Are home care workers been hired as glorified cleaners?

Cleaning is an essential service that is vital for enabling older people to continue living at home for longer.

A clean house can provide clients with a sense of comfort, ensure their home remains hygienic and minimise the risk of them falling or sustaining injury as a result of struggling to do the cleaning themselves.

Most older people who receive government funding for ‘home help’ as it’s known (cleaning services), do so because they have been assessed as unable to safely do it themselves.

And in these instances they rely on ‘trained professionals’ to visit their home and to tidy up, vacuum, sweep and mop the floors, wipe down surfaces, clean bathrooms or do the washing – anything they need to keep their home in working order.

Indeed, many home care workers spend a large proportion of their time cleaning when they visit elderly clients.

But for many home care workers, ‘cleaning’ is not the reason they started working in aged care to begin with, even though it’s something they willingly do as part of their job.

The debate was discussed the other week in HelloCare’s Aged Care Worker Support Group. Many older people (the aged care workers’ clients) think home care workers are actually ‘professional cleaners’, when in reality they aren’t. Their training course often don’t specifically include anything to do with cleaning.

This misconception made us ask the questions ‘Should home care workers’ training include cleaning modules if they are being sent out to clean’ and ‘if home care workers haven’t completed a training course in cleaning, then how much additional training does the home care provider give them to ensure they do their job effectively and safely, especially in COVID-19 times’.

Home care providers are largely funded by the Commonwealth government, and under that arrangement often a home care worker will be sent out to provide personal care to a client and also clean their home.

If home care workers, thousands of whom are providing their services daily in people’s homes all around the country, are not properly trained, why are they doing this work, we wondered?

What we found is there are no minimum cleaning training or qualification requirements for home care cleaners, yet many providers and training organisations have taken it upon themselves to provide ongoing training and ensure workers and their clients are both safe and skilled.

Jacki Attridge is the Head of Home & Community Care Operations UNITING NSW.ACT. She told HelloCare the aged care legislation simply requires that home care clients receive “care appropriate to needs”.

Ms Attridge says it’s the “responsibility of the approved provider to make sure all of the staff that work in Commonwealth-funded services have the right skills to deliver the type of care they’re delivering.”

The legislation “is not silent on it, but [it’s] not prescriptive either,” she said.

Home care providers must be able to “demonstrate” they are providing care appropriate to the needs of clients through quality reviews and audits. They must be “meeting the needs of the client” and enabling them to remain living at home “safely”, Ms Attridge said.

Standard 4 of the Aged Care Quality Standards requires that “the organisation provides safe and effective services and supports for daily living that optimises the consumer’s independence, health, well-being and quality of life.”

Uniting’s carers do provide cleaning services, and though there is no mandatory training for them, the organisation provides it as part of their manual handling onboarding training and as a section of their annual competencies.

Most of the “risk” in manual handling lies in “cleaning… doing washing, mopping, and the like”, so Uniting has developed safe operating procedures to support those roles, Ms Attridge told HelloCare.

Home care staff who are providing cleaning services for their clients do not have the benefit of the training and support professional cleaners in aged care homes receive, yet they are still expected to perform the work.

Cleaning importance ramped up during COVID-19

During COVID-19, Uniting has introduced more training around cleaning. For example, there are “higher degrees of vigilance” around high-traffic areas.

Uniting has also developed in-house infection control modules around cleaning and they use the Commonwealth’s infection control courses as part of their compulsory training for staff.

Carmie Walker, CEO of care training and worker placement organisation, Vative Healthcare, told HelloCare that since COVID-19, there has been a greater emphasis on infection control and risk training for home care workers.

“It’s our number one priority to keep carers safe,” Ms Walker said.

Low barriers to entry important in attracting staff

Ms Attridge said it makes sense for the government to have ‘competencies’ around cleaning skills for home care workers, but mandated qualifications are not necessary.

Providing workers with entry-level jobs is a good way to attract people to work in the aged care sector, she suggested.

“We know that those entry-level roles are a good opportunity for people to get involved in aged care.

“At Uniting we look at opportunities where we can upskill within our own system. We are a Registered Training Organisation (RTO) in our own right, so we offer the Cert III to staff.”

“Qualifications are important, but also being the right type of person and being well equipped and knowing how to keep yourself and the client safe is important,” Ms Attridge said.

RTO delivers cleaning training

Vative provides cleaning and laundry services training, but Australia is “not quite there” when it comes to having compulsory training in this area, Ms Walker told HelloCare.

Vative’s courses have an emphasis on “practicality” and are structured based on what the client needs.

For example, even though steam cleaning is the most advanced form of cleaning today, Vative will not deliver training in this technique to providers who don’t use it.

“We have to make it practical for the company, whether that’s the best is not up to us,” Ms Walker explained.

Should home care providers employ professional cleaners?

The Interim Report of the Royal Commission into Aged Care Quality and Safety identified there is little in the way of “incentive or encouragement” for aged care providers to succeed, and yet aged care providers are innovating and doing well “despite the aged care system in which they operate rather than because of it”.

Training for home care staff cleaning for their clients is an example. The government does not require home care staff to have any training or qualifications before they clean a client’s home and there is little recognition for them to do so.

Yet, many aged care organisations through their own dedication and diligence do deliver the necessary training, and RTOs work hard to provide modules that equip home care workers with the skills and knowledge they need to keep not only themselves but their clients, safe.

But for home care workers not employed by these dedicated organisations, there are fewer protections for themselves and clients. In these cases, perhaps professional cleaners would be a better option.

At the end of the day, it’s not surprising that older people often voice dissatisfaction with the cleaning service they receive.

This article is not a complaint against home care workers, rather the system for not striving to support ongoing education and upskilling.