Carers NSW 2018 Biennial Conference,

Sydney

Myra Hamilton1, Cathy Thomson1, Sarah Judd-Lam2

1 Social Policy Research Centre, UNSW2 Carers NSW

An holistic approach to improving carer employability:

rethinking replacement care

Outline

• Introduction

• Current policy context

• Barriers to carers’ employment

• Carers and employment policy context

• Findings from the Carers NSW 2018 Carer Survey

• Rethinking replacement care

• Holistic approach to supporting carers’ employment

Introduction

• Carers face multiple barriers to participating in paid work

• Few studies have attempted to understand how these barriers intersect

• Consequently, policies aiming to address carers’ employment tend to be

implemented in isolation

• One example of this is the treatment by governments of replacement care.

Current approaches are limited; and

Lack understanding of interaction between carer, care context & labour

market context.

• This paper aims to develop an holistic approach for improving carers’

employability

Barriers to paid work

Lack of support in jobseeking

Lack of replacement care

Challenges with their own health and

wellbeing

Barriers in the income support system

Lack of training or retraining options

Discrimination and lack of employer

understanding

Lack of flexible employment and

leave options

Carers and employment policy context

Lack of support in jobseeking

Lack of replacement care

Challenges with their own health and

wellbeing

Barriers in the income support system

Lack of training or retraining options

Discrimination and lack of employer

understanding

Lack of flexible employment and

leave options

Carer counselling, peer support, carer respite, carer

coaching, health and wellbeing education

National Employment Standards (carer leave, R2R)

Reform of care services (i.e. disability and aged care),

carer directed support packages

Carers receiving Carer Payment permitted to

undertake up to 25 hours of paid work, volunteering

or training/education including travel

SkillsLink2Work, Try Test and Learn fund Projects e.g.

Carer Achievement Pathway, Carers Investment

Program NSW FACS e.g. Care2Work, Upskilling

Carers, Carers in the Balance

Carer Recognition Acts, Anti-Discrimination Acts,

Employer campaigns, Carers and Employers Network

Current policy context

Three reforming sectors…

Disability

NDIS

Aged care

CHSP/HCP

Carer support

ICSS

…one common story

Lack of replacement care Lack of replacement care

Moving from:

• Fragmentation

• Block funding

• Output focused reporting

Moving to:

• Federal oversight/funding of

consumer directed support

• Funding follows the

consumer

• Outcome focused reporting

Shifting service landscapes

• Complex, new siloed systems that are difficult to navigate

Emerging service gaps

Lack of recognition of inter-relatedness of needs

• Emphasis on sustainability of caring role rather than carer wellbeing

• Expectation of ‘respite effect’ (despite limited carer inclusion)

• Some argue that better support for people with disabilities will improve carers’

opportunities for employment

Example: National Disability Insurance Scheme

• Estimates that better services to people with disability will ‘free up’ carers for paid work

• NDIS explicitly relies on, and encourages, ongoing informal care arrangements

• NDIS supports may indirectly benefit carers, but carers cannot access support in own

right

• Carers’ needs (including employment) not necessarily included in NDIS planning

• No direct support for carers to work in the NDIS, CHSP and (so far) ICSS

Source (Hamilton, 2018)

Impact of the NDIS on carers

NDIS enabled carers to take a break, focus on own health, and work

Impact of NDIS on carers

Impact of NDIS on amount of time organising support

Decreased

Stayed the same

Increased

Supporting evidence

• The ‘NDIS evaluation’ found “no significant impact of the NDIS on the

employment of family members and carers”

(Mavromaras et al, 2018)

• And that almost 1/3 of carers said the NDIS had increased the hours it

took them to organise support

(Mavromaras et al, 2018)

• Carers Australia found 3/4 carers said that the NDIS had not reduced their

hours of care or had reduced it by 1-3 hours of care per week

(Carers Australia, 2015)

Aged care services (CHSP/HCP)

Impact of CHSP/HCP on carers

Why aren’t shifting service landscapes creating

opportunities for work for many carers?

• Why aren’t the NDIS and CHSP/HSP providing many carers with the

opportunity to seek or sustain employment?

Shifting landscapes rely on an inadequate conception of replacement

care; and

They do not provide an holistic approach to supporting carers into work

Rethinking replacement care

Replacement care

Time to overcome barriers and be available for work

Short/long periods/blocks of time; regular/irregular; short/long term; planned/flexible

Time to improve health

and wellbeing (i.e. to

have a break or

participate in

counselling etc)

Time to participate in

job-seeking

Time to be available

to participate in work

Time to participate in

education, training

and retraining

Holistic approach to carers’ employability

Replacement care

Time to overcome barriers and be available for work

Short/long periods/blocks of time; regular/irregular; short/long term; planned/flexible

Time to improve health

and wellbeing

Time to participate in

job-seeking

Time to be available

to participate in work

Time to participate in

education, training

and retraining

Labour market and employment conditions (flexible/irregular hours, part/full time/casual, leave, employer understanding)

Job

ready

Rethinking replacement care

• Rethinking the concept of replacement care

• Replacement care that is fit for purpose would:

Move beyond the limited view of ‘respite as replacement care’

Be tailored to needs of different kinds of time-requirements

Recognise that carers have different needs when preparing for or

participating in employment

Take account of current labour market and employment conditions

Rethinking replacement care

• We recommend:

Ensuring that carers’ needs, including their employment needs, are better

accommodated in the planning processes for NDIS and CHSP

Prioritising tailored replacement care in the NDIS, CHSP, HCPs and the

ICSS that flexibly allows a carer to address multiple barriers to their job

readiness

Traditional respite services are important but only part of what is required

References

Carers Australia (2015) National Disability Insurance Scheme Carer Capacity Building

Project, Carers Australia, Canberra.

Carers NSW (2014) The NDIS one year in: Experiences of carers in the Hunter trial site,

Carers NSW Issues Paper, September 2014.

Hamilton, M. (2018), ‘The NDIS hasn’t made much difference to carers’ opportunities for

paid work’ The Conversation

Jackson, D. Williams, D, Saleem, L. Higginson, I. Harris, J. and McCrone, P. (2011) How do

carers of people with long term neurological conditions experience the provision of

replacement care? Final report to the Department of Health R&D grant 053/0012,

Kings College London, University of London.

Mavromaras, K. Moskos, M. Mahuteau, S. and Isherwood, L. (2018), Evaluation of the

NDIS Final Report, NILS (National Institute of Labour Studies Flinders University,

Adelaide, Australia.