The Aged Care sector provides services to persons 65 years and older, or 50 years and older for those who identify as Aboriginal or Torres Strait Islander from herein referred to as (Aboriginal). Aged Care services are designed to support older people’s physical, medical, psychological, cultural and social needs, allowing them to access appropriate levels of care when and where required as they age, to support their comfort and dignity.
To address issues identified in Government reviews of the Australian Aged Care system -- coupled with the projected growth of the ageing population -- the sector has moved to a ‘consumer centric’ and market driven system where Aged Care ‘consumers’ choose the type of care they prefer and are assessed on their financial and care needs. MyAgedCare, an Australian Government website and phone line, is the main entry point for Aged Care consumers.
projected to increase 242% from 2011-2041.
projected to increase 340% during same period.
Majority of those 65+ living in the NT were born interstate but 75% have resided in the Territory for more than 20 years, and over 30% are employed.
Types of Aged Care Programs and Services
Aged Care services in the Northern Territory tend to be delivered by not-for-profit or government organisations, by limited numbers of organisations and sometimes, by just one provider (such as local government) across a vast remote area.
There are three main Aged Care funded options (Figure 2):
Residential Care – Accommodation and care options available for older people unable to continue living independently in their own homes. This can include Respite care, services designed to give carers a break from their caring role, arranged for planned breaks, regular weekly breaks, short holidays or emergencies.
Home Care – Community based care for those who choose to live at home and stay in their community. There are two main programs:
- Commonwealth Home Support Programme (CHSP) -Entry-level home support for older people who need assistance to keep living independently at home and in their community (such as gardening or transport).
- Home Care Packages (HCP)-Provides older people who want to stay at home with access to a range of ongoing personal services, support services and clinical care that help them with their day-to-day activities.
Flexible Care – Alternative funding, such as:
- Transition Care – Time-limited, goal-oriented and therapy-focused packages of services to improve older peoples’ independence and confidence after a hospital stay.
- Multi-purpose services – Integrated health and Aged Care services for small regional and remote communities, allowing services to exist in regions that could not viably support stand alone hospitals or Aged Care homes.
- Short Term Restorative Care – Services that enable reverse or slowing of functional decline in older people.
- Innovative Care - Models of care, that require testing and evaluation.
In addition, the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) funds service providers (rather than individuals) to provide culturally appropriate Aged Care close to home and community (Figure 1).
Figure 1: Allocation of NATSIFLACP places
Figure 2: Places per 1,000 people in the target population
Residential Care, Home Care Packages (HCP) or Transition Care in 2016-2017 (with the exclusion of CHSP).
entry level support to live independently at home through Commonwealth Home Support Programme (CHSP) in 2017.
The NT has the highest share (43%) of NATSIFACP places (Figure 1) and the only jurisdiction with more Home Care than Residential Care places (Figure 2)
Aged Care Regions
Aged Care services in Australia are funded and delivered in regions called Aged Care Planning Regions (ACPRs).

Darwin
115,415 km2
Population 162,521
Outer regional
Aged Care Providers 10
Aged Care Services 20
Clients
Residential 287
Home Care 321
Transition Care 19
Male 44% Female 56%
Aboriginal 20%
Non- Aboriginal 80%
Country of Birth English 77%
Non-English 23%

Katherine
326,627km2
Population 21,158
Very remote
Aged Care Providers 8
Aged Care Services 15
Clients
Residential Care 54
Home Care 73
Male 46% Female 54%
Aboriginal 66%
Non- Aboriginal 34%
Country of Birth English speaking 92%
Non-English 8%

Alice Springs
569,566km2
Population 40,715
Remote
Aged Care Providers 14
Aged Care Services 30
Clients
Residential Care 142
Home Care 231
Male 33% Female 67%
Aboriginal 69%
Non-Aboriginal 31%
Country of Birth English speaking 87%
Non-English 13%

East Arnhem
33,596 km2
Population 13,935
Very remote
Aged Care Providers 4
Aged Care Services 5
Clients
Home Care 103
Male 33% Female 67%
Aboriginal 96%
Non-Aboriginal 4%
Country of Birth English speaking 98%
Non-English 8%

Barkly
303,295km2
Population 6,862
Very remote
Aged Care Providers 3
Aged Care Services 6
Clients
Home Care 43
Male 49% Female 51%
Aboriginal 93%
Non-Aboriginal 7%
Country of Birth English speaking 95%
Non-English 5%

The NT is the only state or territory where all Aged Care clients are considered to be regional, remote or very remote.
Industry Intelligence
Due to the lack of Northern Territory-specific data on the Aged Care workforce, ISACNT conducted 12 in-depth interviews with relevant stakeholders including government health departments, peak bodies and Aged Care service providers regarding the challenges and opportunities specific to the Territory. In addition, Northern Territory service providers (37 in total) were invited to complete an online survey to gain base-line demographics of their workforce as well as their training and skill needs. Thirty providers responded (80% response rate). Findings were compared to the 2016 National Aged Care Workforce Census and Survey – The Aged Care Workforce 2016 and data from the GEN Aged Care website. The findings of the interviews, supported by survey responses, means ISACNT was able to draw reasonably sound themes. We thank the Aged Care stakeholders and providers who gave their time and assistance.
NT Aged Care Workforce
The Aged Care workforce can be defined as:
- Direct Aged Care workforce – Provide services directly to Aged Care clients as a core component of their work; majority made up of entry level workers like Personal Care Assistants (PCA) in Residential Care or Community Care Workers (CCW) in Home Care. Allied Health Workers (like physiotherapists) provide specialist support. Nursing staff, (such as Enrolled Nurses (EN) and Registered Nurses (RN) ) provide management and supervision.
- Indirect Aged Care workforce – Provide services to Aged Care clients as a subset component of their work such as management and administrative positions as well as ancillary and pastoral care workers.



Majority of Territory Aged Care workforce is permanent full or part time
Compared to permanent part-time / casual nationally




Case Study - Roper Gulf

Roper Gulf Regional Council delivers Aged Care and Disability services to 93 participants across seven remote Indigenous Communities scattered across its 186,000 square kilometer local government area. Annalisa Bowden, Regional Manager for Aged Care, came to the Council two years ago and observed the aged care services were being provided by those from outside the community. After experience working in Papua New Guinea – where remote villages have elders looking after community – she focused on empowering the locals to “look after their own”.
Local Indigenous were employed across diverse levels and pay grades to provide aged care services, mentor each other, provide peer support, and engaged in professional development and training opportunities where required. By using local community members to deliver services, the workers were better able to interpret the needs of each individual and then meet those needs in a way that was accurate, culturally appropriate and reflected quality aged care. A ‘buddy system’ for the local aged care workers ensured everyone understood their rights and obligations, such as what forms were required to complete for absences such as illness or sorry business, and a sharp reduction in absenteeism and turnover resulted.
"No one is better positioned to care for the ageing members of a remote community than the community itself, so what we've done is empowered our remote staff with the skills, confidence and resources required to deliver on the specific service model communities told us would produce the most positive outcomes for our participants and the places they call home."
Annalisa suggests ‘ if you are looking to build a community of care that values and enables our elders to contribute and continue to find value, purpose and meaning look to your workforce. Without local staff this will not be achieved.’
Annalisa Bowden Regional Manager Community Services Roper Gulf Regional Council- Northern Territory
Current State
Strengths
Socio-economic
- NT population is ageing and living longer; projected increase in jobs needed to support growth of ageing population creates employment opportunities now and, in the future,
- Increasing attention from all levels of government on importance of Aged Care to the NT
- NT investing in Aged Care infrastructure
- National sector reviews/reforms highlight improvement areas
- Move to consumer centric Aged Care system improves transparency and consumer control
- MyAgedCare portal collects important data to improve evidence-based policy and funding responsiveness can be beneficial to the NT
Workforce and capability
- National Aged Care Workforce census and GEN website provide extensive national data/trends
- Marketing campaigns re-branding sector as satisfying work with long term career prospects
- Aged Care Workforce Strategy Taskforce is completing their findings and recommendations
- Some NT Aged Care workers are highly experienced and committed to the NT, providing some stability to the sector
Training and skills
- Federal government announced new Aged Care-specific committee to tackle longstanding vocational training issues, particularly the lack of job readiness at Cert III and Cert IV level
- Sector looking at Allied Health qualifications to attract young people to sector
- Robust numbers of NT residents enrolling in relevant qualifications
- Sector provides excellent training, education and employment opportunities
-
Newly launched NT Aboriginal Health Academy is working to create pathways into Allied Health
Remoteness
- NT and Australian Government have programs to engage the Aboriginal Aged Care workforce
- Research indicates a high number of unpaid carers in remote NT, that could be employed within Aged Care
- Service providers known to approach challenges with unique solutions
- Sector provides excellent training, education and employment opportunities for local communities
Challenges
Socio-economic
- Sector growth creates pressure to increase service capacity in an already challenged service delivery environment
- National sector reviews/reforms create sector fatigue
- Move to a consumer-centric system not always suitable to remote communities/clients; puts new pressures on service provider business models
- Nationally aggregated data collection findings do not always reflect unique needs of NT
- Historical mindset that sector is economic drain rather than opportunity
- Changes to migration legislation creates workforce supply uncertainty; pathways to permanent residency have changed
Workforce and capability
- Other care sectors with similar skill needs like NDIS offer more attractive remuneration/benefit packages
- Aged Care considered ‘occupation of last resort’
- Finding qualified, experienced, reliable staff who want to, and are able to stay in the NT, and have an interest and suitablity to Aged Care work
- Absenteeism is a challenge for all NT service providers, attributed to workers having second jobs, cultural commitments or challenging work conditions
- Very high staff turnover in NT compared to national Aged Care workforce; difficult to maintain consistent care, plan or develop staff leadership and capability
Training and skills
- Lack of entry level qualification requirement of NT service providers
- Inaccurate reporting on services being delivered to clients
- Variability of job ready skills from those with Certificate III
- Lack of trainers with industry currency and cultural capacity to deliver and assess to those with low Language, Literacy and Numeracy (LLN) skills
- Need for more culturally specific training contextualised to the situation and learner, generalist skill training, and specialised skill training
- Inconsistency of timing, quality, duration, sufficient practical on the job training
- Lack of established career pathways to encourage future training and skill development
Remoteness
- High service costs and fluctuation for remote delivery; few service providers as a result and less access to services for those living in remote areas
- Lack of safe and suitable accommodation, peer support, social activities, regular professional development/mentoring
- Complex cultural norms, family hierarchies and English as a second or third language creates additional challenges not common to other jurisdictions
- Problematic nature of work placements due to distance from regional centres, cost, and access to adequate supervision
- Cultural safety challenges prevents reach out for support, guidance and debriefing about work
-
Reduced level of support from supervisors/mentors
Future State
Opportunities
Socio-economic
- Health and social and assistance is one of the largest growing industries in Australia providing economic and employment opportunities for the NT, offsetting declining jobs in other industries
- NT ageing population numbers are projected to rise sharply, following other states and jurisdictions; NT can learn from their experiences
- The creation of an NT Aged Care advisory body or group could provide a coordinated approach to address issues specific to the NT
- While the NT population is shrinking, the migrant population is growing with an interest in Aged Care work
Workforce and capability
- Ensure NT-specific data is shared with Territory and national authorities
- Use Aged Care Workforce Strategy Taskforce findings as a springboard for improving remuneration/benefit packages and continuous improvement
- Look at cross-industry, cross-sector models to improve recruitment and retention
- Engage Aboriginal people in the development of skills and knowledge about caring for community members through narrative stories underpinned by foundational skills development
- Provide opportunities for Recognition of Prior Learning and/or upskilling for unpaid carers
- Arrange for staff to receive comprehensive up-to-date cultural security orientation to their job, workplace and community
- Develop targeted funding models based on outcomes of the Aged Care Workforce review, to develop new skills and training initiatives and collaboration
Training and skills
- A focus on entry-level qualifications and career pathways, along with recognition of the full range of competencies required
- NT Aged Care advisory body could support employer and Registered Training Organisations (RTO's) engagement to inform quality training and assessment outcomes and relevant course selection
- Map and promote career pathways and ensure funding of qualifications from entry level to RN
- Establish or participate in regional training clusters (i.e. a cooperative arrangement among local Aged Care and health providers) to jointly host specialist trainers and share training costs
-
Promote high quality face to face and online training to unpaid carers at a reasonable cost
Remoteness
- Cultivate local Aged Care workforces through customised approaches to service delivery and training that can be adapted to local conditions to provide employment and skilling opportunities for communities
- Formally recognise the need to place high level value on Cultural Security through a framework that supports staff to operate confidently within it, ensuring Aged Care is respectful, appropriate and recognises Aboriginality
- Implement peer support solutions such as local buddies teamed with new workers to reduce isolation, and improve safety
- Collaborate with government, industry and communities to develop business models that meet the needs of the NT
- Make use of digital and electronic support tools to support collaboration, peer support, training and services where there is the technology and internet coverage to support it
Threats
Socio-economic
- Without an increase in a stable and skilled Aged Care workforce, the NT could miss out on an opportunity to rebalance the economy away from the resources and mining boom
- As Territorians live longer, chronic diseases are becoming increasingly prevalent in the population; without specialist trained Aged Care workers, the NT could lose a growing percentage of their population to other jurisdictions with better Aged Care services or not be able to take care of the elderly appropriately
- Changes to working visas could limit migrants from coming to the NT to work and train in Aged Care
Workforce and capability
- Due to the small size of the Aged Care workforce in the NT, the use of national aggregated data may not address NT needs
- Lack of NT representation in a national reference group can affect the ability for suitable solutions that meet the unique needs of remote areas
- If NT Aged Care work is not incentivised with improved work conditions, the ratio of PCAs/CCWs to ENs/RNs will increase risk to clients and workers
Training and skills
- Continued low skill base will see increased risks for the care and safety of Aged Care workers and clients as services try to meet demand
- Variability of training in terms of quality, vastly different durations of training, insufficient practical workplace training and peer support will see increased risks for the care and safety of Aged Care workers and clients
- Lack of career pathways will disincentivise Aged Care workers from staying in the sector and the workforce will constrict as Aged Care clients increase
- Lack of understanding of unique Aboriginal culture as well as Australia’s recent change to a client centric system to provide appropriate care
Remoteness
- Mainstream and national solutions do not always meet the needs of local communities in the NT
- No one organisation or provider can build a stable and appropriately skilled Aged Care workforce; while providers have the best intentions all levels of government, industry and community need to work together to achieve this
Skills in Demand
NT Aged Care service providers identified a number of Industry and Specialised skills in demand.
In addition, service providers commented on the need for Cultural Security training as a requirement for working in the NT. Cultural Security aims to ensure people of a different cultural background to the Aged Care worker can feel safe in their experience of care and is made up of two main components:
- Cultural Awareness – particularly around Aboriginal people’s health, culture and history.
- Cultural Safety – application of a reflective process to ensure care is provided in a way that is respectful of the things that make people different, considering power differences and unconscious negative stereotypes or discriminatory practices that can render someone unsafe in the context of Aged Care. This requires community engagement and brokering of relationships in the community to empower elders to assist in the Aged Care process to ensure it is appropriate and communicated in a culturally relevant way.
Cultural Skills
in Demand
Cultural Awareness:
- Aboriginal people’s health, culture, history and social determinants of health
Cultural Safety:
- Critical and strategic thinking around culturally-appropriate service delivery
- Consultation with community members to facilitate decision making
- Appropriate protocols and ways to broker relationships with community and elders
Industry Skills
in Demand
Employability skills:
- Reliability, empathy and respect
- Communication
- Documentation, in particular, DEX reporting for grant managment
- Understanding roles and responsibilities
Dispensing medication
Senior First Aid/Critical Incidence
Manual Handling
Food safety
Vital signs
Zero tolerance
Technology:
- Telehealth, medical records, computerised systems and care plans in rural and remote locations
Specialised Skills
in Demand
- Dementia
- Mental Health
- Management and leadership
- Palliative Care
- NDIS systems, requirements and funding
Occupations in Demand & Career Pathways
Occupations in demand and training pathways/qualifications for the NT are listed below. These occupations may require registration, accreditation, certifications and specialised training, particularly in remote areas where skills need to be quite broad. For example, a Practice Manager maybe required to be a Registered Nurse with management qualification/s.
Occupations
NT Apprenticeship / Traineeship
Training Delivered in the NT
NO NT Apprenticeship / Traineeship
NO Training Delivered in the NT

Personal Care Assistant and Aged or Disabled Carer
Alternative Titles: Community Care Worker, Personal Carer, Personal Care Worker
Personal Care Assistant ANZSCO # 423313 Provides routine personal care services to people in a range of health care facilities or in a person's home. Skill Level: 4
Aged or Disabled Carer ANZSCO # 423111 Provides general household assistance, emotional support, care and companionship for aged or disabled people in their own homes. Skill Level: 4
Certificate II in Community Services (pre-vocational)


Certificate III in Individual SupportorCertificate III in Community ServicesorCertificate III in Health Services Assistance






Certificate IV in Ageing SupportorCertificate IV in DisabilityorCertificate IV in Allied Health AssistanceorCertificate IV Leisure and HealthorCertificate IV Community Services










Specialised Skill Sets:
Induction to Disability;
Individual Support - Ageing;
Individual Support - Disability;
Individual Support - Home and Community (Ageing);
Induction to Leisure and Health.

Diploma of Community ServicesorDiploma of Leisure and HealthorDiploma of Community Development







Enrolled Nurse
ANZSCO # 411411 Provides nursing care to patients in a variety of health, aged care, welfare and community settings under the supervision of Registered Nurses. Registration or licensing is required. Skill Level: 2
Certificate III in Health Services Assistance (pre-vocational)orCertificate III in Health Support Service




Diploma of Nursing


Specialised Skill Sets:
Enrolled Nurse - Renal Health Care Skill Set;
Clinical Coding Skill Set (Release 2);

Advanced Diploma of Nursing



Registered Nurse
ANZSCO # 254412 Provides nursing care to the elderly in community settings, residential aged care facilities, retirement villages and health care facilities. Registration or licensing is required. Skill Level: 1
Bachelor of Nursing (BNRSG - 2018)

Graduate Certificate in Primary Health Care (Aged Care Nursing)

Graduate Diploma in Nursing
(Aged Care)

Master of Nursing (Aged Care)


Practice Manager
ANZSCO # 512211 Organises and controls the functions and resources of a health practice such as administrative systems and practice personnel. Skill Level: 2
Alternative Titles: Clinic Manager, Community Services Manager, Aged Care Facility Manager
Diploma of Business


Diploma of Practice Management


Advanced Diploma of Community Sector ManagementorAdvanced Diploma of Program Management





Therapy Aide
ANZSCO # 423314 Assists therapists in providing therapy programs and in the direct care of their patients in a variety of health, welfare and community settings. Registration licensing may be required.
Alternative Titles: Allied Health Assistant, Physiotherapy assistant, Speech pathology assistant, Diversional Therapy Assistant, Nutrition Assistant, Occupational assistant, Therapy Assistant
Certificate II in Health Support Services (pre-vocational)


Certificate III in Health Support ServicesorCertificate III in Allied Health Assistance




Certificate IV in Allied Health Assistance



Physiotherapist
ANZSCO # 252511 Assesses, treats and prevents disorders in human movement caused by injury or disease. Registration or licensing is required. Skill Level: 1
Bachelor of Health/Science


Occupational Therapist
ANZSCO # 252411 Assesses functional limitations of people resulting from illnesses and disabilities and provides therapy to enable people to perform their daily activities and occupations. Registration or licensing may be required. Skill level: 1
Bachelor of Health/Science


Podiatrist
ANZSCO # 252611 Prevents, diagnoses and treats disorder of the feet. Registration or licensing is required. Skill Level: 1
Bachelor of Health/Science

Aged Care Industry - Career Pathways
Health Enrolments and Completions
2014 | 2015 | 2016 | Completion Rate* | ||||
---|---|---|---|---|---|---|---|
Enrolments | Completions | Enrolments | Completions | Enrolments | Completions (Preliminary) | ||
Certificate III in Health Services Assistance | 42 | 8 | 52 | 8 | 81 | 16 | 18.29% |
Certificate III Allied Health Assistance | 0 | 0 | 5 | 0 | 0 | 0 | 0.00% |
Certificate IV in Allied Health Assistance | 26 | 0 | 30 | 0 | 35 | 2 | 2.20% |
Diploma of Nursing | 40 | 17 | 58 | 17 | 80 | 10 | 24.72% |
Advanced Diploma of Nursing (Enrolled/Division 2 nursing) | 7 | 0 | 1 | 0 | 3 | 0 | 0.00% |
*Percentage of completions 2014-2016 of Enrolments 2014-2016
Source: NCVER VOCSTATS Years 2014, 2015, 2016. State/Territory of residence of Student: Northern Territory
Community Services Enrolments and Completions
2014 | 2015 | 2016 | Completion Rate* | ||||
---|---|---|---|---|---|---|---|
Enrolments | Completions | Enrolments | Completions | Enrolments | Completions (Preliminary) | ||
Certificate II in Community Services | 343 | 82 | 302 | 45 | 279 | 78 | 22.19% |
Certificate III in Aged Care (Superseded by Individual Support) | 285 | 46 | 320 | 77 | 240 | 99 | 26.27% |
Certificate III in Individual Support | 0 | 0 | 0 | 0 | 326 | 31 | |
Certificate IV in Leisure and Health | 24 | 2 | 33 | 11 | 8 | 5 | 27.69% |
Certificate IV Ageing Support | 13 | 4 | 51 | 3 | 80 | 0 | 4.86% |
Certificate IV Community Services | 271 | 69 | 237 | 48 | 255 | 209 | 42.73% |
Diploma of Community Service | 74 | 11 | 150 | 16 | 271 | 50 | 15.56% |
Advance Diploma of Community Sector Management | 43 | 20 | 24 | 7 | 35 | 12 | 38.24% |
*Percentage of completions 2014-2016 of Enrolments 2014-2016.
Source: NCVER VOCSTATS Years 2014, 2015, 2016. State/Territory of residence of Student: Northern Territory
Useful links
Australian Government Department of Education and Training
Council of the Ageing NT (COTA NT)
This publication has been funded by the Northern Territory Government. The contents of this publication such as text, graphics, images and information are a representation of the collective views of industry, businesses and stakeholders and in no way whatsoever represent the views held by the Northern Territory Government.