries, investigations and consultations that also advocated mandatory minimum qualifications for aged care workers.

The omission of minimum qualification and ongoing training requirements from proposed worker registration is out of step with the widespread appreciation that a skilled, competent and qualified workforce in decent jobs should underpin quality and safe aged care.

The new Code of Conduct for Aged Care provides some formal benchmarks, setting standards for behaviour that require workers to be able to apply a broad range of knowledge and skills. The Code of Conduct places clear obligations on workers. Yet, these standards and obligations are not matched by requirements for concrete actions and investment to ensure workers attain the required capabilities.

The strengthened quality standards for aged care providers include workforce planning and human resource management outcomes that place the onus on individual aged care providers to identify and provide the training and supervision workers need to perform their jobs.  The standards specify five core matters in which workers are to ‘regularly receive competency-based training’ but do not set minimum standards for training, or identify skills and knowledge requirements. There is no system-wide articulation of the full range of skills and knowledge required by aged care workers and no benchmarks requirements for personal care workers to maintain and continue to evelop their skills and knowledge.

The strengthened quality standards have been welcomed as providing greater clarity about expectations and as ‘refining rather than fundamental change’. But the recommendation of the Royal Commission was not for refinement, but for a more fundamental change: the establishment of an across-the-board consistent minimum qualification for workers and a requirement for continuing development.

A national aged care worker scheme would provide the basis for building the required capability for quality cand safe care. It would support ongoing learning and specialisation for responding effectively to the diversity and growing complexity of care needs across all aged care services.

The benefits of a national worker registration scheme with requirements for a minimum certificate III qualification and ongoing training would accrue to people receiving care, aged care workers and providers, government and the general community. Benefits would include higher quality and safe care, a foundation for better jobs and careers, and increased system responsiveness and stability.

Better retention of workers would result in a more stable workforce, reduce the costs of turnover, and increase opportunity to strengthen workforce capability. It would support better continuity of care, a key factor in care quality and consumer satisfaction. Other benefits would include improved information for better workforce planning and system sustainability.

Risks and possible negative consequences of introducing minimum qualification requirements include restricting occupational entry and increasing worker exits, and a potential lack of regulatory alignment with the NDIS, which could negatively impact on worker attraction and retention in aged care. However, these risks can be mitigated, including through grandparenting provisions for the current workforce.

The most significant costs of a scheme would be short-term establishment and initial training costs. These would be limited, as around two-thirds of care workers already hold relevant qualifications costs. Benefits of a national scheme would far outweigh costs.

The potential for multiple ongoing and longer-term social and economic benefits strongly supports implementation of a new registration and accreditation scheme. “The Aged Care Royal Commission was crystal clear about the need for these reforms. It’s beyond time to deliver them.

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