COVID-19 and disability support workers’ experiences

Anecdotal stories of disability support workers being overlooked as the pandemic unfolded was recently backed up by a UNSW report The Disability workforce and the COVID 19: Initial experiences of the outbreak. More than 415 disability support workers supporting people with disabilities – most of them with intellectual and cognitive disabilities – completed the on-line survey during the last week of March. The survey was well underway at the time COVID 19 emerged in Australia so the researchers, seizing the opportunity, quickly fine-tuned questions to capture workers’ experiences. It’s a timely report, which illuminates some risks for clients and workers beyond the pandemic.

Fear and anxiety for their vulnerable clients, themselves and their own families was a common concern among workers, unsurprising given at the time the threat was evolving rapidly and stories from overseas were increasingly bleak.  Many disability support workers provide intimate personal care so have found the social distancing guidelines near impossible to apply or maintain. Most commonly, the disability support workers have described insufficient access to personal protective equipment (PPE), including masks, sanitisers, antiseptic wipes and shoe covers. Their responses also reveal high levels of tension and uncertainty. They have been trying to minimise the risks of infection to their clients, some of them highly vulnerable, but at the same time are needing to protect their own health and that of their families or housemates. It’s a tough balancing act.

Another concern for workers was the number of people with whom staff and their clients were in contact, particularly in the early stages of the pandemic. Some clients continued to attend day centres, NDIS providers continued to visit clients at homes or in group houses, and casual and agency workers continued to work between different sites. Furthermore, with some staff stopping work when schools closed or taking time off to self-isolate, the subsequent staff shortages have meant an increase in casuals and agency staff.  Some workers were concerned whether casual staff, who lack sick leave entitlements, may continue working with mild symptoms out of financial necessity. For other casuals, however, particularly those in day programs, their work dried up overnight

Others described the additional strain supporting housebound and frustrated clients. Yet, at the same time, they are worried about the long-term viability of the programs clients usually attend that are dependent on clients’ participation under the individualised funding model.

Overall the report highlights how this frontline workforce, who are essential workers but seldom recognised as such, fell under the radar in the early stages, (Raelene West highlighted as much back in her 29 April CPOW blog). It also suggests a downside to the rapid growth in the number of NDIS providers and areas of price gaps in the funding. According to the latest NDIA Annual Report more than 21,500 providers are now registered under the NDIS, a huge jump from around 3,000 providers before the NDIS rollout. This may help explain the wide variation in providers’ preparedness experienced by the workers, in terms of access to information and advice on COVID-19, managerial support, and health and safety protocols for clients and workers. The lack of support many staff experienced most likely reflects inadequate provision in the NDIS price for backend support. Note, however, since the disability support workers were surveyed the NDIA has updated some items in its pricing guides in response to COVID-19 and is updating information and advice for providers on its website. But perhaps the greatest area of risk the pandemic has exposed has been around the funding model that encourages organisations to rely too heavily on casual workers, particularly a model that results in many frontline staff working across multiple sites to earn a decent wage.