Home care workers are essential – allowing nearly one million older Australians to remain at home – yet their working conditions are some of the poorest in the country.
Experts say these low minimum awards and poor working conditions are a major barrier to aged care reform, compromising quality in government-subsidised home care services.
Director of RMIT’s Centre for People, Organisation & Work, Distinguished Professor Sara Charlesworth, is a leading expert on aged care workforce issues and says the case for reform is clear.
As the Aged Care Royal Commission this month exposed fundamental flaws in home aged care, Charlesworth highlighted six aspects of home care work that call out the need for reform.
1. Home care worker pay rates are very low
The award minimum hourly rate of pay for entry-level home care workers is just $21.88.
Of just as much concern, though, is the limit to any further wage increase. The minimum rate for experienced home care workers at the top of the pay scale, who provide more complex personal care, is a little more, at $28.78.
2. Home care workers are not paid for the time they travel between clients
Travelling between clients is an integral part of the job. But while in New Zealand and other comparable countries home care workers must legally be paid for this time, in Australia the award does not provide for paid travel time.
Charlesworth said this is one of the most fundamental and basic reforms needed to improve conditions for home care workers.
3. Rostered ‘shifts’ can be as short as one hour
Casual home care workers can be employed for shifts as short as one hour and could have one, two or more of those shifts in a day.
This compares to a four-hour minimum shift for casual manufacturing workers and a three-hour minimum shift for casual health workers.
For permanent part-time home care workers, it’s even worse – they have no entitlement at all to a minimum shift time. This compares to a four-hour minimum shift for part-time manufacturing workers and four hours minimum for part-time patient transport workers.
What’s more, even for permanent part-time workers, rosters and hours can be changed at short notice.
4. Workers wear the risks and costs of staff shortages and client cancellations
Permanent part-time home care workers are expected to nominate their ‘availability’ outside their ‘guaranteed’ minimum hours. This means they are effectively on call for this period, yet are not paid any allowance for this availability.
Patient transport workers and other health workers are paid an allowance where they are on call and available to work if need be.
If a client cancels their scheduled visit before 5pm the previous day, permanent part-time home care workers are not paid for this visit and have to make up the time lost.
5. Home care work is increasingly complex and demanding
Population ageing and a long-term policy shift towards home care means older people living at home are increasingly frail and have complex health issues.
Caring for older people with dementia, depression, diabetes, heart conditions, cancers or arthritis can be tough and complex.
Many people approved for home care packages are so frail or disabled, they meet the requirements for permanent residential care.
6. Home care workers suffer high rates of injury
Health and safety regulators have identified home care work as a high-risk occupation.
Common conditions reported include musculoskeletal injuries, injuries from falls and trips, work-related stress, injuries from vehicle accidents, verbal abuse and assault.
Common risk factors are poor systems of work, such as not enough time allocated to complete care tasks.
Despite this, home care workers are often reluctant to report health and safety risks such as having to transfer very heavy clients alone or work-related violence.
Charlesworth said there needs to be a reframing of the importance of home care work that recognises the conditions of work are the conditions of care.