State of the sector : 2021 aged care workforce insights - HESTA Super Fund

 
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
state of the sector : 2021
aged care workforce insights

                                     beyond
          covid

                               and
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
a message
    contents                                                          from our ceo

                                                                                                                              It’s a story that shows substantial improvement       Our research, which expands on HESTA’s 2018
    message from our ceo                                        02   As the national                                         in workforce sentiment towards the aged care          Transforming Aged Care report, showed COVID

    overview                                                 04       superannuation fund                                     industry and employers, and which potentially
                                                                                                                              points to an opportunity for the sector as it looks
                                                                                                                                                                                    manifested in the sector through disrupted hours
                                                                                                                                                                                    and increased financial pressures. Approximately

    methodology
                                                                      dedicated to health                                     to build the aged care workforce of the future.       a quarter of our aged care members made
                                                                                                                                                                                    claims to access their super early under the
    key findings                                                      and community services,                                 Creating the future workforce was a key focus
                                                                                                                              of the Royal Commission into Aged Care Quality
                                                                                                                                                                                    Federal Government’s COVID scheme. Despite
    who we spoke to
    royal commission and the future aged care workforce               HESTA has unique data                                   and Safety. With forecasts of increased demand
                                                                                                                                                                                    these challenges, aged care professionals told
                                                                                                                                                                                    us they felt prouder to work in the sector than
    the COVID impact
                                                                      and insights from our more                              for services as Australia’s population ages, the
                                                                                                                              sector faces significant challenges building its
                                                                                                                                                                                    before COVID. Compared to 2019, they felt
                                                                                                                                                                                    more appreciated by their community and their
    employee outlook and experiences                            10   than 880,000 members                                    workforce to the size and capability necessary
                                                                                                                              to deliver the aged care services Australians
                                                                                                                                                                                    employer, and they were more likely to advocate
                                                                                                                                                                                    for a career in aged care.
    disruption to work hours                                          working in the sector.                                  will need.
    industry outlook                                                                                                                                                                While it was clear through our discussions with
    appreciation by employers, community and clients                                                                          The pandemic impact only highlighted the              industry representatives that there are systemic
                                                                      These insights can help inform how we as a              current workforce shortages. COVID outbreaks
    industry pride and job satisfaction                               country meet the challenges of an ageing                                                                      issues that cannot be ignored, the contrast
                                                                                                                              and the need for infection control practices,         between the 2019 and 2020 results in a
                                                                      population and the increased demand                     including visitor restrictions, across the sector
    a typical HESTA member in aged care                         22   for services.                                                                                                 relatively short time and in such a challenging
                                                                                                                              put enormous pressure and stress on clients,          and uncertain environment is significant.
                                                                      The bushfires and now the COVID pandemic have           their families and the professionals who cared        These findings could provide valuable further
    job intentions                                              24   highlighted glaring and often longstanding gaps         for them. I want to acknowledge the hard work,        context as the sector looks to develop
                                                                      in our caring economy. Closing these gaps must          compassion and leadership shown by so many            workforce attraction and retention strategies
    reasons for wanting to stay with or leave employer                focus on the workforce and the people, often our        aged care professionals during this difficult         and implement the Royal Commission's
    employee likes and dislikes about role                            members, who are so central to delivering               time as they cared for and protected Australia’s      recommendations.
                                                                      these services and improving outcomes.                  seniors. Thank you.
    advocating for aged care                                    28                                                                                                                 We understand data is a key challenge for
                                                                      We strongly believe this starts with listening to our   HESTA manages nearly $60 billion in retirement        the sector as it undertakes this important work.
    career in the sector                                              members to find out how they are experiencing           savings for its 880,000 members. We are proud to      That’s why HESTA is committed to continuing to
    employers and their services                                      work and how that shapes their attitudes to their       have forged a strong connection with the health       develop its workforce insights research program
    leaders and managers                                              industries, their employers and their leaders.          and community services sector over 30 years.          to inform solutions for the sector and shed light
                                                                                                                              More than 200,000 of our members work or have         on how the global pandemic, economic recovery
                                                                      As the aged care sector grappled with a Royal           worked in aged care and we are extremely proud
    conclusion                                                   34                                                                                                                 and ongoing sector reforms continue to shape
                                                                      Commission into Aged Care Quality and Safety            of the critical and essential work they do that is    the aged care landscape.
                                                                      and then a global pandemic, HESTA took two              vital for our post-COVID economic recovery.
                                                                      snapshots of our members working in health                                                                    I wish to thank everyone who participated in
                                                                      and community services (HACS). Our research             We remain committed to partnering with the            the surveys and in discussions with HESTA. Your
                                                                      explored their workplace and industry attitudes,        sector to help inform and facilitate collaborative    experiences, knowledge and insights have been
                                                                      experiences and outlook prior to the pandemic in        solutions to address some of the biggest sector       incredibly valuable and will help inform and
                                                                      May 2019, and again in July 2020 during COVID.          challenges, such as workforce planning. This will     further the conversation about how we can
                                                                                                                              impact the working lives of a significant number      create a stronger aged care system for us all.
                                                                      Our data tells a fascinating story for the aged         of our members and will also affect their quality
    Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695               care sector.                                            of life in retirement.                                Debby Blakey
    AFSL 235249, the Trustee of Health Employees                                                                                                                                    CEO
    Superannuation Trust Australia (HESTA) ABN 64 971 749 321.
    © Copyright H.E.S.T. Australia Limited 2021

2                                                                                                                                                                                                                                       3
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
overview                                                                                                  key findings
    HESTA took two snapshots of its members working in health and community
    services, one prior to the global pandemic and again during COVID.

    The research broadened the scope of HESTA’s 2018 Transforming Aged Care report and examined
    the workplace experiences, job intentions and industry outlook of professionals working across health
    and community services more broadly. The research also considered the effect of COVID on the sector
    at that time.

    State of the Sector Aged Care Workforce Insights: COVID and Beyond is the first of three reports
    and focuses on findings for the aged care sector, supported by additional HESTA data and insights.

    The remaining reports explore findings for the early childhood education and care sector, and the
    community and disability services sectors.

    HESTA intends to use this research to provide insights that can help the sector with workforce planning
    strategies and solutions to meet the growing demand for services, which can ultimately improve the
    working experiences and retirement outcomes for HESTA members working in aged care and in health
    and community services more broadly.

                                                                                                              Despite the significant challenges of a Royal         There are still significant workforce challenges

    methodology
                                                                                                              Commission and a global pandemic, the aged            for the aged care sector. The research
                                                                                                              care workforce returned a much stronger, more         highlighted a polarised workforce. There was a
                                                                                                              positive sentiment towards their employers            significant number of unhappy and dissatisfied
                                                                                                              and the industry during COVID in 2020                 aged care respondents who felt unappreciated
    HESTA undertook two online surveys of HESTA           These thoughts and insights have been used          compared to 2019:                                     and who were motivated to advocate against
    members, one pre-COVID (May 2019) and again           anonymously throughout the report to provide                                                              their employers and their sector, potentially
    during COVID (July 2020). The surveys were            context to the survey results.                      • A
                                                                                                                 ged care employees felt more appreciated by       creating difficulties for attracting the next
    obtained from a random representative sample                                                                their employer and valued by their community.       generation of aged care professionals:
    of HESTA members working across health and            The report also includes other supporting data
                                                          and insights, including data on the uptake by       • A
                                                                                                                 ged care professionals felt prouder to            • A
                                                                                                                                                                       round one in three aged care respondents
    community services with open super accounts
                                                          HESTA members of the Federal Government’s             work in the industry, and were the second             did not feel valued and appreciated by their
    in the accumulation phase.
                                                          early release of super scheme due to COVID.           proudest workforce behind community services          community and employer.
    Questions covered members’ workplace                  HESTA has also developed a model to measure           professionals within health and community
    experiences and job intentions, their                 the preparedness of its members for retirement.       services.                                           • B
                                                                                                                                                                       etween 32% to 38% of aged care employees
    employment satisfaction drivers, their attitudes      This model has allowed HESTA to better                                                                      were unlikely to recommend their employers,
                                                                                                              • A
                                                                                                                 ged care professionals were more likely to          leaders, or a career in the sector. This was a key
    towards their employer and industry, as well          understand the level of financial retirement
                                                                                                                recommend a career in their industry, their           concern for industry representatives.
    as how COVID affected their work, financial           readiness of its members who work in aged care
                                                                                                                employer’s services and working for their
    situation and industry outlook.                       and compare them to members working in other
                                                                                                                employer and leader in 2020, with significant       • P
                                                                                                                                                                       rofessionals aged under 30 and nurses were
                                                          health and community services sectors. This
    In 2020, 4622 HESTA members working in                                                                      improvements in employee Net Promoter Score           the most likely to intend to leave the aged care
                                                          data produced by this model has also been
    or intending to return to work in the sector                                                                from considerably negative scores in 2019.            sector in the next year or two.
                                                          included in this report. Please note data totals
    completed the survey. HESTA received responses        may not add up to 100% due to rounding.             • S
                                                                                                                 hort-term intention to leave the aged care
    from more than 1500 members in aged care –
                                                                                                                sector decreased 10%, with a corresponding
    the largest number of respondents for surveyed
                                                          Breakdown of 2020 survey                              increase in professionals who said they
    health and community services sectors. In 2019,
    537 aged care members participated.
                                                          respondents per sector                                intended to stay with their current employer.

    In addition to the surveys, HESTA discussed the        Industry                       Count    %
    findings with representatives from six industry        Aged Care                      1568     34%
                                                                                                              Nevertheless, the improvement in workforce sentiment in a challenging environment
    organisations, including peak bodies, employers                                                           potentially indicates an opportunity for the sector and government to implement
    and unions, to seek their perspective on what          Community Services             975      21%
                                                                                                              workforce strategies and solutions to improve the standard of care for aged
    was occurring in the aged care sector at the           Public Hospital                593      13%
                                                                                                              Australians now and into the future:
    time and the impact of key industry issues.            Private Hospital               510      11%
    These interviews covered topics ranging from                                                              • S
                                                                                                                 kills development, wanting to try something different and pay were the top reasons for aged care
    the impact of the Royal Commission into Aged           Primary Healthcare             414      9%
                                                                                                                professionals wanting to leave their employers.
    Care Quality and Safety’s final report and             Early Childhood Education      364      8%
    recommended reforms to the high casualisation          and Care                                           • T
                                                                                                                 here was unanimous agreement among aged care employers, peak bodies and unions that
    of the workforce and wages and conditions.                                                                  improving pay, conditions and creating more skills development opportunities to ensure high-quality,
                                                           Note: excludes non-HACS professionals
                                                                                                                sustainable jobs were key.

4                                                                                                                                                                                                                          5
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
who we spoke to                                                                                                                                         royal commission + the
    in aged care                                                                                                                                            future aged care workforce
                                                                                                                                                            The past few years have been an extremely                                       The Royal Commission flagged the challenges
                                     1568              aged care professionals completed the workforce survey in 2020.                                      challenging time for the aged care sector. The
                                                                                                                                                            Royal Commission into Aged Care Quality and
                                                                                                                                                                                                                                            involved in building the aged care workforce
                                                                                                                                                                                                                                            of the future. The number of older people in
                                                                                                                                                            Safety, established on 8 October 2018, brought to                               Australia is forecast to grow significantly over
    workplace                                                                 role                                                                          light systemic failures within the sector, including                            the next few decades. The number of Australians
                                                                                                                                                            evidence of abuse and neglect of clients in                                     aged 85 years and over is expected to increase
                                                                                                                                                            residential aged care facilities and other instances                            from 2% of the Australian population to 3.7% by

        79.2%                                     11.6%
                                                                                                                   LIFESTYLE
                                                                                CARE
                                                                               WORKER
                                                                                                                COORDINATORS                                of substandard and inadequate care. These                                       2058, 2 with the Federal Government budgeting
                                                                                                                 / ASSISTANTS
                                                                                                                                                            failures generated considerable media coverage                                  $25.4 billion for 2022-23 aged care expenditure,
                                                                                                       ANCILLARY                                            and resulted in 148 recommendations for reform                                  up from $19.9 billion in 2018-19. 3 This will have
           RESIDENTIAL                             COMMUNITY
                                                                                                       WORKERS                                              in the Royal Commission’s final report.                                         a significant impact on the number of aged
                                                                                                                                   MANAGER
                                                                                                                                    / CEO
                                                                                                                                                                                                                                            care professionals required to deliver the

          4.8%                                    4.3%
                                                                                                                                                            	“In terms of anecdotal evidence, we definitely                                different types of aged care Australians will
                                                                                               NURSE
                                                                                                                                                OTHER
                                                                                                                                                               overall hear from our members that the                                      need. According to Deloitte Access Economics
                                                                                                        8.7%           5.2%                                     system is getting worse. If you talk to an aged                             modelling, the 2020 workforce of 186,130 direct
                  BOTH                                  OTHER                  52.5%           17.4%                               3.5%         12.6%           care worker who’s been in there for 10 or 20                                care aged care staff would need to grow by 70%,
                                                                                                                                                                years, they will all say, 'It’s declining, and                              which is more than 130,000 additional full-time
                                                                                                                                                                I’m just watching year on year that decline                                 equivalent professionals, by 2050 to maintain
    tenure                                                                    work status                                                                                                                                                   current staffing levels.4 The Royal Commission
                                                                                                                                                                continue to happen and get worse'.”
                                                                                                                                                                                                                                            indicated this number will be even higher if the

    12.9%                                                                                                                                                   HESTA’s research indicated this environment has                                 recommended reforms are implemented.

                                          51.5
                                                                                                                                                            affected employee attitudes and experiences of

                                                                       %
    UNDER 12 MONTHS                                                                                                      LOST JOB                                                                                                           To grow the workforce to the required levels,
                                                                                                                       DURING COVID,                        the sector and their own workplaces. This was
                                                                                                                                                                                                                                            the report highlighted the need for “policies and
    14.1%
                                                                                                                       WILL RE-ENTER
                                                                                                                                                            most apparent in 2019, where sentiment was
                                                                                                                        WORKFORCE                                                                                                           practices to drive a ‘virtuous circle’, where good
                                                                                                                                                            significantly negative when it came to members’
                                                                                                                            1.1%       4.6%                                                                                                 working conditions, supportive and visionary
    1 - 2 YEARS                                                                       26.7%        55.5%       12.0%                                        attitudes to their industry and employer. Despite
                                                                                                                                                                                                                                            management, an empowering work culture,
                                                                                                                                                            the challenges of COVID, the aged care sector
    21.7%                                         5+ YEARS                           FULL TIME PART TIME    CASUAL                  UNEMPLOYED,                                                                                             collaborative teams, relevant education and
                                                                                                                                    WILL RE-ENTER           experienced significant improvement in a number
                                                                                                                                                                                                                                            training, structured career progression, and job
                                                                                                                                    WORKFORCE               of these measures in 2020. But while there has
    2 - 5 YEARS                                                                                                                                                                                                                             satisfaction among care professionals underpin
                                                                                                                                                            been improvement, the ongoing overall negative
                                                                                                                                                                                                                                            high-quality, person-centred care”.5
                                                                                                                                                            sentiment across key measures remains a
    household income                                                          personal income                                                               challenge to the sector as it looks to build the
                                                                                                                                                                                                                                            	“We already know they (aged care
                                                                                                                                                            workforce necessary to meet expected future
                                                                                                                                                                                                                                               professionals) leave because they
                                                                                                                                                            demand for services.
                                                                                                                                                                                                                                                upskill out of the sector.”
       $0 - 40k                                                       31.0%     $0 - 40k                                                            37.8%   In HESTA’s discussions with peak bodies,
                                                                                                                                                            employers and unions, there was unanimous                                       In discussions with representatives across the
     $40 - 60k                                         21.3%                  $40 - 60k                                                   31.2%
                                                                                                                                                            agreement that improving pay and conditions to                                  sector, there was wary optimism about the
     $60 - 80k                   8.5%                                         $60 - 80k                 9.1%                                                                                                                                potential for the Royal Commission to be a
                                                                                                                                                            ensure high-quality, sustainable jobs in the sector
     $80 - 100k                6.8%                                           $80 - 100k         4.0%                                                                                                                                       catalyst for long-lasting change. Many pointed
                                                                                                                                                            was going to be key to attracting the necessary
        $100k+                   8.5%                                            $100k+         3.3%                                                                                                                                        to the numerous inquiries and reports into aged
                                                                                                                                                            people to work in aged care.
                      PREFER NOT TO SAY                   23.9%                                  3.9%
                                                                                            PREFER NOT TO SAY 14.5%                                                                                                                         care in recent years. They said the problems are
                                                                                                                                                            In their final report, Care, Dignity and Respect,                               well known but commitment from government
                  0        5      10      15      20     25      30      35                0      5    10      15      20    25      30    35       40      released in early March 2021, the Royal                                         for concrete action is needed now and, more
                                                                                                                                                            Commissioners stated that a “highly skilled,                                    importantly, sustainable long-term funding
    age                                                                       state                                                                         well rewarded and valued” aged care workforce                                   to meet priority reform areas. Many industry
                                                                                                                                                            will be vital to the success of any future aged                                 representatives with whom HESTA spoke said
                                                          9.8%                                                                                              care system.1 The report acknowledged there                                     it would be challenging to fund the cost of the
                                                                              NSW                 QLD                                                       were not enough professionals in many of the                                    Royal Commission’s recommendations. They
         24.6%                            18-29                  16.8%        33.1    %           13.9%                                                     large residential aged care facilities to provide                               noted the 2021-22 Federal Budget would be a
                               60+                                                                                                                          the high-quality, person-centred care older                                     clear indicator to the sector of the government’s
                                                30-39                         VIC                 SA                                                        Australians need, and said there was clear                                      fiscal commitment to implementing necessary
                                                                              30.6      %         8.9%                                                      evidence linking quality of care and quality of jobs.                           long-term reform.

                               50-59           40-49                          WA                  OTHER
                                                                              7.9%                5.5
                                                                                                                                                            1. Commonwealth, Royal Commission into Aged Care Quality and Safety, Final Report: Care, Dignity and Respect (2021), vol 1, 124.. 2. Dr David Cullen and
                                                                                                      %                                                     the Office of the Royal Commission, Background Paper 2 - Medium and long-term pressures on the system: the changing demographics and dynamics of
           28.9%                                               19.9%                                                                                        aged care (2019), 3. Australian Government, Aged Care Financing Authority, Eighth report on the Funding and Financing of the Aged Care Industry (2020),
                                                                                                                                                            xi 4. Commonwealth, Royal Commission into Aged Care Quality and Safety, Final Report: Care, Dignity and Respect (2021), vol 1, 125. 5. Ibid 124.

6                                                                                                                                                                                                                                                                                                                      7
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
the COVID impact
    The pandemic put incredible pressure on an                            been experiencing due to the economic impact            More than 37,000 members working in residential                                 As can be seen from the below table, aged
    already stretched aged care system. By 26 March                       of the virus. Those who experienced disrupted           aged care claimed super under the scheme,                                       care members working in community care
    2021, there had been more than 4000 cases of                          work patterns included professionals in aged            almost 27% of HESTA members in this cohort.                                     saw the biggest decreases in median account
    COVID among aged care staff and residents in                          care facilities with caring responsibilities who        More than 16,800 members working in aged                                        balance (-45%), closely followed by residential
    Australian residential aged care facilities.6 More                    needed to quarantine due to contracting the virus       care made a second claim for super, which                                       care (-40%).
    than 680 aged care residents died during these                        or becoming a close contact. Casual employees,          was typically for the maximum $10,000 they
    outbreaks, the majority in Victoria.                                  who may have worked across multiple employers,          could claim under the scheme.
                                                                          were also under considerable financial pressure
    Throughout Victoria’s second COVID lockdown,                          due to a lack of leave entitlements if they needed
    which started in July 2020, distressing accounts                      to quarantine.
    emerged of aged care residents – isolated from                                                                                 Aged care sub-sector                  Median balance where account remains open after early release
    their families and loved ones – deteriorating                         It is important to note the majority of survey
                                                                                                                                                                         Before claim                          As of 15/1/21                         Change
    from neglect and inadequate care. This was                            responses were received prior to certain COVID
    due in large part to severely depleted staffing                       measures taking effect in Victoria. These included       Community care                        $23,364                               $12,769                               – 45%
    levels as providers experienced disruption to                         the increased visitor restrictions for hospitals         Residential Care                      $24,991                               $14,975                               – 40%
    their operations and worked to manage infection                       and aged care facilities to allow carers only,
                                                                                                                                   Retirement Village                    $27,137                               $17,289                               – 36%
    control, often with limited support or guidance.                      and measures restricting Victorian aged care
                                                                          employees to work at a single site.7 Victoria had
    This was also an incredibly stressful time for aged                   also not yet reached its peak of daily confirmed
    care employees. Beyond the pressures of COVID                         COVID cases.8 Accordingly, the full COVID               Given aged care is the oldest cohort of HESTA                                   A factor that may have contributed to the need
    on their actual work, many also experienced                           impact as experienced by Victoria is unlikely           members (see A typical HESTA member in                                          to access super early is that, while 20% of aged
    significant disruption to their work hours. This                      to be reflected in these results.                       aged care, page 20) they typically have less time                               care professionals were working more due to
    disruption is likely to have increased the financial
                                                                                                                                  to rebuild their retirement savings. In January                                 COVID (see Disruption to work hours, page 12),
    pressure many households may have already
                                                                                                                                  2021, the median account balance for members                                    nearly one in three aged care respondents said
                                                                                                                                  working in community or residential aged care                                   they had experienced a decrease in household
                                                                                                                                  who accessed their super early under the scheme                                 income.
    COVID early release of super scheme                                                                                           was less than $15,000.

    Reflecting the financial pressures experienced by                     The scheme allowed Australians whose jobs
    the workforce, HESTA members working in aged                          and income were affected by the pandemic to
    care were more likely to access their super early                     withdraw up to $10,000 from their super in the
    under the Federal Government’s COVID-related                          2019-20 financial year, and a further $10,000 in
    early release of super scheme when compared                           the 2020-21 financial year up to December.              Did the coronavirus
    to members in other health and community
    services sectors. Approximately a quarter of                          The proportion of HESTA aged care members               pandemic have                                                                        Significantly decreased
                                                                                                                                                                                                                       Somewhat decreased
    HESTA’s members who work in aged care – more
    than 45,000 professionals – applied to withdraw
                                                                          who made early release claims was the largest
                                                                          when compared to other health and community             any impact on your                                                                   The same
                                                                                                                                                                                                                       Somewhat increased
    money from their super under the scheme,                              services sectors: 19.6% of HESTA members working
                                                                          in the early childhood education and care sector,
                                                                                                                                  household income?                                                                    Significantly increased
    resulting in substantial decreases in the already
    low superannuation savings of many of these                           16.4% in primary healthcare and 19.7% in
    members.                                                              community services.

                                                                                                                                   4%       8%                                                60%                                                        16%                  13%
    Proportion of HESTA members by sector who made a claim
    to access their super early under the COVID scheme

     Sector                                                       % of members in that sector who made a claim                          Somewhat
                                                                                                                                        increased                                                                                                                        Significantly
     Aged care                                                    25.6%                                                                                                                                                                             Somewhat              decreased
                                                                                                                                                                                           The same                                                 decreased
     Community services                                           19.7%                                                        Significantly
                                                                                                                                increased
     Early childhood education and care                           19.6%
     Primary health                                               16.4%
     Public hospital                                              10.6%
                                                                                                                                  6. Australian Government, Department of Health, COVID-19 outbreaks in Australian residential aged care facilities 2021)  at 26 March 2021. 7. ‘Workplace coronavirus transmission driving
                                                                                                                                  Victorian case numbers, including in aged care’, Australian Broadcasting Corporation, 19 July 2021 . 8. Australian Government, Department of Health, COVID-19 outbreaks in Australian
                                                                                                                                  residential aged care facilities 2021 
     Other                                                        17.0%                                                           at 26 March 2021.

    Note: based on number of HESTA members as at 17 April 2020.

8                                                                                                                                                                                                                                                                                             9
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
employee outlook
     and experiences
     HESTA’s research indicated                            While this sentiment is lower for aged care
                                                           than most other health and community
     COVID and the Royal Commission                        services sectors, this is still significant. After
     have significantly affected the                       an intense focus by media, government and
     aged care workforce’s outlook and                     the community on the essential nature of their
                                                           work, aged care employees appear to be
     workplace experiences. Like other
                                                           feeling more appreciated by their employer
     health and community services                         and valued by the community. They are feeling
     professionals, aged care employees                    prouder to work in the industry and have
     experienced significant disruption to                 returned higher ratings for job satisfaction in
                                                           2020 compared to 2019.
     their work hours and ability to provide
     care and services. They were also                     While these findings do not negate the
                                                           sector’s systemic workforce issues, the
     feeling less confident about the future               improvement in results – which notably arose
     of their industry when compared to                    in a highly negative external environment
     most other health and community                       – could flag an opportunity for employers
                                                           when developing their workforce attraction
     services sectors.
                                                           and retention strategies. Industry
                                                           representatives with whom HESTA discussed
     Despite these experiences, a key finding              the findings talked about how the 2020
     that emerged through the research was an uplift       environment had changed dynamically.
     in positive sentiment of aged care professionals
     towards their role, employer and industry. The
     data showed most aged care respondents (84%)
     felt somewhat or strongly supported by their
     employer during the pandemic, with no significant
     differences between states and territories.

     How did you think
     your employer supported
     you during the                                                                     Strongly supported
                                                                                        Somewhat supported
                                                                                                                 “What happens at a time of crisis
     coronavirus pandemic?                                                              Did not support me        is people tend to band together.
                                                                                                                    It's no different in aged care.
                                                                                                                So, I think people probably did feel
                                                                                                                under siege. It does knit you closer.”

           42%                                               43%               42%                 44%
                                            48%
                            51%

                                                             46%
           42%                                                                                     38%
                                            39%                                49%
                            38%

            16%                                                                                    18%
                            11%              13%             11%               9%
         Aged care       Community     Early childhood    Private           Public             Primary
                          services    education and care   hospital          hospital           healthcare

10                                                                                                                                                       11
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
disruption
     to work hours
     The research found one in three aged care               While aged care professionals were the most              Industry representatives said aged care’s                                     Discussions with industry representatives
     respondents had their working hours disrupted           likely, compared to those in other health and            ‘highly casualised’ workforce was a key issue                                 indicated community care clients during COVID
     due to COVID. Of the aged care respondents              community services sectors, to feel their weekly         for the sector, which has given rise to precarious                            had been concerned about safety and had cut
     who experienced changes to their work hours,            hours were not ideal – 14% said their hours were         employment arrangements, financial pressures if                               back services.
     60% found they were working more. More full-            too few and 5% said too many – the majority (81%)        employees had to take time off work due to lack
     time aged care employees (29%) experienced an           said their working hours in 2020 were ‘about             of leave entitlements, lean staffing ratios and                               There was a view that there had been a pick-up
     increase in work hours, compared to part-time           right’. This figure increased from 2019 (77%).           employees feeling overworked.                                                 in demand since the research was conducted,
     (18%) and casual (14%) employees.                                                                                                                                                              with this likely to continue to build as the vaccine
                                                                                                                      More than half of aged care professionals                                     roll out progressed.
                                                                                                                      who were managers, general managers or
                                                                                                                      CEOs experienced an increase in work hours,                                   A large proportion of aged care professionals
                                                                                                                      which was not unexpected in light of the severe                               aged 39 and under (21%) also experienced a
                                                                                                                      disruption to the operation of aged care facilities                           drop in work hours due to COVID. This was also
     Did the coronavirus                                         Aged care                                            and the need to manage staffing levels and                                    the case for single parents (21%).

     pandemic have any                                           Community Services
                                                               	Early childhood education and care
                                                                                                                      infection control during the pandemic.                                        On 19 July 2020, the Federal Government urged
                                                                                                                                                                                                    Victorian aged care professionals to stop
     impact on your paid                                         Private hospital
                                                                                                                      For other roles, safety restrictions potentially
                                                                                                                      meant care workers were the most likely to have                               working across multiple age care facilities
                                                                 Public hospital                                                                                                                    to prevent the further spread of COVID.11
     working hours?                                              Primary healthcare
                                                                                                                      experienced a cut to their work hours (19%),
                                                                                                                      compared to 11% of nurses and 9% of lifestyle                                 It is important to note the majority of survey
                                                                                                                      coordinators or assistants.                                                   responses were obtained prior to or just after
                                                                                                                                                                                                    this announcement. This may explain why the
                                                                                                                      Aged care professionals in community care                                     impact on paid working hours due to COVID
     70%                                                                                                              were more likely to have lost work hours, with                                was broadly consistent between different states
                                                                                      On the other
     65%                                                                                                              30% reporting they worked less compared to just                               and territories, as the full impact of this policy
                                                                                    hand, Aged care
     60%                                                                             and community                    11% of residential care professionals. For those                              had not yet taken effect.
                        Early education                                             services were the                 working across both types of care, 26% said they
     55%
                          and primary                                                most likely to be                worked less.
     50%                healthcare were                                               working more
     45%                most likely to be                                                hours…
                          working less
     40%                    hours…
     35%

     30%                                                                                                              Did the coronavirus pandemic have any
     25%                                                                                                              impact on your paid working hours?
     20%

     15%

     10%                                                                                                                  Working less
                                                                                                                                                          20%                                                                   16%             20%               14%
                                                                                                                          Same                                             22%              20%               21%
     5%
                                                                                                                          Working more
     0%
               Working              Working less     Working the same       Working more              Working
           significantly less                                                                    significantly more

                                                                                                                                                          66%              65%              65%               65%               71%             63%              70%

     Just 7% of full-time aged care employees lost hours.    This may also have contributed to the higher
     Casual aged care employees experienced the              rates of claims for the early release of super
     greatest impact, with 40% of these respondents          scheme among HESTA’s aged care member base.
     reporting they worked less due to COVID. While
                                                                                                                                                           14%             13%               14%              14%               13%              17%              16%
     the Fair Work Commission announced in July              	“I think that whole thing shows that
     2020 that residential aged care professionals,            casualisation is not a good thing – that                                              Overall             NSW               VIC              QLD               SA               WA              Other
     including casual employees, should be given                 people are doing lots of different things                                            aged care
     paid pandemic leave,9 concerns were raised                  in lots of different places to put together
     about casual employees slipping through cracks              a living wage.”
     as they would only qualify for this entitlement if                                                               9. Australian Government, Fair Work Ombudsman, Paid pandemic leave in some awards (2020) , at 26 March 2021.
     they worked for an employer on a “regular and                                                                    10. Rachel Clayton and Yara Murray-Atfield, ‘Fair Work Commission awards paid pandemic leave to aged care workers to stop staff going to work
     systematic basis”.10                                                                                             sick’, Australian Broadcasting Corporation, 27 July 2020 . 11. ‘Workplace coronavirus transmission driving Victorian case numbers, including in aged care’, Australian Broadcasting
                                                                                                                      Corporation, 19 July 2021 .

12                                                                                                                                                                                                                                                                          13
State of the sector : 2021 aged care workforce insights - HESTA Super Fund
industry outlook
     The aged care sector has been going through a period of intense
     transformation and change in comparison to other health and community
     services industries.

     When respondents were asked in July 2020                This potentially points to a challenge for the
     how they felt about the future of their industry        sector as it looks to attract the next generation of
     after the pandemic, the Royal Commission had            aged care professionals with the required skills.
     been in operation for nearly two years with
     recommended reforms due in early 2021. The              Unsurprisingly, confidence levels were also lower
     workforce was also just starting to experience          for aged care employees who lost work hours
     COVID-affected work environments.                       due to COVID, with 42% saying they felt moderate
                                                             to uncertain compared to professionals with
     Most aged care respondents were confident               unchanged hours (32%) and those who worked
     about the longevity of their industry. When             more (30%).
     compared to the rest of the health and
     community services workforce, however, aged             Discussions with industry representatives
     care proved to be the least confident workforce         revealed there were concerns around the ability
     aside from early childhood education and care.          of the sector to meet the wide range of reforms
     One in three aged care professionals said they          proposed by the Royal Commission aimed at
     felt moderate to uncertain about the future of          improving standards of care and client outcomes.
     their industry.                                         These recommendations are likely to result in
                                                             substantially increased regulatory oversight
     This was particularly the case for respondents          and demands on the workforce, and industry
     aged 50 to 59 – nearly 40% said they felt               representatives raised concerns around how
     moderate to uncertain about the future of their         this would impact those working in the sector.
     industry – followed by professionals aged 18 to 29
     (36%). Nurses had the lowest confidence levels –
     40% felt moderate to uncertain.

     Which of the following best describes how you feel about the future
     of the industry you typically work in post-coronavirus?
       Confident
       Moderate to uncertain

           66%                                 58%
                               73%                               74%               77%               79%

                                               42%
           34%
                               27%                               26%               23%               21%

           Aged            Community      Early childhood      Private             Public           Primary
           care             services    education and care     hospital           hospital         healthcare

14                                                                                                                  15
appreciation by employers
     and community
     Health and community services professionals were asked to rate how                                                       Similar findings emerged when respondents                Professionals in residential aged care (37%) felt
                                                                                                                              were asked to rate appreciation of their work            significantly less appreciated by their employer
     much they felt their skills and experiences were valued by the community                                                 by their current or most recent employer.                compared to those in community aged care
     and whether they felt appreciated by their employer and clients.                                                         Nearly half of aged care respondents strongly            (24%). Analysing aged care respondents by roles,
                                                                                                                              agreed they felt appreciated by their employer.          40% of nurses felt significantly less appreciated
     By July 2020 there had been increased focus                        Despite 54% of respondents feeling valued by the      Those in management roles (66%) felt the most            by their employer, compared to care workers
     on the vital and essential nature of the health                    community, industry representatives told HESTA        appreciated compared to professionals in other           (35%), professionals in ancillary services (33%)
     and community services workforce during                            they were surprised at the high sentiment levels.     roles, including care workers (48%).                     and lifestyle coordinators (33%).
     the pandemic, including public recognition                         They told stories of aged care professionals not
                                                                                                                              A significantly higher proportion of community           Industry representatives believed these figures
     of the hard work being done by aged care                           wanting to be seen in their uniforms for fear of
                                                                                                                              aged care professionals felt appreciated by their        did not reflect the discussions they were having
     professionals to protect residents from COVID.                     abuse and high levels of negativity among those
                                                                                                                              employer (60%) compared to those who worked              with the sector.
     It is worth noting, however, the full impact of the                in the sector when it came to how they believed
                                                                                                                              in residential aged care (45%).
     second lockdown in Victoria had not taken effect                   they were perceived.                                                                                           One industry representative said:
     at the time this research was conducted.                                                                                 Nevertheless, more than one in three aged care
                                                                         	“There is this underlying theme that I’ve been     respondents did not feel appreciated. While there            	“What I hear from our members and from
     Health and community services professionals felt
                                                                            getting for a couple of years now …              was an increase in the average rating from 6.0                  workers is that they’re feeling by and large
     their skills and experiences were valued more by
                                                                             there is a view that the community doesn’t       to 6.6 out of 10 in 2020, aged care had the lowest              that they like their work, that they are proud
     the community during COVID than prior to the
                                                                             value the work of aged care and that people      average rating out of all health and community                  of the work that they do, but they feel
     pandemic in 2019. For the aged care workforce,
                                                                             don’t feel valued either by the community or     services sectors in 2020.
     the average rating increased from 7.0 to 7.2 out                                                                                                                                         that they are undervalued broadly by the
     of 10 with more than half of respondents strongly                       by the system for want of a better term.”        Industry representatives raised concerns about                  community. That they feel over scrutinised by
     agreeing they felt valued by the community.                                                                              the significant number of respondents who gave                  media and royal commissions and regulation
                                                                                                                              a 0-5 rating. One industry representative raised                and things like that, and that there have been
     It is also important to note just over a quarter
                                                                                                                              the link between perceptions of appreciation                    significant reports of an exodus, of people
     – 27% – of aged care respondents strongly
                                                                                                                              and standards of care, saying: “A third of                      from the sector, because it’s just getting all
     disagreed, the second highest proportion of
                                                                                                                              the workforce is saying that they don’t feel                    too hard.”
     members within health and community services
                                                                                                                              appreciated and we know getting workforce right
     behind early childhood education and care
                                                                                                                              is fundamental to getting care right. That’s got
     professionals.
                                                                                                                              red flags all over it from my perspective.”

     My skills and experience are valued by the community                                                                     My work is appreciated by my current or most recent employer

         0-5         6-7      8 - 10                                                                                              0-5         6-7      8 - 10
     0 = strongly disagree / 10 = Strongly agree                                                                              0 = strongly disagree / 10 = Strongly agree

                                                                                                               Ave. ('19)                                                                                                         Ave. ('19)

                     Aged Care             27%               19%                          54%                   7.2   (7.0)                  Aged Care                   35%           18%                     47%                 6.6   (6.0)

           Community Services           18%           17%                             65%                       7.8   (7.3)         Community Services             23%         15%                       62%                       7.5   (6.8)

              Early Childhood                                                                                                          Early Childhood                         15%                       63%
                                                32%               14%                     54%                   6.9   (6.8)                                       22%                                                              7.4   (6.9)
           Education and Care                                                                                                       Education and Care

                Private Hospital          24%                23%                            53%                 7.1   (7.0)             Private Hospital               33%             22%                     46%                 6.6   (6.2)

                Public Hospital         21%                 26%                             54%                                          Public Hospital              31%            22%                       47%
                                                                                                                7.3   (7.0)                                                                                                        6.7   (5.9)

                      Primary                                                                                                                  Primary
                    Healthcare
                                           24%              17%                         60%                     7.5   (7.3)                  Healthcare               32%            16%                     52%                   6.8   (6.7)

16                                                                                                                                                                                                                                               17
appreciation by clients
     Conversely, COVID appears to have significantly            	“Particularly around visiting when there
     affected whether health and community                         were lockdowns and stuff like that, there was
     services respondents felt appreciated by                       a lot of narkiness, particularly with families.
     their clients or patients. Respondents across                  Which is totally understandable. But I know
     health and community services generally felt
                                                                    that providers felt that really significantly.
     less appreciated by their clients, with aged
                                                                    So, staff on the ground would have as well.”
     care having experienced the biggest drop in
     appreciation rating.
                                                                In community aged care, the reluctance of
     Discussions with industry representatives                  clients to continue services due to safety
     indicated the levels of appreciation felt by aged          concerns, breaking that continuity of care and
     care professionals may have been influenced                regular interaction, may have also impacted
     by the visitor restrictions placed on aged care            appreciation levels.
     facilities and their flow-on effects for families.

     But while residential aged care facilities
     were urged in March 2020 to implement
     visitor restrictions, Victoria’s increased visitor
     restrictions to only allow carers had not yet
     taken effect at the time the majority of survey
     responses were received.

     I feel appreciated
     by my clients or patients                                      2019

     / the parents of the                                           2020

                                                                0 = Strongly disagree
     children I work with                                       10 = Strongly agree

        73%
                           70%     68%
                62%                                                                                   64%
                                               62%        62%                                                61%
                                                                 59%
                                                                           56%               55%
                                                                                    50%

        Aged care           Community         Early childhood   Private hospital    Public hospital    Primary
                             services         education and                                           healthcare
                                                    care

18                                                                                                                    19
industry pride
     and job satisfaction
     The aged care workforce is prouder to work in their sector according                                                                                                                   Respondents also
     to the survey findings obtained during COVID.
                                                                                                                                                                                            appeared to experience
     While there were substantial increases in pride               While most aged care professionals returned                                                                              higher job satisfaction
     scores across health and community services                   similar average pride scores, nurses in aged
     in 2020, aged care experienced the biggest                    care had a significantly lower average score                                                                             during the pandemic.
     jump in average pride score compared to the                   of 7.8. Lifestyle coordinators and care workers
     other sectors. The aged care sector returned                  were the proudest to work in aged care, with                                                                             Approximately half of health and community
     the highest average pride score (8.4 out of 10)               respective average scores of 8.7 and 8.6.                                                                                services respondents said they felt satisfied
     second only to community services (8.6).                                                                                                                                               with their role at their employer. While aged
                                                                   Given the significant challenges the sector
                                                                   had faced over the period the surveys were                                                                               care professionals returned the lowest average
     	“Maybe it’s the sense of people in the sector                                                                                                                                        satisfaction rating for their role (7.2), they
                                                                   conducted, industry representatives were
        going, 'Yeah, my job is really important, not                                                                                                                                      experienced the biggest jump in average score
                                                                   surprised at the improvements in pride score
         just because what I do is business as usual,                                                                                                                                       within the sector. Having an average score now
                                                                   for the sector.
         but because there is a pandemic and there’s                                                                                                                                        exceeding seven was also a positive for the
         an added level of importance and value to                 One industry representative said:                                                                                        industry, as it indicated overall stronger positive
         what I do in keeping people safe in residential                                                                                                                                    sentiment.
                                                                   “Staff, particularly when the Royal Commission
         care and then providing essential services to
                                                                   was announced, they’d be out and they’d have                                                                             Residential aged care professionals were the
         people in their homes.' Maybe that’s what’s at            the uniform on, and someone would have a crack                                                                           least satisfied with their role (7.1) compared to
         play because to me, the thing that changed                at them. Which is why overall, this is surprising.”                                                                      community aged care professionals (7.5) and
         most between (the two research snapshots)                                                                                                                                          those working across both areas (7.7). Nurses in
         was the pandemic.”                                                                                                                                                                 aged care also showed significantly lower levels
                                                                                                                                                                                            of job satisfaction.

                                                                                                                                                                                            The challenges nurses face in terms of
                                                                                                                                                                                            workload, support and staffing numbers are
     I feel proud to work in this Industry                                                                                                                                                  well documented. Discussion of the findings with
                                                                                                                                                                                            unions have also indicated career development
                                             8.4             8.6
                                                    8.2              8.3     8.3                                           8.3                                                              pathways are particularly important to nurses,
                                      7.8                                                                    7.9   8.0
                                                                                                 7.6
                                                                                           7.0                                                                                              with many looking to upskill into the hospital
                                                                                   6.7
                                                                                                                                                                                            sector where pay and conditions are seen to be
                                                                                                                                                                                            better. While professionals in other roles returned
                                                                                                                                                                                            an average score for job satisfaction between
                                                                                                                                                                                            7.2 to 7.6, nurses reported an average score of
        2019
                                                                                                                                                                                            6.7 out of 10.
        2020

     0 = Strongly disagree
     10 = Strongly agree
                                     Aged care     Community   Early childhood      Private       Public            Primary
                                                    services education and care     hospital     hospital          healthcare

     I feel proud to work this Industry                                                                                          How satisfied are you with your role at your employer?
                                       8.4             8.6             8.7           8.4                                 8.4                                                     7.6             7.6
                                                                                                       7.8                                                          7.2    7.1             7.1                    7.2         7.2    7.1   7.3
                                                                                                                                                                                                            6.9         6.7
                                                                                                                                                              6.6

                                                                                                                                    2019
                                                                                                                                    2020

     0 = Strongly disagree                                                                                                       0 = Extremely dissatisfied
     10 = Strongly agree                                                                                                         10 = Extremely satisfied
                                     Ancillary     Care worker       Lifestyle     Manager/        Nurse             Other                                     Aged       Community      Early Childhood     Private      Public      Primary
                                     services                      coordinator/    CEO/GM                                                                      Care        Services    Education and Care    Hospital    Hospital    Healthcare
                                                                     assistant

20                                                                                                                                                                                                                                                21
a typical HESTA member                                                     retirement readiness
     in aged care                                                               HESTA has developed a model to measure the retirement readiness of its members.
                                                                                Aged care professionals are the least prepared for retirement. Just 23.8% of aged care members
                                                                                are retirement ready, compared to 28.1% of early childhood education and care members,
                                                                                29.6% of community services and 38.2% of primary health.

                                                                                AGED CARE :                  EARLY CHILDHOOD             COMMUNITY                 PRIMARY

                                                                                23.8%
                                                                                                             EDUCATION & CARE :          SERVICES :                HEALTH :

                                                                                                             28.1%                       29.6%                     38.2%
                    218,090
                    HESTA members in aged care

                                                                                                                          working                                 retired
                    gender                                                      super balances
                    HESTA’s aged care members are predominantly women.          Aged care professionals           Women                 Men            Women                    Men
                                                                                have the lowest median
                                                                                super balances across          $22,496            $15,611             $136,861         $157,935
                                                                                health and community
                                                      men                       services.
                                                                                While working women in
                               84.5     %                                       aged care have a higher
                                                                                median balance compared
                                                            15.5 %              to men, their median super
                                                                                balance at retirement is
                                                                                13.3% lower.
                                     women

                    age                                                         where                                               NT
                    The aged care workforce is the oldest cohort                they work                                           0.2%
                    of HESTA members. 43% are over the age of 50.
                                                                                                                                                                      QLD

                                                                                53            47
                    This is higher than community services (37.4%),
                    early childhood education and care (23.4%)                          %              %                                                              13.2 %
                    and private hospitals (39.8%).
                                                                                METRO         REGIONAL                  WA
                    A greater proportion of professionals aged 65+
                    work or have worked in aged care compared                                                           9.0%                                ACT
                    to other health and community services sectors.
                                                                                                                                                            1.4%           NSW

                    0.1%    28.4%           28.5%           32.1%      10.9%
                                                                                                                                                                           36.0%
                                                                                                                HESTA’s aged care                SA
                                                                                                                                                                     VIC
                    < 18   18 - 34          35 - 49        50 - 64      65 +
                                                                                                                members work or
                                                                                                                have worked mainly
                                                                                                                                                 10.5%               26.4%
                                                                                                                in metropolitan areas                 TAS

                                                           47,127
                                                                                                                and along the east
                    salary                             $                                                        coast of Australia*.                  3.2%                 *Unknown: 0.2%

                    The estimated median salary for
                    HESTA members in aged care is       per year before tax.

                                                                                what kind of work                 RESIDENTIAL                 COMMUNITY             RETIREMENT
                                              are estimated to earn less than                                     CARE :                      CARE :                VILLAGES :

                    39.3
                                                                                HESTA’s aged care
                                    %         $50,000 a year before tax –

                                                                                                                  76.9%                       13.8%                 9.3%
                                              the greatest proportion behind    members work or have
                                              early childhood education and     worked predominantly
                    of aged care members      care professionals (40.6%).       in residential care.

                                                                                                                                                                           as at 28 February 2021

22                                                                                                                                                                                                  23
reasons for wanting to stay
     job intentions                                                                                                                                         with or leave employer
     With a dwindling supply of younger professionals                               The intention to leave the aged care industry                           A lack of skills development and wanting to                                Providing employees with more variety of
     entering the workforce and a generation of                                     dropped from 27% in 2019 to just 17% in 2020. In                        try something different was a big driver of                                work could potentially be a low-cost way for
     aged care professionals about to retire,12 staff                               addition, there was a corresponding 10% increase                        dissatisfaction across aged care and health and                            employers to fulfil the desire to try something
     shortages present a significant challenge for                                  in respondents who said they intended to stay                           community services generally in 2020, with aged                            different and increase job satisfaction. Training
     the sector given the growing demand for aged                                   with their current employer rather than move                            care professionals citing pay as their third reason                        and development opportunities and pay can be
     care services. HESTA’s 2018 report, Transforming                               within the industry.                                                    why they would choose to leave their employers.                            harder to change due to business constraints,
     Aged Care, indicated nearly a quarter of the                                                                                                           Pay was the top reason for community aged care                             time and resourcing. Developing strategies and
     workforce may be intending to leave the sector                                 It is important to note the survey was undertaken                       professionals wanting to leave their employer –                            starting conversations with employees around
     entirely within the next one to five years.13 This is                          in July 2020 when there was still very high levels                      perhaps unsurprising as aged care professionals                            ways to incorporate greater variety into their
     potentially a significant barrier for the sector in                            of economic uncertainty and job insecurity                              are among the lowest paid in health and                                    roles can potentially be implemented more
     developing a skilled workforce of a size sufficient                            across the community. The increased ‘stickiness’                        community services.14                                                      quickly and at comparatively much lower cost
     to meet Australia’s future aged care needs.                                    of employees to their employer and industry may                                                                                                    than other long-term drivers of dissatisfaction.
                                                                                    therefore have been influenced by perceptions                           “You’re asking people to do what is incredibly
     This research investigated the short-term career                               of the job security of the sector relative to other                     emotionally and physically arduous work, so                                Conversely, the top three reasons in 2020
     plans of aged care employees, including the                                    industries that have typically drawn those seeking                      there does have to be at the outset a sort of                              for those wanting to stay with their employers
     top reasons behind employees wanting to stay                                   to leave health and community services.                                 higher level of motivation to do that nature of                            were because they derived personal fulfilment
     in or leave the sector, as well as the aspects of                                                                                                      work when you’re not being paid particularly                               from their job, the location of their employer
     their roles they liked and disliked the most. These                            An industry representative told HESTA:                                  well,” an industry representative said.                                    and because they enjoyed working with their
     findings may help the sector improve attraction,                               “There’s a lot of uncertainty around the                                                                                                           colleagues or co-workers.
     retention and development of skilled aged care                                                                                                         The research also showed differences by age.
                                                                                    economic situation generally. If they're in                             A lack of skills development and wanting to try                            These reasons were consistent for aged care
     professionals.                                                                 stable employment, they may potentially feel                            something different were key reasons for younger                           across 2019 and 2020.
     While there was a general decrease across                                      safer where they are than if they look at what’s                        aged care professionals (aged 39 and under)
     health and community services in the intention                                 happening in competing industries.”                                     who flagged they wanted to leave their employer,                           Location featured prominently across health
     to leave the industry in the short term, the biggest                                                                                                   while older employees cited dissatisfaction with                           and community services generally, potentially
     year-to-year change was evident in the aged                                                                                                            the organisation, pay and not getting the training                         indicating more personal care pressures during
     care workforce results.                                                                                                                                they need as the top reasons to leave.                                     COVID.

                                                                                                                                                              Industry                                Top three reasons to leave their employers
     Which of these best describes your short-term plans                                                                                                                                                             1.                                2.                                  3.
     (i.e. for the next year or two) for your role at your employer?                                                                                         Aged Care                                  I want to develop new skills    I want to try something different        I’m not paid enough

                                                                                                                                                                                                                                         There are not enough career
                                                                                                                                                             Community Services                         I want to develop new skills
                                                                                                                                                                                                                                                opportunities
                                                                                                                                                                                                                                                                            I want to try something different
      Industry                                               Stay with employer             Move within industry               Leave industry
                                                                                                                                                             Early Childhood
                                                                                                                                                                                                        I want to develop new skills    I want to try something different        I’m not paid enough
      Aged Care                                                      75% (65%)                         6% (8%)                         17% (27%)             Education and Care
      Community Services                                             73% (71%)                        10% (9%)                         17% (20%)                                                       There are not enough career          I’m not happy with the
                                                                                                                                                             Private Hospital                                 opportunities                 organisation I work for
                                                                                                                                                                                                                                                                            I want to try something different
      Early Childhood Education and Care                             76% (67%)                         6% (15%)                        19% (18%)                                                                                                                             There are not enough career
                                                                                                                                                             Public Hospital                            I want to develop new skills    I want to try something different
                                                                                                                                                                                                                                                                                    opportunities
      Private Hospital                                               76% (71%)                         3% (3%)                         21% (26%)
                                                                                                                                                                                                                                            I’m not happy with the
      Public Hospital                                                76% (70%)                        9% (10%)                         16% (20%)             Primary Healthcare                            I’m not paid enough
                                                                                                                                                                                                                                            organisation I work for
                                                                                                                                                                                                                                                                            I want to try something different

      Primary Healthcare                                             76% (68%)                        7% (10%)                         17% (22%)
      Numbers in brackets are 2019 results
                                                                                                                                                              Industry                                Top three reasons to stay with their employers
     Casual and part-time employees were more likely                                These professionals were the most likely to plan                                                                                 1.                                2.                                  3.
     to plan on leaving the industry (21% and 20%,                                  on exiting the industry, with 35% of professionals
                                                                                                                                                             Aged Care                                  Job is personally rewarding                 Location                   Colleagues / co–workers
     respectively) than full-time professionals (17%).                              under 29 and 25% of professionals aged 30 to
     A significantly higher proportion of residential                               39 indicating they plan to leave aged care in the                        Community Services                         Job is personally rewarding      I like the company I work for         Colleagues / co–workers
     aged care professionals (21%) is planning to                                   next couple of years.
                                                                                                                                                             Early Childhood
     leave the industry in the short-term compared to                                                                                                        Education and Care
                                                                                                                                                                                                         Colleagues / co–workers                    Location                 I like the company I work for

     community aged care professionals (8%).                                        Nurses in aged care were the least likely to stay
                                                                                    with their current employer (65%) and were also                          Private Hospital                            Colleagues / co–workers                    Location                 Job is personally rewarding
     The research also showed it could be a challenge                               the most likely to plan to leave the industry (26%).
                                                                                                                                                             Public Hospital                             Colleagues / co–workers          Job is personally rewarding                  Location
     to keep younger professionals in aged care.
                                                                                                                                                             Primary Healthcare                          Colleagues / co–workers                    Location                 Job is personally rewarding

     12. Suzanne Hodgkin, Jeni Warburton, Pauline Savy and Melissa Moore, ‘Workforce Crisis in Residential Aged Care: Insights from Rural, Older Workers’
     (2017) 76 Australian Journal of Public Administration 93, 93 .    14. Sandy Cheu, ‘Union launches case to lift aged care wages’, Australian Ageing Agenda, 12 November 2020
     13. HESTA, Transforming Aged Care (2018), 14.                                                                                                          < https://www.australianageingagenda.com.au/executive/policy/union-launches-case-to-lift-aged-care-wages/>.

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employee likes
     and dislikes about role
     Across health and community services, purpose, culture and convenience,                                                 Industry                                   Top three most-disliked aspects of members' roles
     or having work fit into the broader life demands of a professional,                                                                                                                1.                                  2.                                    3.
     were the consistent drivers of satisfaction.                                                                          Aged Care                                                 Salary
                                                                                                                                                                                                              Not enough opportunities
                                                                                                                                                                                                                                                               Benefits
                                                                                                                                                                                                                     for growth
                                                                                                                                                                          Not enough opportunities
     Health and community services professionals                   Pay was identified by the Royal Commission              Community Services                                    for growth
                                                                                                                                                                                                                         Salary                                Benefits

     generally agreed the rewarding nature of their                as a clear barrier to attracting the quality and        Early Childhood
                                                                                                                                                                                     Salary
                                                                                                                                                                                                              Not enough opportunities
                                                                                                                                                                                                                                                               Benefits
     job and their colleagues or co-workers were the               quantity of people that will be required to enter       Education and Care                                                                        for growth

     most-liked aspects of their roles.                            the sector to meet predicted future demand and                                                         Not enough opportunities
                                                                                                                           Private Hospital                                      for growth
                                                                                                                                                                                                                         Salary                                Benefits
                                                                   lift standards of care.                                                                                Not enough opportunities
     Location also featured strongly in the top three                                                                      Public Hospital                                       for growth
                                                                                                                                                                                                                         Salary                        Hours not flexible
     reasons for liking their job in 2020.                         There was unanimous agreement on the need                                                                                                  Not enough opportunities
                                                                                                                           Primary Healthcare                                        Salary                                                                    Benefits
                                                                   to lift wages and conditions in the sector when                                                                                                   for growth
     This may have been driven by concerns around                  HESTA spoke with industry representatives. There        Note: the survey response ‘none of the above’ has been excluded.
     avoiding public transport due to the pandemic.                was also widespread uncertainty about how
     Economic impacts disrupting households may                    this would be funded, with many saying it rested
     have also seen caring demands increase for                    with government to put the system on a more
     this predominately female workforce, which we                 sustainable, long-term footing.                         However, they noted a nursing job in aged                                       Having clear career progression and clarity
     know already bears the burden of unpaid care                                                                          care lacked the prestige and pay of jobs in the                                 around what professionals need to do to
     responsibilities.                                             Union representatives noted the sector had              hospital sector, particularly the public sector.                                progress was an aspect flagged in the Royal
                                                                   been relying on the commitment many working             More experienced nurses in the sector typically                                 Commission’s final report in relation to
     For the aged care workforce, what they liked                  in the sector had for their clients, with many
     about their role was consistent with their reasons                                                                    had ‘put up’ with lower levels of pay as they were                              building the aged care workforce. The Royal
                                                                   employees staying in the sector despite long-term       dedicated to caring for their clients.                                          Commissioners said they heard evidence that
     for staying with their employers. This was also               unhappiness with pay.
     consistent between different aged care role types                                                                                                                                                     current career paths were non-existent in
     and for residential aged care professionals,                                                                          	“It’s very common, particularly through the                                   aged care for most direct care staff, and they
                                                                   	“Aged care workers doing it for the love not                                                                                          encouraged a collaborative approach between
     however nurses named their colleagues and co-                                                                            Royal Commission, for us to hear from our
                                                                      the money is just a very long-standing and                                                                                          the Federal Government, education providers,
     workers as their top choice, followed by location.                                                                        members that they’re very dedicated to the
                                                                       consistent theme,” one union representative                                                                                         aged care providers and unions.16 The report
                                                                                                                               residents,” an industry representative told
     Those working in community aged care were more                    said. “So, it’s interesting that the intention to                                                                                   also flagged rewarding career pathways as
                                                                                                                               HESTA. “They do the work because they have
     likely to mention flexibility of hours and liking                 leave the sector is down but it’s I guess not                                                                                       a key component for the sector in relation to
                                                                                                                               a long-term relationship with the people that
     the organisation for which they worked as the                     particularly different to what we already know.                                                                                     improving the attraction and retention of aged
                                                                                                                               they’re providing the care for. So, they’ve
     most-liked reasons. Location and the proximity of                 Aged care workers do actually tend to stick                                                                                         care professionals.
     multiple clients who may need services in a shift                                                                         basically accepted the lesser rate of pay
                                                                       around in the sector for quite a long time.”                                                                                        Industry representatives consistently noted the
     may also have been a factor in this satisfaction                                                                          because they feel what they’re doing is
     driver featuring prominently for this cohort.                                                                             really important.”                                                          lack of career pathways and skills development
                                                                   Other industry representatives talked about the                                                                                         as an ongoing challenge for the sector. One
     The challenges the sector faces in providing                  need to push for health sector parity when it                                                                                           representative said: “If we’re talking about why
                                                                                                                           For aged care professionals planning to leave
     employees with high-quality, appropriately                    came to pay but talked about the overall cost of                                                                                        people intend to leave the sector or why is it
                                                                                                                           their employer or industry, not having enough
     valued work was clearly demonstrated when                     such a move as being a barrier. Attracting nurses                                                                                       happening, we already know they leave because
                                                                                                                           opportunities for growth or promotion was
     it came to the top reasons members gave                       to work in the sector for example is challenging,                                                                                       they upskill out of the sector.”
                                                                                                                           the top dislike, followed by salary. Nurses also
     for disliking their work.15 Members identified                with an industry representative noting it was
                                                                                                                           flagged the lack of opportunities to develop
     salary as the most-disliked aspect of their jobs,             typically younger nurses starting out in their
                                                                                                                           new skills.
     followed by a lack of opportunities for growth or             career who were more likely to work in the sector.
     promotion and benefits.

      Industry                      Top three most-liked aspects of members’ work                                            Job intention                                       Top three most-disliked aspects of members’ roles
                                                 1.                              2.                         3.                                                                                  1.                               2.                                3.
                                                                                                                                                                                                                                                    Not enough opportunities
     Aged Care                       Job is personally rewarding      Colleagues / co–workers            Location           Stay with employer                                        None of the above                      Salary
                                                                                                                                                                                                                                                           for growth
                                                                                                                                                                                  Not enough opportunities
     Community Services              Job is personally rewarding      Colleagues / co–workers       Flexibility of hours    Move within industry                                                                             Salary                             Benefits
                                                                                                                                                                                         for growth
     Early Childhood                                                                                                                                                              Not enough opportunities                                            I do not get to develop
                                      Colleagues / co–workers        Job is personally rewarding         Location           Leave industry                                                                                   Salary
     Education and Care                                                                                                                                                                  for growth                                                          new skills
                                                                                                                                                                                                                   Not enough opportunities
     Private Hospital                 Colleagues / co–workers        Job is personally rewarding         Location           Other                                                             Salary
                                                                                                                                                                                                                          for growth
                                                                                                                                                                                                                                                                Benefits

     Public Hospital                  Colleagues / co–workers        Job is personally rewarding         Location
                                                                                                                           15. The survey response ‘none of the above’ has been excluded.
     Primary Healthcare              Job is personally rewarding              Location              Flexibility of hours   16. Commonwealth, Royal Commission into Aged Care Quality and Safety, Final Report: Care, Dignity and Respect (2021), vol 1, 125.

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