A new survey shows that while aged care workers love their job and value the training they receive, low pay levels, high workloads, an ageing workforce and an increasing demand for aged care add up to a concerning picture for the sector. How many more research reports and legal battles will it take for funding and workforce pay levels to be properly addressed? By JUDE BARBACK.

Jenny Goodman is typical of the 900 caregivers surveyed in the inaugural New Zealand Aged Care Workforce Survey, carried out by Dr Katherine Ravenswood from AUT University’s New Zealand Work Research Institute. Jenny Goodman’s pay sits just above the minimum wage. For a long time the community support worker earned $8.50, before the DHB rate increased her wage to $14.10 in 2007, where it sat for seven years until increases in the minimum wage brought about small increases. Jenny’s role includes household management and personal care for a range of clients, most of whom are over 75 years old. She ended up in community support work “not for the pay but for the love of the job”.

According to the survey, which gathered responses from approximately 600 home and community support sector workers and 300 aged residential care facility workers, the average aged care worker is female, aged over 45, the primary breadwinner in her family, but earns $15 or less per hour. She sees herself as skilled but low paid and while she generally loves the work she does, her morale at work is slipping.

Ravenswood says low pay, high workloads, an ageing workforce and an increasing demand for aged care add up to a concerning picture for the sector.

“Overall, our impression is that although many caregivers love the job and have good management support, the negative aspects of their work outweigh the positives. This should be a major concern for those planning for the future of New Zealand’s aged care workforce.”

New Zealand’s ageing population is growing and if the workforce tasked with ensuring its care and wellbeing is becoming demoralised and looking elsewhere for better pay and employment conditions, then surely this is of concern to everyone.

A tick for training

With all the emphasis on low pay levels, it is easy to forget the good things that are happening in aged care workplaces, such as the positive developments around education and training. The AUT survey confirmed the anecdotal evidence that caregivers are receiving welcome opportunities for training to support them in their role.

Employers are finding creative ways of training their workforce that don’t impinge on scant resources.

Eldred Gilbert, from the HHL Group (the parent company of Healthcare New Zealand), shared with attendees at the Home and Community Health Association’s recent conference her experience of rolling out a free e-learning dementia course to a group of 14 learners, all of whom passed.

“We had no budget, no time, a willing branch manager – we made it happen,” she said.

At the close of the presentation, an attendee asked if the learners’ efforts were recognised in their pay, to which Gilbert responded, “Two words: I wish”.

“The training carries an intrinsic value,” she said, “but it does nothing to put bread and butter on the table.”

The intrinsic value of acquiring knowledge and upskilling should not be dismissed out of hand. In a subsequent session at the HCHA conference, Cherie Saunders from PSN Enliven shared from her experience that one of the main barriers to learning was the attitude of the learners; many saying they were “too old”, “too dumb”, “no good at school”, or English was their second language.

However, once these barriers were overcome and the learners successfully completed their training, Enliven’s evaluation revealed that their training not only helped the learners with their job and their clients, but also improved their personal lives, in areas of communication and stress reduction.

Goodman shares a similar experience, where a fear of learning was turned into personal and professional gain.

“It can be difficult for some women who have never received any qualification, are illiterate, and have not been exposed to a classroom environment in a long, long time. A colleague admitted she couldn’t read or write, and the employer set her up with a friend and they underwent literacy training and then went on to get Level 2.”

Industry training organisation Careerforce has introduced a Peer Mentor Programme to help address such issues. Peer mentors are carefully selected people within facilities who can help co-workers identify and overcome their barriers to learning, and support them to complete qualifications. Their mentoring role extends to raising workplace awareness of literacy and numeracy issues, as well as becoming champions for new ways of working or new technology.

Careerforce and Health Workforce New Zealand are also driving one of the more exciting initiatives on the table at present: the Kaiawhina Workforce Action Plan, a plan focused on developing the health and disability non-regulated workforce. It includes closer inspection of future training needs and career pathways.

As part of this, and tying in nicely with a review of all qualifications, Careerforce have started to launch their new qualifications, with more to follow this year. The first batch included the New Zealand Certificate in Health and Wellbeing (Levels 2 and 3) and the New Zealand Certificate in Cleaning Level 2.

Careerforce transition manager Penny Rogers says they wanted to look beyond a ‘tick-box’ approach to gaining the qualifications.

“When we developed our new learning and assessment material, our focus wasn’t just on helping trainees to understand the requirements of their role; we also wanted them to gain the skills they’ll need to improve the health and wellbeing outcomes for those they support,” says Rogers.

This is exemplified by the Health Assistance and the Support Work strands of the qualifications, which focus on developing carers who can work with others to support people using a person-centred approach.

“The qualification suite as a whole will allow employers to develop experienced staff and provide them with further opportunities for skill development and recognition,” says Rogers.

Love of the job is not enough

The AUT survey found that caregivers generally love their jobs. Indeed, it is hard to find a caregiver or community support worker who, in spite of the poor pay, dislikes her or his job.

Most find it rewarding being able to help older people and are able to draw satisfaction from the fact that they are making a difference.

The intrinsic benefits of job satisfaction, training opportunities and feeling valued are significant. But, as the AUT Survey also concludes, the negatives – namely low pay and high workloads – are starting to outweigh the positives for aged care workers.

The Caring Counts initiative, Kristine Bartlett’s ongoing pay equity case, and pressure from aged care providers all help shape the growing argument for the Government to increase funding to these sectors.

The recently launched Deloitte report on the sustainability of the home and community support services sector shows that many providers have responded to insufficient funding by increasing employees’ workloads yet not their pay, leading to high turnover rates.

The sleepover case and in-between travel time negotiations are steps towards a fairer deal for community support workers, but Home and Community Health Association chief executive Julie Haggie says the lack of a consistent national approach to planning and funding is placing home and community support services under threat as providers struggle to stay afloat. She says that although DHBs have agreed a national funding model based on client need, until this is implemented the situation will only get worse.

How many more reports, research, surveys and legal battles will it take for funding and workforce pay levels to be properly addressed?

While there are obvious cost pressures on the Health budget, the value derived from social capital shouldn’t be ignored.

Economist Dr Ganesh Nana stresses the importance of social capital and the increasing irrelevance of GDP, which he describes as a flawed economic measure as it doesn’t take into account the future or social aspects. He says the New Zealand Treasury’s Higher Living Standards are an attempt to look beyond GDP, factoring in ‘sustainability for the future’, ‘increasing equity’, and ‘social infrastructure’ alongside more traditional, monetary economic measures.

Under this framework – one that places value on the social inputs and outputs – investment into the aged care sector, and consequently into its workforce and the people they care for, is likely to produce benefits that extend well beyond the balance sheets.

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