Support for aged care workers and quality care in Australia: A case of contract failure?

Abstract

This paper is guided by Conservation of Resources theory and aims to investigate the impact of personal and organisational support on the quality of clinical care given to aged care residents in for‐profit (FP) and not‐for‐profit (NFP) facilities. Broadly, the paper addresses challenges faced by governments in designing contract specifications that ensure quality outcomes from aged care providers. The argument is that the present accreditation standards that are used to assess the status of aged care providers are too narrow to capture the complexity in delivering social services. Data were collected from 442 aged care workers from aged care facilities in NSW, QLD and WA. The results show that carer support (personal and organisational support) explained half of the variance in quality of clinical care in NFP facilities, and a third of the variance in FP facilities. In particular, the findings suggest support for carers is important for carer retention, and ultimately the clinical care of residents. The findings provide supporting evidence to widen the required contract specifications for aged care provider accreditation to include organisational and personal support for carers.

Austerity, staff inadequacy, and contracting‐out social services: How many government inquiries does it take to improve social policy outcomes in aged care?

“…Research by Brunetto, Xerri, Trinchero, Beattie, Shacklock, Farr-Wharton and Borgonovi (2018) showed that austeirty-led policies in hospitals negatively impact management practices, especially in relation to the support given to SLBs. It also affects safety outcomes for patients (Trinchero et al, 2019) and the quality of clinical care given to aged care residents (Xerri, Brunetto & Farr-Wharton, 2019;Harrington & Jolly, 2013). As stated by Australian Government (2019, p. 5):…”

“…Hence, the impact of implementing austerity-driven policies in the case of contracting-out of social services is examined. Researchers such as Xerri et al (2019), Brown et al (2018), Ditillo et al (2015), and Isaksson et al (2017) have already identified it as a 'blackbox' that needs more research because governments globally have struggled to develop appropriate governance frameworks likely to deliver quality outcomes to the public. Isaksson et al (2017) identified the difficulty of developing, monitoring, and evaluating acceptable performance indicators of social outcomes that are hard to quantify.…”

Nurturing psychological capital: an examination of organizational antecedents: the role of employee perceptions of teamwork, training opportunities and leader–member exchange

“…In this paper, management practices are captured using the leader-member exchange (LMX) concept, which measures the quality of supervisor-subordinate relationships. Past research by Xerri et al (2019) found that employee perceptions of the supervisor-subordinate relationship explained more than 35% of the variance of employee PsyCap. The second potential support factor that could be applied to develop and maintain personal resources (e.g.…”

Comparing the role of personal and organisational support on the innovative behaviour of frontline healthcare workers in Australia and the United States

“…However, the use of traditional public administration theory that underpins such policies and uses rationality and formal rules as the basis for explaining SLBs’ behaviour has been criticised for failing to capture the role and impact of emotions in their behaviour (Grimmelikhuijsen, Tummers, & Pandey, 2017; Vigoda‐Gadot & Meisler, 2010). If governments and organisations want innovative workers, then the policies must be based on empirical evidence that shows the impact on all stakeholders, including SLBs, because otherwise, irrespective of policy directives, the outcome is low level of employee wellbeing (Brunetto, Xerri, Farr‐Wharton et al, 2016, Xerri, Brunetto, & Farr‐Wharton, 2019), which likely results in limited innovative activity.…”