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  • 20th Oct 2022

Home is where their work is

A look into the work health and safety challenges faced by in-home care workers in Australia

October is National Safe Work Month in Australia – a time to re-commit to building a safe and healthy workplace. This National Safe Work Month, we take the opportunity to raise awareness about the unique workplace safety issues faced by in-home disability and aged care workers. 

‘Home’ is typically seen as a place of comfort, safety and independence. It is the starting point for many of our routines, the storing place for our memories and the place where we can most be ourselves.

While many of us take this comfort of home for granted, for hundreds of thousands of Australians, the day-to-day tasks associated with living at home such as cooking, cleaning and gardening, can be difficult – if not impossible – without assistance from in-home care workers.

However, the homes of others can be tricky, and sometimes even hazardous, workplaces. Despite this, very little research has been done on the safety risks faced by in-home care workers in Australia, or on how these risks are managed. In light of rapidly growing demand for in-home care services within Australia, we have partnered with the NSW Government’s Centre for Work Health and Safety (Centre for WHS) to develop an evidence-based framework that can be implemented to create a safer workplace environment for in-home care workers.

Who are in-home care workers?

As of last year, over a quarter of a million Australians were employed as in-home aged or disability care workers, with demand for in-home care more than tripling in the decade between 2011-21. The in-home care sector is one of the largest and fastest growing workforces in Australia (Palesy et al., 2018). It is likely that the sector will continue to grow in the coming years to meet the demands of an ageing Australian population. In fact, earlier this year, the Federal Government of Australia committed over $91 million as part of a Home Care Workforce Support Program to increase the number of in-home care workforce by 13,000 by mid 2023. 

So, what does this growing workforce look like? According to the National Skills Commission (2021), 80% of in-home care workers are female, with an average age of 47. For reference, around 48% of the Australian workforce across all jobs is female, with an average age of 40. This means that in-home care workers are typically older and much more likely to be female than the average Australian worker.

In addition, the National Skills Commission also suggests that the majority (57%) of in-home care workers do not hold formal qualifications, meaning they have not completed a nationally recognised training course on providing in-home care services. 

What are the safety risks that in-home carer workers might face?

In-home care workers face many work health and safety (WHS) risks on the job, which may cause psychological and/or physical harm. Some of these risks include injuries from doing manual labour tasks such as lifting clients or moving heavy objects. Other risks may include harms arising from abusive or aggressive clients, or witnessing traumatic or erratic behaviour from clients with more complex conditions such as dementia or mental health conditions.  

In-home care workers also tend to work alone. This not only means that it is more difficult for workers to get help in the event of a workplace incident, but also that they do not have access to a peer network of other in-home care workers who can share WHS-related tips and advice. 

On top of all of this looms the challenge that the workplaces of in-home carers are private homes, which are difficult to control from a WHS perspective (you can’t go into someone’s house and start rearranging the furniture) and are difficult to monitor for WHS risks on an ongoing basis. 

How behavioural insights can improve work safety in complex work environments

From the gig economy to the work-from-home revolution, new industries and ways of working have changed conceptions of what people consider to be their ‘work environment’. However, the more varied people’s workplaces become, the more difficult it becomes to rely on traditional WHS practices to keep workers safe.  

The Behavioural Insights (BI) approach can be a powerful, worker-oriented tool for developing effective WHS policies for these new types of work environments. Put simply, the BI approach uses evidence-based principles from behavioural science to design systems and processes that work with the grain of human behaviour, rather than against it. BI practitioners achieve this in practice by approaching each new behavioural problem by:   

  1. Applying research methods to understand the specific context and relevant behavioural barriers
  2. Developing evidence-based solutions that address behavioural barriers, and
  3. Testing the solution rigorously, and scaling where it works.

Because the BI approach starts by developing an understanding of how workers behave in context, and uncovering the real-world behavioural barriers that workers face in reducing WHS risks, it can be a responsive and agile approach to developing effective policies in complex or non-traditional workplace contexts. 

For example, we have previously applied a BI approach to develop a road-safety messaging framework specifically targeted at food-delivery workers on gig-economy platforms, whom we found were particularly likely to take road-safety risks when they felt time-pressured to make deliveries. The BI approach was also applied to develop an app that could give truck-drivers real-time feedback on their safe-driving practices, even when driving alone. 

Importantly, the BI approach can also uncover WHS interventions that may be unsuitable in certain contexts. For example, we found that social norms messages encouraging help-seeking actually made migrant workers in Singapore less likely to seek help.

Applying a BI approach in our upcoming work with in-home care workers

In our work with in-home care workers, we will apply the BI approach to first gain an understanding of the key WHS risks faced by in-home care workers, then develop a framework to minimise harm of in-home aged care and disability workers.

The framework will list key stakeholder categories, outline their roles and responsibilities and set out practical guidance on how and when stakeholders should identify hazards, assess risks, control risks, and review their risk management processes. Importantly, we will apply BI to ensure that the framework is something that stakeholders are likely to understand and use effectively. 

In-home care workers play a vital role in assisting some of the most vulnerable people in our society do something that most of us take for granted – living at home. However, in providing this care to the vulnerable, in-home care workers face a unique and growing set of workplace safety risks. Our work with the Centre for WHS hopes to uncover new insights and practical solutions for how we can help these workers stay safe in homes across Australia.   

If you want to know more about this project reach out to Dr. Elizabeth Convery, Acting Head of Research and Evaluation – APAC.