Leadership in the aged care sector

By Heleni Bagiartakis, Strategic Growth & Partnerships Manager at Catalyst Education

As seen on LinkedIn, published 12 August 2021. 

It is unquestionable – the age care sector is facing the greatest overhaul in its history. For decades, many strong, admirable and even inspirational leaders have steered the course for hundreds of thousands of older people to be cared for with compassion and conviction. For many years this compassion and conviction led to innovation and creativity which filled the void where funding could not keep up with increasing care needs and costs to match.

So, in the aftermath of the Royal Commission’s recommendations, the Commonwealth Government has heard the message loud and clear. There has been a considerable effort to encourage people to join the sector where workforce shortages, training and education need immediate attention. This is excellent and encouraging news affirming the important role the sector plays in Australian society. But radical change is needed. To lead that change, we need brave, capable leaders who are clear about the priorities that lay ahead and the courage to challenge the status quo.

To support and drive the reforms that we recommend, consistent and confident leadership at all levels of aged care organisations will be essential. It begins with a genuine commitment by boards, executives and staff to the core values and philosophies on which high quality and safe care are built. This should be reinforced through strategies, policies, practices and behaviours.

Aged Care Royal Commission Final Report: Summary

As a leading education provider in how to better care for one another, Catalyst Education acknowledges the crucial role leaders in the sector play, from experienced staff, to team leaders, to managers and directors, in ensuring the successful implementation and sustainability of transformational change.

Royal Commission recommendations

While the Royal Commission Final Report recognised the effort and dedication of aged care nurses and carers, it also highlighted the challenges the sector faces.

We need to acknowledge that we need to do more to ensure senior Australians are treated with ‘respect, care and dignity and have access to quality care as they age’.

The recent Royal Commission made recommendations in several areas of the sector including:

1. As more Australians wish to stay in their own homes as they age and their care needs increase, the Australian Government aims to support their wishes and increase access to home care packages.
2. A review and enhancement of the sector’s quality standards, with a focus on governance, diversity, food and nutrition will ensure quality and safety in residential aged care delivers dignity alongside care.
3. Investing to drive improvements in residential aged care services and sustainability to ensure ageing Australians have stable and reliable care options.
4. Growing a passionate and skilled aged care workforce to support more Australians get considerate care, whether they choose to remain in their homes or move into residential aged care.
5. A new era of governance for the sector, one that will bring transparency, accountability and oversight and will increase community confidence.

The path to reform

The Australian Government’s announcement of $452.2 million additional funding towards reform to address pressing sector needs is welcome news. On top of that, the 2021 Federal Budget also revealed a $500 million expansion to the Job Trainer program, which translates into training a further 33,800 aged care workers over the next two years and addressing pressing staff shortages. More is needed but this is a great start.

Redesigning the sector is going to need considerable funding.

But funding alone cannot transform it. Especially in times of radical change, it’s strong leaders at every level that play the most important role in steering the ship with vision, that ensure the funds are used wisely, and that staff working in the sector are involved and dedicated participants in the process of change.

Change is a holistic process, and one that needs strong leadership to be effective – and those in leadership don’t sit in a group outside of the rest of the organisation, immune to being challenged, confronted, pushed.

So how can we make sure that the Royal Commission pays off? That it will bring real and lasting change for elderly Australians? Change that happens at a structural, cultural, capability and reputational level.

We need a strong, fresh foundation to enable reform, drive cultural change and transform the sector from the inside out. We need self-aware, wholehearted leadership. And we need compassionate, empathetic, curious leadership. As an organisation with a strong social impact commitment, we take that to heart, because it’s at the core of our mission and all our teaching.

So what do the leaders who will champion the reform look like? What expertise do they need to successfully lead the change?

Many will need new skills, a different mindset and increased capacity to lead the path into new ways of thinking and working to achieve the envisioned outcome: safe and compassionate care experiences for our elders.

Filling the gaps in leadership

An industry benchmarking report^[1] released in August 2020 identified a lack of quality leadership in residential aged care. Drawing on data from 13,714 residents, 11,645 relatives and 1,655 employees, the report recommends a focus on strategic leadership around the needs of clients, as well as investment in education to support navigating the sector’s complex regulatory environment. But more importantly, it highlighted the need for clear career pathways and succession planning, two key elements that the sector has struggled with and desperately needs to address to ensure that a passionate workforce is encouraged and supported to remain that way.

The report also clearly connected the quality of care in the sector with the need for education and training for staff at all levels.

How can aged care leaders influence change?

They say that an organisation can only be as good as the people working within it. This is certainly true of the aged care sector and it has been evidenced by the findings of the Royal Commission and other studies. High quality care relies on high quality training and a work culture that attracts and retains the ‘right’ people.

What does that culture look like, and what does attracting the ‘right’ people take?

The support worker staff shortages in the sector are one of the key challenges. While funding may ensure that enough people are qualified to do the work, that is far from the whole picture. The sector also needs to ensure that:

1) They are the ‘right’ people, with suitable personal attributes, and equipped with human-centred skills that will help them thrive in their work.

2) Once attracted, the ‘right’ people are retained successfully and take pride in the contribution they make.

Addressing these two key challenges will go a long way towards ensuring the sector’s transition to more ‘respect, care and dignity’. We have an obligation to ensure that the sector does not become filled with the ‘right numbers’, but the ‘right people’.

Attracting the ‘right’ people

The profession still struggles with being undervalued and it can still attract a demographic that is not a good fit. To address that, leaders need to deliver on robust induction and probationary processes to ensure the required qualities, like empathy, respect, compassion, patience and dedication are demonstrated.

As education providers, we make every effort to ensure our courses attract people who see aged care as more than just a job and recognise their important part in caring for others. Not only that, we foster these qualities in all our learners, by embedding reflective practice in every course, and by role modelling care and compassion at every interaction, from administrative staff to their trainers. That work and fostering of these key personal qualities needs to continue in the workplace.

Retaining the right people

Leaders need to focus just as hard, if not harder, on retaining the ‘right’ people. Of course, adequate pay is a crucial aspect of that, but there is more to retention than that as many researchers have previously found.

The workforce is often still underappreciated, and their work often goes unrecognised. And team leaders and managers are the first people who can lead the shift to more trust and respect in the profession, by genuinely acknowledging good work.

Work culture is also key in helping retain good staff. And work culture is only as good as the people who lead it – it starts with curiosity, empathy, self-awareness and care and a deep understanding of what it takes to work in aged care.

So what can aged care leaders do to retain staff?

• They can involve staff in defining the work culture and its values.
• They can ensure that workload is realistic and allows for quality human interactions between staff and clients and between colleagues.
• They can demonstrate they appreciate and value the work by listening, empathising and acknowledging good work.
• Provide mentoring, education and opportunities for growth.
• Provide clear progression pathways.

It is a phenomenal task that is being asked of aged care leaders. There is no denying that radical reform is needed in the aged care sector. These changes need strong and skilled leadership to steer it into a new direction, and to transform it into the rights-based and compassion-driven system Australians need.

Can current leadership meet these goals? As education providers, we believe they can, and they will, given the support and encouragement they need to do so. Creating a caring and compassionate workforce will have a positive ripple effect into our society and is worth considering how we can do that at every step of their professional journey.

^[1] QPS Benchmarking Residential Aged Care Performance Report 2020