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The value of care. Understanding the impact of the 2017 Pay Equity Settlement on the residential aged care, home and community care and disability support sectors.


Abstract and Figures

The Care and Support Workers (Pay Equity Settlement) Act 2017 was introduced in order to implement changes to funding, wages, and training for care and support workers in residential aged care, home and community care, and disability support. The Act introduced unprecedented changes to New Zealand aimed at addressing historical gender discrimination in these sectors that had resulted in low wages and conditions for care and support workers in a traditionally female dominated workforce. This research is the first phase of a project that aims to explore the impact of the Settlement and how these changes impacted on managers and care and support workers in the residential aged care, home and community care, and disability support sectors. The full project incorporates three phases.
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        
    ,     
  
The Value of Care: Understanding the impact of the 2017 Pay Equity Settlement on
the residential aged care, home and community care and disability support sectors.
Julie Douglas and Katherine Ravenswood
New Zealand Work Research Institute, Auckland, New Zealand
ISBN: 978-1-927184-53-0
Online copy: 978-1-927184-54-7
First and foremost, we would like to thank all the care and support workers and
managers who took part in this research. We would also like to thank those among
the Caring Counts Coalition member organisations who provided feedback during
the design of the research, helped send out focus group notices and spread the
word. This research would not have been possible without all of you.
We would like to acknowledge the support of Careerforce, the New Zealand Work
Research Institute and the Human Rights Commission.
We would also like to thank Yolina Blanc, Livvy Mitchell, Tamara Tesolin and Tanya
Ewertowska for their assistance throughout this project.
Foreword 4
Executive Summary 5
1. Introduction 6
2. Background to the 2017 Pay Equity Settlement 7
3. Research Approach 14
4. Residential Aged Care 16
4.1 Managers 16
4.2 Care and support workers 23
4.3 Residential Aged Care Conclusions 27
5. Home and Community Care 29
5.1 Managers 29
5.2 Care and support workers 35
5.3 Home and Community Care Conclusions 43
6. The Disability Support Sector 45
6.1 Managers 45
6.2 Care and support workers 51
6.3. Disability Support Sector Conclusions 53
7. Overall Conclusions 55
8. Recommendations 58
References 60
Appendix 1. Agreed Hourly Rates 2017 to 2022 62
The 2017 Pay Equity Settlement for carers was a
vital step in valuing the role they have in our society.
The work of carers in residential aged care, home
and community care and the disability sectors are of
critical importance to support the quality of life of
our older population as they age.
The pay settlement was a significant first step
for Aotearoa New Zealand in re-valuing low paid
female dominated occupations that are and have
traditionally been viewed as “women’s work”.
New Zealand’s population is ageing rapidly. It
is estimated that by 2036 over 1.2 million New
Zealanders will be over 65 years old. Ensuring
that carers are able to be recruited and retained in
residential aged care, home and community care and
the disability sectors is becoming more important in
light of population growth in this age group.
The impetus for the pay equity settlement for carers
came from the Human Rights Commission’s “Caring
Counts” Inquiry led by Dr Judy McGregor in 2011 and
2012. Two of the recommendations of the Inquiry
related to pay. The findings inspired the E Tū Union
to file a pay equity claim for aged care workers led by
Kristine Bartlett against Terranova Homes and Care
Ltd. The litigation ultimately led to the government
agreeing to a two billion dollar pay equity settlement
for carers in the residential aged care, home and
community care and the disability sectors, which
came into effect in July 2017.
This research examines the impact of this pay equity
settlement on the quality of life of the workers, and
managers in these sectors. It is world-leading and
has implications well beyond Aotearoa New Zealand.
It is the first time there has been research into the
effect of moving from minimum wage to a living
wage for a female dominated workforce.
The findings provide insight into the improvement
to the quality of life for workers, unintended
consequences of the settlement on different
roles and service delivery, and important lessons
for implementation of pay equity settlements in
the future. The findings also shed light on wider
implications for the resourcing of care and support
for older and disabled people.
This report will be of use to care provider
organisations, the care workforce, policy developers,
researchers, decision makers, advocates, and
importantly to our elderly and their families.
Ia manuia, best regards and blessings upon all!
’  ,
   
Executive Summary
The Care and Support Workers (Pay Equity
Settlement) Act 2017 was introduced in order to
implement changes to funding, wages, and training
for care and support workers in residential aged
care, home and community care, and disability
support. The Act introduced unprecedented changes
to New Zealand aimed at addressing historical
gender discrimination in these sectors that had
resulted in low wages and conditions for care and
support workers in a traditionally female dominated
This research is the first phase of a project that aims
to explore the impact of the Settlement and how
these changes impacted on managers and care and
support workers in the residential aged care, home
and community care, and disability support sectors.
The full project incorporates three phases.
Focus groups and interviews were conducted with
69 participants nationwide. Participants came from
the residential aged care, home and community care,
and disability support sectors.
Key findings were:
Increased wages for care and support workers
were supported by both managers and care and
support workers.
The way in which the funding was implemented
led to unintended negative consequences for both
providers and care and support workers.
Smaller providers in residential aged care
struggled to remain in operation under the current
funding model.
Home and community care managers had mostly
reduced the hours available to Level 3 and Level 4
care and support workers in order to reduce costs.
There was a disconnection between the NZQA
Certificate in Health and Wellbeing expectations
and graduate outcomes, especially when
considering equivalent qualifications, and the skills
and knowledge expected by managers and care
and support workers.
There is evidence that care and support workers’
workloads and duties have increased since the
introduction of the Act.
Quality of care was negatively impacted in some
The legislation and funding changes have not
been clearly communicated, with a lack of support
and clear information for managers and care and
support workers.
Policy recommendations include:
Creating a culture of value.
Reviewing qualifications and graduate outcomes.
Focus on strategies to improve literacy and
decrease barriers to success for some care and
support workers.
Development of generic, agreed sector wide job
Develop more transparent and consistent funding
models across all three sectors.
Continue to develop readily accessible ‘FAQs’ for
both managers and care and support workers that
clarify their rights and obligations under the Act.
The Care and Support Workers (Pay Equity
Settlement) Act 2017 was introduced in order to
implement changes to funding, wages, and training
for care and support workers in residential aged care,
home and community care, and disability support.
The Act introduced unprecedented changes to
New Zealand aimed at addressing historical gender
discrimination in these sectors that had resulted
in low wages and conditions for care and support
Although government Ministries and agencies are
monitoring changes in these sectors in relation
to issues such as funding, qualifications of the
workforce and numbers in the workforce, there
is little or no research aimed at understanding
the impact the Settlement has had on managers
and workers in these sectors. Consequently, the
Caring Counts Coalition agreed a more in-depth
understanding was needed of how these legislative
changes affected both managers and care and
support workers in these three sectors. This report,
therefore, presents findings from Phase 1 of a three-
phase project exploring the intended and unintended
consequences of the Care and Support Workers (Pay
Equity Settlement) Act 2017. The next two phases
will be conducted in 2020 and 2022 – covering the
period of the implementation of the Act.
Focus groups and interviews were held with 1)
managers and 2) care and support workers across
three sectors: residential aged care, home and
community care, and disability support. The research
was conducted between September and December
2018, approximately one year after the Act was
introduced. Focus group and interview participants
came from a range of locations across New Zealand,
including large cities, towns and more rural settings.
These participants also came from a range of
organisations including small providers with one or
two facilities or locations, national chains and for
profit and not-for-profit organisations.
The report begins with an overview of the
background and key aspects of the Care and
Support Workers (Pay Equity Settlement) Act 2017.
The findings from each sector are then presented
separately – differentiated by managers and care and
support workers. Concluding comments are provided
for each sector separately. Final conclusions
comment on the impact overall across all three
sectors, as indicated by the findings from the focus
groups and interviews. The report concludes with
recommendation (drawn from the findings and
conclusions) for policy issues that need revision in
order to ensure fair and equitable implementation of
pay equity in these sectors.
This section provides a brief overview of The Care
and Support Workers (Pay Equity Settlement) Act
2017. In addition, it provides some information on
the New Zealand Qualification Authority (NZQA)
Certificates that are applicable to residential aged
care, home and community care and disability
support. Finally, it summarises the additional changes
to funding, employee payment and scheduling that
have been implemented in home and community care
since 2016.
The Care and Support Workers (Pay Equity
Settlement) Act 2017 was introduced in order to
enact changes to funding, wages, and training for
care and support workers in residential aged care,
home and community care, and disability support.
It implements the 2017 Care and Support Workers
(Pay Equity) Settlement (Settlement Agreement)
between the Crown (as funder of District Health
Boards and employers), Accident Compensation
Corporation and District Health Boards (as
funders of employers) and E Tū Incorporated, New
Zealand Public Service Association Te Pūkenga
Here Tikanga Mahi Incorporated and the New
Zealand Nurses Organisation Incorporated. The
New Zealand Council of Trade Unions Te Kauae
Kaimahi Incorporated was an interested party to the
The Settlement Agreement was the result of
negotiations between the above parties that
commenced after the New Zealand Cabinet sought
approval in 2015 to resolve a legal case between
Terranova Homes and Care Ltd and Kristine Bartlett
(a care worker) under the Equal Pay Act 1972. The
case had been filed in 2012 and the Employment
Court and then Court of Appeal had found that her
claim could be pursued under the Equal Pay Act 1972
(Treasury, 2017). Significantly, this finding meant that
claims of unequal pay due to gender discrimination
could be determined on an industry basis, rather
than through a comparison of two individuals, man
and woman, in the same or similar occupation. In
December 2014 Terranova Homes and Care Ltd
sought leave to appeal to the Supreme Court which
was then dismissed (Care and Support Workers
Settlement Agreement, 2017).
Cabinet agreed to appoint a Crown negotiator to “better
manage the process and achieve a better outcome than
a court decision” (Treasury, 2017, p. 2). Cabinet agreed
to these principles to guide the negotiations:
A stay in proceedings in the Employment Court
and possible removal of litigation on the matter of
pay equity for care and support workers.
A fair pay outcome that represents value for
money, and supports a sustainable workforce in
the future as demand for care services continues
to increase.
Minimum cost e.g. keeping pay increases to
the minimum necessary to achieve objectives,
avoiding back pay and introducing a phased
approach to allow new pay rates to be transitioned
into the sector at a fiscally responsible rate.
In November 2016, as part of updating the
negotiating parameters, a maximum cost of $507.25
million per annum from 2021/2022 was introduced
(Treasury, 2017).
While the case had been taken with the argument
that wages in the sector were low due to historic
gender discrimination, the Crown’s focus in
beginning negotiations was on minimising cost to
the Crown, and contributing to a sustainable future
workforce (Treasury, 2017).
Care and Support Workers (Pay Equity) Settlement
The signatories to this agreement do not include
providers. However the New Zealand Aged Care
Association, the Home and Community Health
Association and the Disability Support Network
were represented during the negotiations for the
Settlement. Settlement negotiations continued for
almost two years. The purpose of the Settlement
agreement was to:
Background to the 2017
Pay Equity Settlement
Address historical pay equity issues.
Record the outcome of settlement negotiations:
applying pay equity principles, determining
agreed pay rates, and conditions for recognition of
experience and qualifications.
Extinguish the Court proceedings and the right
for employees to make any further claims within a
five-year period.
Provide certainty of employer obligations,
employee rights and “lawful” funding.
The Settlement prescribes hourly pay rates over
four levels, depending on length of service with an
employer or qualifications attained (see Appendix
1). The wage rates for tenure/service were intended
as a transition to the new arrangements for existing
employees at the time of the Settlement. At the
end of the five-year funding period, movement
through the pay levels will be based on attainment of
qualifications only, not through tenure or service.
At Level 4, the hourly rates differentiate between a
Level 4 employee via service and a Level 4 employee
via qualifications. Employees’ service is assessed
based on their continuous service with their current
provider. The stated goal is “to have an industry
wide workforce which is trained to meet current
and future service needs” (Settlement Agreement,
2017, p. 17). Funding for employers was agreed to be
equivalent to two days’ training per employee per
year, to be funded through an ‘on costs’ payment.
Employers are expected to do everything reasonable
to ensure that their employees move through the
levels within a total of six years:
Level 2 NZQA Health and Wellbeing Certificate
within 12 months
Level 3 NZQA Health and Wellbeing Certificate
within 3 years
Level 4 NZQA Health and Wellbeing Certificate
within 6 years
The Settlement allows for any weekend or penal
rates (for example, ‘time and a half’) to be calculated
based on the employees’ hourly wage immediately
prior to the implementation date of 1 July 2017. Penal
rates are not calculated based on the prescribed
Settlement hourly rates.
Employers were paid a one-off amount of $25 per
employee who attended the meetings to ratify the
Settlement agreement.
The Care and Support Workers (Pay Equity
Settlement) Act 2017 and Policy
This Act is administered by the Ministry of Health,
except for employment related disputes which
are dealt with under the Employment Relations
Act 2000. The Act sets out the hourly wage rates
from 2017 to 2022 for the service and qualification
paths. It stipulates that workers must be paid the
greater of either the wages in the Act or the wage
that they were on immediately before the Act. The
Act obligates the employer to take every reasonably
practicable step to ensure that their employee
completes training within the timeframes above.
There is nothing to prevent an employee and their
employer agreeing to more favourable terms and
conditions than are outlined in this Act.
This Act does not change the Sleepover Wages
(Settlement Act) 2011 or Home and Community
Support (Payment for Travel Between Clients)
Settlement Act 2016. Consequently, travel between
clients and sleepover wages must be paid at the
minimum wage or above. Penal rates are calculated
based on the employee’s hourly wage immediately
prior to 1 July 2017. The Ministry of Health (2017d)
states that the different rates are to be itemised on
employees’ payslips. This could include if they are
employed in different positions on different rates.
The Care and Support Workers (Pay Equity
Settlement) Act 2017 states that the four pay ‘levels’
relate to levels of the New Zealand Certificate in
Health and Wellbeing issued by the New Zealand
Qualifications Authority (NZQA) or a qualification
that is recognised as equivalent by the relevant
industry training organisation (ITO).
Careerforce is the ITO authorised by the Tertiary
Education Commission to assess other qualifications
to determine if they are equivalent to the New
Zealand Certificate in Health and Wellbeing levels
awarded by NZQA accredited training providers
(Ministry of Health, 2017d).
New Zealand registered and enrolled nurses working
as care and support workers have been assessed at
Level 4. Overseas qualified registered nurses working
as care and support workers prior to the Settlement
(such as from the Philippines, Australia, South Africa
and the United Kingdom) are to be paid on the level
associated with their length of service with their
current employer in New Zealand. This is revised
when they have achieved two “culturally focussed
unit standards” (The Care and Support Workers (Pay
Equity Settlement) Act 2017, s. 18). After completing
those, they are then deemed to have equivalency
to Level 4 of the NZQA New Zealand Certificate in
Health and Wellbeing levels (Ministry of Health,
The Act addresses funding to providers (Section 18).
The funder must fund any amounts “over and above
the amounts required by the funding agreement
towards offsetting the additional costs faced by the
employer as a result of the Act”. However, the funder
assesses what reasonable costs are and the funder
has the final determination on this matter.
Ministry of Health operational policies provide for
Aged Residential Care costs related to the Act to
be funded via a variation to the price included in
the current Aged Residential Care Agreement for
funding (Ministry of Health, 2017a). This is 1.8%
increase to the contract price, plus an extra payment
“per each client bed day” (Ministry of Health, 2017e,
p.3) (see Table 1 below). In addition, an on-cost
payment of 21.7% was made to cover associated
costs. These were specified, for all sectors, as
(Ministry of Health, 2017e):
20 days annual leave
11 days statutory holidays
5.5 days (time and a half for time worked on
statutory holidays)
5 days sick leave
0.8 percent contribution to training
3 percent KiwiSaver employer contribution
2 percent for ACC levies.
Ministry of Health operational policy for Home
and Community Support Services and Community
Service Type Additional payment (re Pay Equity rate increase)
Rest Home $9.41
Hospital $13.92
Dementia $14.21
Psycho Geriatric $16.18
Table 1. Extra payment for Aged Residential Care
Source: Ministry of Health, 2017a
Residential Living (Ministry of Health, 2017b;
2017c) stipulate that the actual wage costs
associated with the Act will be paid through
advance payments from funders to providers.
The period between the Settlement Agreement
and implementation was short with Ministry of
Health timelines for providers indicating (Ministry
of Health, 2017e):
1 May 2017 - read draft operational policy
8 May 2017 - attend Ministry roadshows
End May 2017 - report employee data to the
End June 2017 - make any payroll adjustments
1 July 2017 - full implemented
New Zealand Certificate in Health and Wellbeing
The New Zealand Certificate in Health and Wellbeing
is the standard qualification referred to in The Care
and Support Workers (Pay Equity Settlement) Act
2017 for residential aged care, home and community
care, and disability support, care and support
workers. There are three ‘levels’ of qualification,
Level 2 through to Level 4. The Level 3 certificate
includes several strands specific to different
healthcare settings: health assistance; newborn
hearing screening; orderly services; support work;
vision hearing screening; and whānau, kin and foster
care. The Level 4 Certificate is differentiated by the
inclusion of ‘Advanced Support’ in its title. There is
also a Level 4 Certificate in Health and Wellbeing
(Social and Community Services). These levels,
referred to in the Act, correspond to the hourly wage
rate levels.
The work experience expectations and graduate
profiles for each level are outlined in Figure 1 below.
Level 2 is considered an entry-level certificate
“to provide a training the health and
wellbeing sectors”. Level 4 is aimed at those who
will provide ‘advanced person-centred support to
a person with complex needs, and their family/
whānau’ (Careerforce, 2019).
The criteria for the qualification have not changed
since prior to the Settlement. Therefore, the graduate
profile of care and support workers who hold
these Certificates, and their knowledge, skill and
competency have not changed from what they were
before the Settlement.
Between travel and guaranteed hours in home and
community care
Although the specific focus of this current research
is on the implementation of The Care and Support
Workers (Pay Equity Settlement) Act 2017, there were
additional changes in the home and community
care sector around the same period. The changes
include the Home and Community Support (Payment
for Travel Between Clients) Settlement Act 2016
and the Guaranteed Hours Funding Framework
introduced by the Ministry of Health in 2017. The
catalyst for these changes was a claim lodged
with the Employment Relations Authority in 2013,
arguing that the time spent travelling between
clients for home-based care and support should be
remunerated at a minimum of the minimum wage
(Ministry of Health, 2017f). Cabinet stepped in to
halt the legal process and authorised the Ministry
of Health to begin negotiations with the unions
involved, providers of home-based and community-
based care and support services, and District Health
Boards. The purpose of these negotiations was to
reach “an enduring, affordable, and sustainable
funding solution for paying workers...for the time and
costs of travelling between each client” (Home and
Community Support (Payment for Travel Between
Clients) Settlement Act 2016, s.2). The 2016 Act
implemented the agreement reached in August 2016.
The Act stipulates the minimum costs to be paid
according to the kilometres travelled between clients
and payment for the time as it is time worked. It
was agreed that, from 1 July 2015, care and support
workers would be paid a minimum of the minimum
hourly wage for ‘fair approximation’ of time and
compensated for a proportion of the costs, not being
less than 50 cents per km associated with travel. The
Act excludes services ‘for the purpose of preparing
an intellectually disabled client to live independently
in the community’ and those care and support
workers working for clients under ‘individualised
funding’. Superior conditions may be agreed to in
employment agreements. The Act stipulated that
no care and support worker should be financially
disadvantaged by the implementation of the Act.
Level 2 (40 credits)
Minimum of 80 hours of work experience
Graduates will be able to:
Work within the responsibilities and boundaries of their role.
Perform entry level person-centred tasks and functions in a health or wellbeing setting.
Recognise and report risks and/or changes in a person and/or family/whānau.
Communicate to support a person’s health or wellbeing.
Level 3 (50-70 credits)
Recommended 100 hours minimum work experience
Graduates will be able to:
Recognise and respond to signs of vulnerability and abuse in a health or wellbeing setting.
Demonstrate ethical and professional behaviour in a health or wellbeing settling.
Healthcare Assistance Strand. Graduates will be able to:
Provide person centred care under the direction and delegation of a health professional.
Recognise and respond to change.
Support Work Strand. Graduates will be able to:
Provide person centred support to maximise independence.
Recognise and respond to change.
Level 4 Advanced Support (70 credits)
Recommended minimum of 200 hours work experience
Graduates will be able to:
Work collaboratively to support the health and wellbeing of a person with complex needs.
Implement person centred approaches to support a person with complex needs.
Take a leadership role in a health or wellbeing setting.
Level 4 Social and Community Services (120 credits)
Minimum of 200 hours work experience
Graduates will be able to:
engage and communicate with people, family and/or whānau accessing social and community services in
a manner which respects their socio-cultural identity, experiences and self-knowledge
relate the history of Māori as tangata whenua and knowledge of person-whānau interconnectedness
to own role in a health and wellbeing setting-display self-awareness, reflective practice and personal
leadership in a health and wellbeing setting
actively contribute to a culture of professionalism, safety and quality in a health and wellbeing
organisation-relate the purpose and impact of own role to the aims of the wider health and wellbeing
Community Facilitation strand. Graduates will be able to:
Work alongside people, family and/or whānau in a community facilitation setting to support autonomy by
using tools and strategies to identify goals, address barriers and achieve aspirations.
Community Health Work strand. Graduates will be able to:
Work alongside people, family and/or whānau in a community health setting to support autonomy by
using tools and strategies to promote self-management of health and wellbeing.
Figure 1. Graduate Profile of each Level of the New Zealand Certificate in Health and Wellbeing
Source: New Zealand Qualifications Authority, 2014a, 2014b, 2015a, 2015b
Part B of the Settlement Agreement for ‘between
travel’ refers to an overall review of the home and
community care sector, including the regularisation
of the workforce. This review is still underway.
The Ministry of Health states that there are four
components to the regularisation of the workforce
(Ministry of Health, 2017f, p. 4):
1. Majority of workers employed on guaranteed
2. Training to enable level three NZQA Certificate
qualifications within two years of commencing
work, consistent with the services needs of the
3. Wages paid on the basis of the required levels of
training of the worker;
4. A case mix/caseload mechanism to ensure the fair
and safe allocation of client to home care workers
at a safe staffing level.
‘Guaranteed hours’ was implemented from April
2017. Guaranteed hours categorises care and support
workers into either ‘casual’ or ‘permanent’. Those
who are permanent are offered agreed guaranteed
hours each week. At the time of the implementation,
this was calculated on the basis of 80% of the
average of their hours worked over three months to
a maximum of 40 hours or the regular client hours
as agreed by the employee (E Tū & PSA, 2017a).
Workers are not required to agree to guaranteed
hours, in which case they are considered a casual
employee. It was anticipated that those who were
casual employees ‘may slowly lose hours as the work
will be given to those on guaranteed hours first’ (E
Tū & PSA, 2017b). Employers are required under the
funding framework to “take all reasonable action
to find other work for employees before proposing
a reduction in an employee’s guaranteed hours”
(Ministry of Health, 2017f, p. 5). The framework
outlines the expectation that providers aim to
minimise the numbers of employees who have their
guaranteed hours reduced. In order to mitigate the
cost to providers, and provide income certainty to
workers, the Ministry of Health continues to fund
any ‘lost hours’ for a period up to three weeks. This is
to counter the fluctuation in client hours due to such
factors as clients in hospital, moving out of home
care or client death (Ministry of Health, 2017f).
This research has its genesis in discussions within
the Caring Counts Coalition. Throughout the
development of the research project stakeholders
in the aged care and disability support sectors
were consulted regarding the research design. In
addition, the researchers met with representatives
from the Home and Community Health Association,
the New Zealand Disability Support Network,
Care Association of New Zealand, Human Rights
Commission, Public Service Association, E Tū, New
Zealand Nurses Organisation and Careerforce. These
discussions contributed to:
a solid understanding by the researchers of the
particular sectors and interests;
the choice of qualitative research (i.e. focus groups,
interviews), based on the experiences of managers
and care and support workers;
the development and refinement of research
an opportunity for the stakeholders to have all
questions and concerns addressed;
identifying contacts within each sector to
disseminate the invitation to participate;
the geographical spread of focus groups and
The project was supported financially by Careerforce,
the Human Rights Commission, and the AUT New
Zealand Work Research Institute. The project
was granted ethics approval by the AUT Ethics
Committee in July 2018.
Data was collected via small focus groups and
interviews. These methods were chosen in order to
gain more in-depth information about the impact of
the Settlement on managers and on care and support
workers. Individual interviews were also held with
participants who could not attend the scheduled
group sessions. Focus groups and interviews were
held in five geographical regions across New
Zealand: Northland, Auckland, Waikato, Nelson, and
Canterbury. These regions included metropolitan
and regional settings. Focus groups were held for
each of the following stakeholders:
Home and Community Care Managers
Home and Community Care, Care and Support
Residential Aged Care Managers
Residential Aged Care, Care and Support Workers
Disability Support Managers
Disability Support Workers
Potential participants were sent an invitation to take
part in the research. This was distributed through a
combination of:
direct contact with individual care facilities and
peak bodies’ dissemination of the invitation and
project information;
social media advertising;
‘snowballing’ (referral) sampling
Each focus group had participants from a range of
care providers. These providers represented large
national for-profit and not-for-profit organisations,
small regionally-based organisations, and stand-alone
operators. Participants’ identities remain confidential
and where names are used in this report, they are
pseudonyms – not the participant’s actual name.
Participants were asked to answer demographic
questions prior to the focus group or interview
taking place. This was not compulsory and not
intended to provide exact data. Nevertheless, the
majority of respondents completed it (58 out of 69
participants). The demographics below (Figure 2)
provide an illustrative example of the participants
only. Amongst those who indicated that they
Research Approach
were born in a country other than New Zealand,
participants identified that they came from the
United Kingdom, South Africa, Fiji, the Philippines
and Europe. Ethnicities identified included Indian,
Samoan and Tongan.
The majority of the focus groups were facilitated
by both researchers together. This ensured
consistency in the research approach across all
focus groups and interviews. The focus groups
and interviews generally lasted for a maximum of
60 minutes. They were digitally recorded and then
professionally transcribed. The data was analysed by
both researchers in two main phases. Firstly, each
researcher individually analysed the data in each
sector for key themes arising across all focus groups
and interviews. Secondly, the researchers compared
and discussed any differences in their individual
analysis, cross checking key themes back to the
transcriptions to ensure that the identified themes in
this report arose from the issues mentioned by the
Sector Occupation # focus groups, #interviews Total participants
Residential Aged Care Managers 4 focus groups, 5 interviews 17
Residential Aged Care Workers 4 focus groups 14
Home and Community Care Managers 3 focus groups, 1 interview 7
Home and Community Care Workers 5 focus groups, 2 interviews 15
Disability support Managers 4 focus groups 10
Disability support Workers 3 focus groups 6
Total 23 focus groups, 8 interviews 69
Table 1. Extra payment for Aged Residential Care
Figure 2. Participant Demographics
Average age was 53 years, ranging from mid 30s to 70s
68% female, 32% male
60% Pākehā/New Zealand European, 20% Māori, 20% not born in New Zealand
14% held a postgraduate qualification; 21.5% held a degree; 25% held nursing degrees or were
registered nurses; 21.5% had no post-school qualifications; 18% held other tertiary qualifications.
Care and support workers
Average age was 52, ranging from their 20s to mid-70s
97% female, 3% were male
63% Pākehā/New Zealand European, 20% Pacific peoples, 7% Asian, 7% Māori, 3% other ethnicities
7% held Level 2 Certificates; 47% held Level 3 Certificates; 17% held Level 4 Certificates; 7% were
enrolled or registered nurses; 20% held other qualifications; 2 % had no post-school qualifications.
The residential aged care managers who participated
came from a range of provider organisations
including single site facilities, national providers,
for profit and not-for-profit. Participants were from
a variety of facility types including rest home care,
dementia care, hospital level care and retirement
villages. Participants came from city, town and
regional areas. Six interviews (combination of in-
person and telephone) and three focus groups were
held with a total of 17 participants.
Key themes that arose across all participants were:
The pay increases for care
and support workers were
The funding associated
with the Settlement did
not adequately cover the
associated costs.
There had been little change
in the number and quality
of applicants for care and
support worker positions,
with the exception, in some
geographical areas, of an
increase in migrant workers
seeking work.
The effect of qualification equivalency to Level
4, versus practical experience, was a concern;
alongside a lack of managerial control over the
distribution of Level 1 through to Level 4 care and
support workers in their facility.
In some facilities, the increased wages for care and
support workers caused some tension with other
occupations such as kitchen and cleaning staff,
and registered and enrolled nurses, who did not
receive comparable pay increases.
Wages to reflect the work
Most managers, if not all, recognised that the
increase in hourly rates for care and support workers
in residential aged care was long overdue. Most also
recognised that the pay increase was because of the
value of the work conducted by care and support
workers, with some stating that the pay was now
close to where it should be:
“the very good things are that staff that have been
working in this field for decades – I am speaking
purely about where I am – that they are actually
paid closer to what they are worth for the tasks
that they do, which are huge” (ARM1, speaker 1).
One manager noted that
it was ‘questionable’ why
they hadn’t been paid more
“I think most of us do believe
the caregivers needed to get
more money. Right? Why we
as individuals didn’t pay them
more before is questionable,
let’s put that to bed” (ARM3,
speaker 1).
Another manager noted not
only the positive financial
impact for their care and support workers, but also
the positive impact on their sense of pride and
“The good things. First, I think it’s a good form of
recognition for the type of work that people do,
and I think it probably had been undervalued, and
it’s good to see people get it. There has been an
area of, I don’t know what you call it, satisfaction
or something, by our employees or caregivers that
they are now more adequately compensated and
recognised for their trade, so to speak. And I don’t
think anybody in the industry begrudges the fact
that they deserve it” (ARM9, speaker 1).
Residential Aged Care
I don’t know a single person
that regrets the idea that
these ladies deserve every
bloody cent they get from the
Equal Pay Settlement, I think
it is a wonderful historic
moment but boy oh boy,
they shouldn’t be knocking
businesses that sideways”
However, nearly without exception, the negative
impact on business (which will be covered in more
depth below) detracted from the positives:
“I don’t know a single person that regrets the idea
that these ladies deserve every bloody cent they
get from the Equal Pay Settlement, I think it is a
wonderful historic moment but boy oh boy, they
shouldn’t be knocking businesses that sideways”
(ARM7, speaker 1).
Recruiting and retaining workers
Although it was expected that the increased pay rates
would make working in residential aged care more
attractive to new recruits, few if any managers had
found this:
“Somebody actually asked me about this the other
day, ‘you must be having people running in the
door’, I’m like, ‘which door’? Because they’re not.
It has made absolutely no material difference
whatsoever to our recruitment, none whatsoever...
Well, it is still a hard job that people don’t
necessarily like to do” (ARM7, speaker 1).
Those who had been involved in recruiting since the
Settlement generally reported aiming to recruit at
lower levels:
“So if we looked at replacing someone we would
never look at Level 4, it just wouldn’t be an option
now because if they don’t perform then we would
need to go through that process. It is Level 1s but
some of our Level 1s are just as good as our Level
4s” (ARM7, speaker 2).
Several (in different parts of the country) noted that
although the increased wages appeared to have had
little effect on New Zealand recruits, they had had an
increase in the number of newer migrants looking
for work in residential aged care:
“But we get huge numbers coming in literally
coming in with their CV in their hand and about
a month or so after the pay equity things went
through in July last year, it was just a flood, a lot
of those were people looking to, the first question
I asked them was, ‘are you a resident’? If they are
not then truly we can’t afford them, it takes so
long, you spend such a long time orientating and
that is an expensive exercise because you are
double shifting them and then if they are good
staff that’s fine” (ARM2, speaker 1).
As indicated, not all providers are willing or can
afford the process involved to employ someone
who does not have New Zealand residency. A
further consideration for smaller providers -who
may have little administrative support - was the
time and effort involved in getting visas for migrant
workers, who may not stay in their employment.
This was compounded by managers’ doubts over
whether applicants with overseas health qualification
equivalency would have the necessary practical
skills and knowledge. This manager hints at parity
issues that arose from the process of Level 3 and 4
equivalencies of overseas qualifications:
“Well it has caused problems, definitely, for me
with my senior care givers because they now
have people who are getting Level 4 who are very
new to the business simply because they jumped
immediately to Level 3 as an overseas RN and
then jumped into Level 4 but they have maybe a
year’s experience as an RN and no experience as a
care giver. The senior care givers have a lot more
experience, they know what they are doing but
they haven’t done their training, they haven’t done
their levels, they have only done Level 1 and 2”
(ARM2, speaker 2).
Experience, training, qualifications
Providers did note that it was much easier to keep
their care and support workers now, and that generally
turnover had reduced. Some of that was because of
those care and support workers who were on Level 3
or Level 4 based on their length of service with their
current employer. This meant they could not change
employers without a reduction in hourly rates:
“We always had very high staff retention anyway
and this has certainly cemented staff retention in
that respect. I suppose the flow on effect of that
is that we do have a far more stable staff than
we have had previously, in many respects. What
we call the churn which is the group underneath
our stable cohort is extremely small compared to
what it was before simply because the staff who
potentially would look to move somewhere else
simply are not moving because it would devalue
their position in a new organisation – because it
is experience based not qualification based they
automatically drop” (ARM 7, speaker 1).
However, there was a negative side to this retention,
specifically for those who were on Level 4 because
of their tenure of service to the provider. This
particular route to Level 4 created several tensions:
managers reported that not all of the care and
support workers who had attained Level 4 through
service and experience had the skills and aptitude
assumed of Level 4 competencies, creating issues
of performance management for managers. Those
care workers who were performing at Level 4 would
lose that pay level and rating if they left their current
provider. Some managers pointed out that this
worked against the intention, they thought, of the
“We were told the reason for pay parity was to
financially recognise a group of women working
in rest homes for many years, just above minimum
wage. Everyone agreed they deserve more.
However, these women have not been recognised
for their own work and their own experience. Any
increase they’ve been awarded, they only get to
keep it if they stay with their original employer. If
one of these women who has amazing skills but
may not be qualified, leave, they go down to the
lowest level with their next employer. They’re tied
to that original employer. That means they do not
have freedom of economic movement and that’s
not fair.” (ARM8, speaker 1).
Having more junior (in skill) care and support
workers who, literally overnight, were on a level
with existing senior care and support workers posed
challenges for managers. Managers noted that
now those care and support workers would need
to be more closely performance managed as there
were some not capable of Level 4 work. Previously,
when they were paid lower wages, and perhaps
had less complex tasks, managers tended to not
review their performance as closely. As one manager
pointed out this was an unfortunate and unintended
consequence for those workers, as many may now be
managed out of the sector:
“The hardest thing for us is accepting that our
hands are tied and that there is a possibility that
certain caregivers who have been here long-term
but are still not Level 3 or 4 material, may be
performance-managed out of their jobs. That’s
definitely the hardest thing” (ARM5, speaker 1).
However, participants noted that this did not
describe all their Level 4 care and support workers:
“To be fair to our staff, most of them who do it
would be keen on doing a more senior role if we
could give them one and we are looking at that,
getting them to do some things. But then, of
course, it all takes time” (ARM3, speaker 3).
Managers felt that they had less control to
plan employee training under the Settlement
requirements, and consequently the composition, by
level, of their staff. Managers reported that care and
support workers did fund and seek qualifications
themselves, without first discussing it with their
managers. The consequence was that they would
present their training certificate at Level 3 or 4 and
the manager would be required to increase their pay
– without prior warning. This meant that managers
could not plan rosters and teams around their client
needs, or plan to balance skill and experience across
a team. It also gave them less control to be able to
plan and budget for future staff:
“We have a cleaner with us who went away and
did a 13 week course came back with supposedly
(we thought she was wanting to be a caregiver, we
thought she was going to come in at Level 2), she
ends up saying, ‘Oh I’m at Level 3’, and went into
our nurse manager saying, ‘please sign off this
work’, and that ‘I am capable of doing this’. And
it’s like, ‘well, no, because you haven’t done half of
that’. But now she has turned up with a certificate
saying, ‘I’ve got a Level 3’ and we are still sitting
there going, ‘we wouldn’t sign off the practical
work, so who has’?” (ARM3, speaker 1).
Further, as mentioned above, managers were
not convinced of the quality or relevance of
online training that did not include practical skill
assessment, or consideration of the skills required
in the facility itself. This meant that some managers
would be reluctant to employ new employees with
Level 3 qualifications from training providers that
managers were not familiar with:
“I do feel sorry for people that go off and train
at some of these places that train you because
these are just young people that are trying to
get a career and they pay money for it and then
they come to us employers who aren’t that keen
to employ them because they haven’t got the
practical experience. So it’s pretty tough for them
as well” (ARM 3, speaker 3).
The issue of ‘equivalencies’ where a non aged-
care qualification was assessed as equivalent to
Level 3 or Level 4 was problematic for managers.
Some managers reported care and support workers
bringing Level 4 equivalency to their attention
without any prior notice or discussion. This caused
issues for planning, rostering and budgeting. Further,
most managers agreed that from their perspective,
Level 4 equivalency focused more on leadership
and knowledge than Levels 2 and 3 which had more
practical components. This meant that someone
may have knowledge at Level 4 that is not supported
by the practical skill, experience and knowledge
acquired over Levels 2 and 3.
“We had an ex-registered nurse working for us
as a caregiver. She’s actually lost her registration
and was really not the most competent caregiver.
But because she’d done that level of training she
automatically got a Level 4, and yeah, education
doesn’t equate to competence...I think that was a
whole element of it that was completely missed”
(ARM5, speaker 1).
Several managers mentioned their suspicions of
online only training:
“We’re not great online advocates. Because again,
it’s about the deeper understanding of what that
knowledge is going to translate into in your job”
(ARM4, Speaker 1).
However, others reported a shift, post-Settlement,
towards online training at their organisation as it
was more cost efficient. Some providers had reduced
their overall training offerings (including in-house
training), and some were not paying care and support
workers for the time taken to attend in-house
training, and not allowing as many care and support
workers as previously to attend refresher and other
in-house training sessions:
“We have dramatically reduced the amount of in-
house training. We now have it once a month and
it is mainly, we have manual handling every month
so that every new employee that comes in that
month never waits more than 3 weeks before they
are assessed by a physio for their transferring and
so on” (ARM2, speaker 2).
Several organisations had not reduced or changed
their training, and while it was a cost, those
managers viewed in-person training as essential to
their business and quality of care:
“Look, we’ve always been quite proactive with
access to assistance with training, so we’ve had
to just increase the amount of hours from our
education team to be able to meet our obligations
under the Act” (ARM4, speaker 1).
Rostering and allocation of tasks to jobs
As indicated above, the tenure and qualification
associated with each level and pay rate had caused
managers to consider how they allocate tasks to
different care and support workers and teams. Some
providers had previously used a ‘senior caregiver’
role that translated well to Level 4 work. In some
cases, providers had added more administrative
or managerial tasks to those senior roles since the
Settlement. It was generally felt that because Level
4 was a significant pay increase, therefore care and
support workers should either do more, or that they
should have greater responsibilities – taking on tasks
once carried out by enrolled or registered nurses:
“So everyone who becomes a Level 4 then
gets trained to be a senior care giver and be
medication competent, wound management
competent and take on supervisory tasks of other
care givers and they haven’t liked it. But every
time that I have happily accepted their diplomas
and put their pay rate up, I hand over a new
contract with a job description” (ARM2, speaker 2).
This change in expectations of a Level 4 care and
support worker role meant that the traditional
divide between registered nurse and senior care and
support worker was narrowing:
“How you could differentiate an RN [registered
nurse] before from a care giver that differentiation
is closing, that gap is closing quite dramatically.
We are expecting the care giver to do much
more of what you would call traditional RN
tasks – blood pressures, like I said there is some
wound management, definitely pills, medication
management and so on and so forth. They are
absolutely capable of it but the system before
didn’t allow that because there was just too much
stratification” (ARM7, speaker 1).
Managers spoke of how they now took into
account the level of their care and support workers
when devising the staff roster. They took into
consideration how to best allocate the skills and
experience of Level 4 care and support workers,
and also how to make the most cost-efficient use
of these care and support workers; spreading them
across shifts:
“I think more the impact with us is that now there is
a very strict four, three, two, one. And so now you’re
selective about the number of 4s that are actually
on shift, the number of 3s and the number of 2s, in
that whole team that you make up... So rather than
having all Level 4s who have been there for yonks
and know exactly what’s happening, you may well
have a more graded system and so we are very clear
at looking at that when putting the roster together”
(ARM3, speaker 6).
Managers had also been forced to consider what
tasks were included in care and support worker roles
– especially where care and support workers had
done some cleaning or kitchen work (these jobs were
not included in the 2017 Settlement parameters).
Some managers were moving such tasks out of care
and support worker roles:
“Next year [we will] look more specifically at the
[non-care] roles and so there are more things that
a [non-care] worker can do that an HCA does at
the moment. So it is like making the beds, little
things like that. So I guess then we will have more
of those and the HCAs will be doing more of just
care. So I know we are going to look at that but we
haven’t yet” (ARM7, speaker 2).
Others had built flexibility into their payroll and
rostering system. One example was where a care and
support worker agreed at short notice to work in
the kitchen to cover an absence. They could be paid
a lower rate for that kitchen shift. However, some
managers decided to reward their willingness to help
out and would pay them at whichever level they were
on as a care and support worker. Most managers
were no longer putting kitchen staff in to a care and
support worker role as it would cost more, and be
more administratively complex. However, some chose
to reward loyal and hard-working staff if they filled in
for a care worker:
“Only for the domestic who, if she is caring, then
we’ll pay her a higher rate, because she has been
here also 11 years so she definitely deserves
her higher rate for the caring. Yeah, we pay her
another rate. And if one of the caregivers works
in the kitchen, we still pay the higher rate. They
do us a favour to fill in that position, yeah, so we
can’t just punish them on top of the favour, and
that brings a cost with it of course. So yes, to keep
the books balanced it will be interesting” (ARM4,
speaker 1).
Parity with other occupations in the sector
As mentioned above, some managers found the
implementation of the Settlement challenging;
incorporating the different levels, training
opportunities, and requirements into the
management of their facilities. In some cases,
managers had to pay more than they thought
an individual’s competencies were worth. There
was a misconception among some managers that
they could not pay more than the prescribed rate
at each level. Among those who thought this, it
was contentious because, to them, it removed
their managerial discretion to award and motivate
their better employees with higher wages. An
added frustration, and another loss of managerial
discretion was when they had good care and support
workers who did not want to do the qualifications,
but were performing at Level 3 or 4 – and the
manager thought they could not offer higher wages.
Managers thought of the prescribed hourly wages
not as minima, but the only possible rate:
“So I had 3 senior care givers come to me and they
said, ‘I am no longer doing the senior care giver
role unless you pay me more than the caregivers
[this one, that one, that one]’. And I said, ‘well,
unfortunately with Pay Equity it dictates what I
can and cannot pay you and this is the level you
are at. We used to have extra incentive money that
we could pay people. That is no longer part of it’”
(ARM2, speaker 2).
Other issues of parity arose in residential care
because several occupations work alongside each
other. In particular, kitchen staff and cleaners often
felt that the significant pay increase for care and
support workers was unfair, as reported by managers:
“There’s division amongst staff. Cleaners and
cooks felt and were left out, and managers have
no money, have no money to pay them extra”
(ARM8, speaker 1).
“It’s harder to retain staff in other areas of the
business, e.g. kitchen, because the staff have
asked and then they see the better money... So
we do have staffing issues as a result of that.
But I don’t think it’s just that, it’s also pretty full
employment these days, so that’s also impacting
upon it as well” (ARM9, speaker 1).
Several managers spoke of how they had discussed
the changes with all their staff, so that any issues
of parity would be minimised. Their approach
was to explain it was a gender equity issue, but
also to distance managers and the provider from
responsibility for any perceived unfairness. This
meant that kitchen and cleaning staff had a better
understanding of the sudden pay increase for care
and support workers, but also could not really lay
‘blame’ on the manager or organisation:
“Well, it was extremely important, because it’s a
sensitive subject. It was never going to be easy for
some people to swallow what happened, because
first of all it was so quick... So for them, it was
presenting it in a way that our staff understood
that this was not anything personal to the
organisation, that this was a difficult decision that
the government had made because of pay equity
issues... And I guess it was also just giving other
staff the options of – if you would like to pursue
this career now it’s more attractive and you can,
and we’ll help you to do that. We kind of placed
them in a position where they really couldn’t
question us as an organisation, ‘cos we were very,
very clear that this decision was nothing to do
with us, or really, the role. It was something bigger,
if that makes sense” (ARM5, speaker 1).
Issues of parity between Level 4 care and support
workers and enrolled and registered nurses were
more acute. Several managers mentioned that at
Level 4 a care and support worker role may have
tasks very similar to that an enrolled nurse used
to do, and that the Settlement was blurring the
boundaries between the roles:
“We now expect Level 4 staff to perform at $24.15
level, you’ve got them perhaps doing maybe some
things that you may not have expected of them in
the past. We’ve trained them to be able to do that
role, PEG [percutaneous endoscopic gastrostomy]
feeds, bowel evacs, some of those types of things
that we’ve actually trained them to do and they’re
very competent to do. But we’ve actually in some
ways perhaps tried to take some of the more
day to day, mundane stuff away from Registered
Nurses” (ARM3, speaker 6).
Some thought that the small difference in pay
between a Level 4 care and support worker and
enrolled and registered nurses was not fair for the
nurses, and had caused disruption:
“I think it’s a good thing for the health care
assistants, it really has made a difference to their
salary structure. The bad thing about it is that
we are not being funded by the government to
cover that pay increase and it brings the Level 4
rates very close to the entry level RNs and that is
causing a lot of disquiet” (ARM3, speaker 2).
Some pointed out that despite small differences in
pay, in some cases, enrolled and registered nurses
had a legal responsibility and liability for the care of
clients, whereas care and support workers did not:
“Both RNs [registered nurses] and ENs [enrolled
nurse] are hugely penalized, but you’ve got the
EN with the professional responsibility, the
registration and everything that goes with that
being paid maybe 25, 50 cents an hour more [than
Level 4 caregivers] because that is all you can
afford to pay them. As the funding related directly
to the 2017 Pay Equity Settlement for caregivers,
managers were not funded to increase the wages
of other occupations” (ARM3, speaker 2).
Others who had paid their registered nurses at
the high end of industry benchmarks before the
Settlement did not experience these same issues:
At the moment our RNs have no trouble because
their hourly rate is set at the highest” (ARM4,
speaker 1).
Funding was a crucial challenge for most managers.
Most, if not all, agreed that the funding was
inadequate to cover the costs associated with the
Settlement. As one manager commented:
“We were told that the government would fund
pay equity 100%, they have not. And then they
realised there were so many people going under
that we were asked to prove our negativity.
And of course that’s me, and you had to pay an
accountant to work it out” (ARM8, speaker 1).
One manager pointed out the difficulty of
maintaining quality of care (as others agreed) with
much tighter margins than prior to the Settlement:
“The negative aspects is that it was already a
difficult industry to give quality of care and
run a business that makes a profit, it is now
exponentially more difficult because we still try
to give that top level of care with only a small
amount of increase in money but with a much
larger increase in expenses in staff wages” (ARM2,
speaker 2).
This was reiterated by another manager who stated
that the funding had shifted focus from care to
“Unfortunately this Equal Pay Settlement has put
us all, every single organisation that I know of, it
has put every single one of us in a position where
money is going to be more important than care
because it is killing us” (ARM7, speaker 1).
Those in smaller facilities struggled to stay in
operation. This was both in city and small-town
areas. Some smaller operators who had more than
one facility had chosen to change the services that
they offered, such as moving more to dementia care
because the funding was higher. Some providers
who provided rest home care with ‘swing’ hospital
beds had reduced the availability of hospital care
beds because it was more cost efficient.
Some small providers had cut the hours of their
staff, (often those in managerial or administrative
positions), rather than lose staff because of
budgetary constraints. More than one manager
spoke openly about the budget with their care and
support workers, and in at least one case, care and
support workers volunteered to temporarily reduce
their hours to keep the facility in operation:
“During the time we had only the [usual core
staff] we did, through communication with our
team over several weeks suggest to them that
financially this was too difficult to keep going and
could we look at, as a team, doing some part time
hours and so we had people who volunteered
taking some hours off, obviously on the condition
that when things improved that they would get
their hours reinstated which is what we did”
(ARM1, speaker 1).
Some smaller providers were barely remaining
operational from one week to the other with costs
such as GST bills, fire safety checks, fresh (instead
of frozen) food becoming impossible to meet. Some
were concerned about whether they would be able to
stay in operation in the short and medium future. It
was suggested that the Settlement was more difficult
for smaller providers to implement because they
could not consolidate costs (such as administrative
costs) in the same way as larger providers:
“The larger flow on effect from a smaller business
perspective is that the larger businesses are
able to cut an awful lot of their costs and spread
costs across their administrative areas... I have
got one facility and one accountant, so obviously
spreading that cost is a significant change” (ARM7,
speaker 1).
Larger providers and retirement villages did not
appear to have the same financial challenges. One
manager mentioned that they could make a loss, at
least in the short term, in their rest home - because
it would be offset by other facilities and units in their
organisation. However, another manager disputed
the idea that retirement villages were better off
because they could subsidise the rest homes, as each
business unit needed to be able to operate within its
own budget and funding.
Some participants thought that the industry averages
the funding model was based on favoured larger
providers over smaller ones. Although no single
reason explained why this might occur, it was
apparent that larger providers did not face quite the
same financial difficulties under the Settlement as
smaller providers.
One manager summarised their divided feelings on
the Settlement:
“I think down the track this will prove to have been
a good step because there is no way probably for
another 5 years or so anybody can complain that
they are underpaid – we will be underfunded for
5 years I imagine – and so in that respect I think,
I hope, that will prove to be really positive for the
companies, the people who survive. My concern is
that there will be more facilities who don’t survive
because I know of quite a few that are struggling
again now. I think people hoped and prayed that
this last budget was going to maybe be something
along that 5% line to bring us up to something but
it wasn’t, it was 2% or 2.5%” (ARM2, speaker 1).
One suggestion for how the funding could be
improved was:
“I think that if I could have had it my way there
would have been a lump payment for length
of service pre-July 17, but then everybody
needed to have worked to the same principles.
To move up these levels you need to complete
this qualification, we will assist you to do that,
but in return we need to talk to you about the
consequences that come along with this, and how
our expectations of you will increase so that you
can be completely sure that this is what you want
to do” (ARM5, speaker 1).
Four focus groups were held with care workers in the
residential aged care sector. A total of 14 participants
took part, and they came from a wide range of
regions across New Zealand. The participants came
from a variety of providers including for-profit, not-
for-profit, and large and small facilities.
The major themes that came through in the focus
groups were:
A dramatic increase in quality of life due to the pay
A shift in rostering practices and a change in hours
offered to workers.
Tension across occupations due to the relativity of
pay rates.
The Settlement has increased the recognition of
the work but has not increased appreciation of the
Financial impact for care and support workers
For many of the care and support workers who
participated in this research the increase in pay had
a profound impact on their quality of life. For some,
holidays away were now affordable, but for others,
more basic choices were now within reach:
“I went to the dentist after not having been to
the dentist for about 6 years. My husband has
just retired and I was able to buy him for his 65th
birthday, a pair of spectacles because we haven’t
had glasses for about 15 years” (ARW4, speaker 4).
While the increase in pay was appreciated
by workers, some did express concern at the
concomitant increase in tax, as many moved to a
higher tax bracket. Several care workers saw this as
a disincentive to work the number of hours they had
prior to the Settlement, and had reduced their work
Aside from the tax issue, the increased pay also
meant care workers were able to make decisions
about how many hours they needed or wanted
to work. Prior to the Settlement, many workers
commented that they needed to work as many
hours as they could get, due to the low rate, as one
participant noted, “before I had to work 15 more
hours to catch up” (ARW3,
speaker 2).
Some were now choosing
to not work weekends or
not to take on extra shifts or
overtime, and instead were
choosing to spend time with
family and participate in
other activities. One woman
commented that she had not
been around for much of her
children’s growing-up years,
during her career in the
sector, but at least now she had time to spend with
her grandchildren. Similarly, some participants saw a
benefit of not working the long hours they used to as
“it has released the stress that we have been through
because we had extra money” (ARW4, speaker 2), and
that the reduction in hours for some meant they “are
less tired so can give better care” (ARW4, speaker 1).
Changes to the role of care worker
While all the care and support workers expressed a
positive response to the increased pay rates for their
work, they were also clear that the Settlement had
created a range of negative consequences relating
to their role. Many of the participants reported a
significant increase in workload expectations, since
the introduction of the Settlement. Care workers also
reported that there appeared to be an increase in
the breadth of tasks required of some care workers.
This included lower level duties such as cleaning,
as well as some tasks traditionally carried out by
enrolled and registered nurses. Those expectations
came from other workers in the facilities and from
“Before I left to go away on holiday our kitchen
staff were just dropping things in a big fat bowl
and sending it down to us and expecting us to
dish it out ourselves, so these are the sort of
things that were coming out of it. But then we
got told that one of the nurses wants to drop the
nurses doing medications and they are wanting
the senior care givers to do it. So our role wasn’t
based on the equal pay case, it was, ‘you’re getting
the good money, you deserve to do all the work’”
(ARW1, speaker 2).
There was a general perception that they were now
expected to “go harder and faster” (ARW3, speaker 2).
As another participant commented:
“The other thing that is
noticeable is the baseline
things that used to go with
care giving like making the
beds, tidying up beds, has
become more of a ‘if you can
get it done’” (ARW1, speaker 2).
Several participants
agreed that the increased
expectations had somewhat
neutralised the positive
outcomes for care and
support workers, and some anger surfaced about
management’s attitude towards them:
“It comes at a cost. I was asked if I felt more
appreciated with the pay rise and I said, ‘I do not
feel that management appreciates me anymore, it
is not management that has given me the pay rise,
it has been the Government that has given me
the pay rise, the boss has been forced to give me
the pay rise, they don’t appreciate it’. The bosses
fought the case, they don’t want to give it to us,
they don’t appreciate us, they fought, they spent
money to fight the case! So they don’t show that
they appreciate us, they couldn’t put that money
to better use paying the staff” (ARW4, speaker 4).
Some participants were concerned about whether
residents’ quality of care would be compromised if
care workers were now performing nurses’ tasks,
because nurses were the ones with specialised
“Like doing medication, like taking the residents
to doctors, things like that, taking them to the
podiatrist in the facility, but doing a lot of things
I went to the dentist after not
having been to the dentist for
about 6 years. My husband
has just retired and I was
able to buy him for his 65th
birthday, a pair of spectacles
because we haven’t had
glasses for about 15 years”
like doing the weights, doing the regular creams
and things like that that nurses should be doing
so that they are checking their skin at the same
time. So a lot of things like that, that nurses
should be doing. The nurses are there to do the
medication” (ARW4, speaker 3).
One participant also questioned whether the
delegation of such tasks to care and support workers
was part of a management strategy to save money:
“Now they are trying to train care givers to do
medication because they are trying to reduce the
nurses” (ARW2, speaker 2).
Changes to rostering and hours of work
Participants reported negative impacts on the
rostering of their hours and workloads since the
Settlement - such as a reduction in their rostered
“It’s like the hours have dropped so people were
used to working a 40 hour week because that was
the law then but now it is slowly dropping down to
20 hours or maybe 25 hours which again, we have
people thinking what is the point of the equal pay
deal because you are screening hours” (ARW4,
speaker 1).
Some reported that rostered hours had been cut,
effectively making little change in their overall
income from prior to the Settlement. This resulted
in some care workers expressing their intention to
In some facilities there had been a reduction in the
number of nurses, and care and support workers
“Our management have openly said that it is
because of the Equal Pay Settlement. They had a
meeting the day before the Settlement came in
and said that people won’t be replaced” (ARW4,
speaker 3).
The reduction in staffing at some facilities resulted in
changes to staff/resident ratios, sometimes leaving
gaps, such as on night shifts:
“We noticed in our place that they don’t replace,
so on a night shift, I work the night shift and if
you leave or if you are off for the night they don’t
replace that shift” (ARW4, speaker 4).
Overall, the issue of staffing ratios was raised as a
concern in general:
“Now that is a guideline, that ratio, but they look
upon it as this is scripture, this is our bible, this
is what we say is going to be, so their ratio now
is 7:1. This is in the continuous care wing, I am
not talking about the rest home. This is hospital
level care. So they are expecting you to be able to
do these people who are stroke victims, people
who have Parkinson’s and all that, people who are
very heavy, a lot more work, you have got to do it
yourself. I work on my own, the only time I have
someone actually working beside me is when I
am hoisting because of health and safety” (ARW1,
speaker 1).
Several participants thought that management
did not understand the nature of care and support
workers’ work, and the time needed to carry out their
tasks well:
“So they don’t staff to acuity, they don’t
understand the workload and they are putting
more and more of the nurses’ workload on the
care givers” (ARW4, speaker 3).
Participants perceived that the quality of care had
lowered with the reduction in hours and numbers of
“Hours cut by the owner or the company that is
meaning that it is cutting the care of these people“
(ARW4, speaker 2).
The increase in pressure to get work done with fewer
staff meant that some participants felt that they
had to make choices about the priority of tasks, to
ensure good quality of care. If they did not complete
all the tasks within their shift then they risked being
A reduction in staffing also led to concerns among
some participants regarding health and safety in the
“On the weekend or when there is a shortage of
staff there are always people that need to hoisted.
We have got 13 or 14 that need to be sling hoisted,
so that takes 2 caregivers, so if you are already
down to 5 or 6, you are struggling. So what people
do is they just use the hoist and one person”
(ARW4, speaker 3).
“...we have had so many people with accidents at
work because they are just rushing and rushing”
(ARW4, speaker 1).
Aside from the increased workload expectations
for care and support workers - that appears to have
occurred for many after the Settlement - relativity
issues were also voiced. These include tensions
with other workers, and also the division of tasks
and responsibilities in the sector. As one participant
And the worse part is that my feeling is that is
coming from the nurses, the nurses are saying,
‘why should we work if you are going to get a
better pay rate than us’? We’ve got nurses who
aren’t on much more than us as caregivers and
they’re sitting there saying, ‘well you guys get
paid the good rate, so you guys can do it’, and we
are sitting there going, ‘hey, hey, hey, you are the
qualified one’” (ARW1, speaker 2).
“I mean, our manager said to us, ‘if you are Level 4
you have to be leading the shift. And I’m like, ‘no
we’re not, what does the RN do? If we are going
to lead the shift what is the point of having an
RN’?’” (ARW4, speaker 1).
Pay rates, progression, training and qualifications
There appeared to be confusion amongst a number
of the participants regarding their entitlements
and pay progression within the Settlement.
One participant expressed their frustration over
who receives the increases in pay, in relation to
qualifications, at their facility:
According to our manager, if you get the
certificate, even if you start it or you are going up
to a Level 1, to a Level 2, you get the qualification
for Level 1, Level 2, Level 3 and something like
that, you don’t get anything for it because you
are already included in the pay rise. There is no
extra money, you don’t get any extra money for it
because you are already in the pay rise from last
year” (ARW3, speaker 3).
This was especially common for those who had
moved up levels due to their continuous service
with their current provider at the time of the
Settlement. A number of participants expressed
some dissatisfaction with colleagues who had not
worked towards gaining qualifications over the years,
yet who were now receiving significant pay rises
because of their experience:
“Yes, but being here for such a long time, in that
time when the courses were going you should have
at least taken some kind of qualification, actually
the whole Level 4, 5 or 6, they should at least have
done something to get up top. Just because equal
pay came in it is just bang! Straight to the top! I
find that is not right” (ARW3, speaker 1).
These concerns reflected a general feeling of
unfairness that those who had gained their
qualifications were now expected to pick up some
tasks previously done by enrolled and registered
nurses, with an increased workload, while others
on the same level due to tenure, but without the
qualifications, had a lower workload - yet were paid
the same.
Participants noticed a change in how training was
offered after the Settlement. Some reported that their
employers offered training towards qualifications,
and paid for the course costs, but expected care and
support workers to complete the study in their own
time. One participant observed that;
“They are not providing training or paying us to
train” (ARW4, speaker 2).
This indicates that care and support workers (and
possibly their managers) were not aware of their
rights and obligations under the Act. As another
participant commented:
“I noticed that a lot of the girls are saying stuff
which is quite concerning, that the training
aspect, being told they cannot and will not go to
Level 4, that’s just that” (ARW1, speaker 2)
Overall impact of the Settlement
One unforeseen impact of the Settlement was
an increased perception of antagonism towards
unions by managers in some organisations. Some
of the care and support workers commented on
the role of unions, and attitudes towards unions in
their organisation. One participant argued that the
Settlement has made it easier for unions to recruit
new members. However, other participants indicated
that an anti-union sentiment prevailed in their
organisations - to the point where some workers
were reluctant to participate in the focus group for
fear of management reprisal:
“I know, but the thing was we had no union
before, we have only just, people are too scared.
So like when I got the email about this meeting I
asked a few people who belong to the union and
I said, ‘are you going to go along’. ‘We don’t want
to talk about that’, I said, ‘didn’t you get the email’?
‘Yes, we don’t want to talk about it’. It is all shush
because they might not get treated good, you
know? Because there is so much bullying going
on” (ARW1, speaker 1).
Overall the participants saw the Settlement as making
a positive impact insofar as recognising their work:
“I think it has notice that there
is something that people can do, that is what I
am telling them, if you fight for your rights it is
not automatically if you say something now it will
happen” (ARW2, speaker 1).
“For my impact, it is my qualification that I have
actually got and getting the right pay for it. I
could have done with that 10 years ago, and that
my qualification has been seen” (ARW3, speaker 1).
However, for many, it also has come at a cost through
reduced hours, extended duties and increased
workloads. A common theme that came through in
the focus groups and interviews, as indicated earlier,
was that although care and support workers’ work
has been recognised through the increase in pay,
they were still not appreciated by their managers:
“There’s more down than up really but we all, yes
we were recognised and that’s what we wanted,
we wanted to be recognised for what we do but
then again, we just don’t get appreciated. The
pay’s good, we don’t have to work these long
hours and we are able to go on leave and go
on holidays and things but then, you know, is it
really worth it because mentally, physically and
emotionally we are drained” (ARW4, speaker 3).
“They expect us to do more, we are expected to
do more and we are not really, I don’t think we are
appreciated. We never have been appreciated”
(ARW4, speaker 4)
Both managers and care and support workers
pointed to the positive impact that increased wages
had had. Most of the managers agreed that these
workers deserved a pay increase. Care and support
workers saw improvements in their personal lives -
when their hours were not cut - making it easier to
work hours that support work-life balance, to better
afford medical care, and for some to take holidays
away from home. However, care and support workers
felt that although their increased pay recognised
the worth of their work, their managers (and other
occupations) still did not really appreciate them.
This was also reflected in reports that registered
and enrolled nurses, and kitchen and cleaning staff,
were often resentful of the pay increases for care and
support workers, because they did not benefit from
comparative pay increases. Some care and support
workers were scared to speak up about their work
Both managers and care and support workers
reported a change in care and support worker tasks.
Sometimes this was a requirement of Level 4 care
and support workers to undertake more complex
care tasks than previously, including some tasks that
were carried out by registered and enrolled nurses
prior to the Settlement. In other cases, Level 4 care
and support workers were given additional tasks
(allocated from other roles) because they now earnt
more money and should therefore, in the managers’
view, do more work.
The implementation of the Settlement had proved
challenging for managers. Some of this was centred
upon a reported under-funding of the Settlement
costs, which led to needing to manage within very
tight budgetary constraints. The link between tenure
or qualifications with pay rates had proved most
challenging. In some cases, managers had care and
support workers who would advise them, without
prior discussion, that they had gained a qualification
equivalency or particular level of training. This
removed managers’ ability to plan rosters and budget
for the increased costs in those cases.
Service versus experience was an issue raised by
both managers and care and support workers. In
some cases, it was perceived that with qualification
equivalency a care and support worker might be
on Level 4 wages, but have much less practical
experience than a care and support worker at Level 2
or 3. Some participants reported that there were care
and support workers who were on Level 4 because
of their service with their current provider, but that
they did not have the skill or aptitude for Level 4
care work, and had not shown previous inclination to
complete their qualifications. Another aspect of the
service requirements that was perceived to be unfair
was that if an excellent care and support worker
was on Level 4 through their service, they could not
change employers and take that wage rate with them.
Related to the issue of experience, qualification and
tenure was an issue raised by some managers: that
those care and support workers who were on Level
4 because of their length of service, but were not up
to a Level 4 job, could be a cohort that would end up
without jobs – they might be performance managed
out of the sector.
Managers’ roles had also become more complex
and were often larger than prior to the Settlement.
In addition to reporting requirements, they had to
look at how they rostered different levels of staff, to
ensure adequate coverage across shifts. Performance
management of care and support workers had
become more important. These were factors that
had sometimes been overlooked when managing
low wage workers. Now that there was a greater
cost involved ,through wages, some managers
had to change their practices to adapt to the new
Both managers, and care and support workers,
expressed concern that the Settlement, and its
associated underfunding, had put more of a focus
on money than on quality of care. Some care and
support workers reported a reduction in the staff/
client ratio, which posed challenges to safe lifting
and care of clients. The funding model placed
considerable stress on smaller providers, who
perceived the model to be more favourable to
larger providers who could, for example, spread
administrative costs across several facilities. Some
smaller providers were uncertain about whether they
could continue to operate in the future.
Home and Community Care
Three focus groups and one interview were held
with Home and Community Care managers, for a
total of seven individual participants. The managers
came from a range of providers across the country
covering both national and small local organisations.
The key themes that arose across all participants were:
The pay increase was generally welcomed for the
care and support workers.
The funding delivered through the Settlement did
not adequately cover the cost of implementation.
Rostering care and support workers to meet
client need, guaranteed hours and between travel
requirements was complex.
Qualification equivalencies to the New Zealand
Certificate in Health and Wellbeing have not met
industry needs.
There was a lack of information for managers
regarding the Settlement requirements and
Increased wages with
negative consequences
Generally, home and
community care managers
acknowledged that the
pay equity Settlement was
important to recognise
the work and contribution
that their care and support
workers made to their
organisations and clients. As one commented:
“I guess, the good thing is it’s a recognition of the
support workers and the care that they do provide.
It is an incredibly important role in society and that
does really need to be recognised” (ACM3, speaker 1).
However, although the recognition of care and
support workers was appreciated, the Settlement
had created negative consequences for those
managing the terms of the Settlement. In particular,
all managers commented that the Settlement had
increased their workload, and that the increased
administrative workload was not reflected in the
funding model:
“it’s a full-time job managing the legislation,
both financially and operationally, and for us we
don’t get any funding for that. So our contracts
are literally just to provide the client services,
and that’s a real issue for us, particularly as a
charitable trust” (ACM2, speaker 1)
Most of the managers perceived that this lack
of recognition for the full cost of administration
associated with the Settlement was in part because
managers and their perspectives were excluded from
the Settlement process:
“from the employer perspective, given we weren’t
party to that Settlement and to that agreement,
the practicalities and the logistics and the flow
on consequential effects outside of this group
has been monumental.
The decisions were made
at a high level from the
Government and a support
worker perspective without
any concern for the employer
party in that relationship”
(ACM3, speaker 2).
Recruiting and retaining care
and support workers
The increased hourly
wages had not made a significant impact on these
managers’ ability to recruit new care and support
workers. While several managers did report a higher
quality of applicant, they also noted that not all
applicants had a good understanding of the work,
and that they were motivated by the pay more than a
desire to do home and community care:
I guess, the good thing is it’s
a recognition of the support
workers and the care that
they do provide. It is an
incredibly important role in
society and that does really
need to be recognised”
“We just also have more higher calibre people
coming in the door and interested because they
see that it is more sustainable at that level of pay.
And I think that what you [other focus group
member] said is right, you really need to gently
let them know that the hourly rate is great but we
can’t really guarantee standard, regular 40 hours
a week of work. And some of the reasons for that
is that everybody needs help at the same time, so
then there is a big gap between for of 10.30 to 12
where there is no work, and then everybody needs
it at 12 and dinner here. So we don’t have the work
to give them, so I always try to let them know that
if they really need a regular number of hours of
work they need to think about whether this is the
right kind of industry” (ACM4, speaker 1).
The Settlement and costs associated with paying
wages for those on Level 3 and Level 4 had
driven a change to recruitment strategies, so that
managers aimed recruitment at applicants with no
qualifications or Level 2. This was in part due to their
changed rostering around client need, and level of
their care and support worker – as is discussed later:
“So we have had to start taking on people who
have no experience and training them up because
we could bring on Level 3s or 4s but we wouldn’t
have the work for them, so it is not fair on them
either” (ACM3, speaker 1).
Another manager commented on how they had
become more ‘selective’ in their recruitment:
“We also have changed our recruitment strategy
and we are seeking what we see as potentially
higher, or more credible, I don’t know how to
say that, more literate type of person because
then you don’t have to spend lots and lots of
time explaining what is a work ethic ? And what
are your performance boundaries? And, you
still failed that test for the fifth time, so we now
have to help you for another 3 hours! So, we are
looking for people that don’t need as much hands
on support from us, no need to spoon feed them”
(ACM4, speaker 1).
There were also cost implications for providers
in retaining Level 3 and Level 4 care and support
workers. If providers were to allocate their care and
support workers based on client need and funding,
they would need more workers with no or Level 2
qualifications than Level 3 and 4. Therefore, while
retaining good workers was generally viewed as
a positive factor, some managers could see the
negative cost implications for them and their
workers. There would be fewer hours available for
those on Level 3 and 4, perhaps leading to them
exiting the sector. If this occurred, it could also Act
as a disincentive to attain higher qualifications, for
those workers without qualifications or on Level 2:
“Well that’s right, if you can’t afford to keep them
anyway...I mean it is a concern that they will
actually have to start moving out of home care
and looking for other work and then support
workers at a lower level are going to be put off
from enrolling and completing those higher level
certificates because they know what is happening
and they know, they are starting to learn that.
So where is that going to leave us in terms of
qualified support workers? We are just going
to have a lot of Level 2 support workers” (ACM3,
speaker 1).
Generally, recruiting enough workers into the sector
was still difficult since the Settlement:
“We thought both of these pieces of legislation
[The Home and Community Support (Payment
for Travel Between Clients) Settlement Act] would
have increased our pool but right now we are all
struggling across the board” (ACM3, speaker 2).
Parity with other occupations in the sector
Participants highlighted the issue of perceived
unfairness that some care and support workers were
on Level 3 and Level 4 because of their experience
or service, rather than qualifications. This was
more obvious to managers when they compared
those unqualified care and support workers with
coordinators and office staff:
“Our coordinators who do a hugely stressful job
with rostering they are not even paid as much as
an unqualified support worker” (ACM1, speaker 1).
Several managers highlighted the relatively close
level of pay between Level 4 care and support
workers, and enrolled and registered nurses, and the
problems that generated:
“I think that the difference between a Level 4 or
greater than 10 years tenure or 12 years tenure (I
can’t remember now off the top of my head) but
they are earning just about as much as my nursing
staff and so there is some tensions” (ACM1,
speaker 1).
Experience, training and qualifications
The link between qualifications and the pay rates
under the Settlement brought a sharp focus on those
qualifications. While the managers understood the
requirement to offer training and support workers
in their training, concerns were raised as to the
motivations behind workers’ training requests. A
number of managers believed that some care and
support workers were solely motivated by money to
gain qualifications, rather than to upskill:
“Now it has become...and for the support workers
a lot of the time it is about the money. It is not
necessarily about the skilling it is just about the
amount of money. I found that they have become
quite belligerent, quite empowered and quite
demanding” (ACM4, speaker 2).
Increased training requests also placed more
pressure on managers to manage costs associated
with training. One manager spoke of their
strategies to upskill workers without seeking formal
qualifications. The manager saw this as important,
as care and support workers with higher level
qualifications may ultimately end up with fewer
hours of work, because of the provider’s desire to
match the level of support worker with the client
need being funded:
“We have more advice available to people who are
wanting to do the levels but we also have a lot of
other options for them as well. We have a lot of
special interest courses for them and a lot of them
opt to do that instead and up-skill because that is
what they really wanted to do and don’t want to
end up with less work “ (ACM3, speaker 1).
An additional cost of training was the cost of
accessing Careerforce training opportunities for
their care and support workers. The cost was not
just in paying for their care and support workers to
undertake the qualification, but in having to provide
training for someone at their organisation to assess
the practical application of the care and support
worker’s learning. This also increasing that assessor’s
workload. Generally, the participants struggled with
the complexity of the Careerforce requirements,
particularly around the role of assessors. The
requirement to complete Careerforce modules
to become an assessor seemed burdensome for
individuals who were often already registered nurses
or had other tertiary education backgrounds:
“So the option through Careerforce is quite
expensive for people in terms of what they have to
pay. And then they kind of looked internally to the
organisation to see whether the organisation can
support them to do that education, which is kind of
a tricky one, ‘cos of course if you could you would
and would want to support them, but financially it’s
not always possible“ (ACM2, speaker 1).
The cost and logistical challenges of using
Careerforce training was heightened for smaller
providers and for those who were in remote rural
areas. Careerforce was perceived by most to be
good quality training, and preferable to other
online courses, which were not seen as engaging or
effective as face-to-face settings.
One key concern around qualifications was the value
of a qualification versus practical competency, with
competency not always reflected by the level of
“I am a Careerforce assessor and we always
say that you can have the qualification, but it is
not a qual until you are competent, so it is not
competency based. What you are saying, basically,
is that you are going to get the money regardless
of whether you are doing a good job or not”
Qualification equivalency to the NZQA Health and
Wellbeing Certificate was a significant issue for these
managers. This was apparent in the participants’
perceptions of the qualifications that were assessed
as equivalent to Level 4. A participant spoke of
qualification equivalencies they had come across that
did not make practical sense to them:
“When you have got aromatherapy or social work
or some really random things that makes no sense
to me at all. You have got no skill set, nothing
in relation to being able to do this job and you
are being qualified more highly than someone
who has done this [NZQA Health and Wellbeing]
qualification... So these people are just on these
higher salaries and these higher levels but they
don’t have the skill set to be providing the care at
that level. So that’s a huge competency issue for
us that I feel is so massive and it was overlooked.
It’s huge” (ACM3, speaker 2).
Concerns were also raised with regards to fairness
to those who might have experience, but no
qualifications, being paid less than someone who
may be assessed at Level 4 equivalency while holding
little practical experience. Equivalencies meant that a
qualification was favoured over practical skill gained
through experience:
“You end up with these higher qualified people
and they are at Level 3 or 4 of the pay equity,
sometimes they’ll be at Level 4. And you will have
an overseas RN who is earning the same as a
Level 3 for pay equity who has more of at least
personal care experience however advanced it
is. There is quite a discrepancy with that” (ACM3,
speaker 1).
Another participant was concerned that the
equivalencies of some qualifications was unfair
to those that had undertaken focused units in the
NZQA Health and Wellbeing Certificate:
“So there is all sorts of weird equivalency
qualifications that have been acknowledged that
need to be on the different pay scales but they
are not relevant to our industry and that is just
not fair on somebody who has actually gone
through and done a Level 3 or a Level 4 with the
right community strand of units and gained that
qualification, they should be proud of that, they
can actually put it into practice. Whereas the
other person that has got an equivalent one, not
relevant to our industry, can’t put it into practice
but they are getting paid the same rate. There is
some real unevenness there” (ACM4, speaker 1).
Several managers felt that there was little
communication between Careerforce and home and
community care providers around the NZQA Health
and Wellbeing Certificate and accepted equivalent
qualifications. Consequently, managers felt that there
could have been more consultation and agreement
within the sector over relevant equivalencies.
Rostering and allocation of tasks to jobs
The implementation of the Settlement, along with
the between travel legislation and guaranteed
hours, impacted managers due to the increased
complexity of rostering involved in managing the
client-skill match for care and support workers.
All the managers saw this as having a significant
and negative impact on their services. This was
compounded by the fluctuating nature of the
demand for services and concomitant funding levels.
Participants had made significant changes in how
they considered rosters. One cause was some care
and support workers choosing to reduce their hours,
and availability for extra shifts, as a result of the
increase in pay:
“We have seen our workforce from my perspective
become more demanding, yes they have actually
dropped off on the hours that they do, they don’t
have to do as many hours so that’s actually great
because they are getting better rest periods
and things like that, but in a sense they are a lot
more unreliable a lot of them, you know, they flip
around a lot, ‘oh I’ll work this week, next week I
don’t have to work as much’. They just don’t have
to work as much, they get paid really well, they are
not actually going to struggle financial and stuff”
(ACM4, speaker 1).
All managers were cognisant of the qualification
level of their care and support workers, the care
required by clients and the funding attached to that,
and the actual cost of hourly wages. As described by
one manager:
“There is an imbalance now where they are getting
paid so much and we are funded according to the
level of care that we are providing, not according
to the level of the support worker that we are
providing for that care. Which means that if the
majority of the care that you are providing is at
a lower level, you are getting funded at a lower
level and you are not really funded enough to be
providing a Level 3 or 4 support worker for that
care that you’re providing” (ACM3, speaker 1).
There were two broad approaches amongst the
participants to resolving this funding and wage-cost
imbalance. First, those that rostered care and support
workers who were available, such as this:
“We don’t differentiate who we send because we
don’t have the opportunity to do that with the
sheer number and volume that we are trying to
meet everyday. We can’t be as prescriptive I guess
now about sending a Level 2 out to do housework.
So, yeah, the Level 3s are doing the housework
and we are trying now to create it as being a
whole holistic approach” (ACM1, speaker 1).
The other group aimed to reduce their wage costs
by closely matching Level 3 and 4 care and support
workers with high-needs clients. The strategy of
more closely matching care and support worker
level with client need was linked to a deliberate
shift to exclusively hiring lower qualified workers,
and reducing the hours offered to Level 4 care and
support workers:
“It is a process for them and they are beginning
to understand that there is less work for them
but obviously previous to this they were being
encouraged to do their Levels 3 and 4 but now
they say, ‘well, what’s going on? You want me to
do it and now you don’t have work for me’? And
this has been within quite a short time frame, so
they’re still catching on to the fact that there is
less work available for them” (ACM3, speaker 1).
That approach had also impacted the choices that
care and support workers made around taking up
training opportunities, as reported by one manager:
“Ones who have that experience and have
that passion and just want to actually do that
qualification to up-skill, to learn, their main
motivation is not that pay increase it really is
just to up-skill and they will often decide not to
because they want to hold on to having enough
clients” (ACM3, speaker 1).
The managers also faced further challenges to
rostering, due to the guaranteed hours and between
travel requirements. Significant stress was felt by
management and co-ordinators due to rostering
(particularly in rural areas) to maximise the efficiency
of distance travelled between clients, the matching
of care and support worker to client needs and
meeting the guarantee of minimum hours. Some
providers deliberately put care and support workers
on lower guaranteed hours, so that they could more
readily adapt to changes in clients – it was easier to
add extra hours than to maintain a higher number of
guaranteed hours:
“When it comes to guaranteed hours it is really
tricky. So because of the movement of clients as
well, and I know in our contracts there’s room to
change the guaranteed hours based on whether
the clients change, but there’s a lag process there
and once again, it’s kind of an onerous process to
go through if you’re a small organisation. So what
we tend to do is put people on lower guaranteed
hours so that we’re not constantly changing
the contract, but we’re giving them more than,
generally, what they have most fortnights” (ACM2,
speaker 1).
Another manager described how the requirements
have forced them to reduce the hours of some care
and support workers, to meet the guaranteed hours
of another:
“We had a worker who the coordinator just came
to me and said – We don’t have enough hours
for them for their guaranteed hours, and I said –
Well, we need to look at everyone’s guaranteed
hours and see who’s working more than their
guaranteed hours, because most of them will be,
then we’ll need to reduce their hours and give
some of those hours to this person in order to
get them up to their guaranteed hours” (ACM1,
speaker 1).
Several managers also
expressed a change in their
expectations of their care
work staff, as a result of
paying higher wages:
“We have got all these
people on all these great
pay rates now, we have
aided a lot of them to get
qualifications as well which has helped them go
up through those scales, but our expectation has
grown with that as well that’s an ongoing effect
really, and it goes up the chain. Our funders too
now have an expectation on providers to provide
better and more because we have got support
workers that are getting paid better and more. So
we are seeing that come right the way through”
(ACM4, speaker 1).
One manager predicted that there could be an
increased need in the future for Level 3 and Level 4
care and support workers, as individuals choose to
remain in their homes for longer:
“There is a market that we have where the need
for Level 4 that is growing but it is still very small,
so I don’t envision that it is going to rapidly
change really quickly in the immediate future. So
that is still going to take time and we still have
enough, currently enough on our books but the
requirement to keep pushing them through will
potentially get to a point where, yes, staff will be
forced to leave” (ACM3, speaker 2).
Further to the guaranteed hours requirement,
the between travel payments posed considerable
challenges to rostering and payroll administration.
In addition, the national trend of increased petrol
costs was not recognised in the government funding
for travel between clients, and therefore not paid
to workers. The impact of this in rural areas in
particular was frustrating, as one manager indicated:
“So, if you travel more than 15km from your home
to your first client you get paid at 50c a kilometre.
Most of our clients live 14.8km from the support
worker’s last job! Oh my God! How many hours
do we spend wasted on that, where support
workers just will not go and that is getting more
and more and more and
more, they just will not, the
more the petrol price goes up
the more they are refusing to
go.” (ACM1, speaker 1).
Overall impact of the
Overall, the managers saw
the Settlement as good for
workers, but as providers of home and community
care they struggled with not being well supported by
the Ministry of Health around the implementation
process. As one manager said:
“There is so much that is still unknown and there’s
no guidance for the employer now. So, if you go
to the Ministry they say it is up to you how you
choose to run this because we have given you
the guidelines and now you do what you want.
So, it feels like we are left out to dry in terms of
the decisions that we make now and that those
decisions have been challenged by the Unions.
Again, decisions are made at that high level but
the consequences we are still dealing with almost
every day because something come in” (ACM3,
speaker 2).
It’s a full-time job managing
the legislation, both
financially and operationally,
and for us we don’t get any
funding for that”
The sense of being excluded from decision-making
processes and information was extended to the
funding model for the Settlement:
“It’s almost impossible to understand the funding.
I’ve got a picture that came out a few months ago
around the bespoke funding calculation. Now, I’ve
tried to understand it, I’ve tried to get people to
explain it to me, I’ve asked the Ministry of Health
for an explanation. It’s so complicated that I can’t
make sense of it, so to some extent, it’s hard to
know what you are getting funded for, apart from
the salaries and the hourly rate. It absolutely
doesn’t… I constantly look at it and try and
understand it. It certainly doesn’t say anywhere on
it that there is anything around management costs
or quality” (ACM2, speaker 1).
The issue of the costs covered was significant; in
order to implement the legislative requirements,
additional administrative and co-ordinating
staff sometimes had to be employed. Such extra
administrative resources were not covered in the
“So our contracts are literally just to provide
the client services, and that’s a real issue for us,
particularly as a charitable trust” (ACM2, speaker 1).
There was a strong perception amongst participants
of the unions having had too much input into the
Settlement process, and that high-level government
officials were not well placed to understand the
impact of the Settlement at the coalface:
“It (the Settlement creation process) was just
hideous and the Ministry didn’t have a clue what
they were talking about. The Union were driven
on money and rights and where was the client
in all of that? I don’t even know if they were
represented to be honest” (ACM1, speaker 1).
The above quote mentions the lack of client
perspective in the Settlement process. Several
managers also commented on the Settlement’s
impact on the quality of care, as indicated in this
discussion in one focus group:
“It didn’t necessarily change the quality” (ACM4,
speaker 2).
“No, it didn’t change the quality which I think is a
real misconception” (ACM4, speaker 1).
“It didn’t change the quality it just changed their
concept of their own worth, but not actually the
quality or change of that provision that they are
providing” (ACM4, speaker 2).
As one participant noted the Settlement has
significantly changed the way that they do business:
“Pay Equity has definitely flipped around our focus
as a service provider, our focus was always on our
clients and ensuring that we are actually putting
all the supports into the client that are allocated as
flexibly as possible, and now it has gone the other
way where the focus is totally, because of all the
requirements put upon us, the focus is totally on
our supporter workers; are they getting enough
work? Are we filling up their guaranteed hours? ”
(ACM4, speaker 1).
Three interviews and four focus groups were
held with home and community care and support
workers. These included both in-person focus
groups/interviews, internet-based focus groups,
and phone interviews. A total of 15 participants took
part. Participants worked for a range of organisations
including national providers, for-profit and not-for
profit providers, and single location providers.
The major themes that arose across all focus groups
and interviews were:
Increased hourly wages were positive and
The 2017 Pay Equity Settlement appeared to
signify a change in providers’ practice of rostering,
leading to reduced hours for many.
The majority of participants were financially
worse off.
Changes to rostering had made a negative impact
on quality of care.
The regulation changes had led to increased stress
on co-ordinators and administrators, and a culture
of bullying and abuse in the sector.
Impact of the 2017 Pay Equity Settlement
Participants appreciated the increased hourly wages
which made a big difference to their income:
“Don’t get me wrong, I really like the pay equity, I
really like the fact that I went from minimum wage
now to what is it $24 something an hour from
doing exactly the same work for 15 bucks, hey, you
can’t really complain about that!” (ACW5, speaker 1).
While the increased hourly rate was appreciated,
some participants noted that their tax level had
increased. For some participants, who had to work
more than one job to bring their hours up to a
liveable income, there was the burden of a higher
secondary tax rate. Several participants also noted
that the increased price of petrol had reduced the
overall positive impact of the Settlement. This had a
big impact in home and community care because of
the reliance on the care/support worker using their
own car and petrol:
“I think the straw that has broken the camel’s back
is the price of fuel, at the moment, that is just, ‘oh
my goodness, how can we afford to do this’?! I
know that I struggle with that, I find it really hard”
(ACW4, speaker 2).
Some participants noted that the mileage rate paid
differed from other industries, highlighting that it did
not really cover actual costs:
“I don’t understand why we’re not like every other
organisation and just claim 70 cents per kilometre
for every kilometre we do” (ACW1, speaker 1).
Participants felt a sense of pride and appreciation
that their work and skill was better recognised
through the Settlement:
“I think that the pay increase has really helped
us because for someone like myself and [Kath]
who have been doing this job for many, many
years and always been on really low rates so to be
recognised and to be put up to a decent wage has
been really good” (ACW6, speaker 2).
There was also a sense of achievement amongst
some participants over the success of the Settlement,
and its impact on women in New Zealand:
“The Pay Equity was a wonderful campaign, it was
really hard work. It follows on with New Zealand’s
history of being pretty proactive in trying to create
an equal workplace but it has still got a long way
to go” (ACW4, speaker 2).
However, this sense of recognition was undermined
for the majority of the participants by the way
in which the Care and Support Workers (Pay
Equity Settlement) Act 2017, the Home and
Community Support (Payment for Travel Between
Clients) Settlement Act 2016 and the Guaranteed
Hours Funding Framework combined had been
implemented in their organisations. As explained
later, this had an overall negative impact on
participants’ morale, work conditions and finances.
Many felt strongly that they were worse off after the
“That’s why I say it is a waste of time. The only
thing that came good out of that was the amount,
the hourly rate, because we were all right down on
low money to my mind” (ACW2, speaker 1).
Changes to rostering and the availability of
guaranteed hours
Participants noted that there had been significant
changes in home and community care, with
guaranteed hours and travel regulations preceding
the Settlement. Many of the participants noticed
changes to the rostering and availability of hours
after the Pay Equity Settlement. They perceived that
this was because of the complexity of managing
under the regulations, with the Pay Equity Settlement
adding an extra burden to their managers and
“I totally appreciate that it is really hard and
providers have struggled haven’t they? They
have had...for us they have had in between travel
and that and guaranteed hours, and the equal
pay. It is boom, boom, boom, and in between that
they have tried to change their systems to try
and incorporate it too, so there has been a lot of
change for the providers” (ACW4, speaker 2).
Most participants reported that their regular hours
had reduced considerably since the 2017 Settlement.
Often, when a permanent client was lost the hours
were not replaced.
Some participants felt under pressure to sign revised
agreements with lower guaranteed hours, sometimes
on a regular basis - multiple times per year. In some
cases, they were advised that if they did not sign the
revised agreement then they would be placed on
a casual agreement, and therefore would lose any
entitlement to guaranteed hours:
“They did it to me once trying to change my
contract and I said, ‘no, no, this is what it is and
I am not signing another contract’, ‘oh, but then
you will go on the casual thing” (ACW1, speaker 1).
Another way in which guaranteed hours was
implemented was the way that ‘relief’ (when a care
and support worker provides care to cover another
worker on leave, or a temporary client) clients were
notified to participants. Several participants reported
that they would be contacted at times when they
were scheduled to be travelling between clients
and, therefore, could not answer their phone safely
or legally while driving; or that they would receive
a phone call or text from their co-ordinator during
scheduled care for a client. This would place them in
the difficult position of not wanting to compromise
client care, but potentially missing the call:
“So all the support workers would get these
calls, ‘can you do so and so’? ‘When do they
need it’? ‘Within half an hour’, I think one of
them it was 5 minutes time that you are meant
to be somewhere. This sort of thing and it puts
pressure on us. We are getting thrown things
while we are with other clients or in the car or
while we are still in bed asleep, things like this, out
of our hours” (ACW4, speaker 2).
“I was over at a job this morning and I got six
calls while I was there and that is a job I can’t just
stop...they just ring and ring and ring to see if you
can...and then, like you are saying, if you haven’t
acknowledged that you will take the next job
then you’ve potentially turned down the work so
then you lose your hours because you have to be
available for the work. It never used to be like this
did it?” (ACW6, speaker 1).
Some were contacted and offered relief hours that
clashed with their current permanent clients:
“When you have got a client away and then like
I went down there the other week and I said,
‘this client’s gone into a home’, then they start
texting you with ridiculous times, ‘can you go to
this client at that time’? And you say, you can’t
because you are already booked in here. So they
are covering themselves by saying, ‘we’ve been
offering you work but you are not accepting it’,
but they offer it to you at a time when you can’t be
there” (ACW2, speaker 1).
The implications of these practices were
understandably significant for participants.
Firstly, there were drops in income after the 2017
“That’s a pretty big impact! Ever since Pay Equity
came in I’ve got no work with the company that I
was with. If I had been with them 5 years I might
be working my butt off, but because I’ve been
there 12 years at the time of the Pay Equity and I
went straight up to one of those higher figures,
bang, within months my hours just went down
and down and down... I am making less now than
I was before when I was on $15 an hour. Crazy!”
(ACW2, speaker 2).
The situation also created considerable stress in
dealing with unpredictable rosters. This participant
describes how it feels like there is constant hourly
change; being unable to predict whether a last-
minute client will be assigned. She couldn’t refuse
such changes because she relied upon relief work
after her guaranteed hours had been dropped:
“You will get a call last minute ‘can you go
somewhere quickly and do this job?’ For people
who want to work and sort of know where you are
going for a whole day instead of just always being
‘can you go here now? Can you go there now?’
every hour it is quite stressful working like that
when you have always had a permanent roster and
you know where you are going all day and these
are your clients. And now with the guaranteed
hours, once they’re cut you will only get relief
work. It is very, very rarely you get offered another
permanent client” (ACW6, speaker 2).
“You know it is another of those problems that’s
come up but I get very frustrated every time the
phone rings, it’s like, ‘oh God, what’s this’? And
you are in the middle of showering somebody”
(ACW3, speaker 4).
Participants noted that the irregular hours and
clients made it very difficult to track their hours on
payslips, and that often payslips were not accurate.
Some noted an increased amount of (unpaid) time
spent following up administrative details like these
with their co-ordinators and
“I find I get kind of fobbed
off quite a lot. Things like
we have been guaranteed
paid for breaks and we
haven’t got any breaks, we
haven’t got guaranteed
anything for breaks. We
have to do so many things
outside of our guaranteed
hours like ringing up and
finding out stuff. We have
to follow up on every pay, every week because our
pay is wrong every week so we have to ring up
and send emails and try and chase up things that
we weren’t paid for and figure out where it was”
(ACW3, speaker 3).
Aside from a reduction in hours, many participants
had rosters that were physically and emotionally
demanding. Several participants reported that
their clients were scheduled in a way that did not
acknowledge the need to get from one to the other,
or give time to contact their co-ordinator if needed.
No one reported having a roster that included time
for them to take breaks (other than those whose
hours were spread across 12-hour days). Some
reported very long days, with their hours spread over
what could end up being a 13-hour day, for example:
“So you might work for 8 hours or 9 hours a day
but it is spread over about 13 hours...It’s really
hard, so it is quite tiring and some of the people
that do just work for one provider and work
quite big shifts, they do quite a big morning one,
might have a bit of a break, and then go back for
early evening, into the evening. They get very,
very tired. Some of them might actually do an
afternoon where they do housework and that kind
of thing too, so some of them get really, really
tired” (ACW4, speaker 2).
Furthermore, several participants worked for
providers who had reduced or eliminated the
number of staff meetings throughout the year; 0r
had ceased paying their workers to attend meetings.
This had the effect of compounding the isolated
nature of working in home and community care,
especially for those working in rural areas:
“The companies, I actually
just don’t think they care to
be honest. It’s actions isn’t
it? I mean if they really care
about how the place is run
and if the workers have got
any problems or anything like
that you would think you’d
have monthly meetings, or
6-monthly meetings. They
just refuse to have meetings,
it just doesn’t happen, they
don’t want them” (ACW6,
speaker 1).
However, even non-rural Auckland participants
commented that the job was very isolated, and
that the distances travelled and time it took with
Auckland traffic meant that they seldom saw other
people who worked for their provider - sometimes
not meeting a co-worker for the first time until they
were scheduled to work together with a client.
Consequently, the impact of the Settlement
implementation by providers led several participants
to consider whether they would stay in the sector.
One participant found the stress of worrying about
their hours was affecting her home life:
“It tells on you when you come home of a night,
you know, when you are stressing about how you
are going to get money to pay this and do that and
of course he cops it because I’m in a bad mood
because I have only had like 4 hours work or
something like that” (ACW2, speaker 2).
Another spoke of how she thought - when some
clients of 10 years or more were lost - that she might
leave home and community care for residential aged
“I have started to think about maybe it would
be good to just go to a rest home. I have had 12
years rest home experience so, do a shift, get your
money, know I have worked an 8 hour shift and 8
hours paid” (ACW6, speaker 2).
One participant, who is a migrant, spoke of the
difficulty in changing employers depending on the
visa that you held. She was stuck with her employer:
The pay equity was a
wonderful campaign, it was
really hard work. It follows on
with New Zealand’s history
of being pretty proactive
in trying to create an equal
workplace but is has still got
a long way to go”
“Because I am on a work visa so I have to stay with
this company because my visa says, that is why. If it
was under skills we could move but now we have to
stick with one company” (ACW6, speaker 3).
Another participant, whose hours had significantly
dropped, would not recommend the job to anyone
“So, I have gone from bad to worse financially.
Would I encourage anybody to take on this
career? No, absolutely not, absolutely not, in
fact I would be willing to speak to their parents!!”
(ACW7, speaker 2).
Priority given to lower level care and support
workers in rostering
The participants observed that one of the reasons
for their reduced hours was that more hours were
being rostered for care and support workers who
were on Levels 1 and 2. Those who, through service
or qualification, were on Level 3 or 4 often had to
struggle to get, or maintain, their hours:
“Everyone that I was talking to at the thing the
other day, all the ones that had been there for
12 years or more and some of the other girls like
Jennifer and a few of the others out in the field
now, they have all been exactly the same as me.
They have been peeled back and peeled back and
their hours are just going down and down and
down. But they still get relief work here and there
but it is at ridiculous times” (ACW1, speaker 2).
One worker had needed to find a second job to make
ends meet:
“I have actually had to go and get another job, so I
am working for 2 different care providers and the
reason being is because I have been with them
over 12 years and that automatically put me up
to that $24 bracket. So all the ones that are on
a lesser pay rate get lots more hours than me. I
never get rung excepting for when it is a high
needs client... Then they’re ringing me and ringing
me and ringing me. I thought, ‘no, bugger you’.
I did, I thought, ‘bugger you now, why should I
bother’?” (ACW2, speaker 2).
Impact on other stakeholders
Participants, despite feeling disadvantaged by the
Settlement implementation, acknowledged not
only the negative impact it had on both their co-
ordinators and providers, but also on their clients.
Participants noted that the burden of several quick
succession regulation changes appeared to have
created high workloads and very tense workplaces.
Some did not go to their administrative offices
anymore because they had become unpleasant
places to be:
“Our coordinators looked haunted, they are
stressed to the max, people won’t go into the
office now just simply because of the atmosphere
in there so what is it like for them?” (ACW7,
speaker 2).
The stressed environments of co-ordinating
teams had a flow-on effect for participants, who
had inflexible, rushed and irritable co-ordinators
assigning clients to workers:
“I don’t take it personally, I don’t think that the
coordinators and that are reacting to us, I just
think the amount of pressure that they are on to
meet the clients, if the only requirement is to get
you there, if you say yes, then that’s it, tick. On
to the next one, tick, onto the next one. I don’t
think there is anything personal – they are under
an awful lot of pressure, the coordinators are”
(ACW3, speaker 4).
Tied in with this culture, and the changes to
rostering of hours, several participants reported
that workers were afraid to speak up because they
feared retaliation through bullying or not being given
available hours:
“There are also people that are scared of losing
their jobs by speaking up... Oh yes, oh they have
tried everything with me. Everything. Being a
bully, being patronising, you name it they have
done it” (ACW7, speaker 1).
One reported that their colleagues who they knew
to be union members were afraid to participate in
this research because of the consequences if their
managers knew they had taken part. This was also
part of a decline in workplace culture in the sector
that had led to increased bullying and a perceived
lack of care and consideration for care and support
“But then the pay equity from that point of view
has made them be less responsible for us. I mean
no support, no care and they don’t, and it doesn’t
matter now because they think, well we have
bought you with money” (ACW3, speaker 5).
This is linked to a sense of a lack of trust from
providers in their care and support workers on
several points, including their ability to make
decisions around their jobs. One participant
commented on managers’ attitude to their work as
care and support workers:
“I just think that they think you are a bunch of
peasants really to be honest. I think they think
it is just a….I did my nursing training years ago,
there are plenty of people that have done all sorts
of training and they have got people who are
really qualified people and they are just...that is
what they of the people, what did they
say? They said it is like working in a shop. It’s
disgusting, but it’s the way they think” (ACW6,
speaker 1).
Another participant commented that the Settlement
had been implemented without policy makers
speaking to the people who did the work. That
participant felt that they were undervalued as
workers, which was echoed in other comments about
care and support workers being ‘numbers’ to get
work done:
“I think part of the problem is that nobody has
ever consulted or communicated with the support
workers. Nobody: Company, Government,
anything, DHB, ACC... None of them have, or do
even on an individual client basis, speak to the
support workers and I think that is perhaps one of
the big problems in making this industry work...
We are working with very vulnerable people, we
are not delivering parcels. We are working in
often very stressful environments and dealing
with people who are also very highly stressed and
sometimes chronically stressed because of what
is going on in their lives. We are never consulted
about what a client needs, we are argued with, we
are ignored” (ACW7, speaker 2).
Another impact noted by participants was a decline
in the quality of care. This manifested in several
ways. Firstly, the way in which rosters were organised
meant that some clients did not know until the last
minute who their carer would be. This was perceived
to be a significant imposition on vulnerable clients,
who allow care and support workers into their
personal home:
“Their ordinary carer goes on holiday. The poor
people, they are 80 or 90 in the shade and they
are worried sick about who is going to turn up,
what time they are going to turn up, if they are
turning up. It is so stressful on these people and
that is what the whole thing is about, the care of
these people out in the community, that is the
whole point of it” (ACW6, speaker 1).
There were also instances where a replacement
worker had not been scheduled, or a client would not
accept a change in time, and so they would miss their
care for a given week:
“So all the support workers would get these calls,
‘can you do so and so’? ‘When do they need
it’? ‘Within half an hour’, I think one of them it
was 5 minutes time that you are meant to be
somewhere. This sort of thing and it puts pressure
on us. We are getting thrown things while we
are with other clients or in the car or while we
are still in bed asleep, things like this, out of our is not fair on the clients, really not fair,
because sometimes some clients wouldn’t even
get covered because they couldn’t find relief and
that’s dangerous” (ACW4, speaker 2).
Sometimes new, less experienced workers were
scheduled to a two-person client. This made the job
tougher for existing carers, as the less experienced
person may not have had training or experience in a
two-person lift, and carers were often left caring for
a client together with a colleague they had never met
or worked with:
“Yes because Level 3 and 4 is more palliative care
and complex care and what they do is that if you
go to a place and there is meant to be 2 people,
they will put somebody in there that is Level 3 or 4
and they will top it up if the other partner is away,
with a 1 or 2. It all comes down to money” (ACW6,
speaker 1).
Training and qualifications
There was a range of work experiences amongst
the participants. A majority of them had significant
experience in their jobs, and were paid at Level 3 or
4 due to their length of service with their current
provider. Most had been offered training, although
some had not been proactively offered training in a
similar way to their colleagues. In those instances,
participants perceived that because of their age
(late 50s, early 60s) they were not seen to be worth
investing in. One of these participants commented
that she appeared to be left off lists for training even
though she undertook, and enjoyed, more complex
Some other participants did not want further training
because they were not interested in the more
complex work:
“I’m on Level 3 and I’ve been offered Level 4, but
that’s more into the high care needs, it’s almost into
nursing things, like doing stoma bags and
things like that, and I’m not a nurse in any sense of
fashion. So I’ve declined that” (ACW5, speaker 1).
Another wryly commented on whether it would be
worth gaining Level 4, because it would most likely
lead to a drop in rostered hours:
“Then on the other hand I hear that some of the
girls we work with say that it is pointless doing
Level 4 because you’ll never get any work because
of the higher pay rate again, you see” (ACW6,
speaker 1).
One participant noted that she had discussions
with her employer over the types of jobs she would
do as her tenure meant that she was on a more
senior level. Her provider expected her to take more
personal care clients rather than the majority of
housework assistance. She did not want that, but was
unable to decline the increase in pay:
“Because I’ve got 17 years of service I go to the
top level. So my boss tries to tell me that because
I was on the top pay rate I should be doing the
hardest work... And I said – Well, I’m not actually
on that pay rate because of my level, I’m on that
pay rate because I’ve worked with you for so long.
So I went to see her and they reassured me that
what I was telling them was fine, and they couldn’t
enforce, you know, they couldn’t expect me to do
more of the personal care” (ACW1, speaker 1).
Several participants appreciated the more
challenging, and rewarding work having Level 4
qualifications allowed. This included working in
palliative care, and with complex clients. This was
important to their enjoyment of the work, and their
sense of value as workers. Another spoke of how
the Settlement had been motivation to gain her
“Yes, it has got a big influence on me, I mean, I have
been in this industry nearly 30 years and I am flying
mostly on experience. It is only in the last seven
years that I have actually got down and got the
qualifications and I have just complete the Level 4
certificate in health and well-being, so it has been a
big motivator for me” (ACW3, speaker 3).
Several participants noted issues with qualification
equivalencies, which overlook relevant practical
“I find it hard that someone who has a Social
Work Diploma can come in and get the Level 4
qualification. I actually think it’s wrong that it is
cross credited because they are not as capable as
someone who is a Level 2 or 3 who has been here
for years with [our provider] working. It’s wrong.
Do you know what I mean?” (ACW3, speaker 6).
Furthermore, several reported a shift to online
training that had no practical exercises built in. They
perceived this choice to be made due to the lower
costs of the training:
“One thing I had noticed is that... a lot of our
training has now become online training rather
than face-to-face training” (ACW3, speaker 2).
Those who had noticed this shift questioned the
utility of online learning for practtical application,
especially if there wasn’t on the job skill assessment
or training:
And apart from the guaranteed hours it is the
whole thing of training as well, so they are
training people up but it is all done in modules
on the computer isn’t it? I don’t know if they are
physically go and learn how to lift or you watch a
video” (ACW6, speaker 1).
In some cases, the support to undertake training had
also changed with a shift to online training modules:
“I guess the main difference is with the face to
face training you got paid for it. The organisation
I worked for paid you for it whereas the online
training you don’t have time to do it during work
so you do it in your own time” (ACW3, speaker 2).
Finally, while expressing frustration and
disappointment with how the Settlement had been
implemented, participants also expressed how
they thought the system could be improved. Firstly,
several noted that policy makers were too distant
from the work itself, and had not sufficiently taken
into account the knowledge and views of those who
actually work in the sector. Secondly, several noted
that care provision and funding in the sector was too
complex, and felt that it needed to be given more
priority and centralised. This may allow service to be
provided in a similar way District Health nurses are
organised by District Health Boards as:
“In the past I think it used to be a way of earning
a bit of extra money, but these days it should be
considered a career. And I really believe that it
should come under the DHB and be like District
Nurses where we have work
vehicles and not have all these
different organisations doing
all that they do... it’s kind of
outgrown having contracts,
the organisation’s contract
to get the work, and really it’s
become… it really needs to be
managed by the DHB” (ACW1,
speaker 1).
It was clear from both managers and care and
support workers that the combination of the Home
and Community Support (Payment for Travel
Between Clients) Settlement Act 2016, Guaranteed
Hours Funding Framework, and the Settlement
had placed significant pressure on managers and
co-ordinators. This was to the extent that care and
support workers reported unpleasant workplaces and
a high level of bullying within the sector. Several care
and support workers avoided needing to visit the
administrative offices because the work environment
there made them very uncomfortable. Care and
support workers felt that most of their colleagues
were afraid of speaking up – that speaking up would
result in reduced available hours, reduced training
opportunities. This, combined with management’s
reduction of staff meetings and opportunities
to meet other care and support workers in their
organisation, meant that many of the participants
experienced a strong sense of isolation.
The requirements of these combined legislative
changes were complex and unwieldy for both
managers and care and support workers. Managers
reported struggling to meet guaranteed hours
requirements while working within funding shortfalls
to roster an appropriate and cost effective level of
care and support worker to each client. Between
travel payments were a disincentive to both care
and support workers, with some care and support
workers refusing clients because of the client’s
location. Both managers and care and support
workers noted that, with increasing petrol prices, the
travel payments did not cover petrol costs. Care and
support workers found it difficult to keep track of
whether they had been paid
correctly, which sometimes
was not the case, because of
payslips that differentiated
each different pay rate.
In response to tight budgets,
managers were working to
closely match client need
(funding) with the level, and
wage cost, of their care and
support workers. They reported that there were
fewer hours available for those care and support
workers who were Level 3 and Level 4. They
also aimed to recruit those on Level 2 or with no
qualification because this matched the majority of
their clients’ needs, and was more cost effective.
Some managers discussed training opportunities
with their care and support workers, explaining
that as they increased in level there would be fewer
available hours. Managers’ experiences concurred
with care and support workers’ reported experiences.
In the past I think it used to
be a way of earning a bit of
extra money, but these days it
should be considered to be a
The majority of care and support workers reported
that since the Settlement their hours had been
reduced. They had felt pressured to agree to
reductions in their guaranteed hours. For many of
the participants, the reduction in hours meant that
they were financially worse off after the Settlement.
Care and support workers noted that managers’
changes to rostering meant that sometimes clients
could miss care, or have new carers at short notice,
and sometimes inexperienced carers – all of which
had a negative impact on the quality of care for
Managers felt that many equivalent qualifications
were not well suited to home and community care,
which meant that they could have workers on Level 4
who did not really have the skills and competencies
required for the job. Some care and support workers,
who were on Level 4 because of the length of their
service, were reluctant to take on care for complex
clients (deemed to be appropriate for Level 4).
Both managers and care and support workers
expressed that in their opinions the Settlement and
its process had been decided by policy makers at a
high level - managers pointed the blame towards
Unions as much as the Ministry of Health - who had
little or no knowledge of the actual work and how it
was conducted day to day.
The Disability Support Sector
Four focus groups were conducted with managers
in the disability support sector. These were held
across New Zealand and represented day services,
community services and residential living. A total of
10 managers took part.
The key themes that arose across all participants were:
Equivalencies of qualifications and their relevance
to the sector.
Concerns and uncertainty around training
expectations for workers.
Increased expectations of support workers’
Poor implementation support from government
The pay increase was well deserved and needed
Overall, the managers were supportive of the
Settlement, and the recognition it gave to their
support workers. As several commented:
“I totally believe in the fairness of the Settlement
and the purpose behind it” (DM1, speaker 2).
“It really lifted that and gave recognition to an
incredibly demanding job and rewarding job at
the same time” (DM2, speaker 1).
“There is an emerging value around training
amongst our staff“(DM2, speaker 2).
The positives for the sector were: attracting better
qualified staff, increased interest in training and
progression by many staff, and an increase in
responsibility from those staff who are at higher
qualified levels. However, participants also identified
concerns related to funding of the Settlement’s pay
and training requirements.
Experience, training and qualifications
The majority of the participants expressed concerns
over the tension between qualifications and
experience, and the pay rates at each level. As one
manager mentioned:
“Experience does not always equal competence”
(DM1, speaker 2).
Another manager also highlighted this tension:
“Someone at Level 4 who gained that Level 4
but they are not really good carers, they are not
good carers because they don’t have a basic
understanding of how to care for people” (DM3,
speaker 2).
These concerns stemmed, in part, from a general
distrust of external non-Careerforce training
programmes, which were perceived to provide
less rigorous training. This created a perception of
unfairness on current staff, who were more skilled
but may not yet have their qualification. It also posed
questions for the quality of care:
“Level 4 is a whole different can of worms but I am
seeing people turning up on our doorstep looking
for work and, as I said, the pool is pretty small to
start with, and so they are fronting up with a Level
3 Certificate in Health and Wellbeing that they
have gained by attending training with an external
training provider and we have to pay that person
Level 3 pay rate, or if it is Level 4, Level 4 pay rate
without having any input into what it is that they
have learned, what their habits are or anything
like that. This has two side effects: One is that
the existing workforce who may have been with
the organisation longer but haven’t been there
long enough are getting paid less and the other is
that the standard of training that they are getting
at those external providers is, I would say in some
cases, almost negligible” (DM2, speaker 2).
One manager expressed a concern that the
qualifications and associated training did not
necessarily have any correlation with what a care and
support worker role required, and how many support
workers were needed at each level:
“There is a wording in the Settlement about the
need to provide opportunity to do Level 4, that
doesn’t mean that we have to put all positions
or roles under Level 4. I think we need to be
very smart about what roles, based on their
competencies, need what level” (DM1, speaker 2).
The connection between skill and qualification
was also raised with regards to the Settlement’s
transitional arrangements for workers with no
qualifications to be paid according to their length of
service with their current provider. Some care and
support workers with long service were now paid
at Level 4 but were not able to work at the expected
level. Some raised the concern that care and support
workers who may have previously entered the job
due to its perceived low skill and qualification may
now be excluded from the sector:
A lovely lady who is illiterate... she can’t do
personal cares because she can’t read the care
plans. She is now on the top rate and our ability
to give her work is really difficult and so people
like that who have slogged away for years and
years in the system are actually going to be
squeezed out and the population of people who
you may employ who has been in this group are
not necessarily as attractive as perhaps they once
were” (DM3, speaker 1).
“There is now a barrier to people who may have
found caring work in the sector because they had
issues like ESOL, dyslexia etc. Now they will be
excluded potentially” (DM4, speaker 1).
Some managers found the training requirements
difficult to afford and implement, and there had
been changes to the training offerings in their
organisations. Most of the managers commented
that they are now offering fewer opportunities to
“We are not encouraging people to progress”
(DM4, speaker 1).
Training offerings were reduced despite their care
and support workers’ increased interest in training:
“There has been a bigger uptake of wanting to do
Level 4. The minute Pay Equity came in it was,
‘when can we do our Level 4s’? Never shown any
interest before but hello!” (DM1, speaker 3).
For one manager, the induction process for new
staff became unpaid, as a result of the Settlement.
Nevertheless, that same manager reported an
increased uptake of further optional training:
“Induction has changed. The expectation is that
people will do unpaid training now whereas
before we paid for all our training that was one of
our flagships. But that has not stopped the uptake
of the optional training which is quite interesting.
So people are...induction now encompasses your
Level 2. So once you have been verified at the
end, you’re done, you are at Level 2 immediately.
The Level 3 is quite weighty in our sector, there’s
a lot of papers to get through and you need to
be pitching everything quite high but people are
powering through it. Whereas before people were
disengaged and just bums on seats, yes I attended
so therefore...There is a shift.” (DM4, speaker 1).
An issue with respect to casual staff and training
was also raised; whether providers’ obligations were
the same as for their permanent care and support
workers. The lack of clarity for some managers was
compounded by the difficulty in gaining good advice.
Providing training to casual workers also presented a
practical challenge:
“I emailed the Ministry and said, ‘what do we do
about casuals’? They said, ‘oh, they don’t count’.
Then at a provider meeting recently, I think it was
NZDSN [New Zealand Disability Support Network]
said, ‘yes they do’! So who is right? What do you
do about part timers? How are you supposed to
put somebody through Level 2 within the first 12
months of their employment if they are only at
your facility 6 hours a week? How is that meant to
happen? You can’t expect them, if they have got
another job, to drop everything. It is just a whole
lot of stuff and when we have talked about it
before, we talked about it at Ministry meetings, we
have talked about with the Union and they love
this phrase ‘unintended consequences’” (DM2,
speaker 2).
The funding of training was also raised as
problematic, with fear of consequences if the
requirements were not met. Several managers
expressed concern over not fully understanding
the requirements, and the difficulties of gaining the
correct information:
“Some of the other things that you haven’t
touched on yet is the complete disagreement
between the signing parties, being the Union and
Ministry of Health around the actual dollar value
of funding per worker to provide their training.
I haven’t yet managed to talk to anyone who
can down to an operational level say, ‘OK, this is
this person and this is what they did in the last
year, this is what they worked, how much money
do I get for that person to train them’? It is an
unanswerable question” (DM3, speaker 3).
Another manager commented on training funding:
“It has just developed back to a gross percentage
figure and they said, ‘here is this spreadsheet’,
and I’m too dumb to work it out so was all their
finance people and our HR and we are all too
stupid to work that out unfortunately, down to an
operational level, and you are just sitting there
scared as anything that you are going to be the
company that gets taken to court and made an
example of and that is what you absolutely don’t
want, what you live in fear of” (DM3, speaker 1).
Recruiting and retaining workers
For several managers, recruitment has not
significantly improved since the Settlement:
“One of the things that we were sold was that this
was going to professionalise your workforce, you
are going to get a whole lot more well trained,
professional people, you are going to have all
these people rocking up at your doorstep with
these qualifications and they are going to be really
super dooper and you are going to have a much
more qualified pool of people to choose from.
None of this eventuated at all, in fact, I think it
is harder now to recruit decent staff than it ever
was” (DM2, speaker 2).
In contrast, several other managers had noticed
improvements in recruiting:
“Our last intake, the quality was really high and
we had half of them were men, were males, they
were young, they were really high calibre” (DM1,
speaker 1).
“There is that push to get good quality staff with
good qualifications in and build that potential to
have longevity in the actual sector is there and
that pay equity has allowed us to do that” (DM1,
speaker 3).
One manager reported an initial spike in interest
after the Settlement, but that for many applicants the
reality of shift work was a deterrent. Overall, many
managers were still struggling to attract the right
candidates for the roles needed. The staff mix that
was required drove some recruitment approaches:
“You are never going to put out there that we will
choose a Level 0 over a Level 4 to replace a Level
4 but you have got to think about it because now
we are legislated to pay people up to Level 4”
(DM3, speaker 1).
Turnover, however, had dropped amongst support
workers, according to most of the participants. This
was explained by care and support workers losing
their higher pay rates (due to length of service) if
they changed providers. However, several managers
did report significant changes to staffing levels (in
non-support workers) since the Settlement:
“We’ve lost of a lot of senior management, a whole
tier disappeared, and that was a direct result, we
have lost an arm of our services and we were told
that was as a result of pay equity” (DM4, speaker 1).
A number of managers did raise the issue of possible
restructuring, and the increased or potentially
increased use of performance management
measures because of the wage rises through the
“Restructures end up having to be done because
people are in the wrong jobs doing the wrong
things” (DM1, speaker 2).
“Yes, and as a manager I loathe to restructure for
the sake of getting rid of people and I don’t do it
for that reason but actually unfortunately think
that eventually that is what some organisations
will end up doing because it will be based on the
need of the role and sometimes people don’t fit
that anymore and the sector is changing” (DM1,
speaker 3).
Rostering and allocation of tasks to jobs
Rostering had been challenging prior to the
Settlement, with funding per client varying
depending on who the funder was (e.g. ACC, District
Health Boards, the Ministry for Social Development).
Tight budgets post-Settlement meant that managers
were looking more closely at their rosters and the
hours available for care and support workers. One
manager discussed how their organisation was
essentially subsidising the shortfall in funding:
Actually Ministry contracts are only 6 hours per
client and we pay staff 8. So the 2 hour extra is
paid by the organisation not by the contract, so
why do we need them for the extra 2 hours? So
you really do have to start looking at the actual
need of what staffing you need to match what the
client wants. If the client is only paying you for
8 hours service, then actually you only need to
match that person with someone that will work
with them. So we do a lot of client matching now,
so we recruit to the need
of the client which is a
really good method to use
because that is where it
should be, it should be
choice and control of the
client but it is tough for
us” (DM1, speaker 2).
Another manager noted that
they now used more part
time staff and casual staff:
“But our services like our supported independent
living, they are all casuals and again that is because
they are recruited to the person as required, so they
are recruited to need” (DM1, speaker 3).
Innovative approaches to managing resources also
surfaced, with some organisations working together
to ensure they had the care and support workers
they needed, and so that good workers also had
sufficient hours, albeit across several jobs:
“To the point where we do that between
organisations now, particularly with part time staff.
So I have no qualms about ringing up partners …
and saying, ‘look, we have got eight hours that we
need to deliver and this person wants three on
a Saturday and two on a thing, do you have any
of your part time staff that want to pick up more
hours’? So I think collaboration and partnership,
if you are willing to do it, it is still a siloed sector,
people are still quite…” (DM1, speaker 2)
All the managers had heightened expectations of
their workforce as a result of the increased wage
levels. This was particularly evident with respect to
those on Level 4. Since the Settlement, managers had
an explicit expectation of leadership in their Level 4
“Nobody is wanting to do the team leader
role. Because they are quite happy with less
responsibility, getting paid more at Level 4 and then
the middle management is again affected because
the pay difference between a team leader and a
middle manager is not huge” (DM3, speaker 2).
Another manager commented that expectations were
higher, and the tasks were
broader for Level 4 staff:
“We do expect them to work
harder, especially our team
leaders and we are asking
for a lot more accountability
from our team leaders. We are
asking them to be managers
which they haven’t been really
and we are asking them to do
a lot more of the stuff around
performance management of
their staff and for them to take more responsibility
around the budget for the home that they manage
and so on” (DM2, speaker 2).
There is that push to get
good quality staff with
good qualifications in and
build that potential to have
longevity in the actual
sector. Pay equity has
allowed us to do that”
The impact of significant increases in wages for
support workers in the sector had created issues
in respect to parity with other workers in the
sector. This meant that individuals in roles, such
as team leaders and service managers, as well as
administrative roles could perceive the pay raises
to be unfair. If an organisation chose to provide
comparable wage increases in these roles, it would
be an additional cost burden:
“Because in the Settlement there was no pay
parity between management and the support
worker we haven’t, as an organisation, been able
to look at, or actually at our detriment we have
had to pay our team leaders and service managers
and those doing different roles to support work at
a different rate. So financially it has been a bit of a
burden on the organisation” (DM2, speaker 1).
When looking at other roles in the provision of care
to clients, one manager expressed concerns over the
application of the pay equity to a narrow group of
just support workers:
“For me it would be getting the people that don’t
have the title support worker on their contract
paid at a rate that actually truly represents the
job they do. So we have got different levels that
work at different points along our stream and I
can’t pay them any more than what the support
workers are getting paid yet these are the people
that are doing top level stuff but I am stuck with
this Pay Equity that goes boomph because they
haven’t got support worker on their contract, I
have to go back to [Amanda] and we have got to
find money in our system somewhere to put them
up to a level that actually truly reflects the job they
are doing because there was no money put in the
original Pay Equity Settlement for those people”
(DM1, speaker 3).
The managers in the focus groups named several
other significant challenges for their sector as a
result of the Settlement. A significant challenge was
that there was insufficient consultation with the
sector, and that clear, readily accessible information
was not available due to the speed with which the
Settlement was implemented. Several managers
commented that the implementation process should
have been slowed down. One manager expressed
disappointment over the focus of the Settlement:
“It was payroll orientated and wasn’t outputs
orientated...lack of faith that the sector could
actually deliver the Settlement levels to individuals
as per a high trust environment” (DM3, speaker 4).
Another also thought that the Act and its
implementation did not take into account how
different the disability support sector is to the aged
care sector which was the focus of the Settlement
and Act:
“The disability sector just tagged on to aged care,
yet the aged care sector is relatively stable service
delivery, disability is going through a fundamental
shift in delivery of care model” (DM3, speaker 2).
However, it was seen as a positive change by one
manager, who saw that the Settlement could have
positive long term effects:
“I have hope for Pay Equity in 10 years’ time, you
look at the future, you will have different focus
of the staff that are coming through because our
younger staff that are coming through are social
work, psychology degrees because the start rate
is potentially the same as their peers starting as
behavioural psychologists or social workers so we
are getting a better calibre. It doesn’t mean that
the work, yet, is there, because there is this shift in
the focus of how we deliver but we are definitely
seeing a change” (DM1, speaker 2).
Participants noted that the Ministry of Health’s
support and information was insufficient and this
raised concerns for the ongoing implementation of
the Settlement:
“The appalling lack of support from the Ministry
around how we go about setting this up and
putting it in place or anything like that. I have
seen no one, I have heard of no one, I have
been flying by the seat of my pants and we are a
moderately sized small provider. I don’t know how
people that are really small providers, that may
have like 20 staff or less, have managed” (DM2,
speaker 2).
The feelings of disengagement and isolation were
summed up by one manager’s comment:
“When Ministry came to do the first feedback
show, in August I think it was, it was very poorly
advertised, I was surprised when I got into the
meeting and basically 50% of the people were there
that I expected and when Ministry presenter came
and said, ‘this is like walking into an air plane and
where’s the pilot’? That was the sort of feeling and
it describes it actually quite well. There are many,
many, many gaps. Those gaps can become very
big, very quickly” (DM2, speaker 1).
One manager was concerned about possibly ongoing
negative impacts of the Settlement because of its
origins in a Legal case, which meant the focus of
policy makers was reactionary rather than one of
strategic planning:
“I am not sure the ripple wasn’t planned.
It came from a court case so this has not been
planned through and we are reacting and
responding now and doing the best we can
but a lot of things are falling over. I would like
somebody with an overarching vision to say, OK,
this is where we are now and how are we actually
going to make this work moving into 2020” (DM4,
speaker 1).
A final challenge, noted by the majority of the
managers, related to the administrative cost of the
additional staff and resources required to implement
the Settlement. This was compounded by the
multiple contracts in the sector:
“So MoH [Ministry of Health] did it, MSD [Ministry
for Social Development] did it and the ACC
[Accident Compensation Corporation] did it in
good faith and none of them worked together:
we had different spreadsheets from Ministry of
Health and different from MSD and then ACC just
added it to the figure, so there was no...They didn’t
want to know because, I mean, ACC’s contract are
high trust faith contracts and MSD and MoH tend
to be accountability based so the spreadsheets
were up the wazoo with what you had to deal with
and it took a lot of work and time and effort to get
all those sorted. So I think if they had have just
worked together a bit better” (DM1, speaker 2).
Role of the unions
Managers had a mixed response to the role of the
union in their sector. Several commented that they
had low unionised workplaces, but that this had
increased slightly since the Settlement. One manager
saw the value and necessity of the union in the
campaign for pay equity:
“So, although it originated from a gender
inequality way that is probably because that was
the only way that this could have been got this
huge political backup because if they came up
with carer rate inequality I don’t think it would
have got this traction” (DM3, speaker 2).
However, another manager saw the union
involvement as the unions wielding too much power
in the workplace. Nevertheless, this manager still felt
they had a good relationship with the union on site:
“The attitude of the union during this has changed,
the power aspect of it, because obviously they are
on the news with the balloons and they are, ‘way
hay we are all wonderful’! That was noticeable
for us and we have a great relationship with the
union and we told them about the changes to our
contracts and our job descriptions because we
wanted if one of our staff says, ‘I’m going to go to
the union’, we go, ‘fair enough’, knowing that there
are no secrets so I think that is a great position to
be in and it works well” (DM3, speaker 4).
Six participants took part across three different focus
groups. Participants came from cities and towns
in the North and South Island (although not from
Auckland); and from day support services, residential,
and community support providers.
The key themes that arose
amongst the participants
The pay equity
Settlement had
improved their personal
They now felt more
They would now be
more likely to stay working in the disability support
sector because it felt increasingly like a career.
Positive impact of the Settlement
Overall, participants strongly felt that the Settlement
had made a positive impact. It had been positive for
their personal finances, making it easier to get by
“The increase in wage makes it comfortable to
actually live and for me it has just made the job
more secure kind of thing, because it is more of a
wage and you are not struggling too bad” (DW1,
speaker 2).
The same participant observed that it must have
made it easier for those working on casual contracts
in the sector:
“I know a couple of people that are casual on
the lower wage end, that made it hard for them
because yes, the casuals here do get quite a few
hours but if you are not working that full 40 hours
that is not really enough to live on. So even if you
are working three days a week or whatever that
is still not enough but with that extra few dollars
an hour that is making it more liveable to still be
a casual and have that little bit of freedom if they
don’t need the full time every week, which I have
noticed” (DW1, speaker 2).
Another participant in community disability support
noted that the increased pay rate meant she could
have more choice in the hours she worked:
“I think that’s one of the big drivers being able
to work less hours if you want to or you can still
chase those hours if you want to. It is having that
option, which is good” (ACW3, speaker 2).
There was a sense of
achievement amongst some
participants, and participants
felt that they were appreciated
and valued more after the
“Pay Equity, winning that
battle after so many years was
really welcome, we were all
celebrating it. It was a long
battle and of course it didn’t
come easy because we battled
everybody all the way through it, it was taken to
court, and went right through to the Supreme
Court” (ACW4, speaker 1).
Pay rates
For one participant, who held a more senior
support worker role, the Settlement had not been
beneficial because she continued with the same
responsibilities, but with less differential between
her and other support workers. This was a contrast
to one other participant, who also held team leader
responsibilities, but was paid an additional allowance
for her responsibilities.
The increase in wage makes
it comfortable to actually live
and for me it has just made
the job more secure kind
of thing, because it is more
of a wage and you are not
struggling too bad”
Some participants reported that managers were
now reluctant to consider pay increases after the
Settlement, including for items that were not part
of the Settlement pay increases, such as a uniform
allowance. It had also negatively impacted on the
participants’ ability to negotiate weekend rates,
where those existed:
“They kind of think that the pay increase that
you get in July through Equal Pay is enough so
even getting allowances like clothing allowance
increased, a weekend allowance increased, has
been hard” (ACW4, speaker 1).
On the other hand, the Settlement pay rates, and
feeling appreciated, meant that most of participants
now felt that they were happier to remain in disability
support work:
“Like a lot of people I would look for something
else that was better paid. I think it has been
undervalued for a long time. It is certainly a step
in the right direction to reward people for the hard
work that they do, I don’t think it is recognised”
(DW1, speaker 3).
Training opportunities
The participants all had opportunities for training,
with most agreeing that training was readily
offered in their sector prior to the Settlement. One
participant noted that not so many people used to
take up the training opportunities:
“It was always [available], when I started four
years ago, it was when it was offered at the job,
obviously not many people used to take it on but
it was there” (ACW4, speaker 1).
A different participant highlighted the usefulness
of having specific training and qualifications, in
addition to their other qualifications that had put
them on Level 4 equivalency:
“Our organisation has always paid for the
Careerforce training and Level 3, I had a degree
before I started so I chose to do the Level 3
because I hadn’t had worked in the disability
industry before. So for me, that was quite useful
for me to actually get a different view and to work
through, I think with colleagues as well” (DW1,
speaker 3).
Another participant felt that the training was now
more worth it both for the participant and also their
“In terms of training, I feel like for me personally it
probably has brought more training opportunities
because it has made it more comfortable to stay
in this job long term... and because of that pay
people are here longer so they are more likely to
invest because it is not like you are going to invest
into someone’s training and then the pay is so
low, two months down the track they are gone. I
feel like the organisation gets more back from
the training because of the pay increase” (DW1,
speaker 2).
A participant from a residential facility commented
that at their facility, training needs to be done at a
high level, and perhaps in-house, because of the
needs of their clients – some of whom are non-
verbal. The same participant observed that, at her
facility, there were a number of support workers who
had not taken up any training, and she felt that they
should – or exit the sector:
“I kind of look at some of the staff that are around
in places and I think they have been there far too
long to be giving benefit to the people, it is just
the pay cheque. So the people are missing out and
they’re the people that have been there for many,
many years without doing any of the qualifications
that are available” (ACW4, speaker 1).
That participant felt that training was crucial in
order to maintain and improve quality of care.
However, the contrast between younger (or newer)
support workers who completed their Careerforce
qualifications with those who had been with the
organisation for 12 or more years, and earnt more but
had not studied for any of the qualifications, was a
little galling for this participant. She spoke of a lack
of parity between these workers:
“So the younger people that are working and
doing Careerforce are thinking, ‘well these people
are sitting on their backsides now getting more
than I what I am getting but doing less work’.
And it is hard to point out that they had to have a
base line of something for time spent in the work
place. So it caused a lot of disharmony in a lot
of people that work at [our place] for that simple
reason; ‘these people sit on their bums all day and
don’t do much, I am working and getting less pay’”
(ACW4, speaker 1).
Rosters, hours and job descriptions
The participants in this study mostly had sufficient
and steady hours, although in one residential care
facility, there had been a change in how extra hours
were offered. This was perceived to be done in
order to reduce costs. That participant spoke of
how people used to be able to pick up extra hours,
sometimes on a sleepover after a day shift; up to
a total of 120 hours per
fortnight. However, these
additional hours had been
harder to come by after the
Settlement, with part-timers
and a ‘casual pool’ being
offered additional hours
before full time staff.
Some participants noted a
small change in how much
work they were expected to
do after the Settlement, but
it was more that managers
asked them to do small extra,
often administrative tasks.
Where the manager had
previously - prior to the Settlement - been a little
apologetic for adding these to the support workers’
tasks, they now were not.
Attracting new people to the industry
All the participants agreed that more people were
attracted to working in the disability support sector
since the Settlement. Generally, they perceived that
people joined the sector because they felt passionate
about the work, but that the low pay rates had been
a barrier:
“I think it has been a disadvantage in the past
because people do get into this work because of
the way they care about other people. And I think
that had been used quite a lot because there will
always be people here that will do it because they
love doing it and supporting people. I think now it
recognises that, but also it may bring more people
into the industry that will actually stay longer now
rather than going, ‘this is a stepping stone for me
to something else’” (DW1, speaker 3).
Another participant agreed, adding that it would
bring people not just with the passion, but with the
right skills as well. The Settlement had given the
acknowledgement needed:
“This actually requires skills, it requires a lot of work
and it requires the right people to be in the industry
and I have definitely seen that you are getting
more, kind of a trickle of those of people coming
in who are doing it for those
reasons. I mean I think that
will definitely be something
that is really, really cool” (DW1,
speaker 1).
Another participant spoke
of how they thought that
the Settlement had already
changed the way people
viewed the sector:
“Rather than being, just, ‘I’ll
do it right out of High School
in between jobs’, it is actually
to me, I look at it as a career
path... but actually now my
career, for me, is to be a support worker and that
feels really nice for me to say that and people
really acknowledge it” (DW1, speaker 4).
Both managers and care and support workers agreed
that the Settlement brought a well-deserved pay
rise that recognised the work done by care and
support workers in the disability support sector.
The Settlement had had made a positive impact
on care and support workers who not only felt
more appreciated, but also now viewed this as a
sustainable job. Prior to the Settlement, although
they enjoyed their work and thought it was
important, the wages were not sufficient to sustain
over a career. Managers perceived that, although
it was not significantly easier to recruit new care
and support workers after the Settlement, they
were generally able to attract a different calibre of
This actually requires skills,
it requires a lot of work and
it requires the right people to
be in the industry and I have
definitely seen that you are
getting more, kind of a trickle
of those of people coming
in who are doing it for those
reasons. I mean I think that
will definitely be something
that is really, really cool”
Although having well-skilled and knowledgeable
workers was important, several managers reported
having changed how they offer training in their
organisations, since the Settlement. This included
ceasing to pay their care and support workers for
time spent in training, as well as offering fewer
opportunities to staff. This was, in part, because of the
increased costs associated with more people wanting
training. Managers were also reluctant to provide
training to care and support workers who previously
may not have shown any interest in it at all.
The managers were concerned about the relevance
of some qualifications to the disability support sector,
particularly where equivalency or qualifications
from lesser-known providers were concerned. Some
managers reported that they did not feel that there
was a good connection between the experience
someone had, their qualification level and the
corresponding pay rate. One example given was of
someone who may have extensive length of service,
but not a high competency level. These concerns
were exacerbated by uncertainty around their
obligations as an employer with respect to training
their care and support workers. Some managers
had been unable to get clear and direct information
about how training is funded.
Both managers and care and support workers
noted that, since the Settlement, care and support
workers had often been given additional tasks to
complete because they were now paid more. In
some providers, changes to rosters had been made,
reducing the availability of hours to care and support
workers - in comparison to the hours that had been
available prior to the Settlement.
Overall, the increase in wages for care and support
workers was welcomed in all three sectors by both
managers and care and support workers. However,
the way in which the Settlement was funded and
implemented led to several negative consequences
for both providers and care and support workers. The
following points identify some of the major themes
that arose across all three sectors.
Changes to hours and rostering
In residential aged care, smaller providers struggled
to survive in the current funding model. They had
changed their service provision and often had made
cuts to staff numbers or hours available to care and
support workers: some care and support workers
in residential aged care experienced a reduction
in their hours. Managers in home and community
care highlighted the complexity of managing the
introduction of three separate pieces of regulation
within a short timeframe, while attempting to match
the qualification level of care and support worker to
client need in an effort to minimise cost. Home and
community care managers said that the majority of
their clients did not need the level of care associated
with Levels 3 and 4 care and support workers.
Managers in home and community care had mostly
responded to these regulatory changes in a way
that reduced the hours available for their Level 3
and 4 care and support workers, to the extent that
several participants reported that their hours had
halved since the Settlement. This, as well as active
discouragement from managers, dissuaded care
and support workers in home and community care
from wanting to complete their Level 3 and Level 4
It appeared that some managers used practices
that attempted to meet the bare minimum of the
guaranteed hours framework, but were perhaps
somewhat disingenuous, such as contacting
their workers when they were scheduled to be
with a client. This was done in order to cut costs,
and reduce the hours of high-cost employees. It
appeared that the burden of implementing the
regulation had escalated tensions and bullying in
the sector, which had not been as apparent prior to
the Settlement. These issues were reported by most
managers and care and support workers across
several providers, and are a significant negative
consequence of the way in which the Settlement was
Expectations of ‘Level 3’ and ‘Level 4’ workers
Both managers and care and support workers across
all three sectors expressed a disconnection between
a qualification attained and the competency of a
care and support worker to carry out their tasks.
This was most apparent for those who were on Level
3 or Level 4 under the transitional arrangements
that recognised their length of service with their
current employer. Some of these care and support
workers provided skilled, high quality care, and their
managers and colleagues thought the higher wages
well deserved. However, there was a cohort that
were perceived to be either less willing to perform
at a higher level, or less able to. There was some
dissatisfaction that this cohort, being on Level 3 or
4, could be paid a higher rate than someone who
had attained a Level 2 qualification and provided an
excellent quality of care.
The other issue that arose was that of qualification
equivalency. Most of the participants did not see
the pertinence of some qualifications that were
assessed as equivalent to the Level 4 Certificate
in Health and Wellbeing. There was concern that
this equivalency did not include assessment of the
care and support worker’s skill and competency.
The scope of equivalency assessment is based
on meeting graduate outcome requirements. The
Level 4 Certificates include an expectation of 200
hours’ work experience “which contributes to the
achievement of the qualification’s outcomes” and
therefore equivalency includes this requirement.
However, the findings suggest that a review of Level
Overall Conclusions
4 and its connection to the previous levels may
be useful to ensure that the knowledge and skills
acquired are well understood by all stakeholders and
that graduate outcomes remain relevant within these
sectors. The researchers understand that a review of
these qualifications is underway at the time of this
In some cases, managers’ interpretation of what
was expected at Level 4 had increased since the
Settlement, despite the qualifications themselves
not changing. Across all three sectors, there was
evidence of an increased workload for Level 3 and
4 care and support workers. Both managers and
care and support workers (in residential aged care
and home and community care) reported more
complex care tasks being given to Level 4 care and
support workers – some of which were delegated
from enrolled or registered nurses. This was in
part due to the smaller gap between the hourly
wages, and perceived issues of parity between these
occupations, after the Settlement.
Quality of Care
Quality of care had potentially declined in both
residential aged care and home and community
care, and to some extent in the disability support
sector. In residential aged care, this was due to lower
staff ratios, which meant those rostered on would
have higher workloads, and that clients requiring
two carers for lifts might wait longer for attention,
for example. In home and community care, issues
with scheduling relief carers for clients meant that
some clients would not know who would visit them
in advance. This also meant that a care and support
worker might not be familiar with the client’s specific
needs. In some cases, a client might miss a day’s
scheduled care because of issues with rostering.
Several managers in residential aged care pointed to
the inadequate funding creating a focus on money,
not care. One manager in home and community care
thought that the complexity of guaranteed hours,
between travel, and the pay equity Settlement meant
that they focused more on their care and support
workers than on their clients.
A valued career?
One of the intents of the Settlement agreement and
Act was to create an environment that would attract
new people into the care and support workforce, as
it would have higher hourly wage rates in addition
to guaranteed opportunity for development and
career growth. One year after its implementation,
there was little evidence of this happening, with
most managers reporting no change in the number
or quality of applicants for care and support worker
positions. There was some evidence that this was
different in the disability support sector, with a
small increase in higher calibre applicants to new
positions. Some participants in the disability support
sector felt that the increased wages made the job a
sustainable career for those who enjoyed the work
and did it for its contribution to society. This was not
as evident in the other two sectors. Although no clear
reason was given for this difference between sectors,
the funding models and aims in the disability support
sector are clearly around (as new frameworks allude
to) a more encompassing model of care that extends
beyond physical cares to supporting people to take
part in communities and live fuller lives.
It is likely that with some positive messaging around
care and support work, it will gain more value and
respect within society, thus attracting a wider range
of people to the work. It may also take time for the
increased wages and training requirements to be
understood in the wider community. This would be
supported by a consensus amongst managers on the
value of the role – recognising that its skill and worth
had been devalued by historic gender discrimination.
Comments made around managerial, enrolled and
registered nurses, and kitchen and cleaning staff’s
perception of the increased wages indicate that
not everyone has accepted the higher value and
recognition of care and support work when once
gender discrimination is removed as a factor.
Lack of information from the Ministry of Health
Both managers and care and support workers, across
all three sectors, felt that there was a lack of support
and information available from the Ministry of
Health. They thought that there had been very little,
if any, consultation with the people who actually
manage and do care and support work on a daily
basis. The lack of attention to what it takes to provide
care and support work was perceived to be behind
flaws in the funding model. This lack of consultation
was exacerbated by the rapid introduction of the Act
and short timeframe within which providers had to
prepare for and respond to the changes. Managers
and care and support workers felt isolated and
unsure of their rights and obligations. Managers
largely agreed that the funding was inadequate
and did not cover the costs associated with the
Looking forward
This research was conducted in the latter part of
2018, one year after the introduction of The Care
and Support Workers (Pay Equity) Settlement Act
2017. Some of the issues raised (e.g. perceptions of
care and support work as a career; the impact on
the number and quality of applicants for care and
support worker positions; length of service, actual
competency; the increased need for management
to conduct close performance management;
and understanding of the levels of qualification
and expectations of the work to be done by
workers at each level) are likely to resolve over
the implementation period as both managers and
care and support workers adapt and become more
familiar with the requirements of the Act.
However, the consequences for two cohorts of care
and support workers must be addressed. Firstly,
there is a cohort who are now expected to carry out
more complex tasks and do not want to, or cannot.
Without change to the current system, a cohort
of care and support workers who do not complete
the qualifications and perhaps do not have the
competency required at Level 3 and 4 may find
themselves without work. This includes care and
support workers who may face literacy or other
learning issues that create barriers to their success
in this career. Secondly, there appears to be a large
cohort whose hours have reduced: they are now
financially worse off because of the reduction in their
regular hours. Funding models and policy advice
must be reviewed with these cohorts in mind - or
significant numbers of women will be disadvantaged
by the implementation of legislation that was meant
to eradicate gender discrimination in wages and
conditions for the care and support workforce in
New Zealand.
These recommendations are based on the issues
identified by managers and care and support workers
in this study. The recommendations are primarily
aimed at sector-wide policy initiatives, but could
be the responsibility of a range of stakeholders
- including government bodies, provider
representatives and unions. These recommendations
are suggested in order to recognise the intention of
the Settlement: to create a skilled, flexible workforce
that can work across these three sectors, and to
value the work without gender discrimination.
Creating a culture of value
Consider an industry wide ‘public service’
campaign that highlights the value of care and
support workers to our communities and society
(examples have come from past union campaigns
highlighting the importance of this work).
Value the ‘clients’ – highlight the difference that
care and support workers make to the lives of
older people and people with disabilities. This
emphasises care over profit, and encourages a
broader approach to care to support all clients to
enjoy full lives, participating in society.
Training and Qualifications
Review the NZQA requirements for Level 4
qualification equivalency so that it connects to
the graduate outcomes of Levels 2, 3 and 4 of the
NZQA Certificate in Health and Wellbeing.
Review the graduate outcomes of Levels 2 to 4 of
the NZQA Certificate in Health and Wellbeing to
ensure consistency in expectations amongst all
stakeholders of how the qualifications relate to
the skills and knowledge required across these
sectors; emphasising that successive levels build
on the previous ones.
Revise funding models with regard to the actual
cost of training.
Ensure accessibility of quality training to small
providers, and those in rural areas.
Workforce Development
Focus on literacy initiatives and other appropriate
strategies to better support passionate and skilled
workers who may face barriers to attaining the
New Zealand Certificate in Health and Wellbeing.
Improve affordable professional development
opportunities for managers, to assist in their skill
and confidence to manage in a more complex
Role expectations
Support the development of agreed sector-wide,
generic job descriptions, with examples of tasks
required by level in each of the sectors.
Develop clearer and more consistent funding
models that are attached to the cost of employing
care and support workers (across the levels), rather
than attached to bed or client types.
Develop funding models that recognise the
importance of having a range of providers
available to communities in New Zealand.
Specifically, ensure that funding models are
appropriate for small providers.
Communicating the Settlement
Continue to develop readily accessible ‘FAQs’ for
both managers and care and support workers that
clarify their rights and obligations. This should be
designed to be accessible to those with literacy
challenges, and in languages that reflect key
cohorts in this workforce.
Care and Support Workers (Pay Equity) Settlement Agreement. Retrieved from
Careerforce (2019). Qualifications. Retrieved from
E Tū and PSA (2017a). Guaranteed Hours – Calculation Method. Retrieved from
E Tū and PSA (2017b). Guaranteed Hours – Frequently asked questions. Retrieved from
Ministry of Health (2017a). Care and Support Workers (Pay Equity) Settlement Operational Policy Document.
For Aged Residential Aged Care. Retrieved from
Ministry of Health (2017b). Care and Support Workers (Pay Equity) Settlement Operational Policy Document.
For Community and Residential Living. Retrieved from
Ministry of Health (2017c). Care and Support Workers (Pay Equity) Settlement Operational Policy Document. For
Home and Community Support Services Providers. Retrieved from
Ministry of Health (2017d). Care and Support Workers (Pay Equity) Settlement. Payroll Processing Guidelines.
Retrieved from
Ministry of Health (2017e). Employer Factsheet. Care and Support Workers (Pay Equity) Settlement Agreement.
Retrieved from
Ministry of Health (2017f). Guaranteed Hours Funding Framework (Transitional Arrangements for the period 1
April 2017 to 30 June 2018). Retrieved from
New Zealand Qualifications Authority (2014a). Qualification Details: New Zealand Certificate in Health and
Wellbeing (Level 2). Retrieved from
New Zealand Qualifications Authority (2014b). Qualification Details: New Zealand Certificate in Health and
Wellbeing (Level 3). Retrieved from
New Zealand Qualifications Authority (2015a). Qualification Details: New Zealand Certificate in Health and
Wellbeing (Advanced Support) (Level 4). Retrieved from
New Zealand Qualifications Authority (2015b). Qualification Details: New Zealand Certificate in Health and
Wellbeing (Social and Community Services) (Level 4). Retrieved from
Treasury (2017). Budget 2017 Information Release. Release Document July 2017. Retrieved from
Legislation referred to
Home and Community Support (Payment for Travel Between Clients) Settlement Act 2016
The Care and Support Workers (Pay Equity Settlement) Act 2017
Appendix 1. Agreed Hourly Rates
2017 to 2022
Qualification 1 July 2017 1 July 2018 1 July 2019 1 July 2021
No relevant
qualification $19.00 $19.80 $20.50 $21.50
Level 2 $20.00 $21.00 $21.50 $23.00
Level 3 $21.00 $22.50 $23.00 $25.00
Level 4 $23.50 $24.50 $25.50 $27.00
Length of Service 1 July 2017
Year 1
1 July 2018
Year 2
1 July 2019
Year 3 & 4
1 July 2021
Year 5
< 3 years OR $19.00 $19.80 $20.50 $21.50
3 to 8 Years $20.00 $21.00 $21.50 $23.00
8 to 12 years $21.00 $22.50 $23.00 $25.00
12+ years* $22.50 $23.50 $24.50 $26.00
12+ Years $23.50 $24.50 $25.50 $27.00
Hourly Wage rates for workers employed on or after 1 July 2017
Hourly wage rates for workers employed before 1 July 2017, based on service
*This rate is applicable if the worker commenced employment with the employer on or after 1 July 2005; and had not attained a
Level 4 qualification; and the employer provided the support necessary for the worker to attain Level 4.
NZ Work Research Institute
... The proactive engagement by the NZHRC in the Coalition continues to make a strong link between the issues of decent work and quality aged care within a human rights context for both workers and aged people in care (Blue, 2014). It remains active today, including in monitoring the implementation of the Equal Pay Settlement (Douglas and Ravenswood, 2019). ...
... Perhaps not surprisingly, there have been some practical implementation issues with several aspects of the negotiated aged care settlement (see Douglas and Ravenswood, 2019). In essence, despite the significant additional government funding noted above, parts of the settlement continue to be underfunded in ways that, in effect, continue to construe aged care work as not quite fully 'work' in the full industrial sense (Charlesworth, 2017). ...
This article explores the apparent conundrum of how, with minimal employment standards and limited equal pay laws, New Zealand managed to significantly redress the gendered undervaluation of low-paid aged care work. To draw out the pathways to these reforms, we focus on the long-term strategic coalitions that underpinned them. We examine, in particular, the activism of a diverse range of policy actors – unions, employers, industrial and human rights bodies and civil society groups, which together have worked to ‘undo’ the limitations of equal pay and employment regulation. Our findings point to the benefits of strategic collaboration between policy actors in New Zealand and an approach which recognises the intersection of unequal pay with other gendered dimensions of disadvantage in aged care work. Different strategies used over time by diverse actors helped them overcome inadequate industrial and equal pay infrastructure to realise meaningful increases in hourly rates of pay, buttressed by improved working time arrangements and provision for career progression. We conclude by highlighting some lessons for institutional and policy actors in other national settings drawn from the New Zealand collaborative approach to equal pay in care work.
... The act was amended to include mental health and addiction support workers in 2018. Although these new legislative changes were ostensibly funded, research indicates that the full costs associated with each change were not funded (Douglas & Ravenswood, 2019;Moore, Ryan & Doust, 2018). The act also limits further claims under the Equal Pay Act 1972 during the five-year period of its implementation. ...
... The implementation of the settlement did not always result in positive outcomes for care workers. For example, particularly in home and community care, some care and support workers were worse off after the settlement because of managerial choices aiming to reduce costs (Douglas & Ravenswood, 2019). ...
This article examines policy responses to the issue of pay equity and equal pay spanning the period of the National-led government in New Zealand (2008-2017). This is a period during which Prime Minister John Key stated in the media that equal pay and pay equity was not affordable and, therefore, not a priority. This article critically analyses employment policy developments in relation to women within the context of the espoused neoliberal value of non-intervention in the employment relationship. We argue that, overall, improvements in pay equity, equal pay and gender equality at work stalled under the National-led government. Further, we argue that under a neoliberal rhetoric of a flexible and free labour market, equal pay and pay equity is something to be controlled and explicitly dealt with only when either politically expedient or financially affordable.
... Rather than resourcing at the community level, funding is linked to individual clients, who are constructed as 'empowered' consumers of care (Macdonald, 2021a;McGregor, 2001). Combined with strong pressures for government to reduce costs, in reality, individualised care translates into the provision of the bare minimum, which is regularly below the care levels that are needed (Douglas & Ravenswood, 2019). Further, the individualised funding system erodes the working conditions of HSWs, as perclient funding is passed from government departments to providers, translating into piecemeal, per-client pay. ...
Technical Report
Full-text available
Home Support Workers (HSWs) care for older people as well as people with disabilities and long-term conditions by providing personal support with activities of daily living in their homes. They deliver a range of services that enable people to take part in their community, to have quality of life, recover from and cope with challenging situations. This can include the provision of medications, cooking, cleaning, and often intimate personal care work. For example, an HSW might assist a person to get out of bed in the morning; perhaps using technology such as a hoist. They might assist with hygiene and ensure that a person has had their mediciation. HSWs perform specialised tasks for people with complex conditions. Most importantly, HSWs ensure people can live a life with dignity. As in many Western countries, in Aotearoa New Zealand this work has traditionally been underpaid, classed as un-skilled and continues to be undervalued. However, as became even more evident during the COVID-19 pandemic, HSWs do essential, highly skilled work in caring for our most vulnerable and isolated, while putting themselves at considerable risk. With the onset of serial health crises combined with an ageing population, it becomes vital that governments take action to ensure the long-term sustainability of this workforce. We argue that this is particularly relevant in contexts such as Aotearoa New Zealand, where services are publicly funded and privately delivered by mainly for-profit providers. New platform technologies are currently being introduced by providers, both private and non-profit, to mediate relationships between care recipients (clients) and HSWs. They have been publicized by actors within the homecare sector as a potential solution to challenges related to health sector strains associated with an ageing population. And much like in other sectors, platform technologies such as apps are represented as offering empowerment for workers and autonomy for clients. This report critically investigates these claims and the broader impact of the introduction of platform technologies on the working lives of HSWs and their ability to provide dignified care for their clients. Drawing on 16 in-depth Zoom interviews and 1 focus group with Aotearoa-based HSWs, we argue that platform technologies as currently used are exasperating pre-existing systemic failures, which have also been severely exposed by the COVID-19 pandemic. We summarise their experiences through the four themes of Digital Frustration, Precarity, Health and Safety and Communication Inequality, highlighting a lack of input for HSWs into the purpose, design, implementation and monitoring of the technology. We argue that this lack of voice is linked to the publicly funded and privately delivered system, which often puts private gain before the interests of care workers and their clients. Digital Frustration We found that a lack of input into the design of the technologies and communication channels being used by HSWs impacts not only worker wellbeing but also the quality of care that can be provided. Precarity We found that the technologies often add to the already significant burden of unpaid labour, while cementing trends towards de-skilling and loss of professional autonomy. Health and Safety We found that during the COVID-19 crisis failures in platform technology and other communication systems left HSWs and their clients exposed to undue risks, while a lack of respect and recognition from both providers and the public further cemented a perception of HSWs being under skilled. Communication Inequality We found that the technology renders HSWs as constantly accessible to providers, but at the same time they lack access to decision-makers and sufficient information on their clients to do their jobs safely. Overall, the evidence indicates that platform technology is being used to increase economic efficiencies for the private providers, rather than increase quality, safety and effectiveness of services. To ensure that the new technology contributes to a sustainable workforce and high-quality care going forward, we make the following recommendations (see Conclusion section for more details): 1. Improve the systemic context surrounding platform technology. Rather than providing a band aid to a broken system, we argue that for the technology to improve care and empower workers it must be introduced within a context of increased funding and stronger accountability mechanisms. 2. Include worker voice in the development of human-centred platform technology. Rather than economic efficiency as the only driver behind the design and implementation of platform technology, we argue that the voices of HSWs must be included through an adoption of the principles of human-centred design, which are grounded in wellbeing and user satisfaction.
... Notwithstanding adjustments in pay equity, travel, and hours over recent years (Douglas & Ravenswood, 2019), this workforce continues to face issues of irregular hours, lack of job security, and concerns over earning a living wage from their work (Ravenswood et al., 2021;Ravenswood & Douglas, 2022;Health and Disability System Review, 2020). Few community support workers work standard hours. ...
... This is despite evidence that care workers, as professionals, are expected to have significant skills that cover; (a) health and medicine, (b) values and philosophies of care, (c) literacy, numeracy, language and communication, (d) technology and digital, (e) employability skills and (f) body work (Hayes et al., 2019). In New Zealand, care worker pay was recently increased and is linked to qualifications and experience (Douglas, 2019). The increase has been welcomed, but workloads and duties have also expanded. ...
Full-text available
Context: The work presented in this paper was undertaken during the first three months of the COVID-19 crisis in the UK. Objectives: The project is aimed to respond to questions and concerns raised by front-line care staff during this time, by producing research-based ‘Top Tips’ to complement emerging COVID-19 policy and practice guidelines. Methods: Eight rapid, expert reviews of published, multidisciplinary research evidence were conducted to help answer care home workers’ questions about ‘how’ to support residents, family members and each other at a time of unprecedented pressure and grief and adhere to guidance on self-distancing and isolation. A review of the emerging policy guidelines published up to the end of April 2020 was also undertaken. Findings: The rapid reviews revealed gaps in research evidence, with research having a lot to say about what care homes should do and far less about how they should do it. The policy review highlighted the expectations and demands placed on managers and direct care workers as the pandemic spread across the UK. Implications: This paper highlights the value of working with the sector to co-design and co-produce research and pathways to knowledge with those who live, work and care in care homes. To have a real impact on care practice, research in care homes needs to go beyond telling homes ‘what’ to do by working with them to find out ‘how’.
... New Zealand has been in the limelight due to landmark legal action such as the 2017 Pay Equity Settlement. This settlement dramatically increased wages for care and support workers in order to address historic gender pay discrimination (Douglas & Ravenswood, 2019). This is a seemingly divergent approach from other jurisdictions which have taken more laissez-faire attitudes towards addressing inequality and workers' rights. ...
Conference Paper
Full-text available
Call for abstracts for the stream 'Improving Workers Rights - politics, social change and the workplace' at the Association of Industrial Relations Academics of Australia and New Zealand annual conference in Queenstown (New Zealand) in February 2020. Abstracts close Friday 27th September 2019. Full details on the conference website
This paper investigates the way in which COVID-19 has exacerbated the poor work conditions within community support work in Aotearoa-New Zealand. It examines the invisibility of care work in New Zealand during the COVID-19 pandemic, in terms of Government policy and communication, societal recognition of care work, and the spatially hidden nature of the work. It does so within the of gender norms in the socio-cultural, socio-spatial and socio-legal spheres that render this work and workers invisible. This paper documents the experiences of community support workers and contributes to our theoretical understanding of frontline health workers’ experiences of work during a global public health crisis.
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