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The Culture of Care.

In human services, toxic cultures affect much more than a product, or a customer. A toxic culture can have an extreme trickle-down effect, that in a worst-case scenario, leads to death and the best case might mean emotional or physical trauma for some of our most precious citizens.

In Day 9 of the Royal Commission into Aged Care, we heard from Counsel Assisting the Commissioners, Dr Timothy McEvoy QC speak on workforce issues that had surfaced during the hearings. Those presented by McEvoy are common workplace issues in Aged Care services at the moment and are dangerous breeding grounds for toxic workplace culture.

Some of the things McEvoy brought up during the hearing were:

  • Issues with funding appear to have a direct impact on staff morale
  • Staff morale impacts the levels of quality and safety of care received by older Australians
  • Remuneration for care staff – from personal care attendants to general practitioners – is far below where it ought to be
  • The system (and its people) is stressed, from start to finish.

McEvoy painted a picture for the Commissioners of those affected by the industry’s collectively damaged culture, setting the scene with a description of the ‘typical Aged Care worker’–– a woman in her 40s and 50s, poorly remunerated and employed on a casual/part-time basis. The picture spells exhaustion and anxiety; not the preferred descriptors when thinking of who will be caring for your most frail loved ones.

Dr McEvoy also spoke of a carer’s responsibilities in contrast to their work conditions and explained that their job can be very rewarding when there’s a possibility of quality time spent with clients––often the very reason someone will enter the industry in the first place. But what we’re hearing throughout the Commission is this “time” is non-existent in the current state of the industry. On top of that, the salary and culture in some centres are not at all rewarding enough to compensate––with an average hourly rate somewhere around $21.

McEvoy raised that the work itself was hard on its staff, and spoke of the “labour-intensive,” “hurried” and “task-orientated” service a carer is required to give, the last two out of necessity, due to poor staffing numbers.

And here’s where the culture is affected.

It’s important for a provider (or any organisation for that matter) to recognise where and when a workplace culture may suffer and do their best to turn it around. It is not undoable.

One indicator of healthcare and human services is when you notice staff are task-oriented. An environment where a workforce is task-oriented, rather than performance oriented, jobs are tending to be done without a real connection to the purpose or values of an organisation. A worker is required to simply show up and gets the job done in any way they can.

In contrast, in a culture where an organisation is focused on performance-based tasks, tasks become holistic. It will be just as important for the person completing the tasks to be physically and mentally well and completely present when at work as it is they are there in the first place. And, without doubt, from what we have seen so far from the Commission; this is the kind of work required for our elderly to live a peaceful and connected life in a caring environment. And they deserve no less.

How does a culture get so bad?

Workplace culture is affected when staff morale is low, often due to low retention of staff, lack of communication or understanding of the company or industry values, as well as underpaid staff and carers that are overworked. Basically, it comes from an organisation who isn’t appropriately caring for its people. And it’s sadly ironic this is happening, given the very nature of their service is to literally “care” for their clients.

Nothing changes if nothing changes.

So how do you change a culture? It really is up to the individual organisations to address their own cultures and look for ways to improve staff morale. The Royal Commission is important. It’s giving the public and providers insight into how bad it actually is, collectively. And exposing these bad cultures and the effects they are having on our community’s most frail is forcing us to do something about it. But ultimately, it will take each provider to take matters into their own hands and be innovative toward change before the culture is improved across the board.

Cultures can be improved; we see it all the time in HR and recruitment. It just takes some clarity around values, communication and some structural changes with those values in mind.

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