Australian rural community aged care services: Precarity and capacity

Abstract

In Australia, the precarity of the aged care sector has been well documented over several decades. During this time, policy reforms have ultimately landed care, and the business of providing it, within a market model. Following recent evidence produced by the Royal Commission into Aged Care and Safety and the COVID‐19 Senate Committee, this model and the sector's incapacity to consistently deliver appropriate care has been the subject of intense public scrutiny and debate. The many COVID‐19‐related deaths of aged care residents have added to demands for urgent action to redress the sector's weaknesses, particularly those relating to workforce adequacy. This paper presents findings from a recent mixed methods study of community aged care provision by five providers who operate across a large rural part of regional Victoria. It utilises data to illustrate the impact of rural location on care provision, and significantly, on local capacity to maintain an appropriately skilled workforce. Demographic factors and funding shortfalls for consumers with multiple, complex care needs underscore the need for strategic planning to ensure workforce adequacy into the future. Encouragingly, our data showcase the many capacities of community aged services in this rural area and the opportunity to develop effective strategies relative to the recruitment and retention of direct care workers and the design of best practice models for meeting complex care needs.

Refugees are a Valuable but Overlooked Economic Resource, and it is Time to Update Our Approach to Migration

“…On the contrary, studies tend to emphasise aspects unrelated to their potential skill supply or their limited participation in Australia's labour market (Khoo 2001; Hugo 2002; Schweitzer et al 2018; Sullivan, Vaughan and Wright 2020). This view of refugees is prevailing despite the most recent two years having effectively stopped Australia's access to internationally mobile workers, with costly implications for the country's economy (Gamlen 2020; Van Barneveld et al 2020; Coates, Sherrell and Mackey 2021), especially in regional areas (Fitts et al 2020; Guaralda et al 2020; Jones et al 2021; Savy and Hodgkin 2021).…”

Rights‐based accountability in aged care organisations: The roles of beliefs and boundary controls

“…Recent scandals in the sector, such as the highly publicised mistreatment of residents/clients at the Oakden Older Persons Mental Health Facility in South Australia, led to the establishment of the Royal Commission into Aged Care Quality and Safety in 2018. Since then, the sector has met with heightened regulatory scrutiny and increasing calls for reforms of organisational practices to enhance accountability (Savy & Hodgkin, 2021). The Royal Commission, in its 2019 interim report titled 'Neglect' and its 2021 final report titled 'Care, Dignity and Respect', emphasises the urgent need for aged care providers to strengthen their accountability to service recipients.…”

“…The current aged care model in Australia is built on the idea of a ‘market’ (Savy & Hodgkin, 2021; Xerri et al., 2019), and older people are described as having agency in their ability to choose and/or switch between competitive services. However, the reality is that many older people do not, of themselves, have sufficiently high bargaining power to negotiate with aged care providers (Royal Commission into Aged Care Quality & Safety, 2019).…”

“…Besides the pressure for improved accountability toward residents/clients, the Australian aged care sector has also been facing a crisis in workforce shortage, with staffing levels under those in other Western countries (Hodgkin et al., 2017; Savy & Hodgkin, 2021). Savy and Hodgkin (2021, p. 327), citing the Productivity Commission (2011), argue that aged care workforce ‘will need to quadruple by 2050’.…”

“…Besides the pressure for improved accountability toward residents/clients, the Australian aged care sector has also been facing a crisis in workforce shortage, with staffing levels under those in other Western countries (Hodgkin et al., 2017; Savy & Hodgkin, 2021). Savy and Hodgkin (2021, p. 327), citing the Productivity Commission (2011), argue that aged care workforce ‘will need to quadruple by 2050’. It has been observed that aged care work is often seen as low status, and because of low pay and casualised employment conditions, aged care workers typically have to work at several facilities (Farr‐Wharton et al., 2021; Hodgkin et al., 2017; Savy & Hodgkin, 2021).…”