This article is part of a series looking into the Final Report from the Royal Commission into Aged Care Quality and Safety. Click here to see the series as it's published.

The Royal Commission into Aged Care Quality and Safety has released its Final Report. In this article we explain the Report’s recommendations regarding the residential aged care workforce, and set out some practical steps you can take right now to develop and maintain a skilled aged care workforce to drive the new focus on “person-centred care”.

The current state of the aged care workforce

The aged care workforce was a major issue in the Royal Commission’s Final Report, with 70% of the public submissions to the Commission identifying staffing as a concern. The Final Report identified many problems regarding the aged care workforce, including:

• poor pay, that undervalues the difficulty and importance of providing care to older persons
• chronic staff and skills shortages that sometimes don’t allow for safe, let alone person-centred care
• skills shortages, particularly in allied health workers and nurses, who are essential to managing the increasing medical acuity of older persons in Australia.

Key recommendations regarding the workforce

Both Commissioners agreed that the key to a successful workforce, and therefore high quality and person-centred care, is to have policies and practices that drive a “virtuous circle”. This includes:

• good working conditions
• supportive and visionary management
• empowering work culture
• collaborative teams
• high quality and relevant education and training
• high job satisfaction.

Key recommendations include:

• Sector-wide planning: the Australian Government should undertake workforce planning at a sector-wide level via an “Aged Care Workforce Planning Division.” The Division would be responsible for developing strategies to ensure the aged care sector has the appropriate distribution of health professionals and care workers. (Recommendations 5 and 75).
• Minimum staffing and qualification requirements: the Government’s planning should include minimum staffing and qualification requirements and working with tertiary education providers to address supply needs (Recommendation 5).
• Improve training: overhaul the aged care learning curriculum (Recommendations 79 and 82).
• Increase wages: standardise job titles, designs, grade and job definitions for all workers in the aged care sector and increasing award wages (see Recommendation 84).
• Professionalise the personal care workforce: Create a national registration scheme for personal care workers similar to other professionals such as nurses and allied health workers (Recommendation 77). Notably, this would require personal care workers to have a Certificate III as a mandatory minimum qualification (see Recommendation 78) and ongoing training requirements.

Tips for developing and maintaining a skilled workforce

Strategic leadership and workforce planning

Conduct a supply, demand and gap analysis of your workforce. This can help ensure the right people, with the right skills, are in the right places at the right time. To conduct your analysis, consider:

• What are the needs of the consumer population, whether clinical or non-clinical?
• What skills and qualifications does your current workforce have?
• Is there evidence in relation to the currency and competency of the workforce’s knowledge and skills?
• What gaps does the above identify?
• Which gaps have the greatest impact on your organisation and the care and services that can be provided safely to consumers, and therefore hold highest priority?
• What oversight and reporting does the Board receive regarding the facility’s workforce suitability, capacity and capability?

Attraction and retention of the aged care workforce

• Support ongoing training and development for new and existing staff, which is an investment in attracting and retaining a skilled workforce. Turnovers cost more than providers probably think – the average cost is $49,255 per RN.
• Start small by offering “micro-credentials” as a means of professional development. They are shorter and cost less than formal qualifications. Dementia and palliative care is a good place to start, which have been recommended as mandatory training for all persons providing direct care to older persons (see Recommendation 80). The Royal Commission has also recommended certain units be “core competencies” for Certificates III and IV in Aged Care (see Recommendations 79 and 80).
• Have policies that support staff learning, for example study leave, on-the-job training and workplace mentoring programs, and support to complete course work online.
• Explore ways to retain staff long-term. The Royal Commission’s recommendation is to reduce the use of agency staff in favour of more full-time positions. Full-time employment is more compatible with the objective of developing a skilled, career-based, stable and engaged workforce. Older people have also reported better care and improved wellbeing when it is provided by the same workers.

Where to start? - Leadership and culture

Two steps you can take right now are:

• Lead by example: ensure the organisation’s values are clearly expressed and modelled by the leadership team.
• Seek feedback: seek staff feedback on opportunities for improvement. Research in the early childhood education sector found listening to employees had a positive impact on staff retention.

About the Authors

Jennifer Ma

Jennifer Ma is a Content Development Assistant at CompliSpace. Jennifer completed her Juris Doctor at the University of Sydney and has recently completed her Practical Legal Training to be admitted as a legal practitioner. She also has a Bachelor of Medical Science from the University of Sydney.

Jenny Wang

Jenny is the Content Integration Team Leader at CompliSpace and a legal research assistant for the aged care team. She has a Bachelor of Science (Financial Mathematics and Statistics) and is currently completing her Bachelor of Laws at the University of Sydney.