Single-site employment (multiple jobholding) in residential aged care: A response to COVID-19 with wider workforce lessons

Objective: This study aimed to capture stakeholder views and issues arising from the implementation of the innovative single-site employment guiding principles (SSE-GP) that the Australian Government, in consultation with the sector, introduced into hot spot residential aged care facilities (RACFs) in July 2020 in response to COVID-19.

Methods: Interviews with 74 stakeholders around Australia were conducted in October–November 2020. Provider interviews included employees and managerial and human resources staff in profit and non-profit services who did, and did not, have COVID-19 outbreaks. Sector interviews included representatives from peak bodies, unions, government, academics, advocates, labour hire and registered training organisations.

Results: There was broad but not total agreement on SSE-GP's effectiveness. Beyond specific SSE-GP feedback, six strategic workforce issues were identified. The quality of resident care was mixed, sometimes improved and sometimes diminished. The extent of employees' multiple jobholding surprised many providers, and rostering and unplanned absenteeism are a substantial strain for both providers and employees. Innovative work practices are often difficult for smaller providers lacking employment relations specialists. Future SSE-GP is seen by larger providers as voluntary and organisation- rather than facility-specific, and unions saw only mandated SSE-GP as appropriate for future outbreaks. Last, all staff, management and executives had additional stress that placed their well-being at risk.

Conclusions: Although SSE-GP revealed new and existing weaknesses in the Australian RACF workforce, the broad industry consultation and collaboration demonstrated that the sector can meet COVID-19's urgent and complex challenges. The experience provided lessons for further workforce challenges that remain to be addressed.