Staffing strategies for success:
In conversation with Russell Bricknell

Interview Transcript

WRK4CE

All right, Russell. Good to be with you this morning. We wanted to talk to you about Juniper’s delivery of care minutes. When reviewing MyAgedCare.gov.au, we noticed that as far as your care minutes and RN targets are concerned, Juniper has been excellent. The numbers show that you've successfully met or exceeded targets in all facilities. I would love to have you elaborate on the strategies that you've implemented to achieve this.

 

Russell

There's a couple of things we did. If we backtrack to late 2022/early 23, we identified that we needed to really focus on recruitment, retention and some of our rostering strategies to be able to meet the timelines. So we had a real recruitment focus, we had a real focus around, how do we get people to stay with us longer, and I think some of that has played out. Some of that is the economic circumstances that are played out. But we also did a whole lot of work around casual pools and flexible staff resources. In our regional locations, we’ve done work around the provision of accommodation and regional allowances to make those positions more attractive. The other piece that we've done a whole lot of work on is around demand planning for our rosters for sites. 

 

We take a really active role, we provide data to our managers to understand what their care minute targets are going to be and how those targets move as the resident mix moves. So they have a quarterly care minute target hit, and they can staff up and down on that target. We've got tools that give a predicted projection to do that. They can then make decisions around their rosters to hit those targets as they go. And so we found putting that information in the hands of managers, and working with our rostering team, means we're much better placed to do that. We're still running really high agency costs. But we're comfortable that a majority of those costs are in country locations. And that's around our ability to attract and retain permanent staff in those areas. And that'll be around some of our migration arrangements, particularly. Some of that's around providing housing and we're in the process of doing that for people.

 

WRK4CE

Okay. You're setting up the housing solutions? In particular, in the regional locations?

 

Russell

Yeah. Not in the city, but in the regional location.

 

WRK4CE

That leads into my next question, you mentioned migration, what role have visa sponsored staff played in meeting your care minute targets?

 

Russell

They have helped on the nursing side, that's been really important to us. On the care worker side, probably less so because we weren't able to bring people in. We're hoping to change that in the next little while. In Perth we have a high migrant workforce that are on some form of visas, and they've come here, either as students or their partners have come in, and they've had work rights. And so that's helped in the metro area, but it's more the country that we're focused on. In locations where we've got a designated area migration agreement (DAMA), that's really helped us.

 

WRK4CE

When you’ve hired these international staff, what have you done to ensure the process was smooth, and you're able to best support them?

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Russell

There’s a couple of things we've done, in three different ways. The DAMA meant that we could go through Migration Agents and work with them to identify people. In some of our locations, we've used the PALM scheme to recruit workers out of Fiji into places like Derby and Albany. Initially, we did that through a remote interviewing process, and we found some issues with that. So the next tranche of people have been secured by sending a staff member to Fiji to interview and screen in person.

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That way we're not going through multiple parties or doing only online interviews. We're hoping that allows us to have a better success rate, we had a pretty good one last time around. But there were a couple of people that we placed that probably shouldn't have come into the program in the first place.

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I think what we'll do moving forward is more in-country screening. We've had a few cases where, and this is an example not a specific case. Imagine we're bringing a nurse out of Mumbai, and we're putting them into somewhere like Katanning. Coming from India into Australia is a culture shock, coming from a very progressive, modern, fast paced, densely populated city, into a really remote country town is really stark. We've had a couple of cases where people have come into a country town and left. From their perspective it is not what they imagined Australia to be, they can't tolerate it and they end up going back home. We're happy to support that process, but we need a better way of doing that at the front end, rather than hiring someone and then stressing them and then sending them back home. That's not good for them or us. We’ve learnt some of that along the way.

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WRK4CE

Economically, that doesn't work at all.

 

Russell

And for the people, it's not the right thing to do.

 

WRK4CE

Correct. 

So here's a hypothetical question. If you joined another organisation that wasn't performing as well, in meeting care minute targets, what approaches would you implement first?

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Russell

First of all, I’d like to know what their life and capacity is. What's their current workforce? Where are the gaps? And is there a latent capacity that they're not using? Can we create some sort of shared workforce model that will help move people around? That's been really helpful for us.

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I think the other thing is, what are they doing to retain people? We've found that in the last 12 months at Juniper, our staff turnover rates have halved. Some of that is the economic situation, people have to work at the moment because the cost of living is going up, and they need additional income. But the other part is, what are the values? What's the culture of the organisation? We're doing things to entice people to stay with us because they want to work as part of our team. And they are easy fixes. If you can address culture, through the lens of keeping people engaged with you longer, you get a better outcome. That drops turnover rate, which is half your problem. Then you can ask, how do we get the specialised staff we need? 

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And if you're gonna go down a migration pathway, you have to address culture first. You don't want migrant workers to turn over quickly, because you're making a substantial investment in getting them into the country, let alone keeping them. So if you don't get the culture right, it’s not going to work for you as well as it could.

 

Ryan

What aspects would you be less concerned about?

 

Russell

I think the initial bit I’m least concerned about is filling the holes. Provided you've got some backup support around clinical care, you'll get through the regulatory process. Let's get the culture right first. And then hire into that culture because otherwise you're going to be chasing your tail all the time.

 

WRK4CE

That's great.

In addition to being the CEO of Juniper, you are the Chair of the HSSO. With that perspective, what upcoming workforce challenges do you foresee in Aged Care?

 

Russell

That's a biggie. If you look at the two big drivers hitting us, or about to hit us at the moment. One is the baby boomer population will start accessing aged care services in the next two to three years. So there's a huge spike in demand that's going to hit us and it's going to remain for 25 to 30 years. At the same time, the workforce participation rates have dropped rapidly because our workforce is older by nature, and people are starting to exit the workforce. So we've got a huge spike in demand at the same time as we have a big drop out of workers.

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From a HSSO point of view, we're really focused on working with organisations in the industry to plan better, so that we've got a longer term solution to how we're going to staff this sector. If we don't do that, we are just kicking the can down the road. They can get staff easier at the moment as salaries have improved. 

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The government is kicking the can down the road too, because there is an election coming up and they want to get through that. The problem is, we don't have a lot of time, and we've been kicking this can down the road. I've been in the industry for way too long. It's 23 years this year. And we've known about this the whole 23 years. And we've done nothing. We've known it’s coming, everybody can read demographics. We've really done nothing as an industry and as a nation to address it. So we've got to get the government engaged in this conversation as well.

 

WRK4CE

Speaking of the Government, one of the things they’ve announced recently is that soon ENs can account for 10% of RN targets. We've noticed, similar to most providers, ENs don't play a major role in your delivery of care minutes. With this announcement are you adjusting your emphasis on hiring ENs? Or is it business as usual?

 

Russell

Not in the short term, probably longer term. We want to understand how that plays out in our workable roster. Because 10% is not a lot. We have a small number of ENs in the business. And that gives us the ability to play around first. We've not baked it into our budgets for the coming year, we've deliberately left it out of our budgets, but we're going to play with it in real time to see how it might work. 

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If there's a benefit in it, once we've piloted it, we will focus on it more clearly. But we're just a bit cautious at the moment. I personally don't think 10% is enough. I think when we went down the pathway of nurse minutes, and focused on registered nurses, rather than nurses as identified as nurses in legislation, we made a big mistake. As a result, the role of EN has largely disappeared from Aged Care. I think EN’s have traditionally done more of the hands on nursing and RNs have done more of the hands off clinical management. And that's a really good combination. And what we've done as a sector because of this sort of really simplistic approach, is we've lost some of the hands-on nursing that we need. That's not good.

 

WRK4CE

No, because that's where the real care is. Right?

 

Russell

Absolutely it is.

 

WRK4CE

Last question. Given Juniper’s success in meeting current care minutes targets, what steps are you taking to prepare for the upcoming increase in care minutes in October?

 

Russell

Same thing, focusing on attraction, retention and really focusing on culture. We've got our demand management tool so people are starting to look at their rosters and planning for that, we’re slowly working towards it. It's been in the pipeline for three months and the next three months we'll bring it to fruition. We hope to make it happen in the next quarter. That way, by the time we get to October first, we're ready. That's all we did last time. The sector has known about it for the last two years. 

 

Interview ends.

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References

• Sutton, N., Ma, N., Yang, J.S., Woods, M., Tsihlis,  E., Brown, D., Debono, D., Ries, N. (2024) Australia’s Aged Care Sector: Mid-Year Report (2023–24). UTS Ageing Research Collaborative, available at <https://opus.lib.uts.edu.au/handle/10453/179532>.

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Appendix 1: Juniper Care Minutes Statistics as at 20 June, 2024

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Source: www.myagedcare.gov.au

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Published by WRK4CE, on 20 June 2024