Submission 45 — United Workers Union — NDIS Workforce | External submission

UNITED

POLICY

SUBMISSION

Submission to the Joint Standing Committee on the National

Disability Insurance Scheme

Inquiry into NDIS Workforce

For further information please contact

Authorised by:

Demi Pnevmatikos

Executive Director

About UWU

The United Workers Union (UWU) is a powerful new union with 150,000 workers across the country from more than 45 industries and all walks of life, standing together to make a difference. Our work reaches millions of people every single day of their lives – we feed you, educate you, provide care for you, keep your communities safe and get you the goods you need. Without us, everything stops. We are proud of the work we do – our paramedic members work around the clock to save lives; our early childhood educator members are shaping the future of the nation one child at a time; our supermarket logistics members are packing food for your local supermarket and our farms members are putting food on Australian tables; our hospitality members are serving you a drink on your night off; our disability members are providing quality support to people with disability; our aged care members are providing quality care for our elderly and our cleaning and security members are making the buildings you work, travel and educate yourself in safe and clean.

Whilst coverage and titles may differ on a state and territory basis, nationally UWU has many members who work in the disability sector. As the people working in the disability sector on a daily basis, members appreciate the opportunity to have their opinions, concerns and experiences considered as part of this inquiry.

“I love this industry. It’s not about coming into work, doing an 8 hour shift and leaving. It’s so much more than that. For some people we can be their eyes, their ears or their hands”.

Disability Support Worker, UWU member

Introduction

UWU members working in disability support are at the coal face of the impact of the National Disability Insurance Scheme (NDIS).

The establishment of the NDIS, combined with the general increase in demand for disability support services, continues to place substantial pressure on the workforce to meet demand. The disability sector is characterised by attraction and retention issues; low pay; insecure hours; high levels of casualisation; and limited career opportunities and in many ways the NDIS has exacerbated these workforce issues.

UWU commissioned the largest ever survey of disability workers this year, finding that alarmingly only 1 in 5 workers agreed the NDIS had been positive for them as workers. More experienced workers were also most concerned about the impact. 1 The survey found significant concern among workers relating to working time arrangements; staffing levels and service quality; remuneration and income security; job quality; supervision and support; training; and safety and reporting.

1 Cortis, N. van Toorn, G. Working in new disability markets: A survey of Australia’s disability workforce. University of

NSW April 2020

All these factors hinder the sustainability of the workforce into the future and the creation of the quality jobs that this important workforce deserves.

UWU disability members believe we must act now to create quality jobs that provide quality support. The alternative will be a further devaluing of the work in this sector, driving down the quality of disability support provided. This will also threaten the viability of the NDIS.

Recommendations

Recommendation 1: The Federal Government as the principle funder;

Undertakes a disability workforce census
facilitate, unions, providers of disability support, State/Territory Governments, people living with disabilities and advocates working together to develop a national workforce development strategy to ensure the sustainability of a quality workforce in response to the rapid growth in workforce demand.

Recommendation 2: All workers in the sector have access to quality, free on-going training, education and information delivered in paid time.

Recommendation 3: Workers in disability support receive an appropriate wage reflective of their skills and the essential work they perform in providing quality disability support. The capacity for wages to exceed the legal minimum must be built in to NDIS pricing.

Recommendation 4: The Government recognises the true costs of service delivery including non direct client facing time and travel between clients for workers and factors this into the NDIS pricing structure and funds it accordingly.

Recommendation 5: The Federal Government should facilitate a process to work with unions, providers and advocates to create models of employment for the disability sector that provide permanent employment with predictable non-fragmented working hours.

Recommendation 6: A disability worker regulation scheme be introduced nationally following consultation with unions, advocates and providers modelled on the Victorian state scheme.

Recommendation 7: There is an independent review of the impact of individualised funding on the nature of work in the NDIS. Where negative impacts are found alternative methods of funding should be examined.

2 Cortis, N., Macdonald, F., Davidson, B., and Bentham, E. (2017). Reasonable, necessary and valued: Pricing disability services for quality support and decent jobs (SPRC Report 10/17). Sydney: Social Policy Research Centre, UNSW

Sydney,

Background to the NDIS workforce

There is little national workforce data in the disability sector, making a comprehensive understanding of the disability workforce difficult. Some of what we do know is contained in the NDS workforce report.3 This report is based on the responses of NDS members.

This data shows;

 48% of workers are permanent. The rate of casual employment though has been increasing, from 40% in September 2015 to 46% in March 2018. Casualisation is more prevalent in small and medium organisations.

 The workforce growth rate was 11.1% per year (averaged over a two-year period between September 2015 and 2017). This compares with growth of just 1.6% for the Australian workforce as a whole at the time. This remarkable growth rate came overwhelmingly from the recruitment of casual workers. The average permanent workforce growth rate was just 1.3% per year, while the casual growth rate was 26% per year.

 In the two most recent quarters workforce turnover for permanent disability support workforce has averaged 5.2% per quarter. Casual workforce turnover in the same period has been 8.5% per quarter.

 The average hours worked by a disability support worker increased for the March 2018 quarter to 22 hours per week. This compares to 21 hours per week in the preceding two quarters.

A 2017 report examined the impact of NDIS pricing on the experience of workers in the NDIS. 4 The report sought to examine the prospects for quality services and decent jobs under NDIS. Specifically, it examined how the prices set by the National Disability Insurance Agency (NDIA) were:

 affecting disability support workers;

 enabling employers of disability support workers to meet their industrial obligations; and

 supporting development of a skilled, high-quality, and decently remunerated disability support workforce

The report found:

… that disability support work has been under-priced in the NDIS. Prices for disability support work set by the NDIA according to the ‘Reasonable Cost Model’ do not enable minimum Award conditions to be met, and prevent employers who offer above-Award conditions from meeting their legal obligations. Particular issues include:

3 National Disability Services. Australian Disability Workforce Report. 3rd Edition July 2018

4 Cortis, N. Macdonald, F. Davidson, B. Bentham, E. Reasonable, necessary and valued: Pricing disability Services for quality support and decent jobs. 2017 University of NSW pp1,2

 Prices do not recognise the time needed to deliver quality services to NDIS participants. Disability support workers have inadequate time to build relationships with participants, follow up on participants’ needs, co-ordinate and communicate with supervisors and other workers, complete paperwork, debrief, and handover between shifts, all resulting in lower quality support and increased risks for participants.

 Prices are not covering the induction and training required to enable staff to address the health and other complex needs and behaviours of participants.

 Prices are limiting the pay and career progression of support workers and supervisors.

 Many disability support workers have very fragmented working time. Multiple very short shifts with unpaid time between them results in long working days and inadequate time for rest.

 Pay for disability support work is low, exacerbated by under-classification and underemployment from short shifts, and is likely to undermine efforts to expand the workforce.

 Casualisation is contributing to financial insecurity for staff and worker turnover, disrupting services and exacerbating risks for participants.

 Physical injuries, exhaustion, stress and other negative psychological impacts arise from combinations of unsafe working conditions, high work intensity, overwork, lack of support, and workers’ recognition that participants are not receiving the quality of supports they deserve.

A recent report surveying the disability workforce in 2020 has found that conditions for workers in the NDIS have not significantly changed since 2017. The report is attached to this submission and the key findings are summarised below. 5

Only one in five workers agreed the NDIS had been positive for them as worker, with experienced workers being most concerned about the impact. Many workers flagged issues relating to working time arrangements; staffing levels and service quality; remuneration and income security; job quality; supervision and support; training; and safety and reporting.

 Working time arrangements

55% of respondents worked part time and almost half the respondents reported working unpaid time of at least an hour in the previous week. Tasks completed in unpaid time included; completing case notes or other reports; communicating with colleagues; handover and communicating with a supervisor.

Many workers experienced significant fluctuation and unpredictability in their working hours from week to week as well as short notice for changed working hours. Split shifts requiring long periods of time away from home with only a few hours of paid work were also of significant concern for workers.

5 Cortis, N. van Toorn, G. Working in new disability markets: A survey of Australia’s disability workforce. University of

NSW April 2020

 Staffing levels and service quality

Workers felt under considerable pressure with staffing shortages and high workloads with 44% disagreeing that there were enough staff in their service to get work done.

 Remuneration and income security

Only 37% of respondents said they were satisfied with their take home pay. Satisfaction dropped off significantly for workers who had been working in disability for 12 months or more, reflecting the lack of recognition and reward for experience in the pay structures. Additionally many workers were not paid for travel time and not adequately reimbursed for out of pocket expenses. Only 1 in 5 workers expect to have enough superannuation for retirement.

 Job quality

Job security is a concern amongst workers with more than half agreeing with the statement “I worry about the future of my job”. Only a third felt there were career advancement opportunities.

 Supervision and support

Workers were concerned about access to induction and supervision with this leading to workers making important decision on their own without support. These views were corroborated by people in supervisory roles who felt they had too many people to supervise and had not received adequate training in how to supervise.

 Training

Workers felt that training was critical to providing quality disability support, yet many felt they did not get enough training nor enough quality and relevant training.

 Safety and reporting

Most workers reported feeling confident in reporting unsafe practises or unsafe behaviour toward a client, around half of the respondents reported being aware of harm to a client in the past 12 months, mostly perpetrated by another client.

Almost two thirds of respondents reported being aware of another worker being subject to bullying harassment or violence in the past 12 months.

These experiences of workers in the NDIS point to fundamental issues with the way this work is undervalued, under-resourced and poorly planned.

Fundamentally quality disability support cannot continue to be provided in the NDIS with these workforce conditions. Quality support can only be provided by people who have quality jobs; are well remunerated; are well trained and have adequate time to provide the best possible support for their clients.

“The industry has become a revolving door of people who only want to do the job for a short term. How are you going to attract the right people to the industry if society doesn’t

see this as a viable long-term employment choice? We want this job to be recognised and respected as being a professional career. Because that’s what it is”

Disability Support Worker, UWU member Improving NDIS job quality

We know that the NDIS is predicted to be an area of substantial job growth, with 1 in 5 new jobs predicted to be in the NDIS. This equates to 90,000 FTE new jobs over the next five years.6

This level of workforce growth will be significantly hampered by the continuation of the poor workforce conditions described above as well as a lack of national planning.

Below are a number of areas that if addressed will go a long way to creating an NDIS that provides quality jobs for its workforce and in turn quality supports for participants.

Workforce planning

Existing attraction and retention problems in the sector will be exacerbated by the required level of workforce growth. Competition for workers between the aged and disability sectors will also intensify as aged care reform puts further strain on the pool of potential workers. Where workforce supply is limited, the quality of the workforce, and therefore the quality of the service, can suffer.

There is no national workforce strategy to address the current workforce issues nor future growth needs within the disability sector. Such a strategy needs to be developed by the Federal Government, unions, providers, State/Territory Governments, people living with disabilities and their advocates working together. A national strategy must address current workforce conditions and consider future growth requirements.

Given the crucial lack of data available about the disability workforce UWU recommends a government funded census of the disability workforce be undertaken as part of the development of a workforce strategy.

Recommendation 1: The Federal Government as the principle funder;

Undertakes a disability workforce census
facilitate, unions, providers of disability support, State/Territory Governments, people living with disabilities and advocates working together to develop a national workforce development strategy to ensure the sustainability of a quality workforce in response to the rapid growth in workforce demand.

Training

A critical concern related to job quality for disability support workers and the quality of support provided through the NDIS is the provision of training. Since the transition to the NDIS, research

6 Australian Government. Growing the NDIS Market and Workforce. 2019 8

shows there has been a reversal on already low levels of training occurring in the sector. 7 Similarly, the recent evaluation of the NDIS found the sector was undergoing ‘de professionalisation’, whereby roles were increasingly undertaken by workers with fewer skills and experience than prior to the transition to the scheme.8

Additionally in the absence of employer-funded training, there is no incentive for workers to invest in their own skills under the current pay structures as they do not offer sufficient pay progression according to qualifications or experience. Under these circumstances, the government needs to intervene in this ‘market failure’ to ensure a skilled workforce to provide the required and necessary level of care.

Recommendation 2: All workers in the sector have access to quality, free on-going training, education and information delivered in paid time.

Wages

This is a sector that has long experienced low pay, but what is most concerning is that the current funding arrangements under the NDIS are actively working to place even further downward pressure on wages. A 2017 report found the capped prices for disability support work are too low to cover the actual costs of service provision and, most concerning, prevent providers from meeting the minimum award or enterprise agreement conditions. 9

Not only does the NDIS funding and pricing framework institutionalise low pay, it entrenches Award conditions as the ceiling rather than the minimum, preventing any capacity for providers to appropriately compensate and attract skilled and experienced workers. The supports provided under the NDIS are not ones that can be carried out exclusively with entry-level, unskilled workers. Not only do the low wages act as a barrier to entry, it is a disincentive to remain in the sector as it becomes apparent that there is no prospect for pay progression over time, thus making it difficult for workers to justify remaining in the sector.

NDIS pricing

There are a variety of factors that are currently constrained by NDIS pricing, some as described above.

7 NILS . Evaluation of the NDIS: Final Report. National Institute of Labour Studies. 2018 Available at: https://www.dss.gov.au/disability-and-carers/programs-services/for-people-with-disability/national-disability insurance-scheme/ndis-evaluation-consolidated-report 8 ibid 9 Cortis, N., Macdonald, F., Davidson, B., and Bentham, E. (2017). Reasonable, necessary and valued: Pricing disability services for quality support and decent jobs (SPRC Report 10/17). Sydney: Social Policy Research Centre, UNSW

Sydney,

These include:

 specified Award rates of pay, resulting in limited scope for employers to pay above Award wages or offer pay advancement for increased experience or time served, do not address the already low wage rates in the sector;

 limiting the paid time covered in the cost to mostly direct client contact time. This means there is limited paid time for workers to; attend team meetings or training, undertake administrative work such as case notes, undertake adequate handover among other things that should be able to be undertaken during paid work time;

 setting a supervisory ratio, this does not allow any scope for a lower ratio where there are newer or less experienced workers; and

 Inadequate payment for travel time between clients, other related vehicle costs and reimbursement of out of pocket expenses for workers.

Current NDIS pricing will not ensure the quality delivery of the NDIS. Until and unless pricing can reflect the capacity to create quality jobs the delivery of the NDIS is at risk. An NDIS pricing structure that inhibits quality from the outset is not one that can meet the designs of the scheme to transform the delivery of quality disability support to people living with disability.

Pricing should be set via an independent price setting mechanism. This was recommended by the

Productivity Commission In its 2017 NDIS Costs Review.10

Insecure employment and unpredictable working hours

“When working conditions suffer, so does the quality of support that people can expect to receive.”

Disability Support Worker, UWU member Casualisation and the unpredictability and fragmentation of working hours has been exacerbated under the NDIS arrangements which have increased flexibility, choice and control over when services are delivered, and by whom.

The sector is dominated by a part-time and casual workforce and full-time employment is relatively uncommon for direct support workers. The pervasiveness of part-time and casual employment creates insecurity and impacts the total take home pay of these workers.

Unpredictable and inadequate hours are a significant feature of disability support work, which negatively impacts on job quality and thus the quality of support provided. Latest figures suggest

10 Productivity Commission. National Disability Insurance Scheme (NDIS) Costs. October 2017

the rate of casual employment is almost 46% compared with the whole of workforce average of about 25%.11

Another feature of work in the disability sector is highly fragmented work days with large ‘breaks of engagement’ between small periods of paid work. Subsequently, workers are only paid for a few hours of work spread across a very long work day. These extended breaks are not equivalent to genuine rest periods during days off and is a particularly troubling aspect of the work.

While UWU members recognise that providers need some degree of flexibility to meet the fluctuating demands of NDIS participants, this must be carefully managed to not place increased risks and insecurity on workers. It is essential that participant’s needs are balanced with workers’ workplace rights. Furthermore, this must be better managed in order to address staff retention issues in disability service provision so everyone can benefit from a sustainable and well functioning NDIS.

Per employment screening/ worker Regulation

“Most people who work in the sector will not have a problem with undertaking a pre employment screening process provided it is appropriate and their rights to privacy are being respected. If someone does have a problem, then maybe they aren’t right for the sector”

Disability Support Worker, UWU member UWU welcomes the introduction of the NDIS Worker Screening Check, as a first step toward a national screening and regulation scheme. However we believe the scheme should be national not just ’nationally consistent’ and should be administered by an independent national body.

Furthermore UWU believes following the establishment of a national pre-employment screening process a professional regulation system should be phased in. Broadly such a proposal would provide a system of positive clearance for workers, minimum qualification standards and ongoing training.

The Victorian Disability Worker Regulation Scheme is a possible model for a full regulation scheme. 12 There should be extensive consultation with workers, as well as providers, people with disability and disability advocates to develop a scheme based on this model. We would argue any eventual scheme should be mandatory.

Currently there are no minimum regulation or qualification standards for workers in disability services. Both a scheme and any implementation must take these factors into account in transitional arrangements so as not to disadvantage current workers, nor to create unreasonable barriers to workforce entry. Transitional arrangements should include: funded Recognition of Prior

11 National Disability Services. Australian Disability Workforce Report. 3rd Edition July 2018

12 Victorian Government https://www.vdwc.vic.gov.au/about and https://www.legislation.vic.gov.au/as-made/acts/disability-service-safeguards-act-2018 11

Learning (RPL) programs for existing workers; provisions to commence work while undertaking minimum qualifications; and capacity for exemptions where these are genuine.

We propose a system of regulation for ‘direct care and support workers’, separate and distinct from any existing regulation system that would be administered by a national independent body and should include the following features:

 Regulation requires minimum entry level qualifications  Ongoing regulation requires continuing training and development, provided in paid time  All regulated and cleared workers are listed on a positive registry  Provides a regulated right to review of decisions or complaint

“There are many vulnerable people in the community and they need to feel confident in those workers who are entering their homes and develop trust with those workers to know that they will receive a high standard of care and that their service is delivered in a friendly, professional manner”.

Disability Support Worker, UWU member Recommendation 6: A disability worker regulation scheme be introduced nationally following consultation with unions, advocates and providers modelled on the Victorian state scheme.

Issues of a market model and individualised funding

Fundamentally many of these workforce issues stem from the individualised model of funding. Individualised funding models are lauded for putting control in the hands of the consumer, however they often result in poor care and support for the consumer. In these models, work becomes fragmented and insecure and there is cost cutting to wages. For providers of disability support individualised funding means unpredictable income and difficulty in planning and providing supports, for example day centres under this funding model can struggle to remain viable without certainty of exactly who will attend each day. Researchers have identified several issues with individualised funding for the workforce:

“This potential is unlikely to be realised in the long term if the implementation of the NDIS model of individualised care weakens the sustainability of the workforce by undermining what are already fairly basic labour minima in disability support jobs.

As with cash-for-care systems elsewhere, the NDIS carries risks for both the quality of care jobs and the quality of support and care provided. Our preliminary analysis has shown the factors implicated in poor outcomes for care workers in other countries are present to some extent in the design and trial implementation of the NDIS. There is evidence of cost containment, including through some reliance on informal work, and there are gaps in the regulation of care quality and care employment.”13

It may be that some types of service delivery or aspects of disability support are not viable in an individualised funding model and that other methods of funding would better support these services. A move away from individual funding does not need to mean a reduction in choice and

13 McDonald, F. Charlesworth, S. Cash for care under the NDIS: Shaping care workers working conditions. Journal of Industrial Relations 2016, Vol. 58(5) 627–646 12

control for participants, there can be a balance that recognises the principle of providing choice and control to participants and providing quality jobs that can support that choice and control.

Conclusion

The working conditions of disability support workers are grossly inadequate. Workers are paid very little for the level of skill and responsibility they are expected to deliver and they regularly and consistently work unpaid hours in precarious employment situations with fragmented hours of work. Under these stressful conditions, they are expected to provide the necessary level of support within tight timeframes and in challenging environments. These working conditions coupled with, the ongoing deskilling of the workforce, lack of career pathways and inadequate or non-existent training and development leads to high turnover. This diminishes quality and the disability sector becoming a stop in one’s working life rather than the destination. This is not good enough. Disability workers and the people with disability they support deserve to be valued.

The NDIS and inadequate NDIS price is contributing to this bleak picture. The issues identified in this submission go far beyond logistical issues for service providers to overcome. These are structural issues that prevent the NDIS from delivering its promise to its participants. It is therefore paramount that the Federal Government implement the recommendations contained herein to improve the working conditions of disability support workers. Ensuring quality, well paid jobs for disability support workers is key to ensuring the successful implementation of this critical scheme and the sustainability of the NDIS into the future.