As a result of recent changes to work practices in the Australian Aged Care Quality Agency, the CPSU and the ANMF surveyed their members to see what impact the changes have had on workloads and stress in the workplace.
The results of National Staff Survey are now in. We received a significant number and range of responses from across AACQA.
- Nearly 70% of the staff surveyed were not satisfied with the way in which changes have been implemented
- Staff are reeling from the multiple changes being made this year to the way in which their duties are performed. This includes to job descriptions; the manner in which audits, assessments and reviews are conducted; how IT systems, data base processing systems, new work templates and policies and procedures are implemented.
- Respondents were particularly concerned at the lack of meaningful consultation from the Quality Agency about the impact of these changes on their work and their ability to maintain the high-quality standards they see as fundamental to their roles. The results of this survey reveal that the majority of staff who responded feel overworked, undervalued and stressed.
- Almost 60% of staff surveyed did not believe that recent changes were efficient or effective or had helped them do their work better. 60% of staff surveyed feel there is no effective forum where they can raise their concerns about the impact of these changes and where these concerns are heard and actions taken to address these concerns. Staff said they have been raising these issues at staff meetings and with line managers but nothing has changed, in some cases staff feel it has got worse and the implication is they are not doing their job.
Fewer than 15% of respondents thought the CAAT made the audit easier, 57% thought it did not. Fewer than 10% thought it made the audit process faster, whereas 65% did not.
Some staff agreed when CAAT was working it is a valuable tool, but believe it needs to be further refined. Staff reported it is cumbersome to set up, and at times acts as a barrier when interviewing care recipients. Staff also raised concerns about having to add additional information after the visit and therefore this practice did not provide any improved efficiencies. The tablets are not fit for purpose: keyboards often do not work or become overheated and can be awkward to manage when moving around a home. Some respondents raised WHS issues about using tablets extensively on site such as when reviewing and entering clinical information to meet defined sample requirements.
Staff said that on complex visits it is not practical to use CAAT and they then revert to written note taking to speed up information collection.
72% of respondents said there was insufficient time built in to the reaccreditation site audit schedule to complete CER interviews. And 70% of respondents stated that the processing of CER added additional time and complexity to the job.
While 21% of surveyors felt the Consumer experience interview (CER) and report (CER) had improved the quality of information for care recipients, 43% disagreed. Some believed the 10 CER questions were relevant but the greater majority of respondents had concerns about CERs effectiveness in gathering comprehensive care recipient information. For example, the CER questions did not cover issues such as cleaning, specific clinical issues and safety. Staff have to ask these questions separately.
Significantly, surveyors felt they had to rush from one interview to another due to the mandatory number of CERs to be completed and the methodology used to achieve this. The impact of this was not being able to ask more probing questions. This left staff feeling both dissatisfied and not getting a true picture of what was happening in the home. The issue here is that surveyors believe time to complete CER questionnaires is taking away assessment time and this will have an impact on the quality of their findings.
Disparity in allocation of time on site:
We are very concerned that over 72% responded they did not have enough time on site to complete CER interviews within the current times scheduled for reaccreditation site audits. Also that only 15% of staff felt confident approaching management requesting further time on site. 56% did not have that confidence or that management would give them extra time to complete audits due to the use of CER and CAAT.
Further to this, survey results reveal that time on site to complete CER is being applied differently in different states. In Queensland and WA surveyors have been allocated an extra half day on sites, than their counterparts in the other states. This raises the question of consistency.
If additional time is not allocated to staff to meet these changes then this puts individual staff under considerable pressure to complete the extra work expected from the Quality Agency. This we believe from the survey results is becoming a work, health and safety issue. Putting both AACQA staff and residents at risk.
Training for CER and CAAT:
Over 45% of respondents stated they had not had sufficient training in the use of CAAT and CER.
Staff said, to effectively use the tools, refresher training needs to be provided for those who did not use the tools immediately. Staff have said they were having difficulty learning to work with CAAT and complete the CERs on the run.
Staff reported they have a forum to provide ongoing feedback as to how CER and CAAT were working in practice (confluence) but not all staff find this effective. Likewise, staff told us they are increasingly writing reports in their own time to meet the requirements of CAAT.
Scheduling was consistently shown to have an impact on surveyors and administrative staff. Staff who have worked in the agency for many years commented their scheduling was the worst they had experienced.
Notice of Schedules:
In some states, little notice is given of upcoming schedules. Such as schedules being released on the last day of a calendar month for the next month. This is causing staff difficulty in planning their lives outside of work. Indeed, over 70% of staff surveyed say that the scheduling of visits does not allow them a work life/balance
Surveyors stated that late changes (variations) to schedules are common. This creates difficulties for employees in trying to balance family responsibilities and work commitments and in having adequate time to prepare for changed visits. It also means preparations for previously planned visits are discarded. This is particularly wasteful when this preparation has been in scheduled work time, is extensive and there is no scheduled work time to prepare for the change of schedule. Workers are increasingly preparing for changed visits in their own unpaid time. 63% of respondents said they did not have adequate notice of schedule and schedule changes.
Overall the data from the survey clearly shows Staff are feeling overworked, and undervalued, and not listened to. AACQA has lost sight of protecting the health and safety of AACQA staff. We are seriously concerned about the implications of this and strongly believe action is required by AACQA to address this, and that this action should be given priority.
We believe the information from this survey should be considered in line with the findings of the “Review of National Aged Care Quality Regulatory Process” Kate Carnell and Ron Paterson (2017). As this reflects on the safety of the work staff at the Quality Agency conduct and the impact on the community we serve, Australia’s frail aged population.