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Consumer Directed Care: Creating a flexible workforce in aged care

Consumer Directed Care: Flexible aged care workforce

Aged care reforms continue to shift towards increasing choice, control and tailored services for older people and their families. To deliver more innovative and individual services, providers will need to think about their future workforce models and ask which industrial frameworks are best suited to their market and long term goals.

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Healthcare professional and a senior woman during a home visit

As consumers, we want choice. We want services to fit our schedule. We ask for products to be tailored to our needs. Our desire for freedom of choice presents both an opportunity and challenge for businesses and providers. Interestingly, this desire for choice and great customer experience doesn’t change with age. In aged care, greater choice, control and flexibility in the way services are delivered have changed the way consumers receive home and residential care.

Over recent years, Home Care Packages have shifted to be more consumer-centric, supporting older people to choose who provides their Package, as well as what is delivered within their Package. Whilst Home Care Packages continue to be allocated to consumers under the Consumer-directed care reform, residential care packages currently remain with the providers. However, an impact analysis will now be conducted to determine the impact of allocating residential care packages to the consumer.

As aged care reforms continue to shift towards increasing choice and control for older people and their families, one of the key areas of choice that are being exercised is to have consistency in the individual supporting them in their home, and when services are delivered. A lack of workforce flexibility has stifled deeper levels of service innovation that these reforms are seeking to achieve. However, workforce flexibility is limited to the opportunities provided by the industrial framework. To achieve greater workforce flexibility and become an employer of choice, providers will need to think about their future workforce models and ask which industrial frameworks are best suited to their market and long term goals.

Working flexibly

Workforce flexibility is about enabling employees to deliver services that can adapt to changing consumer needs. As Australia’s baby-boomer generation retires and starts to need aged care services we will need a workforce that can grow, learn new skills and adopt new ways of working to meet demand. In some parts of the country we may need to reduce the number of carers to help meet demand in faster growing regions.

However, whatever the specific situation, a workforce can only be as flexible as the industrial framework allows:

 

Industrial Framework
Pros Cons
Modern Awards
  • Industry-specific
  • Tailored to aged care sector
  • Minimum rates of pay
  • Limited operational flexibility
  • Difficult to change award provisions
Enterprise Agreements
  • Tailored to specific providers
  • Ability to negotiate for operational flexibility without compromising minimum entitlements
  • Can be a lengthy bargaining process
  • Potential for reputational damage if negotiations escalate
  • Exposes providers to industrial action
Individual Flexibility Arrangement (IFA)
  • Tailored to specific employee and employer
  • Can be made at any time during employment
  • Does not need to be registered or approved by regulator
  • Is not regulated by a regulator
  • Difficult for providers to track and manage as it is made at the individual level
  • Could impact rostering if there are different arrangements in place

Modern Awards

For some aged care providers, modern awards are the chosen industrial framework due to their industry based minimum rates of pay. While modern awards are industry-based with minimum employment standards tailored to the sector, they only allow for operational flexibility to some extent. For example, the Aged Care Award requires the ‘ordinary’ hours of work to be between 6am to 6pm. Any hours worked outside of this will be deemed shiftwork or overtime for a day worker. For those recalled to work overtime, they must be paid for at least 4 hours. As an industry that operates over 24 hours with unpredictable requirements to enable service delivery that meets consumer choice, this presents a very real challenge for rostering and managing labour costs.

Enterprise Agreements

One option to navigate through these award limitations is choosing to use Enterprise Agreements (EAs). By moving from awards to EAs, providers can achieve greater workforce flexibility at an individual enterprise level. EAs enable the negotiation of work arrangements that meet the needs of the business without compromising on employee entitlements. Providers can negotiate with employees any flexibility option required, as long as it meets the Better Off Overall Test (BOOT).

For example, creating new forms of employment in an EA such as flexible part time or partial part time work would enable a workforce to flex up and down as required. Compressed working weeks or flexible full time hours would allow employees to work the hours suited to their lifestyle, without compromising on the quality of care. Identifying the right balance of casuals, contractors and permanent employees could also enable flexibility in rostering and workforce planning.

Where an EA already exists for providers, there are opportunities for flexibility by better managing to the EA, and by developing policies and procedures that enable a ‘principles-based approach’ to empower greater manager discretion. With longstanding issues of low wages in aged care and growing union concerns that more flexible working arrangements would result in worse working conditions and job insecurity, there may be an opportunity for EAs to assist aged care providers to become both the right choice for consumers and an employer of choice.

Individual Flexibility Arrangement (IFA)

While EAs are one option for workforce flexibility, some providers may choose not to invest their time and resources into bargaining, especially as protracted EA campaigns can have lasting financial impacts if not done right. Bupa for example, are still awaiting for FWC approval on their EA following 14 months of negotiations during which over 1000 nurses and carers across Bupa’s 26 aged care facilities took part in 37 days of industrial action. This included 3 days of full strikes – a first in the aged care sector. To avoid this complex process, providers may choose to implement workforce flexibility in the form of an Individual Flexibility Arrangement (IFA).

An IFA enables employers and employees to negotiate changes to how certain terms in an award or EA applies. It can be made at any time during employment and must be a genuine agreement between both parties. IFAs don’t need to be approved or registered with a regulator as it is an agreement between the employer and employee. This option may be more attractive to some providers where EAs may not be appropriate.

Under an IFA, an employee can agree to vary their hours of work, choose their start and end times and even the length of shift. This flexibility needs to be balanced with the operational needs of the provider and meet the quality of care standards. With the Australian Nursing & Midwifery Federation (ANMF) launching their national ‘More staff for Aged Care’ campaign in May, providers will need to consider workforce models and operational practices that not only meet these challenges but also ensure continued quality of care.

Implementing and managing an IFA will require strong managerial capability. By gaining an understanding of the legislated requirements, frontline managers will be empowered and can achieve the mutual benefit of creating a flexible workforce that delivers flexible care.

Building manager capability in understanding IFAs or transitioning from a modern award to an enterprise agreement is a complex process. When poorly managed, there are inherent risks to both the internal operations and external brand of a provider.

Looking ahead

If Australia is to meet the needs of an aging society then providers in the sector will need to make informed decisions about their workforce models and the industrial frameworks that can enable those models.

To improve workforce flexibility and support flexible care it’s time to get on the front foot and start building flexibility into the workforce today.

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