Table 2 Common workforce issues relating to the improvement of the quality of LTC services in Australia and South Korea
Themes/ sub-themes | Quotes |
|---|---|
1. Labor shortages: Insufficient manpower retention & inadequate staff ratios at the facilities | • The lack of registered nurses (RNs) was a serious problem in the residential facilities (Participant B in Australia). • The number of care workers may decrease once the accredited staffs are gone. The staff members are mostly casual workers (Participant G in Australia). • There are difficulties conducting a cognitive and physical activity program due to labor shortages (Participant A_1 in South Korea). • The lack of nurses and nursing services in the LTC program are issues. The quality of LTC will improve when we secure the proper number of nurses who can work in LTC facilities (Participant J_1 in South Korea). • The staffing ratios of the day-care service should be realistic. The ratio should be 1 (career) to 5 (staff members) for LTC service. The current ratio is 1 (career) to 7 (staff members), and that operation cannot provide a variety of services to clients (Participant D_1 in South Korea). |
2. Inadequate work conditions: Excessive work burdens with insufficient rest time, low wages, and improper rewards | • It is necessary to improve the environment so that staff can work effectively with sufficient rest time (Participant C in Australia). • The wages in the field of LTC are too low for RNs. The same level of pay is necessary for RNs working in LTC as for those working in a hospital (Participant F in Australia). • They would have pride in their job if working conditions were improved and wages were increased by adjusting governmental subsidies (Participant G_1 in South Korea). • Improving working conditions is an urgent matter, as workers often leave their jobs within 1 to 2 years. We need to show a clear career path for caregivers by increasing wages – to improve the quality of candidates (Participant N_1 in South Korea). • Improvement is needed in relation to the collective burden of direct service staff. This problem occurs when they record information on the system according to the evaluation standards (Participant A_1 in South Korea). • The evaluation items are too broad and complicated in a situation with poor working conditions (Participant D_1 in South Korea). |
3. Insufficient career and staff training: Unskilled workers’ relatively low-level capacity and lack of essential competencies & not enough continuing professional development | • The capacity of the workforce is lower than the required level. The most important competency of care workers is the ability to understand the social situation and the health of the consumers (Participant A in Australia). • In particular, it is very important to care for dementia cases. The ability of the workforce to manage diabetes is also critical. Care workers need basic LTC skills, which require lifting clients, communication skills, and personal care skills. It is also very important to form good relationships with the clients. There is a huge gap between care workers and competencies (Participant E in Australia). • Care workers need communication skills to communicate with people about their care needs and their emotional and social problems. Client-centered care competency is required in a care worker. They must have the ability to identify the clients’ emotional and social needs and [they must be able to] build a care plan. However, unskilled care workers are [also] a frequent issue (Participant C in Australia). • Continuing professional development for care workers is necessary; including manual handling, fire safety training, and infection training. Palliative care and training for dementia are required. Continuing professional development is also essential to improve the quality of the services (Participant F in Australia). • Many caregivers do not have the ability to provide services even if they have sufficient practical training in the field because they have a poor academic background (Participant H_1 in South Korea). • Education for caregivers, including work ethics, should be strengthened (Participant B_1 in South Korea). • Continuous training for caregivers should be more systematically improved (Participant D_1 in South Korea). |
4. Need for counselors or consultants for finding proper services | • I think the information technology system is very useful for obtaining data on older people, but it is inconvenient for older individuals themselves to use and should be supported by the workforce (Participant A in Australia). • We need a person who can help us understand the system and [who could] choose services within our budgets [for us] (Participant B in Australia). • We need someone like a service navigator to help people use the service. The service clients need help from someone because online information is not sufficient to solve all the problems involved in getting help or advice (Participant C in Australia). • Case managers provide advice, make plans, and check the changes. Therefore, their roles are very important. This should be a public service; but presently, it is a service provided by the providers (Participant D in Australia). • Currently, no one is taking on the role of the care manager at present. There are many gaps in the service, and [many] parts that need to be revised (Participant B_1 in Korea). |