No surety of standards in Cert III for aged care

High demand for aged care workers and cost-cutting is contributing to the deterioration in cert III quality, writes Dr Maree Bernoth.

If the Certificate III in Aged Care Work and the Certificate IV Assessor and Trainer were designed to be the cornerstones of education and skill development for workers in aged care there is a problem.

My experience with these qualifications began with the pilot program for the Certificate III Aged Care Work which was administered and monitored in NSW by the New South Wales Nurses’ Association in the mid-1990s. The facility in which I was the educator was awarded pilot site status and over the following twelve months, about 80 care workers completed the Certificate III Aged Care Work. The program was closely monitored by the NSWNA, an organisation which has an intimate knowledge of the education and skills required for aged care work. There were stringent guidelines for the RTO delivering the qualification and standards set for those who could teach the program. There was an expectation that the rules governing Recognition of Prior Learning (RPL) and assessment of skills articulated in the Certificate IV Trainer and Assessor (TAA) qualification would be followed.

Over subsequent years, I have delivered the qualification for a number of private RTOs and observed the deterioration of a once substantive qualification into a meaningless piece of paper.

The deterioration of the qualification is related to the demand for aged care workers and the focus on the fiscal rather than on the person - the person being both the person receiving the education and the person who is the potential recipient of care.

The inconsistency in the outcomes of the qualification can be related to the qualifications and experience of those doing the training, the standard and quantity of the resources and equipment provided by the RTO to acquire and practice skills, the amount and quality of face to face learning, the length of exposure to the reality of the aged care setting and skills and competency assessment. In each of these components, there is the ability to rationalise costs by the RTO and increase profits.

Of particular concern is that of skills and competency assessment. One strategy to get competency assessment done expediently is that the RTO will withhold payment to the trainer for work they have done until all paper work related to the module they have taught has been submitted to the RTO. This means that the trainer must present the students’ signed competency forms prior to receiving any money. How reliable then, in this instance, is the competency assessment process?

Another problem occurs when the student is placed in an aged care facility for experience. Here, the student is buddied with an aged-care worker who is expected to sign skills assessment and competency documents without having any training in competency assessment and without being given any extra time or reimbursement to fulfil this role. Then a person with the required Certificate IV TAA is required to counter sign the competency and the complex, expensive process of competency assessment has been completed at very little cost to the RTO but with very little surety that competency has been achieved.

A significant portion of the training program can involve the completion of workbook by the students. These books are given to the students to be filled in and returned for marking. There is no guarantee that the student who was given the book was the person completing it and there is little follow up to ensure that what has been written has been translated into learning and skills. The book eliminates the need for expensive face to face education. This is significant if an aged care facility is contracting an RTO to deliver training. The fewer hours in the class room, the more hours the student can be rostered for clinical work and fewer costs related to time away at training. When RTOs are vying for contracts with aged care facilities, it is the lower cost and the shorter training time that is most important.

In a recent article in last month’s Nursing Review, Sue Lyons from United Voice asked why complaints about training providers have not been raised in forums other than the media and the Productivity Commission. They have, but no-one was listening.

Skills and attitudes of aged care workers were one part of Rhonda Nay’s thesis in 1993. A result of her willingness to highlight deficits incurred the wrath of some facility managers and according to the media at the time, Nay was banned from doing further research in some facilities. In 2002, Somerville investigated how students in a Certificate III Aged Care Work program, learnt to care for older people. Her work demonstrated the significance of providing skilled mentors in the workplace so that the nuances of caring for the heterogeneous cohort of people with multiple chronic conditions could be explored and explained in the clinical setting. Further, through interviews with the students, it became clear that the students valued the opportunity to reflect on their clinical experiences as part of their formal education.

This significant research received recognition within adult education forums but has been ignored by the aged care sector. Somerville and McConnell-Imbriotis (2004) examined the value of using the learning organisation framework for determining learning needs of an aged care organisation and Billet and Somerville (2004) articulated the significance of learning to the aged care workers’ sense of self. However, the paucity of aged care workers’ clinical decision making skills were again demonstrated in Anita de Bellis’ thesis in 2006. None of this research has been used to change and evolve aged care education instead kudos is given to those who implement the most cost effective strategies irrespective of their outcome.

My own PhD thesis (2009) exposed the level of bullying between aged care workers when a different approach to skills development was introduced. The thesis articulated the price paid by aged care workers when they spoke of the abject nature of the environment in which they worked.

When I spoke of those conditions to managers of aged care facilities, I then became the target and felt the repercussions; the poor level of care and the bullying between staff was my doing because I was a “poor educator.” The cost of speaking the abject in aged care has professional, personal and financial cost which many find too high a price to pay. The choice is to remain silent or, as many other very valuable and experienced workers have done and continue to do, leave the industry. Some move away from the clinical to the academic where there is a chance to have a voice.

Organisations who are recruiting aged care workers can be assured of one thing and that is, there is no surety of the standard of education and skills of the person presenting with a Certificate III aged care qualification. Yet, uniformity of standards at each level of qualification is purported to be one of the reasons for the existence of the Australian Training Framework.

Dr Maree Bernoth is a lecturer in research and aged care at Charles Sturt University and is course coordinator for post-graduate mental health studies. She is researching impacts on rural families with members in aged care.

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