The valuable work of in-home support workers is largely unrecognised in the Victorian community, with the nature of the work environment putting their safety and wellbeing at risk. WorkSafe Victoria set out to understand these risks, and foster the conditions for systemic change in support of in- home workers. MAKE had the privilege of participating in this system-led, community driven endeavour.
Healthcare and social assistance is Australia’s largest and fastest growing industry, however considerable risks are leading to a disproportionate amount of physical and mental injuries and claims. As Australia’s population rapidly ages and the trend toward ageing at home continues, in-home support in particular is also set to grow in response to demand.
In-home support workers provide physical, social and emotional support to people who require assistance in and out of the home, including for Older Australians, people with a disability or injury and people experiencing mental health needs. Not only is the work physically and emotionally taxing, but the complex situations they work in put them at high risk of occupational violence and manual handling injuries. As a workforce with a high proportion of women and people of culturally and linguistically diverse (CALD) backgrounds, they are also at a high risk of gendered and racial violence.
In home workers are deeply motivated by a sense of care, and provide essential services that enable the broader community to live their lives independently and pursue their goals. For this reason, they are not only deserving of deep gratitude in the community but should be robustly safe guarded from from risk and injury.
Due to the in-home environments in which the workers operate, WorkSafe is unable to regulate safety in the same way as say a construction site or a hospital. In response to this call for a nuanced, preventative approach to safety, WorkSafe took a community-led approach. A network of diverse perspectives and community voices were called upon to assess the situation and come up with ideas.
This network was made up of:
Participants were encouraged to be open and honest about the adverse structural and social conditions in the sector, so that everyone could understand and empathise with the lived experiences of in-home support workers.
“Even though I loved my job I needed to leave. My role was to support others but I was having difficulty holding myself together. So the last two years I’ve spent building myself back up again to the point where I can support others.”
In addition to structural constraints and pressures (such as funding and casualisation), we learned that a lack of positive relationships, healthy boundaries and clear expectations between providers, workers, clients and family members created an environment for injury and risk.
There were countless stories about barriers to communication and lack of respect and trust in home environments. For example, a worker may fall victim to racial abuse because they misunderstood a client’s request, or may be obliged to perform an unassisted lift because there was no other option. For workers, unsafe conditions can lead to abuse, stress and fatigue - many of which are precursors to mental health injuries.
Communities are fertile ground for change because they nurture relationships and unite people around shared visions, values and ideals. A solution called ‘Safe Support’ emerged by harnessing the insights, hopes, fears and ideas shared between members of the in-home support community. The collective ownership of the proposed solution was a necessary foundation from which greater impact and reach was enabled.
While there are many structural factors that still need to be addressed for home support workers, this approach demonstrated that starting small, and prioritising safe relationships over process is a powerful way to seed powerful change. For WorkSafe, this approach represented a radically different way of reaching its safety objectives.
The community led-approach is opening new doors for WorkSafe to have greater impact.
The Safe Support initiative focuses on building positive relationships between workers and clients, and creating an environment of respect, understanding and communication between different stakeholders. It serves as a guide to help individuals to openly share their needs and create boundaries, by starting conversations about safety before it becomes a problem.
“It’s good that the client and worker participate in the decision making, so they know they have a role to play and work together to compromise.”
“It opened the door to talk about some hard topics, but now we can refer back to it .”
The initiative was successfully piloted with 41 workers and clients across different cultural and community groups, and is now being scaled and made accessible to the wider community.
We’ve also written a case study for this piece of work and the impact it has made at WorkSafe, read it here.