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Community Affairs References Committee
23/02/2017
Future of Australia's aged-care sector workforce

FRECKLETON, Mrs Lyn, Director of Community Services, Palm Island Aboriginal Shire Council

[11:06]

CHAIR: Do you have any comment to make on the capacity in which you appear?

Mrs Freckleton : I have been employed with council for about nine years.

CHAIR: I will just double-check that you have been given the information on parliamentary privilege and the protection of witnesses and evidence.

Mrs Freckleton : Yes.

CHAIR: Could I invite you to make an opening statement, and then we will ask you some questions.

Mrs Freckleton : So the statement is with regard to Sandy Boyd Aged Care Hostel?

CHAIR: Yes, if that is the provider, in relation to work force and the provision of aged care services. That would be great, thanks.

Mrs Freckleton : I have been working with the Sandy Boyd hostel now for many years. I have seen quite a number of changes over the years with regard to the work force. I have experienced some difficult times with regard to the staff that we take on board. The reason for this is a lot of the community members that we do take on board have little or no experience. There have been a lot of changes with Sandy Boyd hostel because over time we have changed a lot in terms of how we operate. It was run under the old community services. Now we are under the shire council. That has made a lot of difference in terms of policies and procedures that are implemented within the service. We are considered a low-care service for 15 residents. Currently we have nine residents on board. The full capacity is 15. We have one palliative and one respite care. At the moment, we have four high-care residents and five low-care residents.

Our maximum staffing is 19. We currently have 15 carers on board—10 males and six females. Our clinical staff include an RN, an EN and a clinical support staff member. It is mandatory for staff we recruit that they are willing to do the certificate III in individual support for aged care. Last year 16 people went. That course is not restricted to Sandy Boyd; it is available for the wider community. We had about 10 staff from Sandy Boyd who attended and three staff who completed the course successfully. We have now got four staff who are willing to go on and do their EN. One is about to start and the other three will start in the middle of the year.

CHAIR: If you are happy with that statement, we will go to questions, if that is okay.

Mrs Freckleton : Yes.

Senator POLLEY: Thank you for coming along and for the submission. You said you had three staff who completed that course and there were 10 who started. What was the reason why some of them dropped out of the training? Was that training provided within their community or did they have to travel? What were the contributing factors as to why they did not complete the course?

Mrs Freckleton : Last year the program was actually facilitated by Campbell Page, the employment agency on the island. It depends on the individual in terms of their interest, because working in aged care is a fairly difficult area, as you probably know, and you have people that do start and—

CHAIR: And find it is not for them?

Mrs Freckleton : Yes.

Senator POLLEY: It is good to hear that there are four who would like to go on and do their EN. Where will they have to go to complete that study?

Mrs Freckleton : That would be done with TAFE or in conjunction with JCU.

CHAIR: On the island?

Mrs Freckleton : Yes. We go to TAFE on the island, but with JCU they would have to come into town as well.

Senator POLLEY: Would all your carers and professional staff now come from your island?

Mrs Freckleton : Yes.

Senator POLLEY: Is there a potential for you to meet, from your own community, the requirements that you will have, going forward, for your workforce?

Mrs Freckleton : Yes. We have come a long way in terms of employment, with staff and the requirements that we need. We now [inaudible]. And we have an Indigenous RN on board that is pretty hands-on and is putting a lot of time into the individual staff members coming into Sandy Boyd Hostel. Previously, we did not have that happening.

Senator POLLEY: And, as you said, it is a sector that is demanding; the work and the responsibility—being sensitive to the culture of Aboriginal and Torres Strait Islander peoples. But, if we had a magic wand, what could we do to make your workforce better than it is? What can the federal government do to help your people make sure they get the best care they should be getting?

Mrs Freckleton : Certainly, the training that is required in that particular area—the people, the community members that we do recruit we have to start right from the beginning, because they come in with little or no experience whatsoever. So it is always starting from scratch. We do not have any funding—we do not have a lot of funding. The funding that we do get is basically taken up with wages, and a small amount is on the operation of the hostel. So funding, as you know, normally plays a great role in terms of the further training and success of ensuring the community members that we do recruit—we can have nurses and doctors that can operate aged care by themselves as well. We are getting there. But we have to rely a lot on government funding, which we do not get a lot of. So, yes, we would need a lot more support in terms of funds.

Senator POLLEY: In terms of your hostel, do you provide services for people in their own homes? Do you have community care packages that you deliver to people living in the community?

Mrs Freckleton : No, we are not set up for that. We are just a hostel.

Senator POLLEY: So with the changes of the consumer directed care that take place in a few days, has there been any consideration given to being part of that new process?

Mrs Freckleton : No.

CHAIR: For the residents that you have, do you get packages from the Commonwealth—aged-care packages for the people that you have at the hostel?

Mrs Freckleton : No. I think we have just started tapping into, on a small scale, the NDIS—for some of our residents.

CHAIR: So you are not getting Commonwealth funding for—

Mrs Freckleton : We do, for the flexible aged-care program. That is where we get our funding from.

CHAIR: Okay.

Senator POLLEY: Of your residents in the hostel, do you have any that are living with dementia?

Mrs Freckleton : I think we have about one at the moment.

Senator POLLEY: And what sort of training do your staff have for dealing with that person?

Mrs Freckleton : At the moment they get the hands-on training by the RN and they are doing their cert III in aged care. That is all the training they get.

Senator POLLEY: Okay.

CHAIR: Senator Macdonald.

Senator IAN MACDONALD: G'day. Good to see you. When you were talking about training, I did not catch it; did you say you use TAFE in Townsville and JCU for training? Or do you use them?

Mrs Freckleton : We are currently working with—the cert III in aged care is currently being provided by TAFE in Cairns.

Senator IAN MACDONALD: In Cairns?

Mrs Freckleton : Yes. So, because we have the four staff that are interested in the EN certificate, we are now going to work with TAFE and JCU to get those people through.

Senator IAN MACDONALD: Do you have some registered nurses who would have been trained at James Cook University?

Mrs Freckleton : No. We have just employed an RN who is Indigenous.

Senator IAN MACDONALD: Sorry?

Mrs Freckleton : We have just employed an RN who is an Indigenous lady.

Senator IAN MACDONALD: Okay. Is she a local person?

Mrs Freckleton : We recruited her from Townsville.

Senator IAN MACDONALD: Okay. So the on-the-job training is more or less done by TAFE in Cairns. Does TAFE in Townsville not do that? It is not easy to get to Cairns.

Mrs Freckleton : I do not know. There have been a lot of changes in TAFE. We do have a TAFE facility on the island but their funding is outsourced from Cairns.

Senator IAN MACDONALD: Okay. So the people you have in residential care on Palm Island, are they high-care people, are they? You said you had one dementia patient.

Mrs Freckleton : We inherited some of the high-care people; two of them early in the year, and we have two people that have progressed into high care. So five are low care. We are hoping that eventually it will be a fully low-care residential care place.

Senator IAN MACDONALD: But you also have home care workers working in your organisation? Is that right?

Mrs Freckleton : No, we do not have home care. We only have carers.

Senator IAN MACDONALD: Who does the home care on the island?

Mrs Freckleton : The hospital. They would look after the aged-care people.

Senator IAN MACDONALD: Before your organisation was operating, elderly people in need of care would have been at the hospital; is that right?

Mrs Freckleton : No. We would get applications from the hospital but also from the community.

Senator IAN MACDONALD: Okay.

Mrs Freckleton : Or, if there are people who are in mainstream aged-care agencies, we would generally get applications from them as well. And we would assess them.

Senator IAN MACDONALD: Do you know if, at the present time, there are people from Palm Island in residential care on the mainland, in Townsville or elsewhere, who would rather be on Palm Island but there is simply no room? Do you know of any instances like that at all?

Mrs Freckleton : Simply for residents that are here?

Senator IAN MACDONALD: No. I really mean people who lived on Palm Island, who needed aged care, but there was not enough room at your facility.

Mrs Freckleton : Yes. There are quite a number of people who are in residential care in the mainstream agencies.

Senator IAN MACDONALD: In the mainland?

Mrs Freckleton : We do get applications from aged-care places in mainstream areas. They all get assessed. It depends. The RN does the assessment and it is on a case-by-case basis. You will find that Palm Island people who are living in a mainstream aged-care residence do look to come home. Sometimes we just cannot take them.

Senator IAN MACDONALD: Alright. Thanks very much for that.

Senator WATT: Thanks for coming in today, Mrs Freckleton. One of the topics we covered with some of the other witnesses is the level of training in cultural appropriateness that is available to staff when they are assisting Indigenous elderly people. Have you got anything to say about the kind of training that you have seen that is available to your staff to assist them in that regard?

Mrs Freckleton : In cultural awareness?

Senator WATT: Yes. Probably many of your staff are pretty familiar with it.

Mrs Freckleton : Yes. Well, 99 per cent of my staff are Indigenous. They are all familiar with the cultural awareness requirements in terms of the community's families and what is required. Really, there is not a lot that we need to do in terms of that kind of training.

Senator WATT: I am not sure what your background is. Leaving your own service aside, have you got any thoughts about the training that is available to aged-care staff who go on to work with elderly Indigenous people, to upskill them in the cultural awareness they need to be able to do their jobs properly and look after people properly?

Mrs Freckleton : I have had a lot of experience with Palm Island people in terms of training. Palm Island people are the most trained people I know, but they do not get trained in the areas where it is really necessary, particularly in aged care. Like I said earlier, we start from scratch, because we are getting people coming in with little or no experience whatsoever. The amount of training that is required is 100 per cent with lots of our staffing structure, in terms of them coming in to be carers with residents, because they do not have any experience at all.

There are about 900 people on the island that are unemployed. A lot of those people that I have interviewed for positions—I know you said 'outside the organisation'—do not have a lot of skill whatsoever. They have gardening skills; that is it. So that gives you an idea in terms of what is required, alone, when we are recruiting. We have a major headache. I have requested that we trial the individuals that we take onboard to make an assessment of whether they are really interested in the job, whether they can do the job, because they are requirements that are needed to run a home, to be involved in a residential care facility.

Senator POLLEY: What happens when you are at capacity? You have got 15 beds. What happens if there are two or three other people who need to go into the hospital? What happens to them?

Mrs Freckleton : We have to refer them to mainstream.

CHAIR: So that means they come over to the mainland?

Mrs Freckleton : They go off the island. And then there is a waiting list to get into aged-care facilities here—here, or Charters Towers, or Ingham.

CHAIR: You made a comment in answer to a question from Senator Macdonald about low care and high care, and said that you were moving towards low care—is that correct?

Mrs Freckleton : Yes. That is what we get funded for. We get funded for low-care residents, but we have four high care.

CHAIR: You do not get funding for the high care?

Mrs Freckleton : No, we do not.

CHAIR: Can you take me through how someone ends up at the hostel?

Mrs Freckleton : We get a referral from the hospital or we have families who approach us, or we get referrals from outside—aged-care agencies.

CHAIR: So you only get funded for low care? How do you get the funding from the flexible funding pool?

Mrs Freckleton : Through the Department of Social Services, through the flexible aged-care program.

CHAIR: Have you sought funding for those residents who are high care? Have you sought further funding to support them? Surely, you cannot afford to keep paying for high care.

Mrs Freckleton : We cannot afford to. We apply for once-off funding in the middle of the year for any funds that are available for capital. We have been successful over the last two years. We constantly look around for funding. We are very close to the flexible aged-care people. There are not a lot of options for where you can get funding for aged care.

CHAIR: Once you move to just maintaining low care, everybody else will have to go into residential care in Townsville or Charters Towers—is that correct?

Mrs Freckleton : Yes. You find there are a lot people who want to come home. We are finding lately that families are wanting their loved ones to be on the island. It can be frustrating when you cannot assist community members, and the aged-care people do not want come over.

CHAIR: You also made a comment about the NDIS now that it is establishing and up and operating on the island. How do you interact with the NDIS?

Mrs Freckleton : They have a coordinator on the island. The RN does a lot of interaction with the coordinator there. I think she has a couple of packages with a couple of residents.

CHAIR: If they are under the age of 65?

Mrs Freckleton : Yes.

CHAIR: You have young people in the hostel as well?

Mrs Freckleton : I think there might be one or two.

CHAIR: In regard to the people who have an NDIS package, what sorts of staffing levels do you need to maintain for the provision of those services? Do you provide those supports through the NDIS package or do people come in to provide those supports?

Mrs Freckleton : We do everything within the hostel with the RN. She provides the training for the staff where required. The RN does a lot of that.

CHAIR: Who provides the in-home support, the community care, on the island?

Mrs Freckleton : The Joyce Palmer hospital. They do the home and community care, the aged care.

Senator IAN MACDONALD: Is that run by Blue Care?

Mrs Freckleton : No, it is run by the state government, as far as I know.

CHAIR: Do you get people transitioning from community care into the hostel or are they more likely to go to the mainland?

Mrs Freckleton : Not that I am aware of. A lot of them work with the Home and Community Care Program on the island.

CHAIR: Generally what we are seeing patterned into aged care is that people stay at home longer with home support and go in at a much higher level of care requirement for shorter periods of time.

Mrs Freckleton : I will give you an example. We have had a couple of people who were referred to us on the island but there was no way we could pick them up because of the amount of care that was required—the medications the individual person was on. We would need about four RNs to be able to care for that person. We have had a number of aged care people pass on in the community. Most of them are at home now and being cared for by family. But, going back to the high-care needs, we do not have the facilities to care for them. We are only a 15-bed establishment now.

CHAIR: Thank you so much for coming today. It has been very useful for us to hear about the way care is provided and is available on the island.