Workforce Visibility in Residential Aged Care
Residential aged care is a significant site of social need in contemporary Australia. Alongside nursing care, personal care, and assistance with daily living, residents and families encounter relocation, loss of home, grief, family conflict, loneliness, cultural dislocation, safeguarding concerns, supported decision-making, complaints processes and end-of-life uncertainty. These issues are not secondary to care; they shape residents’ dignity, wellbeing and quality of life.
Recent reforms, including the Aged Care Act 2024 and Aged Care Rules 2025, strengthen expectations around rights, safety, dignity, wellbeing, person-centred care and provider accountability. However, a key workforce question remains: which forms of care labour are made visible within the regulatory model of residential aged care? This article argues that residential aged care increasingly requires forms of practice closely associated with social work, but does not structurally embed social work as a core profession. Nursing and direct personal care are essential and should not be displaced. Rather, the issue is that the strongest regulatory mechanisms make some forms of labour measurable, reportable and enforceable, while psychosocial, relational and rights-based work remains less visible. In this sense, the forms of labour that are counted most clearly become those most strongly recognised by the system.
Counted Labour in Residential Aged Care
The Aged Care Act 2024 establishes important workforce obligations for residential aged care. Approved residential care homes must have at least one registered nurse onsite and on duty at all times, subject to exclusions and exemptions, and prescribed providers must deliver direct care in accordance with the Aged Care Rules (Aged Care Act 2024, ss. 175 - 176). The Aged Care Rules 2025 then operationalise direct care through the care-minutes framework, including calculation of average care minutes and registered nurse care minutes (Aged Care Rules 2025, ss. 176 - 5, 176 - 15, 176 - 20).
The care-minutes framework is grounded in the Act’s definition of “direct care”. Under the Aged Care Act 2024, direct care refers to prescribed funded aged care service delivery by a direct care staff member, including a registered nurse, enrolled nurse, nursing assistant or personal care worker (Aged Care Act 2024, s. 7). Since 1 October 2024, the care minutes framework has been expressed as a sector-wide average target of 215 care minutes per resident per day, including 44 minutes of registered nurse care (Department of Health, Disability and Ageing, 2026).
This model has clear policy strengths, as it responds to long-standing concerns about inadequate staffing, clinical risk, and insufficient direct care. It also provides a measurable basis for oversight when providers report relevant care hours, which support monitoring and potential regulatory responses. Counted labour therefore becomes more than a reporting category; it becomes part of the system through which care quality is monitored, assessed and regulated.
However, this produces an important analytical problem. The care-minutes framework does not simply measure care; it also shapes which forms of labour are most visible within the system. Registered nurse, enrolled nurse, personal care worker and assistant in nursing time become measurable, auditable and compliance-relevant. Other forms of care may remain valued in principle, but they are not embedded with the same regulatory force in the principal staffing model.
Psychosocial Labour Outside the Counting Framework
The Aged Care Act 2024 and the Aged Care Rules 2025 contain broad commitments that closely align with social work practice. High-quality care is framed in terms of dignity, self-determination, mental health and wellbeing, meaningful activity, connection to family and community, privacy, reablement and culturally appropriate care (Aged Care Act 2024, s. 20). The broader aged care framework also emphasises supported decision-making, access to advocates and supporters, complaints processes, restrictive-practice safeguards, behaviour support, information provision, and care and services planning. These obligations are not merely clinical or administrative, but require relational, psychosocial, ethical and systems-informed practice to translate rights and quality standards into residents’ and families’ everyday experience of care.
In residential aged care, residents and families may require assistance to understand rights, raise concerns, negotiate conflict, adjust to relocation, manage grief and loss, navigate substitute decision-making, respond to possible elder abuse, or maintain dignity within an institutional environment. These functions align closely with social work’s commitments to human rights, social justice, self-determination, advocacy, cultural safety, critical reflection and person-in-environment practice (Australian Association of Social Workers, 2020, 2023).
The difficulty is that these psychosocial functions are not attached to a named and counted residential aged care profession in the same way. Social work is neither prohibited in residential aged care nor irrelevant. Social workers may be employed in some settings, and social work-type functions may appear indirectly through care management, advocacy, transition support, complaints work or psychosocial support. However, in the dominant residential workforce model, social work does not sit alongside nursing and direct care as a core counted staffing category.
Labour excluded from formal counting and reporting mechanisms is more likely to be positioned as discretionary, supplementary, or dependent on local provider priorities. Psychosocial work may therefore be recognised at the level of policy principle while remaining weakly embedded in workforce structures. A central tension emerges: residential aged care increasingly adopts a language of rights, dignity and wellbeing that aligns closely with social work, yet the workforce mechanisms through which care is organised do not clearly recognise social work as a core professional carrier of these commitments.
Importantly, residential aged care is not devoid of psychosocial or wellbeing-oriented labour. Lifestyle and activity workers, for example, make important contributions to leisure, social participation, everyday engagement and residents’ quality of life. However, lifestyle work should not be conflated with social work. While social engagement and activities are important components of wellbeing, they do not necessarily encompass the professional scope required for psychosocial assessment, family mediation, supported decision-making, safeguarding, complaint support, grief and loss work, or rights-based advocacy. The presence of lifestyle roles indicates that residential aged care recognises certain dimensions of wellbeing, but it does not address the absence of a clearly embedded psychosocial profession within the residential aged care workforce.
Social Work’s Distinctive Contribution
Unlike contexts such as the United States, Canada or Ireland, where social workers are more established in long-term care teams, Australian residential aged care has yet to structurally recognise a role that existing literature already shows is needed. Hardy et al. (2020) argue that social work can contribute to integrated, person-centred and holistic practice in residential aged care. Lee et al.’s (2022) Australian pilot evaluation further demonstrates that social work in residential aged care can provide a distinct contribution through independent third-party support, transition assistance, family-centred work, role clarification and preventive intervention.
These contributions should not be absorbed into generic “wellbeing” language. Social workers bring a particular professional orientation: psychosocial assessment, family systems awareness, advocacy, ethical judgement, grief and loss work, safeguarding sensitivity, interdisciplinary collaboration and attention to structural power. In residential aged care, this orientation is directly relevant to everyday practice. Admission to care is not merely an administrative event; it can involve grief, guilt, fear and conflict. Complaints are not merely service issues; they can involve power, voice and vulnerability. End-of-life care is not only clinical; it is also relational, cultural and existential.
Noble and O’Sullivan’s (2009) question of whether social work remains a distinctive profession is therefore still directly relevant. Their article examines social work distinctiveness in a context where social workers may compete with allied professionals for recognition, service provision and funding, and where multifunctional health and social care systems create challenges for professional role clarity. Residential aged care is such a setting. Psychosocial work may be dispersed across nursing, lifestyle, pastoral care, care management, complaints processes and provider duties. When this occurs, social work’s contribution can become simultaneously necessary and invisible.
The issue is therefore not simply whether social workers could be useful in aged care. The deeper question is whether aged care systems can recognise social work as a distinct form of professional labour. Without such recognition, social work risks being absorbed into broad language about support, wellbeing or person-centred care, even where the complexity of the work requires professional social work expertise. This is a professional identity issue as much as a service design issue.
Implications for Social Work Education, Practice and Policy
The care-minutes model illustrates a wider challenge for residential aged care reform. While recent reforms recognise broad rights and wellbeing goals, workforce accountability remains organised around narrower categories of counted direct-care labour. The importance of reform is not diminished, but reform remains incomplete if psychosocial care is not given stronger structural visibility.
These issues have important implications for social work education. Residential aged care should not remain peripheral within social work curricula, placements or professional formation. It brings together many of the profession’s core concerns, including dignity, grief and loss, family systems, culture, power, rights, advocacy, institutional life and end-of-life care. Yet aged care is often less visible than fields such as mental health, child protection, hospitals, family violence, disability, homelessness or justice. Nagaddya et al. (2025) argue that preparing social work students for gerontological practice is essential to a sustainable aged care workforce. The marginality of social work in aged care is therefore not reproduced through policy alone, but also through curriculum, placement availability, supervision structures and professional imagination.
Aged care placements should therefore be more than observational or generic support experiences. They should enable students to practise psychosocial assessment, family meetings, advocacy, supported decision-making, grief and loss work, complaints support and interdisciplinary communication. Given the ethical complexity of residential aged care, students and practitioners also require appropriate supervision and structured opportunities to reflect on vulnerability, risk, institutional power, cultural safety, family conflict and professional boundaries.
There are also implications for practice and policy. Residential aged care requires clearer social work role descriptions that move beyond generic statements about “supporting wellbeing”. These descriptions should name specific functions, including psychosocial assessment, transition and adjustment support, family mediation, supported decision-making, complaint support, rights explanation, safeguarding consultation, grief and loss work, end-of-life psychosocial care and contribution to organisational learning.
Finally, if social work remains outside the principal counted workforce model, aged care policy should develop complementary mechanisms for recognising psychosocial labour. These could include clearer reporting categories for allied health (including social work), minimum access expectations, funded pilot models, quality indicators, or stronger guidance on when residents and families should have access to professional psychosocial support. The profession itself also has a role to play by articulating more clearly what is distinctively social work in residential aged care, developing field education pathways, supporting supervision models and producing practice resources that make aged care visible as a legitimate social work territory.
Conclusion
Australian residential aged care now emphasises dignity, rights, wellbeing and person-centred care, yet its strongest workforce mechanisms continue to privilege a narrow set of counted direct-care roles. Nursing and personal care are made measurable and enforceable, while social work remains less structurally visible despite the clear need for psychosocial, relational and rights-based care.
This article does not argue that social work should replace nursing or direct care. Rather, it argues that if care includes adjustment, grief and loss, family relationships, advocacy, safeguarding, cultural safety and resident voice, then social work should not be treated as peripheral to residential aged care. Labour that is counted becomes institutionally central; labour that remains uncounted risks being treated as discretionary. For aged care reform to meaningfully address psychosocial wellbeing, policy recognition must be matched by structural recognition of the professional labour required in practice.
References
Aged Care Act 2024 (Cth). https://www.legislation.gov.au/C2024A00104/latest/text
Aged Care Rules 2025 (Cth). https://www.legislation.gov.au/F2025L01173/latest/text
Australian Association of Social Workers. (2020). Code of Ethics. AASW. https://www.aasw.asn.au/about-aasw/ethics-standards/code-of-ethics/
Australian Association of Social Workers. (2023). Practice Standards. https://www.aasw.asn.au/about-aasw/ethics-standards/practice-standards/
Department of Health, Disability and Ageing. (2026). Care minutes: Guide for registered providers of residential care homes. Australian Government. https://www.health.gov.au/sites/default/files/2026-05/care-minutes-and-24-7-registered-nurse-requirements-guides-for-registered-providers-of-residential-care-homes.pdf
Hardy, F., Hair, S. A., & Johnstone, E. (2020). Social work: Possibilities for practice in residential aged-care facilities. Australian Social Work, 73(4), 449–461. https://doi.org/10.1080/0312407X.2020.1778051
Lee, J., Splawa-Neyman, M., & McDermott, F. (2022). The role of social work in residential aged care facilities: Evaluation of a pilot program in Australia. The Qualitative Report, 27(1), 64–78. https://doi.org/10.46743/2160-3715/2022.4761
Nagaddya, T., Doh, D., & Drake, G. (2025). Preparing social work students for gerontological social work practice in Australia: Contributing to a sustainable aged care workforce. Social Work Education. https://doi.org/10.1080/02615479.2025.2579676
Noble, C., & O’Sullivan, J. (2009). Is social work still a distinctive profession? Students, supervisors and educators reflect. Advances in Social Work and Welfare Education, 11(1), 89–107.