Sourcing Skilled Workers for Complex and High-Intensity Supports

While there is a wide range of roles for people with complex needs, there is one category that sits vacant longer on most SIL providers' books than any other: the role supporting a resident with complex needs. The worker responsible for enteral feeding, or for a resident's tracheostomy care. The home where a behaviour support plan is a real skill. The role three able generalist workers turned their noses up at. These vacancies don't sit open for lack of applicants. They stay open for lack of the right ones, and the more they're open, the more the burden is placed on the small team of qualified people you already have, which is how you lose them as well.

Recruiting for complex supports is a different kind of sourcing than general sourcing, and if it is treated like general sourcing, you spend the extra time and still end up without a worker.

Lead with the requirement, not the vacancy

When a job is difficult to fill, the instinct is to soften the job ad: "The more the merrier" is the theory. For complex supports, this is backwards. Vagueness attracts generalists, who tend to step back on the first visit to the house, and off-putting for the seasoned workers, who view vagueness as a red flag. The people you want are drawn to precision, what the supports are, what training is needed, what the plan requires, what makes this house hard and what makes this house worthwhile. Precision narrows the field to those who looked at the reality and stepped forward, and only that sort of shortlist is worth having.

Know the training gate and hold it

Some supports that are common in complex SIL settings are included in the NDIS framework for high intensity daily personal activities, and providers of the supports have specific skill and training expectations and obligations. Others sit under state rules or clinician delegations. The operational rule is straightforward, if a support in a house is gated, then no worker delivers a gated support until they have been shown to be trained and competent in it and this has been documented. This is not care overlaid on top of bureaucracy. It's the difference between a workforce and a liability; experienced workers take providers who hold the gate seriously, because they do too.

In the case of the independent workforce, this is a filter benefit: profiles that include descriptions of the training and complex-support experience let you filter first and then evaluate fit. When starting an engagement, check certificates and currency as you would when hiring an employee.

Grow skills where you cannot buy them

In many markets, particularly regional, there is no fully trained worker for a particular support available locally, and at any price. An alternative to an unfillable vacancy is to find workers, whether employed or self-employed, who have the right temperament and are already working in an adjacent field, then get them the right training for the supports you need, and pair them with your experienced workers, or the relevant clinician, early in the shifts. It requires up-front cash and effort, and it's often quicker than the market can deliver, and better than the market can deliver: workers trained on your residents' needs, in your houses, stay with you and your homes.

Protect the skilled workers you have

The most scarce item on the list is a complex-support worker, and the most common mistake is to reward that worker's skill with all the most challenging assignments. The idea of sustainable services is to distribute more complex supports throughout a carefully expanded pool of trained personnel, not a "deep" roster resting on a few skilled workers, but a broad one, and to view each new worker that is trained as an insurance policy on all the others. For a complex house, the sourcing goal is never the one hero. It's a bench deep enough that no one has to be on it alone.

How this plays out in practice

Imagine a home where the new resident needs to be fed by a feeding tube for a few hours each day and where one nurse-trained employee is covering every shift that involves it and is clearly showing signs of burnout. The discipline above is advertised and searched: two independent workers with documented relevant training are verified and inducted, and a third worker who has the appropriate temperament is put through accredited training with supervised early shifts. Within a quarter, four people can hold the support, the original employee's roster comes back to human proportions, and the resignation that was quietly coming doesn't.

Next steps

Write down all the gated supports on your houses and beside each the number of people that are verified to deliver it. Every support with a 1 beside it is on your true vacancy list.