Poor conditions for carers and clients – the demand for a new solution
As the population increases, the number of people who require home care support is expected to significantly increase. By 2050, over 3.5 million Australians are expected to use aged care services each year with around 80 per cent of services delivered in the home2,3.
Consumers of home care increasingly want to remain independent and in control of how and where they live, to have choice in care providers and to remain connected to their family and community2. The National Disability Insurance Scheme also emphasises consumer-focused services providing another opportunity for new entrants such as co-operatives. The quality and consumer-focus of co-operatives is appreciated by consumers.
The sector faces significant challenges attracting and retaining suitably qualified workers to provide high quality care that meets clients’ expectations and needs2. These challenges are intensified by a tightening of the overall labour market, an expected relative decline in family support and informal carers, and strong demand for workers from other parts of the health and disability systems2. The sector needs to adopt new models of care and scopes of practice2.
The existing home care workforce largely comprises qualified women (90%) over the age of 45 working on permanent part-time or casual contracts4. Home care workers have a high level of job satisfaction, attributed to being able to improve the health and wellbeing of their clients4. In particular, satisfaction is improved by the ability to spend time with clients, form relationships and adapt the level of care required to meet their needs5.
Despite high levels of job satisfaction, employee turnover rates remain high due to a combination of factors including poor wages and conditions (e.g. casual workers do not accrue leave entitlements), occupational health and safety challenges, limited career progression opportunities and limited training4,6,7. Support workers are considerably over-represented in lower bands of income distribution; 57 per cent of support workers fall into the minimum wage category, compared to 50 per cent counterparts in other industries7. In addition, higher qualifications are not recognised in remuneration levels, there is an overrepresentation of support workers holding Certificate III and IV qualifications in lower income bands7.
These workforce challenges create difficulties for service providers to maintain quality and continuity of care for clients. As a result, clients feel unsettled by frequent changes in the individuals supporting them and the rosters they work to.
“In traditional models there are too many different carers visiting the one client… It can be can very confusing for the client when there are all these different people coming and going. Some companies have a minimum shift of 15 minutes… Clients don’t need or want to be hurried along because it’s convenient for the carer. Clients like to see the same faces and recognise the people that are coming into their homes. Sometimes they don’t remember your name but they will remember your voice or face… with so many carers coming and going they don’t feel they are being cared for – just a number.”
Rhonda, TCL member
The Productivity Commission2 argues that an increase in the level of wages and working conditions for aged care workers will increase the retention of workers resulting in higher quality care8. This will become increasingly important as there is a slowing in workforce growth and increasing competition as the overall population ages2.
Employee owned co-operatives have the potential to meet a growing gap in the market by addressing the needs of both support workers and clients by providing a supportive, empowering and autonomous work environment that results in high quality, affordable service. In addition to providing improved working conditions, co-operatives offer new affordable models of service delivery that provide clients with greater choice and autonomy in services.