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

BLOOD, Mrs Denielle, Graduate, HANMAC Pty Ltd

CHARNLEY, Ms Bev, Manager, Community Services Lifecycle Management Authority, TAFE Queensland

CREMA, Ms Lisa, Project Officer, Rural and Remote Training Project, TAFE Queensland North

DIXON, Mrs Teena, Registered Nurse and Teacher, TAFE Queensland North

HANNA, Ms Leeanne, Trainer and Manager, HANMAC Pty Ltd

PYNE, Ms Jo, General Manager, TAFE Queensland North

[14:52]

CHAIR: I now welcome representatives from TAFE Queensland and HANMAC Pty Ltd. Can I check that everyone has been given information on parliamentary privilege and the protection of witnesses and evidence? It should have been emailed to you when you got all the other details. Yes? Thank you. Who is speaking for TAFE?

Ms Pyne : We would like to give a short presentation. We have talked about what each of us will discuss.

CHAIR: Okay. I am on a very strict time line. I need to finish at 3.30. It is the only way I can get back to my home base of Perth. So I am going to ask you to keep it succinct so we can ask you lots of questions. If you go longer, we can ask you fewer questions.

Ms Pyne : Okay. I am the general manager of TAFE Queensland North. Aged care is an important part of our portfolio. Across TAFE Queensland, we have five regions that deliver aged-care training. The qualifications we deliver are the Cert IV in Ageing, Cert III in Individual Support (Ageing) with HACC and ageing electives, Cert III in Allied Health Assistance, Diploma of Nursing, and then a set of skill sets.

One of the priorities for TAFE Queensland at the moment is, in Bev's role in particular, looking at ensuring the delivery we run across the state is consistent in all regions so whoever comes to TAFE Queensland can be assured of a consistent and very high level of service. We have a product plan where we have developed resources for our teaching staff to use. We have a policy of providing excellent professional development for our teaching staff. Teena, for example, has undertaken a Bachelor of Dementia Care and is also doing some training as an educator through Tasmania.

There are literacy issues. Some of the key issues for us are increasing areas of literacy training that is required to be delivered alongside the ageing training. We have also brought Lisa here because we have a contract with the Department of Health that delivers aged-care training to 38 different services in 35 discrete Indigenous communities around Cape York and the Torres Strait. It is a very significant program for us, and we have a lot of expertise in delivering to Indigenous students in that area.

I might just hand over to Bev to talk a little bit. We have also surveyed all of the teachers across TAFE Queensland with the questions that the Senate committee was interested in and collected data.

Ms Charnley : I will try to whiz through this as quickly as I can, and I totally respect that. I am the LMA chair for community services, and we have 10 portfolio areas that sit under that. As I mentioned, ageing and HACC are one key area. We conducted, in support of your inquiry, a survey across the five TAFE Queensland regions that deliver the relevant VET qualifications, and we asked the teachers to identify key aspects of the student cohort, so who is in the classes in the regions, highlights, and any challenges they face. I will just quickly go through that.

Interestingly, with the student cohort—so age, background, prior study, gender and diversity, as examples—repeatedly across the regions there is a wide range of student ages, from 17 to 65. There is a large percentage of people who have English as their second or other language. Many are women who are returning to work and perhaps have not studied for many years, so obviously they are mature-age students. School leavers, interestingly, are not highly represented in our cohort. There are small numbers of international students, but most are domestic Australian students. There is a broad geographical range across TAFE Queensland, with some regions, as you would know, being the size of some European countries, yet there are also urbanised and provincial towns in the same region, so a range of delivery methods need to be on offer to accommodate all learners. Finally, in terms of the cohort, there are a number of students who already have qualifications—not necessarily in community services or aged care—but for a variety of reasons have decided to change careers. Lisa Crema, our colleague, will talk about the rural and remote training project that Jo alluded to a moment ago.

We also asked the teachers to identify some common qualities in those people who are endeavouring to enter the aged-care sector. Repeatedly, the responses were that they need empathy and a caring attitude and they need to be responsible and patient, with additional needs of a level of physical fitness and good energy levels, because it is an occupation that engages with people, and it is an active type of occupation; it is not sedentary. They also need to be emotionally giving, so there is that aspect of the person. The students, the teachers report, generally hold an appreciation for people who are ageing in their community, and they value their contributions past, present and future, assisting people to maintain their interest and identify a desire to work in the community services field from a person centred approach. So that is very much the focus of the teachers and what they look for in the students.

The teachers identified why people entered the aged-care workforce: to give back; to advance into new second-stage careers, and that is quite a common theme; to gain employment; a desire to work with older people. Some use the certificate III and IV as a pathway to a diploma of nursing, and a substantial number of people noted that there was a lack of opportunities when some of these new student entrants were younger and they are at a stage in their lives when they are able to enter their own study later in their own lives.

Some of the teacher-identified challenges faced by aged-care students in the VET sector include: shiftwork, especially weekend work and the impact on family lives; the cost of uniforms for vocational placement, which is a compulsory component of a VET qualification in this area; managing behaviours that students are not familiar with, for instance, behaviours that are associated with dementia; juggling external study, work and home responsibilities; understanding the VET system; little prior study skills and the industry requirement for a level of computer literacy. If you think of some older people entering the workforce, they may not have had that immersion in computer literacy that some others have had. A loss of income is a challenge to returning to study, as is working night shifts after attending classes all day and the cost. As an example, some students in classes have paid $5,000 and others have paid very little. That is to do with funding models and who is able to access which particular stream of funding.

The teacher has also identified a percentage of students who are retraining after leaving other occupations. Three of our regions indicated that over 70 per cent are retraining, and two indicated that over 50 per cent of their students are retraining. They have had a first career or type of occupation and they are retraining into the aged sector.

I asked for some highlights. I asked them: what are some highlights of things that you have observed students achieve or that you have achieved? Teachers love the way some students gain employment while they are on their compulsory vocational placement—their VPC, as we call it. Another highlight is people going on to higher ed—people who keep that pathway going and either complete a high-level VET course or transition into the university sector. There were specific projects such as AQUAVET, where delivery of the medication skill set, which is a very in-demand skill set, occurred across provincial regions with great successes; BPC partnerships established with major facilities, which guarantees student vocational placements each semester; the delivery of My Aged Care training, which was something that one particular region was delighted to be involved in; and the Logan Hospital project. That is just a snapshot across the state of some of the things that teachers regarded as highlights.

There were issues that were identified by teachers. Students who have English as a second language are sometimes reluctant to ask for support. Computer literacy seems to be a challenge, and there are strategies around that, but I am just bringing that to your attention. VPC, vocational placement, is compulsory in the training package. It is harder and harder to secure, yet it is a mandatory part of the qualification. This is because TAFE Queensland, RTOs and universities are competing for the same placements. Some students have no internet. That is a challenge. The south-west region of Queensland, in particular, say that to me about a number of their sites. Regarding computer access, for instance, it is not uncommon to hear that one computer is shared amongst many family members. Access to industry will be discussed later in more depth by Teena. There are head office decisions around VPC that exclude student engagement. Sometimes we find that our teachers are actually liaising with head offices in Sydney or Melbourne, and by the time a reply comes back to our teachers around whether we can get this group of students into your very large facility, the timing or the communication is not right and it is very difficult to make it happen. There are a number of strategies that people put into place about that. They include: literacy support; working hard to establish and build relationships with industry in their regions; making sure that the only students who go out to placement are those who are absolutely ready to hit the ground running to cut out any poor practice, miscommunication or wasting of people's time; and the use of a vocational placement officer.

In conclusion, other comments that the teachers see as relevant are the advent of the NDIS—so training workers for the individual care occupations across a lifespan—and the parallel need to ensure that our teaching staff are updated to include NDIS information that is embedded across the training that they deliver—this is a very important point. The comment from one region about the industry changing to a person-centred approach is that some long-serving staff in some facilities are reluctant to change their practices, and some elements of the aged-care workforce do not totally understand the VET curriculum and just how practical the training is that the teachers provide before the students go out there. That ongoing link between industry and what is happening in VET is crucial to the future.

I also took an opportunity this morning to consult with some Indigenous elders who we work with quite closely. They have some key messages that they want me to bring today. Firstly—and I did not ask them if I could say this; they asked me to say it—they have a belief that TAFE Queensland has the power to create futures in Aboriginal communities, to contribute to those futures, and has the power to support futures in urban and suburban Aboriginal and Torres Strait Islander communities—and not to forget the urban and the suburban. They believe that the Certificate III individual support in relation to this inquiry creates the skills to care for their mob.

They believe Indigenous workers need industry currency to give them up-to-date support when working with vulnerable groups in their communities. So the message there is that we need to be sharing in those communities what is going on with the NDIS in an appropriate way. There is a need for all educators to create an inclusive, welcoming campus when the training is not occurring on country. Also, elders are very keen to work with TAFE Queensland to support an Indigenous workforce of the future and to provide jobs to young people in aged care and disability support under the NDIS—it is just a matter of joining the dots and making sure it happens effectively. That concludes the summary from the teachers—I am sorry it took so long.

CHAIR: Mrs Dixon, do you want to say something?

Mrs Dixon : I work as a project officer, overseeing the rural and remote training project. It is a project that has been delivered by TAFE Queensland since 2009 and is funded by the Department of Health's Health Workforce Fund. There are 38 different services across the state that we deliver training to. They are rural and remote and very remote. The communities include the Torres Strait, Doomadgee, Mornington Island, Coen, Lockhart River, Kowanyama, Woorabinda, Stradbroke Island, Palm Island, Cherbourg, Kuranda and Bamaga—so that is a bit of a selection. Many of these services are also supported under the Indigenous Employment Strategy so they receive wage subsidies to employ Indigenous staff in their services. The training is delivered face to face and the aim of the program is to improve and build the capacity in the Aboriginal and Torres Strait Islander aged-care workforce, and to assist in improving the delivery of the services in those communities.

We deliver to services that are residential or home and community care services—so the Commonwealth Home Support Program services. The staff are delivering services to residents in their homes. We deliver the Certificate III and the Certificate IV and skill sets such as the dementia support skill set, the chronic disease self-management skill set. These have been really well received by the services that we deliver training to.

With the training that we deliver, the teachers go out to the communities about once a month and work with the aged care staff to deliver the training. Many of those staff are really keen to get through their certificate III qualification because it is important for them to care for their mob, essentially. It does help with retaining staff in some of these services, because retaining staff in aged care Indigenous communities can be difficult but the training does give those staff something to focus on when the trainers come to deliver. Training has a direct impact on the quality of care in these services, and in particular we have had feedback on dementia care, palliative care, food hygiene and workplace health and safety. Communities are saying that they are able to manage those behaviours of concern around dementia. They know what it is now. They did not understand it before but now they are able to implement some strategies to better manage those clients.

Some of the services they are delivering include meals to clients, so the food safety training has been instrumental in helping them to provide a better service to their clients. I was on Palm Island yesterday and some of the students who are doing their certificate III in individual support are looking at this training as a pathway to enrolled nursing and registered nursing into the future. So it is giving them some insight into the opportunities that are available in the aged care sector in their own community. That is the succinct version of our program.

Unidentified speaker : I am mindful of the time, so I will not go on for long. First, I want to brag that we get very good feedback on the training that we do. The feedback that we get is that our students are well trained and have good skills. For the literacy skills and computer skills that our students require, our course is now online so that while we are teaching them the skills and the attitudes, as far as you can teach that, that they require in aged care, we are also teaching them computer skills, because the aged care facilities are doing more and more of their documenting online rather than in paper form. The students come out with two skill sets, although initially they are just intending to get the one.

We started delivering the new training package in July last year, and that has had a few changes which have impacted on our training. There is the volume of learning, plus a lot more evidence is needed for the skills, so we are spending a lot more time in our labs, simulating what we do, having scenarios and things like that to make sure that, as far as we can, we set up an environment where they can practise before they deal with real people.

The mandatory 120-hour placement has put a strain on us delivering, because it is very hard to get placements at the moment. What I am about to say is in no way a criticism of the facilities. We talk to the people and they have got so much work to do; they have got so many things they need to get done. Our students are not their core business and so, in the end, it can be hard to get them out there. We have about 10 facilities in Townsville. A couple are new and not ready to take students—and that is fair enough. There are some that we have trouble getting a hold of. Also, the requirements for those facilities that do take our students have increased over the last couple of years. For instance, immunisation for one facility has gone from just hep B to showing evidence for measles, mumps, chickenpox and things like that. That is okay for younger people who have the books, but, if you have older workers and they have to go and get doctor's certificates or blood tests, it increases the cost for them. We had a student come in with a pathology form. They had put a quote on it for how much it was going to cost her to get the blood test so that she could go to this facility, and it was 250-something dollars. She just could not afford it, so we had to find somewhere else for her.

There is another facility which, due to the issues that they have had with some students—and they tell us that it was not our students—feel that their HR and their resources are being stretched by student issues. Students have meltdowns from what they are seeing and maybe not being emotionally ready. One particular facility has said that they now need to have a person from us there the entire time that the students are there. That adds thousands of dollars. They take four students and need us to be out there for the entire time. We cannot say no because there are only so many places we are sending our students, but it is getting harder and harder. A few years ago we thought it was hard, but it is getting much harder.

I love aged care. I did my nursing degree because I wanted to work in aged care. I am very proud to be part of TAFE and instilling that passion that I have in the students who come to us. I think we have good outcomes.

Ms Hanna : HANMAC, by comparison, is a very small RTO. We just practise in North Queensland. We have the odd student across South-East Queensland et cetera, but most of our training is done face to face or externally with face-to-face visits. We have some very good outcomes as far as employment goes. Denielle will speak very briefly about some of the barriers that she has had to employment just lately. We have had an 85 per cent employment rate up until this last group, where the sector has imposed six months experience for students who are graduating to get jobs—not the whole of the sector, but a lot of it. Where do the students get the experience when we have a fairly encapsulated city with, as you said, 10 or so facilities? How are they able to get that experience? If five of them are saying that you need six months, how do you get it? We have students now who are not getting the employment they did. However, on a more positive side, we have three services that call us when they need staff and we recommend students for them to employ. They employ them and everybody is happy, so that is good.

We are the trainer of choice for several services across North Queensland, which is great. We too have troubles with placement. Certainly, as Teena was saying, the one facility that has imposed that we need to have someone on-site all the time represents 16 hours a day for four students, which works out at about $10,500. That is a lot of money when you are getting probably $2,500 if you are training a subsidised student. We try to keep our costs down. We keep our classes small. We base everything that we do on person-centred care. Interestingly, we have some, I suppose, broadening of the terms of the course because we have such small groups. We have probably one to two students out of each group that will go on to do their EN or RN at a minimum. We have been successful in that.

One of the issues for us is the entrants to the market that charge $10 or $20 to do a certificate III in individual support under the certificate III guarantee, which is a Queensland government funded program. It is difficult to compete with that. I have put in the paper that I have presented to you a model from New South Wales that is a capped model. I have given you the link so you can look at that. Just while I am talking about my submission, the third-last recommendation in the last line has a typo in it that says 'lost costs' instead of low costs. I just draw your attention to that. I will resubmit it.

Those are probably some of the bigger impactors on us. I have also annexed a paper from one of our students who did not want to appear today who had a lot of trouble getting to us because their job service agent kept saying to them, 'You do TAFE or you don't do it at all.' We had the same problem in Charters Towers just recently as well. We went out there to start training. We did a very small cohort but we had other people coming to us saying, 'We want to do the training with you because it is face to face and it is here, but we have been told we will not be funded unless we go to TAFE.' That is nothing against TAFE—they give a good service—but there should be freedom of choice around that.

Senator IAN MACDONALD: Who tells them that?

CHAIR: The service providers.

Ms Hanna : The JSAs. The people who are unemployed get funding through them to come and do their training. We also get called TAFE. TAFE is the generic term. I would like to see governments and others start to use registered training organisations as the term rather than TAFE, because there is a larger population. ASQA, our governing body, is certainly rooting out the ones that are unscrupulous and is doing a good job of that. So I think it is time for terminology to change and for registered training organisations to be the terminology of the day.

Mrs Blood : The hardest thing I found about getting the job was, as Leanne said, that what most places are looking for is a minimum of six months experience. Where do you go to get that when there are only a limited number of places in town? The other thing that I find very hard is that places everywhere only take casual employees to start with. As a main income earner for a family, to take a chance on a casual job is a big chance, because an employer is under no obligation to give you any shifts a week. If you have to have an income, that is a very hard thing to take a chance on. Those are the biggest things: experience and job security.

CHAIR: Only two small things, really!

Mrs Blood : That is right.

Senator POLLEY: Thank you very much. They were quite detailed opening comments from everyone, which I really appreciate. Why we are here today, as part of our responsibilities, is to give you the opportunity to tell us what more the federal government can do to support training in this sector. Everywhere we have gone around the country so far, the issue from providers has been that there isn't standardised training, so too often people come onto the floor and are not trained in the areas or to the level that they want. We would really appreciate your response to those comments.

Ms Hanna : I think there are a few impactors. The first is that we have low-cost training organisations that charge $10 or $20 for the training, and therefore turn out students—just churn them out. A lot of them do not have clinical labs. They do not do any hands-on, or do very minimal hands-on, training with the students before they go. There are now requirements within the course for those clinical practices to be demonstrated during the course, but there is nothing that says they must be simulated before they actually go out onto the floor. We hear time and time again that students come out not even knowing how to make a bed properly. That is a fundamental skill for a person in the home, let alone in an aged-care facility.

Ms Pyne : We would endorse those comments. Our fees are around $300 for a student where it is their first qualification. Where it is their second it could be up to $3,000. We will see competitors coming in and offering the qualification for $20, and the local pub will have a room booked for the training. We know that those students are not going to be prepared when they go out to the facility. One of the comments we have made across TAFE Queensland is that we really make sure that we moderate that delivery so that it absolutely is consistent, and being one of the larger providers that is something. Because we do cover that geographic area it is something we can do.

The other issue for us in training, the program that Lisa manages has been going for six years now. It is a brilliant program. The communities love it. The facilities love it. There has been a huge increase in the standard of care. But every year we are challenged, because the department of health funds it. For example, last year it took 10 months before we were told that we would have a contract. We were able to keep some of the staff but a number of our very experienced staff had to be let go. We are still in doubt this year. We work really well with the officers in the department and they have been really great. They are just as anxious as we are. There seems to be quite a lot of difficulty getting that continuity of funding happening.

Ms Hanna : There is the cost of delivering funding outside the major centre. You have to get in your car and drive out to wherever and then do the practical skills. You put everything on the trailer and take it with you. It is not good. If you want to give quality input you can do it online or you can do it by going out there almost every three months. We do all those things. But, if you really want to give quality face-to-face training and be able to do an informed assessment of the suitability of the people who are looking for the jobs, then you need to be Johnny-on-the-Spot for at least some of the training.

Ms Pyne : Because the training is funded by the state there is a different level of funding in each state. We are one of the most regionalised states in the country and our funding is amongst the lowest. It really is very challenging to deliver a quality program when you are facing those sorts of restrictions. We have staff like Teena and Lisa who just go above and beyond probably what they are paid to do that delivers the service.

Mrs Dixon : We visit our students twice a week and make sure we are out there. As soon as there is an issue or as soon as they say that we are missing something, we get onto it and we change what we deliver. Even if it is not specifically written, if this is what the facilities are saying, then we make sure we tailor it appropriately.

Ms Pyne : We are getting lots of inquiries from China for aged-care training. The amount that we would be paid under those contracts is usually twice what we get.

Ms Hanna : Can I just make an additional comment that private RTOs are not privy to the funding that goes to TAFEs as well like the recent rescuing TAFEs. The government has put a lot of extra funding into TAFE that we do not get, so that makes it difficult for us as well. We have nothing against TAFE but it is a business unit of the government so naturally they look after their own, I guess.

Ms Pyne : I guess it or it is all relative. It is $5 million over three years. Our budget is $85 million just for the north, so it is all relative.

CHAIR: Senator Macdonald, do you have a question?

Senator IAN MACDONALD: Can I just clarify something. What you are telling me about TAFE, does that relate to all training or were you specifically referring to training in the aged-care sector?

Ms Pyne : No, these comments were specifically about aged care. We try to do it across all of our programs but, today, we have been talking about aged care. Which part, Senator Macdonald?

Senator IAN MACDONALD: What you were telling is generally in your opening statement, was that related just to aged care?

Ms Pyne : Aged care.

Senator IAN MACDONALD: Okay. Perhaps I missed this, but what courses do you specifically for aged care?

Ms Pyne : Those cert III in individual support ageing with HACC and ageing electives; cert II in allied health; allied health assistance; diploma of nursing; and we are increasing the ranges of skill sets.

Senator IAN MACDONALD: Okay. Ms Hanna, was yours the same?

Ms Hanna : It is very much the same but we do not offer the diploma of nursing and we do offer disability training as well. So we have a cert II in individual support disability and the cert IV in disability.

Senator IAN MACDONALD: Okay. Again you may have said this and I missed it, but in any one year how many people go through the training? Do you have the statistics that would tell me the number in the north or in Queensland as a whole?

Ms Pyne : Teena, do you know?

Mrs Dixon : We do not have it for Queensland.

CHAIR: Would you take notice?

Mrs Dixon : Yes.

CHAIR: That would be very helpful.

Senator IAN MACDONALD: Could I ask you the same, Ms Hanna?

Ms Hanna : Yes, sure. I can tell you now. Ours is only about 130 students a year. We are very, very small.

Senator IAN MACDONALD: In North Queensland? You operate only in the Townsville area.

Ms Hanna : We only operate really in North Queensland and we have few students down south but not many.

Senator IAN MACDONALD: It is mainly North Queensland. So it is 150?

Ms Hanna : Is 135.

Senator IAN MACDONALD: Yes, 135. And they are mainly people who are now actively working in aged care?

Ms Hanna : Yes, in aged care and disability.

Senator IAN MACDONALD: Okay.

Ms Hanna : We have a really good uptake of our students, which is great, apart from recently when the barriers came in.

Ms Crema : Between July and December last year 290 staff across all of our communities participated in some training.

Mrs Dixon : Here in Townsville we currently have 40 students in our class which we started this year. We graduated probably 35 in December last year. We have another 30 or so that are coming up to the end. About 100 a year would graduate.

Senator IAN MACDONALD: Can I ask both of you, not getting to specifics: do your students ever talk to you about, 'If I do this course, how much more money would I get in the job I am in or looking at'? Do they ever talk to you about that sort of thing.

Mrs Dixon : Money does come into it. A lot of our students do this because they are keen to work and they are wanting jobs. We have had people from the nickel industry who have lost their jobs and they have come to us to try to find another way of working. They do definitely talk about money. Nobody would come into aged care for the money; it is other reasons that bring us here.

Ms Hanna : We have probably 10 or 15 per cent of our students who come to us wanting to do the certificate III in health services assistance, which they see as a foot into the hospital. When we talk to them about why they want to do that it is because they see that aged care or ageing has such a negative bias in everything that is put up. You hear about people being abused, you hear about nursing homes being closed down.

Senator IAN MACDONALD: The same as in politics, too, I might say. I speak from experience.

Ms Hanna : Exactly, so you know what I am talking about. When we sit down and talk to them and ask them what they really want to do, what they want is to work with older people, but they see that the hospital has better conditions and does not have the stigma of aged care, which is really sad because it is a great career pathway.

Senator IAN MACDONALD: Thank you.

CHAIR: Thank you very much for your time. Are you able to provide a copy of the survey because it is extremely useful information.

Ms Charnley : I could give you the one for the regions. Would I send that to Carol?

CHAIR: Yes, Carol or Kate. That would be very useful. It gives a really nice snapshot about why people are going into the profession and how they are feeling. Your evidence was very much appreciated. Thank you to all our witnesses today. I know a lot of them have left but I am sure that they will read this in the Hansard.

Committee adjourned at 15:33