NDIA Accountability Project

Rural disability workforce challenges: training, remuneration and working conditions

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Joint Standing Committee on the National Disability Insurance Scheme

PO Box 6100 Parliament House Canberra ACT 2600

Submission to the Inquiry on NDIS Workforce

This submission is directed towards the terms of inquiry, specifically (b.) and (c.).

The submission will address rural challenges, training needs, remuneration, working conditions and working environment.

This submission draws on the findings of a research project conducted in 2019 at the University of New England, Faculty of Medicine and Health. This research was part of an Honours Thesis titled “Changing nature of the disability workforce under the NDIS in rural areas: Impacts for disability support workers” by Melissa van Leeuwen in conjunction with the supervisor team of Dr Stuart Robertson and Dr Erica Russ.

The project was a small scale study with a rural emphasis that was undertaken in the New England/North West region of NSW and focused on the disability workforce operating under the National Disability Insurance Scheme (NDIS). The research considered issues such as employment status, exacerbated travel times in rural communities, unpaid expectations of care, communication, funding, training and supervision and work environment satisfaction.

The study found that respondents were concerned about working conditions and constraints in NDIS funding and the impacts of these, not only for workers, but for NDIS participants.

Age and gender were also examined, as the evidence suggests that the disability workforce is a highly gendered and ageing workforce (National Disability Service [NDS], 2018) and women are nearing retirement age at a time when the industry is needing to attract more staff.

Approximately 70% of the disability workforce is female (NDS, 2018), which was reflected in the research, with 69% of survey respondents indicating they are female. Of the survey respondents, 32% were in the 45-54 years age category, and as the average retirement age for women in Australia is 52.3 years (ABS, 2017), this will add to the current challenges in expanding the workforce.

Due to the geographical dispersion of rural areas, travel time is a factor that can adversely impact disability support workers, with 50% of the survey respondents indicating they are required to drive their own car for work purposes, and a further 35% reporting they are

Workforce Challenges Facing Disability Support Workers

sometimes required to drive their own car. In addition, only 37% of the survey respondents who state they are required to drive their own car are reimbursed for kilometres travelled, and 56% state they are only sometimes reimbersed.

With 32% of survey respondents indicating they provide support services to NDIS participants in areas outside where their local office is based, this has the potential to financially disadvantage disability support workers in terms of out of pocket costs, exacerbated wear and tear on personal vehicles, and excess travel kilometres.

A recurring issue identified by survey respondents was experiences of unpaid work time. Of the survey respondents, 52% reported they are not allocated paid worktime to complete mandatory paperwork that is a disability sector requirement for quality assurance purposes (Wark, Hussain, & Edwards, 2015). Some organisations allocate paid worktime, however, a survey respondent from an organisation that does stated;

  • Staff are allocated 10 minutes to complete all their progress notes, regardless of the number of clients in their care. As a result, notes are completed at lunch and after work

This example demonstrates that ‘wage theft,’ defined by Macdonald, Bentham, and Malone (2018) as underpayment of wages, overtime violations and break time violations is taking place within this research population.

A further example of unpaid worktime is 76% of the survey respondents reported they are not paid for a comprehensive handover. Additionally, 82% of the survey respondents reported they often felt obligated to work past rostered hours, and 43% of these respondents reported they are not paid overtime. Appropriate handovers are necessary for participant safety purposes,

and as 32% of the survey respondents indicated they work more than one shift per day, and 30% indicated they sometimes work multiple shifts, this suggests that 62% of survey respondents could be late for their next shift if they are not allocated paid work time for an appropriate handover. For disability support workers in rural areas this is even more prevalent, given the likelihood of longer travel time between participant homes. If appropriate paid work time is not allotted to mandatory tasks, this can exacerbate the potential for vital information not being passed on in a timely manner. With disability support workers engaged in multiple and successive short shifts, it is essential that paid work time be allocated to tasks such as mandatory paperwork and comprehensive handovers to ensure the safety of NDIS participants. This also reflects the need for the NDIS pricing structure to be flexible and

responsive to participant needs and ensure disability support workers are correctly

remunerated.

Communication and confusion were identified as issues when interacting with the National

Disability Insurance Agency with particular reference to job roles and job expectations. A

point of concern is the impact this confusion is having on NDIS participants, as one survey

respondent stated:

 o too many changes, one week we are told to do something and then the next we are

    told no its not in guidelines… No training no buddy shifts with new customers

    especially those with challenging behaviours. No meet and greets and there is no

  money for this so many colleagues along with myself walk into our first shift with no

   real information on that customer

Consistent with previous studies, Cortis et al. (2017) contend that the NDIS pricing structure

is damaging the quality of support services and not providing suitable funding for appropriate

communication between NDIS participants, supervisors and disability support workers.

This is indicative of another issue found by the research, limited team meetings and lack of

training opportunities. Survey respondents reported team meetings are taking place less

frequently, and 55% indicated their dissatisfaction with this. Furthermore, 69% indicated that

adequate staff training opportunities are not being provided since the transition to the NDIS.

Most survey respondents indicated limited and inflexible NDIS funding as the reason for the

infrequent meetings and minimal training, as one survey respondent stated:

 o …there has been no training since the role [sic] out of the NDIS, less staff

   meetings and everything comes down to the dollar

This suggests a direct correlation between funding issues and organisational abilities to

provide appropriate supervision and relevant training opportunities to their staff. Other survey

respondents expressed concerns regarding staff being hired without relevant qualifications, for example:

 o …organisations are accepting people due to lack of numbers in staff or high

  numbers of participants needing support…leading to workers not efficiently

   being trained in dealing and supporting people with complex needs

The Need for Correctly Trained Staff When Working With NDS Participants

The need for correctly trained staff when working with NDIS participants is crucial to their health and wellbeing and is vital to achieving the goals outlined by the NDIS.

Many of the survey respondents expressed concerns with NDIS funding, stating the funding was inadequate and inflexible, and had direct impacts for their work with the NDIS participants they support. The inflexibility of the NDIS pricing structure also directly affects staff being remunerated correctly. An example is a respondent who stated:

  • My contract is for 46.6 hours. I am paid for 60.8 hours. I work an average of 20 hours per fortnight unpaid due to workload but NDIS does not allow sufficient funding to cover true hours worked

Furthermore, it does not allow for last minute changes to the roster initiated by the participant, consistent with current literature (Cortis et al., 2017).

  • The client can cancel or change their support whenever and how ever they like, and our companies no longer have the resources to pay the support workers if the client cancels at short notice

Funding gaps in the NDIS pricing structure, such as ‘funding for on costs’ are also identified by the survey respondents, and rostering of extra staff when necessary was noted as an issue:

  • Before the NDIS if a client was displaying violent behaviours of concern, they could put on an extra staff member to assist but now they have to justify why and apply for the funding

Moreover, this is in line with inherent caring characteristics demonstrated by disability support workers, as their concern is not only for themselves, but also for the NDIS participants they support, as one survey respondent stated:

  • …it is much harder to get the customer to see specialist…due to the lack of funding

This highlights issues of inequity for NDIS participants in receiving appropriate funding packages, and while this could be attributed to the planning stages of the individual participant packages, it highlights a need for appropriate training across all levels of staff employed under the NDIS.

Lastly, the primary purpose of the research was to ascertain if there were high rates of

casualisation in the disability sector working in rural communities. There is documented

concern for the health and wellbeing of workers who are employed in a non-standard

capacity, such as casual employment, including little guarantee of future employment and

receiving no leave benefits or paid sick leave (McGann, White & Moss, 2016). The research

determined that when compared with national trends of casualisation found in the literature

(Cortis et al., 2017; NDS, 2018), the rates of casualisation within the research population

were minimal, and there were higher numbers of permanent part time staff. Of the survey

respondents, 29% reported they were employed in a casual capacity, compared with 46%

ationally (NDS, 2018). The NDIS commenced its rollout in the New England/North West #region in July of 2016 (Australian Productivity Commission, 2017), and as 30% of survey

respondents reported having only worked in the disability sector for less than three years, it is

likely those jobs were created to accommodate new NDIS participants. However, it is of

interest that of those 30% of survey respondents that are relatively new to the industry, 56% [indicated] they were employed in a casual capacity. This supports findings from previous research (Cortis et al., 2017) and is inline with predictions from the NDS (2018), that

casualisation is increasing in the disability sector.

Overall, the principles that underpin the NDIS have generated a marketised environment, and

while the introduction of individualised funding packages is invaluable to participants,

funding shortfalls in the NDIS pricing structure have created barriers for organisations and

disability support workers. The shortage of labour standards within the NDIS is perpetuating

poor working conditions (MacDonald et al., 2018), and the tensions created between marketisation and labour rights need to be regulated. This illustrates the need for workforce regulations to be embedded in public policies such as NDIS, and will ensure disability support workers are correctly remunerated, well supported and will assist in attracting new staff to the sector.

If further information from the research is required, or if you require a copy of the thesis, we would be happy to provide it, as well as discuss any further aspects.

Yours sincerely,

Melissa van Leeuwen Bachelor Social Work Student

5

University of New England

Dr Stuart Robertson B. Soc. Sci PhD ACWA Member, New England Institute of Healthcare Research (NEIHR) Lecturer- Community Services University of New England

Dr Erica Russ B. Soc. WK., Grad. Cert. ASWP, PhD Lecturer, Social Work and Community Services, University of New England AASW Member 467937

References

Australian Bureau of Statistics (2017). Cat no: 6238.0 - Retirement and retirement intentions, Australia, July 2016 to June 2017. Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/mf/6238.0

Australian Productivity Commission. (2017). National Disability Insurance Scheme (NDIS) costs, study report. Canberra.ACT.

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

Macdonald, F., Bentham, E., & Malone, J. (2018). Wage theft, underpayment and unpaid work in marketised social care. The Economic and Labour Relations Review, 29(1), 80-96. doi:10.1177/1035304618758252

McGann, M., White, K., & Moss, J. (2016). Labour casualization and the psychosocial health of workers in Australia. Work, Employment and Society, 30(5), 766-782. doi:10.1177/0950017016633022

National Disability Services. (2018b). Australian Disability Workforce Report, July 2018. Deakin West, ACT

Wark, S., Hussain, R., & Edwards, H. (2015). Assisting individuals ageing with learning

disability: Support worker perspectives. Tizard Learning Disability Review, 20(4),

213-222. doi:10.1108/tldr-02-2015-0008