Professor Phillippa Carnemolla, University of Technology Sydney
Australia is in the middle of one of the most significant reforms to aged care in decades. The new Support at Home program is expanding the scope and complexity of care delivered in people’s own homes. Policy discussions have focused on funding models, assessment systems and clinical standards. But another factor will determine whether Support at Home succeeds:
The experience of the workforce delivering care in people’s homes.
Workforce retention remains one of the sector’s most pressing challenges. Evidence highlighted in ARIIA’s Workforce Retention topic shows that staff are more likely to stay when working conditions are safe, manageable and supportive, and when they feel able to deliver high-quality care with confidence.
In home-based care, an older person’s home becomes the workplace, yet this workplace is rarely discussed in reform conversations.
Unlike residential aged care, homes are not purpose-built for clinical care or accessibility, and, whilst autonomy is highly valued, home care staff are doing their job solo, without the immediate physical presence of multidisciplinary teams and clinical support if help is required.
For home care staff in every role - including domestic support, personal care, allied health and clinical care, the home environment shapes both the practical delivery of services and the experience of the aged care workforce. It influences:
- Physical safety and manual handling risk
- Time and task efficiency
- Access to appropriate equipment
- Hygiene and infection control
- Privacy and dignity in personal care
- Worker stress, fatigue and confidence in delivering quality care
The workplace extends beyond the home itself. Many hours are spent travelling between clients, driving to appointments, navigating traffic and searching for parking within fixed time windows. Some staff report risking (and getting) parking fines or rushing between visits to avoid running late, or rushing to find a clean public toilet before an appointment. These cumulative demands form part of the real workplace conditions for the diverse Support at Home workforce.
If these factors are not recognised, they may quietly undermine workforce sustainability at the very time reform seeks to strengthen it.
At the University of Technology Sydney, we are currently conducting research examining how housing environments and location shape the delivery of home-based aged care. This work is happening now, during the implementation of Support at Home, when evidence is urgently needed to inform workforce planning and retention strategies.
We are interviewing aged care staff working in Support at Home and home care programs across Australia to explore:
- How people’s homes affect the care you can provide
- Risks and benefits of home care work
- How housing conditions influence safety, workload and stress
- What would make care delivery more sustainable
The findings from this research will inform policy development, guide workforce planning, and support aged care providers to strengthen workplace practices that improve safety, retention and quality of care in the Support at Home system.
An invitation to contribute
Listening to home care staff is essential to building a Support at Home system that works for both the workforce and older Australians.
Aged care providers can ensure that policies and procedures consider home care workers’ environments.
Home care staff can contribute to research by sharing their experiences in an interview.
Learn more about Workforce Retention in the Knowledge & Implementation Hub.
To learn more about how to participate in the research, please contact Phillippa Carnemolla
University of Technology Sydney
Phillippa.carnemolla@uts.edu.au
*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health, Disability and Ageing.