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June 2014 This project is supported by funding from the

Victorian and Commonwealth Governments under

the Home and Community Care (HACC) Program.

Workforce discussion paper: Planning for growth

and change in Home Support & Community Care

in Melbourne’s vibrant west

Workforce

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Compiled by: Anne Schultz with support from Tanya Sofra

Acknowledgements: With thanks to the HealthWest Western HACC Growth Project Advisory Group.

This project is supported by funding from the Victorian and Commonwealth Governments under the Home and Community Care (HACC) Program. About HealthWest…Compiled by: Anne Schultz with support from Tanya Sofra

Acknowledgements: With thanks to the HealthWest Western HACC Growth Project Advisory Group.

This project is supported by funding from the Victorian and Commonwealth Governments

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About HealthWest…

Our Vision

All of our communities: healthy, vibrant and connected.

Our Mission

Bringing local communities, organisations and councils together to achieve real improvements in health and wellbeing for everyone in Melbourne's west.

What are Primary Care Partnerships?

Established by the Victorian Government, HealthWest is one of 30 primary care partnerships (PCP) throughout Victoria. PCPs are a network of local health and human service organisations working together to improve the health system and the health of Victorian communities.

What does HealthWest do?

HealthWest Partnership brings together 35 health care providers, community organisations and local councils in a voluntary partnership. The Partnership is committed to supporting an integrated approach to strengthening our local communities' health and wellbeing. HealthWest strengthens coordination and provides input into:

healthy public policy;

prevention;

early intervention; and

chronic care initiatives.

HealthWest promotes partnerships and coordinated service system development by:

identifying and responding to specific community needs;

incorporating social determinants of health into health planning;

promoting equal access to health information and services;

fostering joint health initiatives and discussion; and

supporting professional and staff development on shared health and community issues.

Priorities HealthWest is focused on achieving the Partnership's mission through advancing the following

priority areas:

Health Literacy: HealthWest aims to improve the capacity of health and community organisations

to respond to the health literacy needs of communities.

Integration: HealthWest aims to partner with new and diverse sectors and increase partnerships

between members and stakeholders to deliver integrated planning and action.

Community Participation: HealthWest aims to increase opportunities for communities to influence

and direct the work of members.

Collaborative action: HealthWest aims to increase planned and targeted action to reduce inequity.

For more information visit www.healthwest.org.au

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Table of Contents

Contents About HealthWest… ................................................................................................................... 3

Our Vision ................................................................................................................................... 3

Our Mission ................................................................................................................................ 3

What are Primary Care Partnerships? ............................................................................... 3

What does HealthWest do? ............................................................................................... 3

Priorities ............................................................................................................................. 3

Table of Contents ....................................................................................................................... 4

Table of Figures ...................................................................................................................... 6

Acronyms ............................................................................................................................... 6

Executive Summary .................................................................................................................... 7

Introduction ............................................................................................................................... 8

Rationale ................................................................................................................................ 8

Purpose .................................................................................................................................. 8

Aims........................................................................................................................................ 9

Methodology .......................................................................................................................... 9

Scope ...................................................................................................................................... 9

Target Audience ..................................................................................................................... 9

Context ................................................................................................................................. 10

Home Support and Community Care ............................................................................... 10

Better Health Plan for the West....................................................................................... 10

Workforce Development Explained ......................................................................................... 12

What is workforce development? ....................................................................................... 12

Why is workforce development important? ....................................................................... 12

Workforce Development Model .......................................................................................... 13

Industry Sector Profile ............................................................................................................. 14

Health and Community Services Industry............................................................................ 14

Current & Emerging Challenges ............................................................................................... 17

Growth ................................................................................................................................. 17

Employment ......................................................................................................................... 18

Recruitment ..................................................................................................................... 18

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Diversity ............................................................................................................................... 20

Responding to cultural and linguistic diversity ................................................................ 20

Workforce diversity & inclusion....................................................................................... 21

Person Centred & Consumer Directed Care ........................................................................ 22

Complexity ........................................................................................................................... 25

Ageing Workforce ................................................................................................................ 25

Leadership ............................................................................................................................ 26

Technology ........................................................................................................................... 26

Defining Roles & Competencies ........................................................................................... 27

Training and Development .................................................................................................. 29

Ongoing Professional Development ................................................................................ 29

Vocational Education Training ......................................................................................... 29

Summary .............................................................................................................................. 30

Strategies from the sector ............................................................................................... 31

Conclusion ................................................................................................................................ 33

Recommendations and Future Directions ........................................................................... 33

Tools and Resources ................................................................................................................ 34

References: .............................................................................................................................. 36

.................................................................................................................................................. 39

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Table of Figures Figure 1: Map of North West Metropolitan Region of Melbourne ........................................... 9

Figure 2: CS&HISC Workforce Development Model ................................................................ 13

Figure 3: Industry Growth 2006 – 2011. .................................................................................. 14

Figure 4 No. of HACC Consumers across the West (HealthWest Partnership, 2014) ............. 17

Figure 5: Most common countries of birth other than Australia of HACC consumers in the western region of Melbourne (2011/12) ................................................................................ 21

Acronyms

AOD Alcohol and Other Drugs

ASM Active Service Model

CALD Culturally and Linguistically Diverse

HACC Home and Community Care

LGA Local Government Area

LOTE Language Other than English

MDS Minimum Data Set

NWMR North West Metropolitan Region

RTO Registered Training Organisation

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Executive Summary

This paper is intended to inform strategic planning, and promote informed debate regarding workforce development amongst home support and community care providers in the western region of Melbourne. This paper considers workforce development in relation to current industry reform and service demand and reflects upon work undertaken at a national, state and local level. The Victorian home support and community care sector has undergone state-wide reforms over the past decade, moving towards a person centred and consumer directed model of care. At the same time, the demand for home support and community care services has grown, and the complexity of need amongst consumers has increased. Consumers are no longer seen as just passive receivers of services, but are encouraged and empowered to take greater control of the services they require. Within the home support and community care sector, worker satisfaction is at a low. Workers have expressed their dissatisfaction with financial rewards, low status and the increasingly demanding nature of their work. These issues pose challenges for the home support and community care sector and intensify the need for suitably skilled and experienced staff. Across Australia and locally, organisations are implementing innovative workforce practices that are shaping a more robust, skilled and flexible workforce. This paper highlights examples of best practice and resources from the western region of Melbourne and within Victoria. To continue working towards the implementation of a skilled, diverse and innovative workforce, key recommendations were sourced from peak bodies, industry professionals and government departments across the home support and community care sector. Recommendations are reflected upon using current workforce development models. In the absence of an integrated national approach to workforce development for the sector, this paper recommends the home support and community care sector in the west commit to developing and implementing a regional workforce development plan. This paper recommends action on the following as a priority:

Profile the home support and community care workforce across the region to enable more informed regional workforce development planning and evaluation.

Coordinate a regional workforce recruitment strategy in partnership with the tertiary education sector, with a focus on the direct care workforce and its diversity.

Partner with consumers to ensure planning activities align with the communities changing needs and expectations.

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Introduction

Rationale This paper was conceived as part of the ‘Ageing in Growth Corridors: Home and Community Care (HACC) Service Development Action Research Project’, funded by the North West Metropolitan Region (NWMR) Department of Health in 2011. The Project was established to build capacity in the service system to meet the support needs of the target population.

In an environment of rapid population growth in the corridors of the NWMR, a planned and strategic approach over a number of years is required to build the capacity of the home support and community care workforce to respond to increased demand, and the changing needs of the target populations.

According to the Community Services and Health Industry Skills Council (CS&HISC) (2014) the home support and community care sector will need to respond to significant challenges to assist in meeting workforce demands and changes. Currently the sector is experiencing growing community expectations, changing consumer and carer needs, an increase in comorbidity, an ageing population and increasing demand for services that are consumer driven (Government Skills Australia, 2013). With the introduction of the National Aged Care Reform and the National Disability Insurance Scheme (NDIS), the service system is moving towards a consumer directed model of funding and care (Community Services & Health Industry Skills Council, 2013). For the home support and community care sector in the western region of Melbourne, these changes are compounded by rapid urban development and population growth. The systemic issues impacting on the sector are broad and multifaceted, and can inadvertently influence other policy and funding responses that endeavour to create a sustainable and responsive workforce (Health & Community Services Workforce Council Inc, 2012).

The Australian Productivity Commission (2011) has highlighted the need for the home support and community care sector to commit to workforce development. The Commission recognises the importance of the sector meeting these challenges in ways that enable positive wellbeing and person centred care, while remaining cost effective.

Purpose This paper is intended to inform strategic planning, and promote informed debate regarding workforce development amongst home support and community care providers in the western region of Melbourne. It explores current trends and practices in workforce development, planning and policy in the home support and community care sector. It highlights useful resources and constructive insights that will assist the sector in developing future workforce development strategies, policies, procedures and practice both within their organisations and across the western region of Melbourne.

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Aims The aims of this paper are to:

Present key learnings and strategies regarding workforce development from the home support and community care sector.

Present case studies on current best practice.

Provide recommendations for the home support and community care sector in the west.

Methodology This paper explores current practice, trends and policy at a local, state and national level. As there is limited literature regarding workforce development from the home support and community care sector, particularly the HACC sector, this paper draws upon literature from a diverse range of related sectors.

Scope The western region of Melbourne includes the Melton, Wyndham, Brimbank, Maribyrnong and Hobsons Bay Local Government Areas (LGAs). This is the catchment area for HealthWest Partnership.

Figure 1: Map of North West Metropolitan Region of Melbourne

Target Audience This paper is intended for use by various levels of management and human resource management amongst the members of HealthWest Partnership who provide home support and community care. It may also be of interest to relevant Victorian and Commonwealth government departments.

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Context Home Support and Community Care Home support and community care sectors include services such as nursing care, allied health, packaged care, social support, personal care and assessment and are provided predominantly by community health centres, local councils, Royal District Nursing Services, ethnic specific organisations, not-for profit community organisations and the Aged Care Assessment Services (ACAS). A large portion of the sector is employed within what is currently known as the Home and Community Care (HACC) program. As part of the Living Longer Living Better aged care reform package, these services are currently transitioning to a Commonwealth funded Home Support program and the National Disability Insurance Scheme. These changes will take effect in Victoria in July 2015. The Living Longer Living Better aged care reform package aims to create a flexible and seamless system that provides older Australians with more choice, control and easier access to a full range of services. It aims to position the sector to meet the social and economic challenges of the nation’s ageing population (Commonwealth of Australia, 2012). The current Victorian HACC program funds approximately 470 agencies to support nearly 300,000 people. The intent of this support is to provide an opportunity for individuals to maintain independence in the home, and in the community, promoting wellness and reducing the risk of premature, or inappropriate admission to residential care. The Victorian HACC Active Service Model (ASM) was introduced as a quality improvement initiative in 2010. Its focus is on implementing person and family centred care, wellness promotion, capacity building and restorative care in service delivery. The Victorian Department of Health developed a set of ASM guidelines, which support change at an organisational level, embedding workforce development and staff education into both process and practice (Department of Health, 2014). Many of the reforms and initiatives occurring across the country emphasise providing care and support to people in the community, and in their own homes. The policy directions of the state and territory governments reflect the increasing pressure felt as a result of population growth, increasing levels and types of chronic disease, rapidly evolving technologies and the rising costs of services. New policies and initiatives highlight workforce development as a key priority in facing the ongoing challenges in the home support and community care sector. They reflect the need for further development and evaluation of existing models and settings, but also further investment in workforce education, training, student placements and role development.

Better Health Plan for the West In 2011, in response to the growing demand for health services in the western region of Melbourne, partnering organisations developed the Better Health Plan for the West. This plan includes an agreed set of key health planning and high level directions for future service delivery in the region, with an overall goal of creating healthy and engaged communities in Melbourne’s west. A key objective for the plan is to attract, grow and share outstanding staff in the west. This initiative identifies the opportunity to work together to

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recruit, develop and share staff across the health sector. The Better Health Plan for the West provides both short and long term strategies to further guide agencies in the west in tackling the challenges currently within the sector (Western Health, 2011). These strategies were considered in the development of this paper.

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Workforce Development

Explained

What is workforce development? Workforce development is an emerging framework within the sector that extends beyond the traditional approach of training and professional development. The concept draws from principles underpinning human resource development and workforce planning and considers systems, settings and people (Comyn, 2008). Government Skills Australia (2014) define workforce planning and development “as the process for ensuring the organisation has the right number of people, with the necessary knowledge and skills to meet business objectives now, and in the future.” While workforce development is not a new concept, it has only recently emerged as a priority within the home support and community care sector. Historically workforce development was linked exclusively to training and professional development, with a focus on the needs of the individual worker (NCOSS, 2007). The term is now used to capture a wide range of factors relating not only to the individual worker, but to the organisation within which they operate, and the systems that surround them (Comyn, 2008). According to The Council of Social Service of NSW (2007) ‘systems thinking’ is the key to understanding workforce development. Implementation of simultaneous strategies across multiple levels that support best practice and addresses barriers to effective work practice are essential to a successful workforce development strategy (Roche & Skinner, 2005):

Level 1. Systems (e.g. funding, legislation).

Level 2. Organisations (e.g. policies, resources, supervision).

Level 3. Teams (e.g. support, cohesion).

Level 4. Individual (e.g. motivation, skill, rewards).

Why is workforce development important? Unlike traditional workforce planning, workforce development is a multi-level approach that considers a wide range of factors that impact on organisational practice and has the power to influence and change service delivery and policy (Roche & Skinner, 2005). Good workforce development supports organisations to (Government Skills Australia, 2014):

Understand current and future skills needs. Understand employee demographics, career aspirations and learning needs. Increase productivity. Increase employee engagement and retention. Manage and develop organisational and individual performance. Manage employee numbers. Develop strategies to encourage the development and use of new skills.

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For the home support and community care sector, workforce development is a crucial factor in providing effective responses to issues within the sector and ensuring that services meet consumer demands. A workforce development approach extends beyond professional development and ideally should encompass the work environment, management, roles and responsibilities and organisational policies.

Workforce Development Model Over the past decade, extensive effort has gone into the development of industry specific workforce development models. A successful model needs to operate across multiple levels and across a diverse range of issues. Although there is not a model specific to the home support and community care workforce, those from related sectors are applicable.

The Community Services and Health Industry Skills Council (CS&HISC) Workforce Development Model (Figure 2) (2014) is often drawn on to help guide workforce development initiatives within the sector. CS&HISC have created a model that attempts to streamline the complexity of workforce planning and development, and reflects the need for top-to-bottom involvement in the policies, planning and implementation of solutions to workforce development. It embeds an approach of integrated planning for, and by, the individual, the organisation, the region or sector through to the industry as a whole and the Commonwealth. At each level, there is a cycle of planning, performance development, measurement and evaluation of success.

Figure 2: CS&HISC Workforce Development Model Sourced from CS&HISC, Workforce Development, Canberra, 2014

A key component of the CS&HISC model is the idea of sharing good practice. By sharing experiences, networks will strengthen and further collaboration will start to occur. These activities can assist to access further workforce development strategies (Community Services & Health Industry Skills Council, 2014).

The CS&HISC (2014) model encourages workforce development to occur across all levels of the sector, as it is evident that unless all levels work together with the aim to improve processes, systems don’t work. Across the sector, the workforce should be provided with opportunities to share ideas, case studies, tools and initiatives. This will promote good practice and allows organisations to learn from each other.

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Industry Sector Profile

Health and Community Services Industry The home support and community care sector is one of the largest employers, with an estimated 1.35 million workers (Australian Bureau of Statistics, 2011). Whilst there is no known data specifically profiling this sector in Australia, there is some limited data available which may offer some insight. Between 2006 and 2011 the health and community care workforce was the second fastest growing sector in Australia, contributing to the largest number of jobs in Victoria (Australian Bureau of Statistics, 2011). Aged and disability carers make up the sector’s largest and fastest growing occupation, as illustrated in Figure 3.

Figure 3: Industry Growth 2006 – 2011.

Sourced from Australian Bureau of Statistics. (2011). Labour Force, Australia, Detailed, Quarterly.

Across the sector, individuals are employed by Commonwealth or state and local government, as well as non-government organisations. Job roles and career pathways are varied and complex, depending on what stream and organisation the worker is employed within (Aged & Community Services SA & NT Inc, 2008). Census data (2011) indicates that employment within the health care and social assistance sector is projected to grow by at least 35 per cent over the next ten years, with an estimated 3 million workers within the sector by 2025. The health and community services sector is one of the largest employees of women, who represent an estimated 90% of the workforce (Australian Bureau of Statistics, 2011). Older

0 20000 40000 60000 80000 100000 120000

Occupational and Environmental Health…

Other Personal Service Workers

Other Medical Practitioners

Dieticians

Health and Welfare Services Managers

Welfare, Recreation and Community Arts Workers

Nurse Educators and Researchers

Aged and Disability Carers

Psychologists

Anaesthetists

Fastest Growing Community/Health Occupations

2006

2011

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people are also highly represented within the workforce, with an estimated one third of direct care workers being over the age of 55 (CEPAR, 2014). In metropolitan Melbourne, local government staff providing domestic assistance, personal care and respite in HACC, work an average of 0.55 full time equivalent (HealthWest Partnership, 2014). In particular, the aged care sector provides an opportunity for flexible hours and work arrangements that suit people who may be raising a family or tending to other caring responsibilities (King, Mavromaras, & Wei, 2013). The majority of the workforce has post school qualifications appropriate to their level of work. Over 92% of workers have a Certificate III or higher and just over 5% are working towards this qualification. About 20% of direct care staff have no post school qualifications (Municipal Association of Victoria, 2013) Census data indicates that there is an increasing number of workers in the home support and community care sector that are from Cultural and Linguistically Diverse (CALD) backgrounds (Australian Bureau of Statistics, 2011). In an audit completed by Municipal Association of Victoria (MAV) it was found that 25% of the HACC workforce in 29 councils across the metropolitan area spoke a language other than English and used, or could use this language in their work. Within this workforce a total of 69 languages were spoken (Wositzky, 2006). The home support and community care sector is a diverse, flexible and female dominated workforce that is facing challenges in staff recruitment. The absence of high quality workforce, and training data in the home support and community care sector at a regional level is notable. Having access to such data would assist in planning for the community and health sector across all levels, particularly with changing service demand and a shifting policy landscape (Community Services & Health Industry Skills Council, 2013).

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.

A snapshot of the workforce…

Health and Community Services is Australia’s largest industry grouping employing 9% of the workforce (Australian Bureau of Statistics, 2011).

The industry is projected to grow by at least 35% over the next 10 years (Community Services & Health Industry Skills Council, 2014).

Expenditure has increased by $53 billion (Community Services & Health Industry Skills Council, 2013).

Direct care workers make up 81.2% of the Community Care workforce (Health & Community Services Workforce Council Inc, 2012).

Over 60% of the workers are permanent part-time employees, approximately 10% are permanent full-time employees and 30% are casual employees (Health & Community Services Workforce Council Inc, 2012).

The average hours worked are 16-34 hours per week (Martin & King, 2007).

Over 90% of workers are women (King, Mavromaras, & Wei, 2013).

Professions strongly dominated by women include direct care workers and social work (Health & Community Services Workforce Council Inc, 2012).

50% of direct care workers are 40 years or older when they first start working in the community aged care sector (King, Mavromaras, & Wei, 2013).

Community care involves more non direct care workers (38%) than residential care (27%) (Martin & King, 2007).

More than 80% of the workforce has at least one post-school qualification. Nearly 20% of all workers are currently completing some post school qualification (Health & Community Services Workforce Council Inc, 2012).

2o% of direct care staff have no post school qualifications (Martin & King, 2007).

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Current & Emerging

Challenges When considering the effective delivery of home support and community care, recruiting appropriately skilled and qualified staff should be viewed within a wider context. This chapter explores some of the systemic issues which are impacting on the sector and require consideration in the context of workforce development.

Growth Whilst population growth is a key driver of economic growth and provides increased access to skills and labour, it also drives increased demand for the services of the home support and community care sector (Australian Bureau of Statistics, 2008). An increase in population will bring both advantages and challenges for the home support and community care sector. Victoria's population growth was higher than the national figure of 1.8 per cent (Australian Bureau of Statistics, 2013). By 2026, the western region of Melbourne is anticipated to match Victoria’s total population from 2006, which was just over 4 million people. The population forecast in the western region for 2014 is 682,911, and is forecast to grow by 47.7% to over 1 million by 2031 (www.id.com.au). The local government areas of Wyndham and Melton are among the fastest and largest growth areas in Australia. The population of people aged 65 and over in the western region is forecast to grow by 74.6% from 68,305 people in 2014 to 119,277 people in 2031 (www.id.com.au). In the Wyndham and Melton growth corridors significant growth is also forecast in the population aged under 65 years. Mirroring these population trends, the number of HACC consumers in the west rose by over 28% between 2006/07 and 2011/12. This compares to a 15.9% rise across Victoria for the same period (Department of Health, 2012). The most significant rise in the number of HACC consumers occurred in the Melton (48%) and Wyndham (39.7%) LGAs. The least growth occurred in the Maribyrnong LGA with a 14.2% rise (HealthWest Partnership, 2014).

Figure 4 No. of HACC Consumers across the West (HealthWest Partnership, 2014)

28.3% growth

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A shift from residential care to community care is also reflected in the data. Between 1995 and 2007, there was a 54% increase in funded community places (Productivity Commission, 2008). With an ageing population, increased incidence of individuals staying at home longer, and a shift to community care, consumers are presenting with more diverse and complex needs than in the past. As the community ages, there will be fewer informal supports to provide care and support to the aged and individuals with a disability. Individuals that have provided informal caring in the past, are now returning to work, are already stretched or are ageing and unable to provide the level of support required. In the west, approximately 29% of HACC consumers had a carer in 2011/12, compared to 38% in 2006/07 (HealthWest Partnership, 2014). The decline in the availability of informal supports and care will further compound demand on the sector. With sustained population growth, it is envisaged that skills shortages will emerge in the sector in the near future. Some organisations, in some localities across the west are already noting skills shortages, particularly for direct care workers and in selected allied health disciplines.

Employment The home support and community care sector is facing a range of challenges and complexities when it comes to recruitment and retention of staff. Details may differ between organisations, however across the sector there is shortage of suitable staff, difficulty with attracting new workers and low rates of pay (Allen Consulting Group, 2007). While demand is increasing there is at the same time a diminishing labour pool (Victorian Council of Social Service, 2007).

Recruitment There are a wide range of barriers that are affecting the recruitment of workers into the sector. The CS&HISC Environmental Scan (2014) identified low wages, negative perceptions about the work, low awareness of opportunities and poor employment conditions as contributing to barriers with recruitment. The sector also faces challenges in competing in the employment marketplace and making the sector attractive as a career option (Sorensen, 2012). Low wages are widely perceived as a disincentive to joining the industry (Allen Consulting Group, 2007). Once within the sector, employees are seeking higher wages, and are moving towards employment within the public health system, including local government and councils because of the disparity in wages between government and not-for-profit, non-government sector (Productivity Commission, 2011). The Productivity Commission (2011) highlighted that there are rewarding features of aged care work which are often overlooked. This was highlighted in the NDIS (2011) nationwide survey which sought to find out what factors attracted individuals to work in the disability sector. The following attributes were identified:

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Opportunity to contribute to the wellbeing of others.

Working in an exciting and challenging role.

Flexible work environment.

Job security.

Good salary packaging. Retention of the staff within the sector is becoming increasingly difficult. In particular, for the non-government sector it is becoming hard to attract and retain workers, as they are unable to match the remuneration packages offered elsewhere (Productivity Commission, 2011). In the future this may create considerable disparity on the overall quality of workers within the sector, especially non-government organisations. Overall satisfaction within the sector is mixed, staff are reporting both satisfaction and dissatisfaction depending on the area of work, their organisation or level of employment (King, Wei, & Howe, 2013). Several studies have been conducted on worker satisfaction in the home support and community care sector (ConNectica, 2010). The emerging themes affecting staff satisfaction are:

Remuneration.

Casualisation of the workforce.

Career pathways.

Training.

Work environment.

Challenging work.

High stress. A survey completed by HACC staff in Queensland (2014) indicated that men and permanent employees report higher levels of dissatisfaction. Around 25% of the HACC workforce is at risk of leaving their organisation. These individuals are typically 31 – 40 years of age, are full time employees and have higher levels of education. This suggests that the sector’s younger; most qualified and senior appointed workers are those most likely to leave (ConNectica, 2010). Turnover within the sector, may also be attributed to the presence of workers who intend to work in the industry for a short period of time, such as university students and people entering the sector towards the end of their work life (Productivity Commission, 2008). Although many appreciate the flexibility of the sector, several workers are in casual positions by default, not choice (Productivity Commission, 2011). The lack of continuous work or benefits that come with full time employment, continue to add to the unattractiveness of the sector, especially for those looking for full time work (King, Wei, & Howe, 2013). Many of the reported issues vary in complexity and are heightened by the poor image, either perceived or real (Victorian Council of Social Service, 2007).

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To improve the attractiveness of the sector the Productivity Commission (2011) identified the need for an integrated approach, both at an organisational and strategic level, by:

Paying staff competitively.

Fostering a rewarding work environment, especially through better management.

Providing further opportunities for skill development.

Exploring the opportunity to source direct care workers internationally.

Strengthening career pathways.

Improving public perception of the industry.

Promoting better working conditions. Many past discussions around recruitment and retention within the sector have focussed on drawbacks to sustained and successful employment practice. Organisations continue to report difficulty in recruiting suitably qualified staff and levels of turnover remain high. Difficulty with recruitment is heightened by the sectors continuous involvement with new reforms. These often result in a change in the scope of practice and an increase in the complexity of the work. All this combined results in an industry that will continue to face challenges in attracting and retaining a suitable workforce (Martin & King, 2007).

Diversity The communities of the west are enriched by cultural and linguistic diversity. The west is among the most culturally diverse areas in Victoria, and Australia, with people from more than 130 different nations and Aboriginal and Torres Strait Islander people represented. Whilst diversity should be considered in terms of other factors such as disability and sexual and gender identity, the focus of this paper is on ethnic diversity as the communities of the west are characterised by Cultural and Linguistic Diversity (CALD). This paper recognises that other forms of diversity are important and require further consideration.

Responding to cultural and linguistic diversity With such a diverse community, cultural competency training is becoming essential for anyone entering or working in the home support and community care sector in the west. Organisations are increasingly expected to provide culturally safe and inclusive services to Aboriginal and Torres Strait Islander people and people from CALD backgrounds. Across the west, less than 0.5% of HACC consumers were identified as Aboriginal or Torres Strait Islander and 49% of HACC consumers were born overseas in 2011/12 (HealthWest Partnership, 2014).Whilst cultural safety is increasingly recognised as a core competency for the home support and community care sector workforce, implementation of cultural safety training is not systematically delivered across the sector or through educational institutions, and is therefore reliant upon individual organisations offering this training to their staff.

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Figure 5: Most common countries of birth other than Australia of HACC consumers in the western region of Melbourne

(2011/12) (HealthWest Partnership, 2014)

Whilst there are a number of ethno-specific HACC providers in the west, just over 10% of HACC consumers born in non-English speaking countries accessed HACC services through these ethno-specific providers, with the majority accessing main-stream HACC services such as those provided by local government, community health and nursing services. Similarly, consumers identified as Aboriginal or Torres Strait Islander people in the west accessed HACC through an increasingly diverse range of HACC providers since 2006/07 (HealthWest Partnership, 2014). As such, responding to diversity remains a priority for mainstream services, and is not the sole responsibility of ethno-specific service providers.

Workforce diversity & inclusion Workforce diversity is increasingly considered a determinant of health equity. There is growing interest in how workforce diversity can improve the system’s ability to respond to the diverse needs of the community (LaViest, 2014). There are many public health benefits associated with increased ethnic diversity in the health workforce. A more ethnically diverse workforce would (LaViest, 2014):

Improve overall quality of care through higher levels of patient satisfaction and trust.

Enhance the level of cultural competency in health care by improving patient-provider relationships.

Expand access to and utilisation of health services and, consequently, improve health outcomes.

Improved workforce diversity will reap many economic benefits for organisations and the broader community. Economic benefits would be observed through improved health access, reduced morbidity and mortality, and increased job opportunities for people from diverse backgrounds (LaViest, 2014). Whilst there is increasing awareness regarding benefits of recruitment and deployment of a diverse workforce and bi-lingual workers, commitment to this is varied. A survey of HACC workers in NSW who spoke a language other than English (LOTE) in their home revealed that whilst having another language was an asset, some experienced low recognition of their language skills. Organisations are encouraged to view having a LOTE as a positive attribute

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and provides recommendations regarding recruitment and retainment of a diverse workforce (Zadro Communications, 2012). There is also an emerging awareness of the benefits of employing people who identify as Aboriginal and Torres Strait Islander. The sector is increasingly expected to offer services provided by Aboriginal and Torres Strait Islander personnel or service providers (Productivity Commission, 2008). However, the literature indicates that to provide adequate support for Aboriginal and Torres Strait Islander people, career pathways need to be clearly defined and traineeships and scholarships need to be offered (Allen Consulting Group, 2007). An audit completed by Municipal Association of Victoria (MAV) (2006) found that 25% of the HACC workforce in 29 councils across the metropolitan area spoke a language other than English and used, or could use this language in their work. Within this workforce a total of 69 languages were spoken. However, this bilingual workforce did not necessarily match, correlate with, or reflect the diversity in the community. They also identified a number of challenges which need to be addressed to ensure the workforce environment is culturally safe.

Person Centred & Consumer Directed Care Across Victoria home support and community care sector reforms are being implemented, and new models of care are emerging. Trends such as person centred care, consumer-driven care and the Active Service Model (ASM) have sparked a notable increase in the demand for specialised and skilled workers (CEPAR, 2014). With these new approaches, new challenges may emerge for the workforce (Social Policy Research Centre , 2012).

In the past, home support and community care users were considered to be more passive recipients of services, now consumers are demanding more choice and better care (Consumer Health). Organisations are required to provide holistic care to ensure that consumers are provided with an opportunity to remain autonomous and build their capacity (Community Services & Health Industry Skills Council, 2013). Nationally and locally, there is a push towards encouraging consumers to exercise choice over the health and community services they receive, and to be more involved in the design and delivery. There is now a greater focus on community participation and the insights gained from consumer experiences and how their input can guide future service delivery and workforce development (Roche A. , 2011). For example, work completed by Saxon (2012) used a consumer consultation process to further understand the needs of the consumer to drive service change across the region.

With greater awareness there will be a demand from future consumers for higher quality, yet economical care, which raises the level and complexity of demand for services (Allen Consulting Group, 2007). As well as the introduction of new models of care, organisations are still expected to be providing services in a cost-effective manner. This additional pressure may result in organisations employing less skilled and lower cost staff to ensure they meet funding arrangements or remain a viable business (Productivity Commission, 2011).

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There is evidence that staff responsibilities are now extended beyond current capacities and motivations (Community Services & Health Industry Skills Council, 2013). Staff within the sector are reporting that they are needing to be experts in all areas and are not supported to develop their skill set to effectively deliver new approaches (Productivity Commission, 2011). The skills required by a staff member may not only relate to job-specific skills, but can extend to communication skills, customer service and importantly, managerial and leadership skills (Laragy, Ramcharan, Fisher, McCraw, & Williams, 2013). In interviews conducted by MAV (2013) direct care workers noted a change in the expectations about their role since the introduction of ASM. Inconsistency in implementation and expectations were also reported, with many staff members noting that they understood the philosophy behind ASM, but not necessarily on how to implement the approach. To help drive this, workers within the sector will need to be multi-skilled and have greater capacity than expected before (Community Services & Health Industry Skills Council, 2014). With the introduction of new reforms, the workforce is required to be more versatile, professional and highly-skilled (Government Skills Australia, 2013). Many of these new initiatives will undoubtedly change the future of the home support and community care sector, for the consumer and the workforce (Productivity Commission, 2011).

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CASE STUDY: Community Support Worker Project Wyndham City provides HACC services to around 3000 residents who have a disability and/or ageing and the carers of these people. In 2013, Wyndham City developed the Community Support Worker project in an attempt to redesign the Community Support Worker (CSW) role within the current model of HACC funded services. The project was established following a Workforce Planning report created by SACS Consulting. A pilot began in late 2013 with a small team of Community Support Workers (CSWs), recruited specifically for the project. New position descriptions were written for the roles, to be outcomes-focussed, shifting away from existing task-focussed definitions of roles. The CSW positions began in temporary part-time appointments, of 20 hours per week (0.52EFT), employed to work a flexible 5-hour shift across 4 days per week. CSWs were empowered to negotiate service decisions with their clients in progressing client-identified goals. Objectives

Improve service efficiency o In quality and relevance of services o In reportable and non-reportable hours o Service hours per client over time

Reduce staff travel costs (kilometres claimed)

Complete project within budget, measuring reportable services for service planning

Understand population needs to inform workforce planning o Shift timing o Staff numbers o Positions and numbers o Service delivery locations

Clients set and achieve personal goals

Client independence enhanced

Clients demonstrate increased autonomy

Staff report improved satisfaction Alex Smith (HACC Strategic Development Officer) explains where to next… While the formal evaluation report is yet to be delivered, internal data show that the model delivers the equivalent business efficiency in staff reportable hours compared with standard care, with greater control for clients and direct care staff over service provision. We see this as obtaining higher value for equivalent cost. The pilot provides support for around 100 people in Wyndham, with some clients already having achieved their identified goal and ceased receiving support. This is seen as a positive outcome. With this goal in mind, staff are encouraged to begin their relationship with clients with an understanding that a “goodbye/farewell” is the aim. We manage expectations with open communication from the outset. For clients to no longer require support is a win for both sides. While this is not always possible or appropriate, the intention of this pilot is to seek every opportunity to reduce dependence and increase autonomy. In designing the project, we realised that many of the barriers to implementing the Active Service approach were internal and either psychological or policy/procedural and therefore were possible for us to change. We also saw that, to increase independence and autonomy with clients, it was important to do the same with staff. We learned from the consultant that there are inherent personal characteristics that make some people more suited to a flexible and autonomous role that the existing staff may not possess, or take time to develop, so it was suggested that we attempt this pilot with new staff. As it turned out, it was a combination of new and existing staff who applied for the roles and were successful. The group was afforded a level of trust that they have accepted and responded to.

More info: Alex Smith, HACC Strategic Development Officer, (03) 8734 5461

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Complexity Older Australians are living longer. The population of people aged 65 and over in the western region is forecast to grow by 74.6% from 68,305 people in 2014 to 119,277 in 2031 (www.id.com.au). As well as living longer, Australians over the age of 65 are much healthier than a few decades ago (Productivity Commission, 2008). The range of services provided by the home support and community care sector will need to continue to adapt to the changing health status of the aged population (Allen Consulting Group, 2007). With advances in technology and medicines, diseases such as heart disease, stroke and cancer are no longer considered a death sentence, and over the past 30 years there has been a decrease in mortality of patients that endure these diseases (Productivity Commission, 2008). As well as medical technology, advances in social conditions have also assisted in raising the overall life expectancy amongst the general community (Allen Consulting Group, 2007). As more people live to older ages, the prevalence of chronic, dual or multiple disabilities are increasing (Productivity Commission, 2008). In 2009, 40% of 65-69 year old Australians had a disability. The probability of having a disability increases with age, peaking at 88% for Australians in the 90 years or older age group (Australian Bureau of Statistics, 2011). Illnesses such as dementia and depression are also increasing, with an estimated increase in dementia from 220,000 to over 730,000 between 2007 and 2050 (ConNectica, 2010). With the increasing complexities and changing needs, the home support and community care sector will need to review how the workforce is modelled and what training is provided (Allen Consulting Group, 2007). The sector will need to start working more collaboratively and effectively with the acute, disability and health sectors to ensure service delivery maximises the individuals health outcomes and improves the quality of life of the people who use the services (Productivity Commission, 2008).

Ageing Workforce Many challenges associated with providing quality health and aged care services can be linked to population ageing (Radford, Shacklock, & Bradley, 2014). According to the Department of Health and Ageing (2013) the aged care sector has been an occupation that has attracted older workers. Data collected by the National Institute of Labour Studies (2007) found that 70% of the community care workforce were aged over 45 years. This is almost double the national average, which is at 37%. With a higher proportion of older workers comes a unique range of challenges and complexities (Aged & Community Services SA & NT Inc, 2011). Within the sector, many occupations require staff to participate in tasks that can be physically demanding and psychologically challenging. With the workforce ageing, a decline in physical capacity is expected. Job demands, however, continue to grow with increased workloads and frailer and more complex clients (Aged & Community Services SA & NT Inc, 2011). With these ongoing demands and possible decline in health, many older workers are leaving the workforce or moving to part-time roles (Productivity Commission, 2013).

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Organisations are being encouraged to adapt their policies to reflect the ageing workforce to include workforce health and safety, flexible work arrangements and career development (Queensland Government, 2014). The loss of staff, and the associated corporate knowledge has the potential to have a major impact on operations and productivity (Government Skills Australia, 2014). Given this, the sector may be faced with widespread skill shortages as workers approaching retirement age exit the workforce at the same time as demand for services is increasing (Martin & King, 2007).

Leadership According to the ABS (2011) there has been growth in management roles within the home support and community care sector. The combination of changing clients’ needs and the necessity to work more effectively and efficiently with the resources available has resulted in staff requiring a higher set of skills than in the past (Meissner & Radford, 2014). To meet these needs, organisations are seeking employees with experience in management, workforce planning and change management (Health & Community Services Workforce Council Inc, 2012).

Within the sector, managers often work their way up into leadership roles, either from clinical or administration backgrounds. Along the way they frequently receive little to no development in leadership and management capabilities. Professional development is often driven by current reforms, meeting audit requirements and skilling clinical staff (Productivity Commission, 2011). Many generic management courses are not meeting the specific needs of the health and community sector workforce (Meissner & Radford, 2014). In addition, managers are expected to keep up with the constantly changing policy context and subsequent program changes. With these pressures, management are reporting that they are lacking confidence, and are unable to effectively support and lead their staff and are at higher risk of burnout (Aged & Community Services Australia, 2013). Workload is one of the main reasons why managers’ report they are leaving the home support and community care sector, along with the treatment they receive from regulatory bodies (Community Services & Health Industry Skills Council, 2013). The Productivity Report (2011) found that a key determinant for potential employees to work for an organisation is the quality and effectiveness of management. Effective leaders will be necessary to manage the organisational, cultural and financial implications of consumer-directed services. Strong management will be vital in the development and implementation of effective services for the future (Laragy, Ramcharan, Fisher, McCraw, & Williams, 2013). To support future leaders and managers, additional training and support for supervision and mentoring of staff and implementing ASM principles will need to be provided (Municipal Association of Victoria, 2013).

Technology Across the sector, there has been an increase in the adoption of new technologies in the collection, storage and use of health documentation and records (CEPAR, 2014). With the introduction of new databases, cloud based systems and e-health, the workforce is

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experiencing a new set of challenges that have not been present in the past (ConNectica, 2010).

With the adoption of new technologies, organisations can take advantage of streamlined service provision and operational efficiency, but require effective and appropriately skilled staff to achieve this (CEPAR, 2014). Although workers are seeing the benefits in the use of technology, there is low computer literacy across the sector. There are also negative views amongst some staff on additional skills and time required to use the tools and databases (Community Services & Health Industry Skills Council, 2013).

Across all levels, the uptake of advances in technology will help to ensure that increased resources are available for enhanced consumer delivery and future reform initiatives (Community Services and Health Industry Skills Council, 2013). To address these issues, organisations and management will need to provide training and ongoing support and up skilling for their workers (Community Services & Health Industry Skills Council, 2014), as well as introducing more streamlined and simplified databases and systems (Productivity Commission, 2008).

Defining Roles & Competencies Changes in reform, increase in service demand and a shift to consumer-driven care has left many workers feeling unclear about their current role, responsibilities and scope of practice (Community Services & Health Industry Skills Council, 2014). Among community aged care workers, there is considerable variation in work scope, training and responsibilities (Victorian Council of Social Service, 2007). There is also a lack of consistency in the roles and functions of community aged care workers (Community Services & Health Industry Skills Council, 2014). The traditional two-tier workforce comprises professionals who require tertiary qualifications and then entry level, lower qualified staff. This is now being challenged and a new set of professional standards are being sought (Moffatt, 2013). There has been further pressure within the industry to create new roles to help cope with the changing climate and demand in services (Community Services & Health Industry Skills Council, 2013). Workers are now needing a higher skill set than in the past and often workforces are blurring the boundaries between the current requirements and the work completed in the past (Community Services & Health Industry Skills Council, 2014). Workers are asked to develop specialisations, work within community settings and in multi or trans-disciplinary teams. For many workers, scope of practice is no longer driven exclusively by regulatory bodies, but is now being influenced by consumer needs, demand for services, and the settings at which professionals practice (National Health Workforce Taskforce, 2008). Now more than ever there is increasing need to extend existing roles and scope of practice to provide greater workforce flexibility. Improving the productivity and effectiveness of the current workforce will require organisations to work beyond providing ad hoc training and development, and provide staff with the opportunities to further increase their scope of practice (Allen Consulting Group, 2007). Scope of practice should not be limited to less

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skilled roles, but extend also to clinician and advanced practice and leadership roles (Productivity Commission, 2011). The creation of new professional or assistant roles, may assist in meeting consumer demand (Community Services & Health Industry Skills Council, 2013). Widening the scope of practice for varied roles will allow for higher quality of care to be provided and allow for further worker satisfaction (Productivity Commission, 2011). There are several examples both locally and nationally that are working toward expanding existing workers scope of practice, by extending their knowledge, skills and competence. Examples of projects that reflect this are provided later in this paper. To continue attracting and retaining staff across the sector, organisations should continuously seek to provide opportunities for skill development, career paths and scope of practice for all levels of staff (Productivity Commission, 2011).

CASE STUDY: Redefining the scope of practice Project Name AHA Implementation Program The Department of Health (the department) is funding the Allied Health Assistant (AHA) Implementation Program (the Program) which is being implemented across Victoria. The Program assists health and community services to strategically position themselves to sustainably build their future AHA and allied health workforce capacity using the Victorian Assistant Workforce Model (allied health). The Program aims to increase the AHA workforce and utilise AHAs to their full scope of practice to increase allied health workforce capacity, make most effective use of highly skilled clinicians, improve access to allied health services and grow a sustainable allied health workforce. The Program is underpinned by the Supervision and delegation framework for allied health assistants and is being rolled out across Victoria through a staged approach. Stage one of the Program was conducted in 2012-13 across 16 sub-regional clusters; involving over 1000 allied health and community service staff from 86 organisations across rural-regional Victoria. Stage two was conducted in 2013-14 in 11 major metropolitan health services consisting of 31 sites and almost 2000 allied health staff. Stage three of the Program is currently being delivered in metropolitan community health and ambulatory services. There are 25 organisations participating in this stage across eight metropolitan sub-regional hubs. Stage three is due to be completed in April 2015. Improved utilisation of the AHA workforce will help to alleviate some of the increasing demand pressure on allied health services, provide improved access and continuity of service to clients and, in turn, support more advanced practice opportunities for allied health professionals (AHPs), all of which will have a positive impact on the retention of AHPs. Further information about the Program, including a report which outlines the overarching outcomes and findings of Stage one, can be found on the department’s Health Workforce website. More info: Sarah Bird, Senior Policy Adviser, Health Workforce Innovation and Reform

(03) 9096 9941

http://www.health.vic.gov.au/workforce/reform/implementation-program.htm

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Training and Development

Ongoing Professional Development Training and development is a key strategy in any workforce development model. Effective training is more than individual professional development and is about creating opportunities for skill development and learning across all levels, providing a more integrated and holistic approach to the development of individual and organisational capacity (Comyn, 2008). Organisations with low turnover reported placing higher value on professional development for their staff. Although many organisations set aside professional development budgets each year, many smaller agencies are financially strained in their ability to support professional development and are unable to provide staff with time to complete relevant training (Productivity Commission, 2011).

In the past, the home support and community care sector offered workers the opportunity to enter the workforce with minimal requirements. Since the rapid change within the sector, there has been a huge shift away from minimal qualification roles. Workers who have entered the sector on minimal requirements are now expected to build on their skill set by returning to the education system. This has resulted in an array of challenges, as there is not a clear pathway into accessing the appropriate course (Moffatt, 2013).

Vocational Education Training The Vocational Education Training (VET) sector has undergone significant change. The Australian Government, alongside peak industry bodies, created a work plan that provides a set of standards for the home support and community care services training packages. The standards aim to increase demand-driven training, reduce duplication and provide easier pathways to and from VET (Community Services and Health Industry Skills Council, 2013). Organisations are now expected to comply with a new set of standards and regulations to ensure quality training and assessment occurs (Health & Community Services Workforce Council Inc, 2012).

The VET sector has had an increase in the number of enrolled students in the Community Services training, with 230,477 enrolments in 2012, up 14.5% since 2011. This growth has been as a result of the increase in direct support worker roles within the sector. There has also been greater enrolment figures within the university sector. Across the board, degrees in Public Health, Disability and Service Coordination have experienced a higher intake than in previous years (Community Services & Health Industry Skills Council, 2014).

To align with recent changes in the HACC sector, the Victorian Government created the HACC Statewide Education and Training Service program. The program aims to provide opportunity for greater investment in training and improved access to training options for all HACC workers. All training offered is focused on supporting the ASM model across the diverse HACC workforce. Its target audience ranges across registered and enrolled nurses, allied health professionals and allied health assistants, tertiary and VET-qualified assessment staff and community care workers, and volunteers. Training opportunities reflect and respond to the diversity of the HACC workforce by offering options that include in-service training, refresher training, competency-based gap training and registered vocational

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education and training (Chisholm Institute, 2014). Training organisations are starting to develop and conduct courses and workshops that target the home support and community care sector by providing the opportunity for staff to have a broader and deeper breadth of skill (ConNectica, 2010). However there remains an absence in the availability of more sustainable training models which can be integrated into in-house orientation and training programs, such as train-the-trainer and online modes (Community Services & Health Industry Skills Council, 2014).

Within the sector there is concern about inconsistencies in the education and training provided between comparable qualifications, for example, Certificate III or IV level (Productivity Commission, 2011). In a report completed by the CS&HISC (2014) they surveyed a range of stakeholders from across the sector on the current gaps in training and qualifications. Majority of respondents were unsatisfied with the current quality and delivery of training packages. The report also highlighted the lack of practical components and the need for more on the job training opportunities.

The RTO’s and TAFE’s providing the training have come under scrutiny over the quality of trainers and assessors, length of training, delivery and amount of practical experiences offered (Allen Consulting Group, 2007). Although regulations and standards are being development and implemented, organisations are still identifying training quality as an area that needs to be addressed (Community Services & Health Industry Skills Council, 2012). As well as quality of training, there is concern that the VET system may not be able to supply the number of appropriately skilled workers required to respond to changes in service demand and delivery (Community Services & Health Industry Skills Council, 2014).

Summary People over the age of 65 are much healthier than a few decades ago and are expected to live longer than in the past. Organisations are working with larger numbers of consumers with more complex needs. In response, they are working hard at redefining workers roles and responsibilities. Workers across all levels are requiring more specific and defined skill-sets than in the past. Managers are expected to be on top of reform and policy changes, manage a complex and varied workforce, with little management training and support. Entry level positions are now near obsolete and higher skill sets and qualifications are being sought. This has added pressure to the current workforce, as previous expectations and skills are now seen as dated and additional training is expected to ensure they are seen as a competent worker. The sector is also currently experiencing an ageing workforce and difficulty in recruiting and attracting younger workers into the sector. The ability of the sector to address these issues will greatly influence the quality and sustainability of the future workforce.

The challenges facing the sector are several and varied. The funder and broader community are scrutinizing more than ever the nature, size, distribution and effectiveness of the home support and community care workforce. There is great interest, not only among those providing these services, but also in the populations they serve, to invest in and change the size and composition of the workforce (Australian Institute of Health & Welfare, 2013). The literature consistently highlights the benefits of collecting workforce data by policy makers, sectorial stakeholders and provider organisations to further shape and inform future reforms and policy decisions (Social Policy Research Centre , 2012).

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Strategies from the sector The creation of a national workforce development plan would assist the health, community services and education sectors to shift towards service models that reflect the current policy changes, consumer-directed care and a more coordinated approach across the sectors (Community Services & Health Industry Skills Council, 2014). However, in the absence of such a plan, organisations will need to coordinate a response to these challenges within their organisations and at a regional level. To coincide with current reforms, introduction of new policies and in response to the increased service demand, there have been several articles and reports highlighting key recommendations for future workforce development. The following strategies have been sourced from local projects and findings, industry bodies and government reports. These strategies are related back to the CS&HISC workforce development model and are reflective of the emerging issues discussed in this paper. Each of these suggested strategies is to be considered in the context of the organisation, current policy directions and budget constraints.

Systems Strategies:

Development and revision of policy and legislation to ensure effective and efficient functioning of the home support and community sector.

Ensuring adequate funding arrangements for home support and community care organisations.

Development and review of awarded structures to ensure fair and adequate remuneration.

Provision of workforce development grants.

Support for research and projects on workforce development within the home support and community care sector.

Development and support for home support and community care specialist qualifications in tertiary institutions.

Create better pathways between VET and higher education.

Raise awareness through strategic communication of aged and community careers and workforce achievements.

Organisational Strategies:

Redesigning roles to provide greater workforce flexibility, job satisfaction and retention.

Enabling and encouraging staff to work to their full scope of practice, within their range of competencies.

Support and encourage inter and trans-disciplinary teams.

Development and implementation of workforce development policies.

Establishment of clinical supervision and mentoring programs.

Provision of professional development opportunities.

Provision of adequate rewards and recognition.

Participation and support for workforce development programs and research

Provision of a culturally safe work environment.

Building the workforce development capacity of managers.

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Team & Individual Strategies:

Identification of professional development needs/priorities.

Proactive development of mentoring and supervision relationships.

Provision of support, guidance and encouragement to co-workers and colleagues.

Openness to change and innovation in work practices.

Development of professional networks and alliances.

Implementation of shared care arrangements.

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Conclusion

Recommendations and Future Directions Workforce development and planning is currently in focus, with current reforms, peak bodies and the media highlighting the need for a national workforce plan for the home support and community care sector. The sector is facing many challenges, including an increase in demand on services and a change in service users, resulting in higher expectations on the workforce. Service models are changing rapidly and the complexity of client demand continues to intensify. As a result, the work of the home support and community care sector is becoming increasingly complex and professionalised. Workforce development aims to address these barriers by approaching the issues at all levels. This paper recommends Commonwealth and state governments coordinate a more strategic approach to workforce development in the home support and community care sector, involving government, education and relevant peak and industry bodies. This paper recommends an integrated approach to workforce development in the west in an effort to avoid fragmentation across the home support and community care sector. A whole of sector approach will ensure more efficient use of resources and also enable more diverse and enriching opportunities for people within the workforce. As such, the recommendations below apply to the home support and community care sector as a whole. This paper recommends the home support and community care sector in the west commit to developing and implementing a regional workforce development plan. Notably, existing networks or strategic planning groups, such as Better Health Plan for the West, could integrate the recommendations into their activities in an effort to ensure an integrated whole of sector approach to workforce development. This paper recommends action on the following as a priority:

Profile the home support and community care workforce across the region to enable more informed regional workforce development planning and evaluation.

Coordinate a regional workforce recruitment strategy in partnership with the tertiary education sector, with a focus on the direct care workforce and its diversity.

Partner with consumers to ensure planning activities align with the communities changing needs and expectations.

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Tools and Resources

Describing the Complex Care Coordination Workforce in the West:

A resource Tool A resource developed by Western Health as a part of Health Workforce Australia’s (HWA) Aged Care Workforce Reform. The guide is to be used to help organisations working in the complex care coordination field to better understand workforce integration, improve workforce partnerships and reduce the fragmentation that currently exists within the sector. More info: Please contact Indra Process and Performance Consulting info@indraconsulting.com

A Capability Resource: for Complex Care Coordination Workforce

in the Community A resource developed by Western Health as a part of Health Workforce Australia’s (HWA) Aged Care Workforce Reform. This resource identifies and documents competencies that are specific to complex care coordination in the community. More info: Please contact Michelle MacDonald – Michelle.MacDonald@wh.org.au

Community Services & Health Industry Skills Council (CS&HISC) CS&HISC works with stakeholders at all levels to design solutions focused on planning and strategy, performance development, and productivity and measurement. The CS&HISC has developed a Workforce development kit, which guides organisations with a practical guide on implementing Workforce development plans and models. More info: www.cshisc.com.au/develop/what-is-workforce-development/

Theory into Practice Strategies (TIPS): A Resource Kit for the

Alcohol and Other Drugs Field The National Centre for Education and Training on Addiction (NCETA) is the research centre for the alcohol and other drugs (AOD) field. The Workforce development 'TIPS' Kit provides practical workforce development tools and resources aimed at supervisors, managers and policy makers who engage in workforce development activities and interventions.

More info: http://nceta.flinders.edu.au/workforce/publications_and_resources/nceta-workforce-

development-resources/workforce_developemt_tips/

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Tasmanian Workforce Development Plan Skills Tasmania funded TasCOSS to work in partnership with other peak community sector bodies to develop an evidence-based workforce development plan for the various health and community sectors. This Plan covers the period 2012-2015 and represents the shared priorities of the participating specialist sectors. It supports the specific workforce development and planning requirements in each sector. More info: http://www.tascoss.org.au/Portals/0/IDU/Workforce%20Development%20Plan%202012-15.pdf

The SWAP Project – Workforce Planning Tool The SWAP Project was funded by the National VET E-Learning Strategy. The project resulted in the creation of an online e-learning tool that organisations can use to discuss, design and implement their own workforce plan. The tool is an interactive process that gives you step-by-step guidelines on developing a successful workforce plan. More info: https://agedcommunity.asn.au/resources/swap/story.html

Bilingual Community Care Workforce This paper was developed by the Multicultural Access Projects of Ethnic Communities Council of NSW (statewide) and Bankstown Area Multicultural Network (SWS). The paper provides key recommendations and understanding on the needs and experiences of workers who speak a language other than English (LOTE) in their home for HACC funded organisations. More info: http://www.sscci.org.au/_resource/bilingual-community-care-workforce/8701bb5e-b4e7-4032-84ee-845835fac46e

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