Direct Client Care and Support

• Direct Client Care and Support IRC's 2019 Skills Forecast
• IRC membership
• SkillsIQ – Skills Service Organisation

Employment snapshot

The Health Care and Social Assistance industry is the largest employing industry in Australia. In 2019 there were close to 1.7 million people employed in this industry, which is projected to increase to more than 1.9 million by 2024. While it is difficult to quantify how many people work in Direct Client Care and Support, it does form a significant part of the Health Care and Social Assistance industry.

Within this industry, and relevant to Direct Client Care and Support, is that the employment numbers for Aged and Disabled Carers are expected to grow from close to 175,000 in 2019 to 222,300 in 2024, an increase of more than 25%. All other occupations within this sector are also projected to grow by 2024, with Counsellors expected to grow by 25%, Welfare Support Workers expected to grow by 23%, and Health and Welfare Services Managers expected to grow by 19%.

Media Release – Community and Personal Service Workers on the Rise from the 2016 Census indicates that in terms of absolute growth Aged and Disabled Carers was the third highest ‘largest growth’ occupation between 2011 and 2016.

Industry insights on skills needs

The Direct Client Care and Support IRC's 2019 Skills Forecast identifies the top priority skills for the sector as mainly soft skills, ranging from emotional intelligence, teamwork and communication, resilience, stress tolerance and flexibility, through to problem solving and self management, followed by technical / job specific skills. The top five identified generic skills are:

• Communication / Virtual collaboration / Social intelligence
• Customer Service / Marketing
• Learning agility / Information literacy / Intellectual autonomy and self management (adaptability)
• Language, Literacy and Numeracy (LLN) (Foundation skills)
• Design mindset / Thinking critically / System thinking / Solving problems.

According to the job vacancy data, the top requested skills by employers in the sector were communication skills and planning. The most advertised occupations were Health and Welfare Services Managers followed by Child Carers. The top employers were the New South Wales Government and the Government of Victoria.

The Direct Client Care and Support IRC's 2019 Skills Forecast highlights several key challenges and opportunities for the sector, including:

• Skill shortages – needed to assist those with chronic health conditions, and in the areas of dementia care and palliative care, as well a need for workers with technological and interpersonal skills
• Government policy / legislation changes – relating to the National Disability Insurance Scheme (NDIS) and government expenditure in the Aged Care sector
• An ageing workforce
• A lack of career progression, a lack of career pathways and an increased casualisation of the workforce.

The above Skills Forecast states that the sector’s client base has changed over time, as the prevalence of mental health and alcohol and other drug-related conditions, as well as other chronic conditions such as asthma, diabetes, obesity and arthritis, increases. In addition to increased demand for skills relating to the care of individuals with chronic mental health conditions, or those individuals who need care as a result of their usage of alcohol and other drugs, there are also workforce deficiencies in skills related to dementia care, palliative care, and a need for individuals with technological, communication and interpersonal skills, most noticeably in the aged and disability care sectors. A focus on updating the workforce skills mix is therefore of high priority.

The above Skills Forecast summarises the multitude of challenges influencing skills shortages across the sector as:

• A scarce supply of skilled trainers
• A lack of investment in workplace training, compounded by funding limitations
• Limited opportunities for continual training (e.g. continued professional development)
• No formal requirement for aged care-related training before entering the aged care workforce, and the onboarding of unqualified staff
• A disassociation between components of training and industry needs (e.g. skills areas such as technology, communication, customer service, negotiation, risk assessment skills, etc.)
• Poor language, literacy and numeracy (LLN) skills
• The high cost of training to both workers and employers, especially where there are no subsidised training places to meet particular sector demands.

The Direct Client Care and Support IRC's 2019 Skills Forecast also discusses the challenges and opportunities associated with the National Disability Insurance Scheme (NDIS) for the sector. The NDIS provides an individualised approach to funding and connecting individuals who have a permanent and significant disability to services that will support them in their daily lives and help them to achieve their goals. A challenge to the implementation of NDIS is an insufficient number of staff employed to create NDIS plans (i.e. individualised care plans) which is a critical component of the Scheme. The significant labour shortages in this area have resulted in employers having little choice but to hire people regardless of their level of skills and experience. Despite the additional recruitment of staff external to the public sector workforce, the incremental level of demand has resulted in a pressurised process and, as a result, a significant number of NDIS plans are unsatisfactory, meaning they are not reflective of the clients' wishes or situations. Those individuals conducting assessments require specialised skills in order to understand the complexity of clients' needs, and in order to put together NDIS plans that best meet their requirements. With a certain portion of NDIS plans not catering to the full breadth of client concerns, it is possible that the disability support workforce may face flow-on difficulties in providing holistic care to clients.

The Disability Services Market Report 2018 states that demand is highest for Disability Support Workers and Managers and Supervisors while demand for other staff remains strong. Constraints on workforce recruitment continue to limit capacity to meet demand. The profile of sector employment is continuing to shift towards part time employment and casualisation. Growth in the employment of part time workers continues to increase at a rate faster than full time workers.

Precarity and Job Instability on the Frontlines of NDIS Support Work highlights that the NDIS labour force is underdeveloped and not growing fast enough to meet demand. This means that many agencies seem prepared to recruit almost anyone, including people with few skills and possibly little interest in the sector beyond having a job. This situation and the lack of resources devoted to training raise serious concerns for workers, clients and their families. The new workforce in NDIS-funded services provision can be described as 'very, very green', young, low skill and inexperienced. This results in even greater workload and work intensity for experienced staff, who are required to support and compensate for the limited capacities of newer workers. Lacking appropriate training and supervision, new staff have few opportunities to improve their skills. This can lead to a culture of bravado, rather than a culture of support. The NDIS does not provide adequate funds within the unit price structure for regular training of staff. Hence, in most agencies, training opportunities for newly hired staff range from minimal to non-existent. Given the already inadequate training systems for newly-recruited disability support workers, the departure from the sector of many long-time, more experienced workers will only exacerbate the problems of skill and capacity faced under the NDIS. Frustratingly, most of these workers support the goals of the NDIS and would prefer to stay in their current occupation, if the immediate problems (such as inadequate training and supervision, unfair transportation arrangements, risks of violence, and others) could be resolved.

Growing the NDIS Market and Workforce: Supporting the Market to Deliver Innovative, People-Centred Services so that Participants can Achieve Their Goals, published by the Australian Government Department of Social Services, outlines the Government's key priorities to assist an efficient and effective NDIS market and workforce to grow. The NDIS presents one of the largest job creation opportunities in Australian history. The Productivity Commission estimates the disability care workforce will need to approximately double from the 2014–15 level to meet the demand created by the NDIS. This means that one in five jobs created in Australia over the transition period will need to be disability care jobs. Approximately 71% of newly created jobs are expected to be support worker roles, 12% allied health service roles, 11% case and social worker roles and 6% managerial roles. As such, most NDIS roles require the right capabilities and experience rather than formal qualifications. The Government's long-term vision is for a capable and adaptable NDIS workforce, with workers pursuing attractive career pathways. This vision will require a mature market of diverse and strong providers delivering effective on-the-job capability development for workers, along with appropriate and accessible formal training pathways. In the short-term, this requires Government investment in supporting providers to develop their workforce, coordination to improve formal qualifications, and better collaboration between existing initiatives, including employment services. As the aged care workforce will almost treble by 2050, the Government is also working across sectors to remove barriers, find synergies, and enable and promote attractive career paths across the broader health and care workforce.

Navigating the Maze: An Overview of Australia's Current Aged Care System reiterates the longstanding concerns around workforce numbers and skills mix, attraction, retention and career paths, remuneration, and the levels of skills and qualifications in the aged care sector. The aged care workforce will need to expand considerably as the population ages and adopt new models of care and scopes of practice to meet changing expectations. The Productivity Commission has estimated that by 2050 the aged care workforce will need to have grown to around 980,000 workers.

A Matter of Care: Australia's Aged Care Workforce Strategy was developed with the aged care sector, for the aged care sector. It outlines 14 areas for action to support Australia's aged care workforce. The actions identified in the strategy aim to support the sector to invest in better workforce planning, implement better job pathways to allow for career progression, build leadership across the sector at all levels, foster the next generation of leaders, implement practical strategies for attracting and retaining the right people with the right fit, and keep valued skills and talented people. This strategy can be executed in one to three years and in doing so will then position the sector for the next four to seven years.

The report, Profiling Capacity to Support Older People in Remote Communities to Age in Place, discusses the workforce challenges associated with the provision of services to Indigenous communities. Hands on Indigenous service providers, especially women care workers, are squeezed between their employment in health care training and service delivery, and their more traditional roles and cultural responsibilities. Hence, there is a high turnover of people through these service positions. This adds to overall cost through the need to continuously recruit and train new staff members. Moreover, in the interim, fly-in and fly-out staff are needed to fill the gap. Burnout of Non Indigenous staff is high due to harsh and unique working environments in regional and remote communities. They are faced with inequities in accommodation, compared with workers in less remote communities. They are also confronted with the enormous task of delivering appropriate and effective services for aged care and disability under these conditions.

Victoria's Alcohol and Other Drugs Workforce Strategy 2018–2022, released by the Victorian Government Department of Health and Human Services, sets the direction for workforce development and planning for Victoria's alcohol and other drug treatment sector to 2022. The strategy presents a new approach to workforce development and planning that reflects best practice, better data collection and planning. This approach promotes a capable and sustainable workforce with the necessary knowledge, attitudes, values and skills to deliver high-quality treatment that meets the needs of people with alcohol and other drug issues and their families, now and into the future. The strategy focuses on six key result areas:

• Improve workforce availability
• Build workforce capabilities
• Increase workforce diversity
• Improve worker health, wellbeing, safety and engagement
• Strengthen leadership and collaboration
• Deliver person-centred, integrated care.

Industry associations and advisory bodies

Aged and Community Services Australia (ACSA)

Allied Health Professions Australia (AHPA)

Australian Community Workers Association (ACWA)

Carers Australia

Community Mental Health Australia (CMHA)

Diversional and Recreation Therapy Australia (DRTA)

Leading Age Services Australia (LASA)

Mental Health Australia

National Disability Services (NDS)

Alcohol and other drugs State and Territory peak associations

Alcohol Tobacco and Other Drug Association ACT (ATODA)

Alcohol, Tobacco and Other Drugs Council Tasmania (ATDC)

Association of Alcohol and Other Drug Agencies NT (AADANT)

Network of Alcohol and Other Drugs Agencies (NSW) (NADA)

Queensland Network of Alcohol and Other Drug Agencies (QNADA)

South Australian Network of Drug and Alcohol Services (SANDAS)

Victorian Alcohol and Drug Association (VAADA)

Western Australian Network of Alcohol and Other Drug Agencies (WANADA)

Employee associations

Australian Nursing and Midwifery Federation (ANMF)

Australian Services Union (ASU)

Health Services Union (HSU)

United Workers Union

Regulators

Aboriginal and Torres Strait Islander Health Practice Board of Australia

Australian Government Aged Care Quality and Safety Commission

Relevant research

A Matter of Care: Australia's Aged Care Workforce Strategy – Aged Care Workforce Strategy Taskforce

Disability Services Market Report 2018 – D. J. Gilchrist and P. A. Knight

Growing the NDIS Market and Workforce: Supporting the Market to Deliver Innovative, People-Centred Services so that Participants can Achieve Their Goals – Australian Government Department of Social Services

Navigating the Maze: An Overview of Australia's Current Aged Care System – Carolyn Smith and the Office of the Royal Commission for the Royal Commission into Aged Care Quality and Safety

Precarity and Job Instability on the Frontlines of NDIS Support Work – Donna Baines, Fiona Macdonald, Jim Stanford and Jessie Moore

Profiling Capacity to Support Older People in Remote Communities to Age in Place – Heather Gibb and Dean Dempsey

State of the Disability Sector Report 2018 – National Disability Services (NDS)

Victoria's Alcohol and Other Drugs Workforce Strategy 2018–2022 – Victorian Government Department of Health and Human Services

Department of Employment 2018, Employment Projections, available from the Labour Market Information Portal  

• by ANZSIC 1 digit industry, Health Care and Social Assistance, employment projections to May 2023
• by ANZSCO, selected occupations, employment projections to May 2023
  
  • 2721 Counsellors
  • 3112 Medical Technicians
  • 4113 Diversional Therapists
  • 4117 Welfare Support Workers
  • 4231 Aged and Disabled Carers
  • 4233 Nursing Support and Personal Care Workers.

Australian Bureau of Statistics 2018, Employed persons by Industry group of main job (ANZSIC), Sex, State and Territory, November 1984 onwards, 6291.0.55.003 - EQ06, viewed 1^st November 2018

http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/6291.0.55.003May%202018?OpenDocument

• Employed total by ANZSIC 1 digit industry, Health Care and Social Assistance, 2000 to 2018, May Quarter.

Australian Bureau of Statistics 2018, Employed persons by occupation unit group of main job (ANZSCO), Sex, State and Territory, August 1986 onwards 6291.0.55.003 - EQ08, viewed 1^st November 2018 http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/6291.0.55.003May%202018?OpenDocument

• by ANZSCO, selected occupations, employed total 2000 to 2018, May Quarter.
  
  • 2721 Counsellors
  • 3112 Medical Technicians
  • 4113 Diversional Therapists
  • 4117 Welfare Support Workers
  • 4231 Aged and Disabled Carers
  • 4233 Nursing Support and Personal Care Workers.

Australian Bureau of Statistics 2017, 2016 Census – employment, income and unpaid work, TableBuilder. Findings based on use of ABS TableBuilder data.

• Employment level by 1 digit industry, Health Care and Social Assistance, and 4 digit level occupations to identify the relevant VET-related occupations in the industry as a proportion of the total workforce.

Training data has been extracted from the National VET Provider Collection, Total VET students and courses from the following training packages or qualifications:

• CHC – Community Services and HLT – Health Training Packages
• Aged Care and Ageing Support
  
  • CHC30102 - Certificate III in Aged Care Work
  • CHC30208 - Certificate III in Aged Care
  • CHC30212 - Certificate III in Aged Care
  • CHC40102 - Certificate IV in Aged Care Work
  • CHC40108 - Certificate IV in Aged Care
  • CHC43015 - Certificate IV in Ageing Support
• Alcohol and Other Drugs
  
  • CHC40408 - Certificate IV in Alcohol and Other Drugs Work
  • CHC40412 - Certificate IV in Alcohol and Other Drugs
  • CHC43215 - Certificate IV in Alcohol and Other Drugs
  • CHC50208 - Diploma of Community Services (Alcohol and other drugs)
  • CHC50212 - Diploma of Community Services (Alcohol and other drugs)
  • CHC50408 - Diploma of Community Services (Alcohol, other drugs and mental health)
  • CHC50412 - Diploma of Community Services (Alcohol, other drugs and mental health)
  • CHC51102 - Diploma of Alcohol and Other Drugs Work
  • CHC53215 - Diploma of Alcohol and Other Drugs
• Allied Health Assistance
  
  • HLT32407 - Certificate III in Allied Health Assistance
  • HLT32412 - Certificate III in Allied Health Assistance
  • HLT33015 - Certificate III in Allied Health Assistance
  • HLT42507 - Certificate IV in Allied Health Assistance
  • HLT42512 - Certificate IV in Allied Health Assistance
  • HLT43015 - Certificate IV in Allied Health Assistance
• Disability
  
  • CHC30302 - Certificate III in Disability Work
  • CHC30408 - Certificate III in Disability
  • CHC40308 - Certificate IV in Disability
  • CHC40312 - Certificate IV in Disability
  • CHC43115 - Certificate IV in Disability
  • CHC50108 - Diploma of Disability
  • CHC60108 - Advanced Diploma of Disability Work
  • CHC60112 - Advanced Diploma of Disability
• Health Services Assistance
  
  • HLT32507 - Certificate III in Health Services Assistance
  • HLT32512 - Certificate III in Health Services Assistance
  • HLT33115 - Certificate III in Health Services Assistance
• Health Supervision
  
  • HLT40407 - Certificate IV in Health Supervision
  • HLT40412 - Certificate IV in Health Supervision
• Health Support Services
  
  • HLT21207 - Certificate II in Health Support Services
  • HLT21212 - Certificate II in Health Support Services
  • HLT23215 - Certificate II in Health Support Services
  • HLT32807 - Certificate III in Health Support Services
  • HLT32812 - Certificate III in Health Support Services
  • HLT33215 - Certificate III in Health Support Services
• Home and Community Care
  
  • CHC30202 - Certificate III in Home and Community Care
  • CHC30308 - Certificate III in Home and Community Care
  • CHC30312 - Certificate III in Home and Community Care
  • CHC40208 - Certificate IV in Home and Community Care
  • CHC40212 - Certificate IV in Home and Community Care
• Individual Support
  
  • CHC33015 - Certificate III in Individual Support
• Leisure and Health
  
  • CHC40608 - Certificate IV in Leisure and Health
  • CHC43415 - Certificate IV in Leisure and Health
  • CHC50508 - Diploma of Leisure and Health
  • CHC50512 - Diploma of Leisure and Health
  • CHC50802 - Diploma of Community Services (Lifestyle and Leisure)
  • CHC53415 - Diploma of Leisure and Health
• Mental Health
  
  • CHC40508 - Certificate IV in Mental Health
  • CHC40512 - Certificate IV in Mental Health
  • CHC42912 - Certificate IV in Mental Health Peer Work
  • CHC43315 - Certificate IV in Mental Health
  • CHC43515 - Certificate IV in Mental Health Peer Work
  • CHC50308 - Diploma of Community Services (Mental health)
  • CHC50312 - Diploma of Community Services (Mental health)
  • CHC53315 - Diploma of Mental Health
• Nutrition and Dietetic Assistance
  
  • HLT31507 - Certificate III in Nutrition and Dietetic Assistance
  • HLT31512 - Certificate III in Nutrition and Dietetic Assistance.

This includes superseded qualifications and training packages.

Data covers a range of selected student and training characteristics in the following categories and years:

• 2015, 2016, 2017, 2018 program enrolments
• 2015, 2016, 2017, 2018 subject enrolments
• 2015, 2016, 2017, 2018 program completions.

Total VET students and courses data is reported for the calendar year. Program enrolments are the qualifications, courses and skill-sets in which students are enrolled in a given period. For students enrolled in multiple programs, all programs are counted. Program completion indicates that a student has completed a structured and integrated program of education or training. Location data uses student residence. Subject enrolment is registration of a student at a training delivery location for the purpose of undertaking a module, unit of competency or subject. For more information on the terms and definitions, please refer to the Total VET students and courses: terms and definitions document.

Low counts (less than 5) are not reported to protect client confidentiality.

Percentages are rounded to one decimal place. This can lead to situations where the total sum of proportions in a chart may not add up to exactly 100%.

Community Services training package apprentice and trainee data has been extracted from the National Apprentice and Trainee Collection, including:

• 2010 to 2018 commencements
• 2010 to 2018 completions
• 2018 apprentices and trainees in-training October to December 2018 collection, by qualification and state and territory of data submitter.

Priority skills data have been extracted from the Direct Client Care and Support IRC's 2019 Skills Forecast.

Job vacancy data have been extracted from Burning Glass Technologies 2019, Labor Insight Real-time Labor Market Information Tool, Burning Glass Technologies, Boston, viewed July 2019, https://www.burning-glass.com.

Data shown represent most requested generic skills, occupations and employers according to internet job postings in Australia between July 2016 and June 2019 filtered by ANZSIC and ANZSCO classification levels listed below.

• Generic skills / Occupations
  
  • 27 Legal, Social and Welfare Professionals
  • 41 Health and Welfare Support Workers
  • 42 Carers and Aides
  • 134 Education, Health and Welfare Services Managers
  • Industry Sector: Health Care and Social Assistance
• Employers
  
  • 1342 Health and Welfare Services Managers
  • 4211 Child Carers
  • 4233 Nursing Support and Personal Care Workers
  • 4114 Enrolled and Mothercraft Nurses
  • 2726 Welfare, Recreation and Community Arts Workers
  • Industry Sector: Health Care and Social Assistance.