In this opinion article, Dr Don Perlgut, CCA CEO, comments on how Australian adult and community education (ACE) providers can assist the country to meet future aged care workforce skills needs.
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In an election where policy differences between the two major parties often seem “shaded” rather than clear-cut colours, different approaches to aged care workforce training stand out.
In this article, I review the issues facing Australian aged care, note the impact of COVID-19 on older Australians and outline the Community Colleges Australia (CCA) proposed important initiatives to support training and development in Australia’s hard-pressed aged care workforce.
The Aged Care Issue
Crikey’s Bernard Keane summarises: “Regular scandals about conditions in aged care facilities led to the aged care royal commission, and the large number of deaths in aged care during the pandemic further concentrated attention on a growing problem with a lack of workers. A case to significantly raise aged care remuneration is before the Fair Work Commission. As the key funder of aged care services via grants to providers, the Commonwealth is crucial to lifting remuneration. It is also in a transition from the current soft-touch regulatory environment to one with more stringent requirements on aged care providers and a stricter regulator.”
Keane continues: “Unions and employers … have called for a government commitment to funding the Fair Work Commission remuneration outcome. The Coalition has declined to state its position, despite requests from the parties involved. Labor has agreed to fund the outcome — the cost of which will be unclear until the commission makes its decision — and has stated that it intends, in line with the royal commission recommendation, to require nurses be on duty 24/7 in all aged care facilities, rather than the 16 hours a day the government proposes.”
Permanent part-time aged care workers starting salary is currently a very low $21.62/hour – the average salary is $23.76 – so raising the pay is one of the essential factors in recruiting and retaining a quality aged care workforce.
The aged care sector suffers from a massive workforce shortage: a Catholic Health Australia report conservatively estimates that shortage of 45,561 qualified age care workers - 11,787 in residential care and 33,774 in home care. “I think Australians know there is a shortage of health workers in our system, but I don’t think many understand just how enormous this problem has grown,” said Catholic Health Australia chief executive Pat Garcia.
Aged care facilities remain highly vulnerable to COVID-19: I know of at least three in metro Sydney which are in “lockdown” because residents picked up COVID while outside their facilities. The Commonwealth Department of Health reports that as of 12 May 2022 there were "5,320 active COVID-19 cases in 761 active outbreaks in residential aged care facilities across Australia. Of these, 3,321 cases were in residents and 1,999 cases in staff." Further, there were 1,418 COVID deaths "reported by aged care providers so far in 2022, accounting for about one in four of all COVID deaths in Australia. That dwarfs the 686 deaths in aged care in 2020 and 231 deaths in 2021." The Guardian Australia estimates COVID "outbreaks in almost 30% of the nation’s residential facilities."
COVID-19 is Deadliest for Older Australians
Because of high Australian population vaccination rates, COVID-19 has largely morphed into a disease that is of greatest immediate concern for the immunocompromised (about 500,000 Australians) and the aged (let's set aside "long COVID" for the moment): the great majority (more than 75%) of deaths have occurred in people aged over 70; and 39% of deaths have occurred in people aged over 90, with a median age of death around 84. In the week ending 14 May, of the 90 people who died with COVID-19 in NSW, 85 (94%) were aged 65+ and 37 (41%) were aged care residents - despite extraordinarily high vaccination rates (99%+) among the elderly.
COVID-19 is not disappearing: “According to global databases, Australia led the world in per-capita COVID infections,” the ABC reports. Experts agree: “The pandemic is still with us and is hurting us badly…. There is no sign of this slowing down…. High case numbers matter to our health and to the functioning of our society. Ambulance ramping, emergency department and healthcare stress, travel chaos, general staff shortages, school disruptions, and a slow return to work are just some examples that tell a polar opposite story to the prevailing ‘live with COVID’ narrative…. 350,000 people currently have COVID in Australia, all are at home, more than 3000 are in hospital, and an incomprehensible 40 or so are dying each day," write Brendan Crabb and Mike Toole.
Australian Bureau of Statistics data shows that COVID-19 was the second most common cause of death in January 2022, and is reportedly now the leading cause, according to Dr John Saul of the Australian Medical Association. And it’s the elderly who suffer most: “As with all waves of the disease, people aged 80 and over were mostly those who died… Among 80-89 year-olds, only 1% are not fully vaccinated, this tiny group made up more than 20% of those in their age group who ended up in ICU or dying. Almost one-third of 80-89 year-old COVID sufferers with fewer than two doses ended up in ICU or dying,” write Craig Butt and Melissa Cunningham.
These facts make the training of aged care workers – both the quantity and quality of workers, along with the delivery of aged care services – not just important, but for many, truly a “matter of life and death”.
The Australian ACE Sector Excels in Aged Care Training
Australian ACE providers excel in aged care training, as they:
- Constitute an important part of the nation’s aged care training infrastructure, training 23% of NSW, 19% of VIC (and 13% nationally) of government-funded vocational education and training (VET) aged care students, a total of 8,435 students in these qualifications in 2019 (NCVER 2020).
- Specialise in delivering the Certificate III Individual Support, which is the most popular training package for ACE provider students nationally, with more than one-third of students enrolled, with almost every CCA member offering the qualification.
- Over-perform in engaging vulnerable and disadvantaged groups in education and training programs – an essential outreach function to sustain the desperately needed expansion of Australia’s aged care workforce.
Community Colleges Australia Proposals to Address Aged Care Training Needs
Proposal 1: The Aged Care Trainer Shortage
CCA has noted the critical shortage of skilled aged care trainers, especially acute in many regional and rural areas; existing workers are often reluctant to move into the training; the TAE Certificate IV qualification is often seen as an obstacle; and the negative press around the quality of care and qualifications of staff compounds challenges. Some CCA members report aged care trainers leaving their positions to work in more consistent and less stressful work.
In response, CCA proposes an ACE TAE scholarship program for aged care trainers, combined with a complementary mentoring support program that pairs potential trainers with experienced VET and/or industry professionals, to assist new trainers to engage with VET.
Proposal 2: Meet the Language, Literacy, Numeracy & Digital Literacy Needs of Aged Care Workers and Trainees
CCA also notes high language literacy numeracy (LLN) and digital literacy (DL) concerns (see the work undertaken by 26Ten in Tasmania) in both the prospective and existing aged care workforce, and the limited funding available. Literacy for Certificate III Individual Support presents a significant barrier to new students from both CALD background and many native English speakers.
In response, CCA proposes a special contextualised LLN & DL program for aged care workers and students/trainees. ACE providers will work with service providers to implement embedded LLN support specific to CALD and native English speaker learners.
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Both CCA proposals arose from extensive discussions leading up to and during the CCA National ACE Summit in June 2021. I thank my CCA colleague Evelyn Goodwin for her contributions to this article.
First published 17 May 2022; updated 21 & 23 May 2022.
