Workforce crisis in residential aged care: an insight from a rural provider

It is estimated that more than 65% of residential aged care providers in Australia are operating at a loss. Add workforce shortages, funding issues and social pressures, and it is clear the sector is in a state of crisis. For Adina Care CEO Graeme Sloane, leading a residential aged-care organisation in the current climate has proven to be the most challenging period of his 40-year career.

In Australia, workforce shortages in residential aged care present a huge challenge. An aging population coupled with a shrinking supply of younger candidates has created a growing demand for workers in aged care. The current shortfalls are set to worsen as the generation of predominantly women who have been the backbone of the aged care workforce for more than three decades approach retirement.

Adina Care is a community-owned, not-for-profit organisation, offering residential aged care, respite and palliative care for residents in the rural town of Cootamundra and surrounds. Sloane has been leading the organisation for more than a year and says it’s time to shine a light on how dire the current situation is, especially within rural communities.

“The Commonwealth and public demand a certain quality and standard of care which is ideal but is difficult to achieve, particularly when you examine the poor government funding allocated to our sector,” Sloane explained.

“Staff shortages, increasing demand, inadequate funding, pandemic expenses, limited allied health services and a lack of support services make it hugely challenging to maintain the quality of care, safety and support necessary within residential aged care,” he added.

The demand for a skilled and sustainable workforce in Australia will continue to grow while worker availability is dwindling. However, recruitment and retention problems are especially acute in rural areas.

“We are experiencing a shortage of registered nurses across the board within hospitals, private practice and aged care, but what is particularly problematic is how our regional and rural communities can continue to meet the demand with no available and skilled workers,” Sloane continued.

Caring for more than 60 residents, Adina Care has had to develop an innovative workforce recruitment program to attract out-of-town workers to the region.

“At Adina Care, we have had no choice but to take on the battle of workforce shortages ourselves. With a population of just 6000 residents in Cootamundra, we have had to increase our ability to appeal to international and interstate workers.

“As a result, a lot of RNs working here have been given costly incentives including flights, accommodation and, of course, premium wages. Without these incentives, Adina Care offers no point of difference and people would be unlikely to move to our area,” Sloane added.

The viability of regional, rural and remote aged care providers is of great concern across Australia, and this is only made more evident for those who try to remain independent from their for-profit competitors.

Rural providers have lower cohorts in terms of the number of residents and staff and operate on smaller scales, which make them less viable than metropolitan and for-profit facilities. In addition, the current funding model is in no way attractive for future sustainability.

“Aside from our workforce issues, we’ve also had to get creative with keeping other costs low to make up for the increases in recruitment and retention,” Sloane continued.

Adina Care is a member of PACE Care, which assists independent, not-for-profit aged and community care service providers to maintain financial viability and competitiveness. It’s a unique shared services model that allows organisations to share resources, training, development and administration.

“PACE Care offers concentrated expertise and efficient systems, and allows us to remain competitive across award rates, pay, roster, incomings and outgoings. These business systems all come with a smaller price tag, which has allowed us to remain viable in our area,” Sloane said.

“The money we save through using PACE Care allows us to employ six additional aged care staff, which provides invaluable support to our organisation,” he said.

There are around 1.4 million people aged over 65 living in regional, rural and remote Australia. On average, older people in the regions have lower incomes, poorer education and poorer health outcomes, increasing their need for support in older age.

Despite the current adversity facing aged care providers in rural areas, Sloane holds hopes that the new government will support the aged care industry out of crisis.

“We need borders to open to skilled workers and we need the funding provided to our sector to better reflect the high-quality standards of care expected by our industry, the government and the wider community.

“We can only hope that the new government works quickly to address the dire situation we are experiencing, otherwise more providers will close their doors and aging residents will only add strain to our already overburdened hospitals,” Sloane concluded.

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