To: Joint Standing Committee for the NDIS
From: Tim Wilson
Re: NDIS Workforce
Date: 7 May 2020
Contact: Tim Wilson
Executive Manager Workforce Development
Cara is a not-for-profit disability services provider based in Adelaide, South Australia, providing services to over 750 customers living with a disability. Cara’s over 1,000 employees provides support to empower people for greater independence. Our services
include Supported Independent Living (SIL), Short Term Accommodation (STA), Home
Care Support (HCS) and Holiday Options. Cara provides these services throughout SA in the greater Adelaide metropolitan area and Mt Gambier, Port Pirie, Kadina, Port Augusta and Port Lincoln.
Workforce Demand Issues
Customers have expectations that are much higher than those provided from respective
Certificate III and IV programs. Individual National Disability Insurance Scheme (NDIS)
providers should be able to develop their workforce according to the needs of their customers. Because of the wide range of customer complexity, providers need to ensure they have enough staff in their workforce to be competent in a range of skills. This is best achieved by partnering closely with Registered Training Organisations (RTOs).
Under the Scheme training costs are a significant factor in meeting customer expectations. It is a requirement that support workers (who are unregulated health workers) remain competent in skills like medication administration, gastrostomy feeding, managing seizures, tracheostomy support and other clinical needs that customers have in community settings.
Providers continue to meet these needs without the ability to price our own services, which would allow us to self-fund all staff training and competency requirements. Where staff turnover is high or customer bookings are short, these costs increase quickly. Where both staff and customer turnover are high, the costs increase exponentially.
There can be detrimental effects on customer outcomes where the NDIS quickly implements changes or approves extra measures. Recruiting skilled workforces takes time, especially in the numbers required for the NDIS to meet the needs of all participants. It is very difficult to recruit new employees for new SIL services because the process to approve SIL quotes is haphazard.
Introducing the NDIS, to a large extent, was a singular event as management of funding transferred from State Government to the National Disability Insurance Scheme (NDIA), however it highlights that workforce supply does not respond quickly to sudden changes in direction.
Current demand is greater than what we can supply in normal circumstances. Demand for new SIL, STA and HCS services are very high. The lead in time for SIL services is short (8 weeks). This provides little time for recruitment of additional staff to meet all customer expectations from the first day of operation. Where there is significant competency development required to meet the customer’s expectations, these delays increase and require significantly more planning resources to safeguard the customer.
Recommendation:
The price cap should be removed, allowing providers to set their own prices and ensure that customer needs are met by trained employees.
Consider workforce supply issues and agility when introducing changes to the way the scheme operates so that providers can adjust to new demands.
Workforce Supply Issues
The marketability of the disability sector as a career is a significant barrier to attracting and maintaining workforce numbers. Commonly people perceive that the sector is unskilled, poorly paid, disrespected and overworked. The aim of Cara’s Employee Value Proposition is to convince people that their perception of the sector is wrong.
Despite the poor image of the sector, there is not a shortage of people applying for roles as support workers. However, there is a shortage of support workers that meet our quality criteria, which focus on our values, good communication/English language skills and digital literacy. Covid-19 has led to greater job applications than previously. However, the quality of these applications is lower than normal, resulting in lower percentages of these applicants being hired.
We aim to improve the safeguarding of customers by focusing on our values. Good communication is vital to support people living with a disability and the need to follow support plans, including clinical directions accurately. Further, good communication is also essential to provide sound behaviour support.
A workforce with relevant qualifications will be of a higher quality than a workforce with irrelevant (or without) qualifications. The primary mechanism of attaining Certificate III in SA is through a Traineeship. Whenever a trainee is in the workplace, they must be directly supervised. It will not be workable to train the number of workers we require (or the industry requires) under this model. It is possible to train employees outside a Traineeship, while they remain on the job and attain these qualifications – but it is expensive to do so. Further, we will not meet customer demands if we wait for people to be qualified before hiring them. More affordable and flexible on the job training for recognised qualifications are required in order to meet demand.
The current price caps reduce our ability to meet customer needs and upskill our staff. Other organisations do not recognise the skills that people have previously attained as there are no skill set standards at an industry level, which prevents transfer of skills from
one provider to another. This approach subsequently increases training costs. Skills and experience that count towards required professional development standards will professionalise all disability sector workers and improve employee career options (recognition of prior learning (RPL) in both RTO and University settings). It is in the financial interests of the NDIS for industry to have greater acceptance of portable skills.
The price cap suppresses wages. This makes it difficult to compete with other occupations and draw fresh talent to the organisation and sector. It also prevents attraction of higher calibre people to the workforce and limits our ability to bargain industrial agreements that would benefit employees and customers.
The NDIS would have a higher calibre workforce and improved participant safeguarding and goal achievement if there was no price cap. The price cap prevents organisations meeting customer needs through training and improving staff retention and turnover.
Poor staff retention and turnover result in organisations losing significant investments they have made in their people. Further, improving industry turnover and retention will reduce the number of additional staff that the industry requires to meet the increased demand of NDIS participants.
Several national, state and micro-level projects, providers are collaborating to understand and accept the concept of skills portability. This is to stop cannibalization of the training funding and do more with less. Some of these projects involve aged care and disability providers who recognise the portability of skills between these industries. It will be extremely beneficial to both these sectors if people can work seamlessly across both these sectors - particularly in regional areas.
The creation of career pathways within the industry will enhance the number of people remaining in the industry. Some individuals will need to move from one organisation to another to realise their career objectives. Career pathways that identify the recognised training and skill sets required to progress from one role to another within the industry will reduce losses of people from working in disability. At present, such clarity does not exist.
Recommendation:
Remove the price caps and allow providers to set their own prices. Removal of the price caps would improve supply as providers could then pay market rates and bargain more efficient and effective workplace agreements.
With the price cap removed, professionalise the industry by requiring professional registration of all disability employees – either through an existing professional body (e.g. AHPRA, CPA etc.) or through a new body. If we pay and treat people as professionals, this is easy to achieve.
Other Workforce Issues
Under the Work Health and Safety Act (SA) any place where a worker performs NDIS services is a workplace. Injuries within the Disability sector are predominantly musculoskeletal. In a lot of cases, our employees rely on the smooth approval of safety equipment and resources to ensure their safety at work. Funding for the maintenance and renewal of manual handling plans, equipment and wheelchairs does not flow freely if it is not in a participant’s plan. Waiting for an NDIS change of circumstance approval is impractical and places the customer and employee at harm.
Recommendation:
Provide and preserve essential funding within participant plans specifically for worker safety such as manual handling, planning and maintaining equipment.