How are we going to solve the problems plaguing aged care? “We’re going to do everything we can to fix this”

Nurse overworked

When Louise O’Neill was appointed Chief Executive Officer of the Aged Care Workforce Industry Council last year, the appointment brought her working life full circle. 

O’Neill was a registered nurse for 22 years, and often worked in aged care homes. She was also responsible, later in her career, for the workforce reforms that came from the ‘Living Longer, Living Better’ campaign. 

She understands the challenges aged care workers face because she has experienced them first-hand, and to now have an opportunity to fix some of the problems plaguing the sector is a “privilege”, she told HelloCare when we caught up recently.

O’Neill is at the helm of an organisation that is working closely with all sides of the industry – unions, providers, the government – to try to redefine what a career in aged care means.

“For me this was completing something I had started a decade before,” O’Neill said. 

The ACWIC is less than two years old and currently only has six employees (soon to be 10). 

It relies heavily on board member organisations – the board consists of nine provider CEOs, the CEO of National Seniors Australia and one representative of the unions – to deliver its projects.

It’s an “amazing” collaborative approach that O’Neill says is “the most engaged” board she has worked with.

Creating change

The ACWIC has a number of levers it is pulling to create improvements for the aged care workforce.

Its ‘Bring Your Thing’ social change campaign was launched three weeks ago to highlight the range of jobs available to aged care workers, and the possibilities associated with using your passions to help people.

“It’s early days,” says O’Neill, but the response has been “very positive”.

O’Neill admitted there were comments from some workers “feeling not heard”, who see the promotion as a “glossy campaign that overstates the work they do and how they feel about the organisations they’re currently working in”. 

“Sure, there’s hard work in aged care. There are very sad moments in aged care where you’re dealing with people who are unable to care for themselves, we shouldn’t walk away from that fact. 

“But the reality is there’s so much to be gained from working in aged care and so many different roles. It’s very diverse and it will diversify as we go along,” she said.

The social change campaign will continue to be developed, with the aim of opening people’s eyes to what a career in aged care can offer. They will target a range of groups such as school leavers, older people who might have finished caring for someone and find they miss that caring experience, and people who might be looking for a new career from industries that have suffered due to the “long tail of COVID-19”. 

“We really hope that that campaign will drive a lot more workers into the industry, into many different roles,” O’Neill said.

Gender diversity

A diversity of roles requires a diversity of genders, and O’Neill would like to see a better balance of gender diversity in the aged care workforce.

To this end, the ACWIC is advertising to fill its Chair position, and have taken a step O’Neill admits is “provocative”: they have advertised for a woman to fill the role.

In a workforce which is more than 80% female, the board was unanimous in its belief they should try to recruit a woman to the role of Chair. The board itself currently consists of 11 men and four women.

The ad states, “In an industry where senior female leadership is essential – supporting a predominantly female workforce and providing inspiration to people that could follow in the footsteps of their leaders – it is important that the Chair is female and is someone the workforce will uphold and respect.”

“We should be able to [employ a female Chair] in a country like Australia,” O’Neill observed.

As time goes on, O’Neill would like to see more men entering the sector “on the ground” and greater equality of genders across workers at all levels. “That would be our dream,” she said. 

Better pay fundamental to attracting new workers

Low pay rates in aged care is another issue O’Neill does not shy away from. Until pay rates improve, it will be very difficult to attract more people to work in aged care, she stated.

O’Neill uses an analogy to show how little we value the work done by carers in Australia. 

“They are male-dominated industries and this is a female-dominated industry. 

“It’s clearly apparent that we don’t value the work of aged care like we do about flushing a toilet. That’s really a sad indictment on our country.

“We really need to amend that balance, and we need to signal that care is important. It’s as important as flushing the toilet, well – more important actually.” 

“That is why we’ve not attracted high pay in care industries. 

While the unions are stepping up demands for higher pay rates with the Fair Work Commission, the Council is considering how it works with providers, unions and the government to “drive that work to improve wages in the sector”.

“There’s definitely a role for Council there. [Pay is] really important to how we change the tipping point around gender and expertise of workers in the sector,” O’Neill shared. 

The Council is also working on a ‘jobs architecture’ for the sector, which maps job hierarchies, titling conventions, career paths and pay rates.

“Having that job architecture is incredibly important,” said O’Neill.

The Council is also working on a practical interactive workforce planning toolkit that supports providers in planning their workforce. The workforce architecture will feed into that toolkit, which should be well thought through by the end of the year. 

The Voluntary Industry Code of Practice is another of the Council’s levers. Launched in February, the Council plans to consult with providers, workers and consumers on its implementation. Even though the Council hasn’t been funded to do the work, O’Neill believes the sector will “jump in” to help fund it. 

There have been some issues with the Code, O’Neill said, but it is a way providers can take charge of their own quality, to establish benchmarks and make them publicly available.

Louise O’Neill, CEO of the Aged Care Workforce Industry Council

Royal commission nuances

The royal commission recommended the Council remain “embedded” in the industry. “It says [the Council] is important, which I was very pleased to see, and so were our directors,” O’Neill said.

And while most of the royal commission’s recommendations reinforce previous recommendations for the sector, some of the “nuances” are complex.

For example, the royal commission’s focus is on pure research, whereas the Council believes the Centre for Growth and Translational Research is “incredibly important” in helping the sector deliver quality care, and has to be funded “very well”. 

“That is the work that is going to drive delivery of services at the coalface,” O’Neill said.

The Council is working closely with the government on these reforms and more, meeting weekly with the Department of Health and monthly with the Minister.

“We’re going to do everything we can to fix this”

It is nice to hear of aged care workers being spoken of as at the centre of the Council’s reforms.

O’Neill herself was a registered nurse for 22 years. A single mother, she worked two jobs, and did contract work on the weekends. 

“I would more often than not end up in residential aged care,” O’Neill said. Though she loved working with older people, she “saw the best and the worst” of aged care.

“I worked the agency casualised workforce. I was there,” she said. “I used to turn up and not know any person in a 100-bed home and I’d have the medication trolley and have to run around and work out who they were with their photos at night time. I understand this completely,” she said.

“Government needs to do a lot, the sector needs to do a lot, we all need to do a lot. Society needs to do a lot here, so that’s why I’m doing this role.”

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  1. P lease concentrate on the level of training given to Assistants in nursing……………There needs to be an overall SUPERVISOR on every shift………someone who is not a Friend or Family member of Ains on Duty…….NOT THE RN on duty…….this supervisor needs to be available to residents at all times ….Complaints from residents need to be taken seriously and delt with…….Property lost or stolen needs to be investigated.. …I worked in aged care many years and loved it . I was constantly frustrated by situations being ignored and not delt with appropriately . STAFF were not held accountable…It does not matter how many more staff you roster on if , at the end of the day, they only want everyone in bed as quickly as possible, regardless of the residents wanted needs….I am now retired but often feel sad I could not do more

  2. The aged care industry is just that If the education industry behaved the way it does we would all be idiots. The system must get outcomes for residents and clients that are acceptable Unfortunately nurses treat aged care as a hospital and see residents as patients. A totally new model that produces great outcomes involving all employees therapists families and the residents to create a new model is a paradigm for aged care needs to be constructed and implemented. The existing professions and core providers need to have a vision for this.

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