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The Competency Conundrum in Home Care

The Competency Conundrum in Home Care

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Assessing competency across a sizeable mobile workforce presents unique and unresolved challenges for many home care providers.

During our webinar on competency assessments this week, a large home care provider raised a tough challenge around meeting Action 2.9.6: How do you deliver competency assessments at scale when your workforce is mobile and is already time-poor?

This question cuts to the heart of the aged care sector’s biggest workforce tension: maintaining rigour and reliability in a high-risk, high-variation environment. This challenge isn’t unique to any home care provider.

There are many unknowns and even unknown unknowns! A lot of the literature is about what could work, rather than what has worked. This article is a guide and an opportunity for further thinking and testing out new ideas.

What Competencies are Required?

Action 2.9.6 clearly outlines the core matters that require competency-based education.

Core Matter Listed in Action 2.9.6 Corresponding Ausmed Module Duration (minutes)
Person-centred, rights-based carePerson-Centred, Rights-Based Care for the Older Person12
Culturally safe, trauma-aware, healing-informed careCulturally Safe, Trauma-Aware and Healing-Informed Care25
Caring for people living with dementiaDementia and Understanding Behavioural Changes30
Responding to medical emergenciesBasic Life Support (BLS)32
Recognising Deterioration: Care WorkersRecognising Deterioration: Care Workers23
Understanding and applying the Code of ConductThe Code of Conduct for Aged Care15
Serious Incident Response Scheme (SIRS)Serious Incident Response Scheme (SIRS)15
Strengthened aged care quality standardsStrengthened Aged Care Quality Standards40
Emergency and disaster management*Emergency, Disaster and Evacuation Management30

What Will Auditors Look For?

Honestly, who knows? While the audit evidence requirements under the strengthened Aged Care Quality Standards are precise, there is currently limited regulatory guidance on assessing competency or what process auditors will look for. Providers must therefore make informed, defensible decisions based on:

  • The risk and complexity of the task
  • The opportunity to observe real-world performance
  • The workforce’s context, supervision, and support structures

This list is the beginning. It is designed to prompt thoughtful consideration, not to lower the bar, but to help you build consistent, safe, and scalable systems in a real-world care environment.

Core Competency Domains

Ranta and Kaunonen (2024) identified eight core competency domains in home care, including decision-making, teamwork, and technological skills, highlighting the complexity of the role. However, the review found no clear guidance on how, how often, or by whom these competencies should be assessed.

What are the Core Challenges?

Understanding the required competencies is only part of the challenge. The more significant challenge lies in assessing these competencies in dispersed, home-based settings.

Ranta (2024) highlights that competence is not just about having knowledge or performing a skill in isolation but about applying them effectively, ethically, and contextually in the unique home care environment. Furthermore, assessing and verifying competence requires observing actual behaviour and demonstrating skills, behaviours, and attitudes, not just testing knowledge.

Therein lies the challenge!

In many cases, home care staff only attend team meetings occasionally or come to the base for mandatory training. That creates real barriers to practical competency assessment:

  • Limited contact hours with staff
  • Competing demands on their time
  • Lack of proximity to assessors or training facilities
  • Minimal opportunity for real-world observation

Understandably, many providers consider virtual assessments.

Virtual Competency Assessment

This raises an important distinction: can virtual assessments support some aspects of learning? Can they satisfy the requirement to observe and verify actual performance?

As Michelle Wicky, our Chief Customer Officer, reflected during the webinar, it might not cut it, especially when actual demonstration of skill is required under the strengthened Aged Care Quality Standards, Action 2.9.6 requirements.

Virtual assessments are a helpful part of the L&D toolkit, especially for knowledge checks and reflection. But competency isn’t just about knowing. It’s about doing and doing safely, independently, in the real world.

According to Action 2.9.6, providers must ensure that aged care workers have received competency-based training and that their competence is verified. That means:

  • Clearly defined, role-specific competencies
  • Demonstrated application in practice
  • Reliable verification methods

This bar is even higher in home care, where staff often work alone.

Train-the-Trainer: A Costly but Credible Path

Michelle suggested a train-the-trainer model, upskilling regional assessors who could rotate between service areas, attend client visits, and conduct on-the-ground assessments.

Yes, it’s resource-intensive. However, it may be one of the only reliable ways to provide the level of assurance auditors will look for. The challenge is not just scale, but structure and consistency.

Creative Solutions Worth Exploring

  • Team meetings and virtual sessions as structured touchpoints: Use these moments for short observed demonstrations, scenario walkthroughs, or roleplay, especially if real-time assessment isn’t always feasible.
  • Video-based demonstration: Workers can submit recorded evidence of a task (with appropriate consent), which will be reviewed by a qualified assessor.
  • Simulation kits and case-based assessments: These can be deployed during team days or regional meet-ups to assess complex skills in a controlled way.

Each approach has strengths and limitations. The point is not to find one perfect model, but to blend methods that uphold quality while meeting operational realities.

What Could Be Assessed Virtually – and What Can’t

Action 2.9.6 requires providers to deliver competency-based education on key “core matters” that underpin safe, quality aged care. These areas align with the competencies outlined in Ranta’s (2024) review, particularly in how knowledge, behaviour, and real-world application intersect.

Below is a categorisation of each core matter based on assessment method, factoring in risk, context, and opportunity for observation.

This table is intended to support home care providers in applying a risk-based approach to assessing core matters under Action 2.9.6. It explores which topics may lend themselves, in part, to virtual or blended assessment models, and which likely require in-person demonstration and verification due to their complexity or risk profile.

Assessment Considerations for Action 2.9.6 Core Matters

This is not a recommendation or endorsement of virtual-only assessment methods. Instead, it's a practical discussion of providers' challenges in assessing a mobile, time-poor workforce, particularly in home and community settings.
Core Matter Assessment Mode Rationale / Notes
Person-centred, rights-based careIn-personRequires observation of tone, presence, and adaptability. Complex interpersonal behaviour must be demonstrated.
Culturally-safe, trauma-aware, healing-informed careIn-personSensitive and context-specific care. Demonstration of behavioural response is essential.
Caring for people living with dementiaIn-personRequires observation of critical thinking, response to behavioural change, and advanced communication in real time.
Responding to medical emergenciesIn-personHigh-risk, high-pressure competencies include essential life support and responding to clinical deterioration. Real-time recognition, decision-making, prioritisation, and communication should be observed.
Code of ConductVirtual + scenario-basedProcedural; application can be assessed via case studies, but context matters.
Serious Incident Response Scheme (SIRS)Virtual + mock reportingKnowledge-driven; can use scenarios, reporting walkthroughs, or policy quizzes.
Strengthened Aged Care StandardsVirtual + reflection/discussionBehavioural integration and understanding could be assessed through team forums and reflective activities.

Start with Standardisation

Regardless of the method, consistency is critical. Inconsistent assessments lead to unreliable results, which undermines the purpose of competency verification. That’s where standardised tools can help.

To address this, Ausmed’s Competency™ Beta assessment templates are:

  • Role-specific and aligned to the Strengthened Standards
  • Editable, yet standardised
  • Evidence-based, developed by an expert Competency Assessment Panel
  • Designed to reduce variation and assessor burden

Over time, these will integrate into a digital competency management system, designed to help providers:

  • Solve paper-based administration issues
  • Address a lack of oversight on competency and capability
  • Streamline competency assessment tracking, recording and reporting
  • Link assessments with Ausmed resources for learning and skill development

Questions That Remain

This conversation is just beginning, and I am very mindful that there are important questions we still need to answer:

  • Where should assessments take place? If competency is about performance in context, should demonstration happen in the home? If so, what does that mean for client privacy and consent?
  • What counts as valid evidence, and how could a worker provide this?
  • Can simulation or video review be used alongside in-person observation as an assessment and verification method?

A Strategy Worth Investing In

Despite the challenges and sizeable investment in developing a scalable model, competency assessment in home care is one of the most powerful tools for improving care quality and safety.

It’s about reducing risk (Safety-I) and building confidence, adaptability, and assurance (Safety-II). It’s about ensuring our people don’t just know what to do; they’re ready to do it, independently and safely, every time.

Competency shouldn’t be a checkbox. It’s a quality strategy. And it’s one worth getting right.

Join Our Competency-Based Education Community (Home Care)

We’re calling for Expressions of Interest to join a new Community of Interest focused on competency-based education in home care. Help shape practical tools, share what’s working (and what’s not), and connect with others tackling similar challenges.

Submit your EOI here → Email Zoe Youl

References and Useful Resources

Author

Zoe Youl - Head of Community at Ausmed

Zoe Youl 

Zoe Youl is a Critical Care Registered Nurse with over ten years of experience at Ausmed, currently as Head of Community. With expertise in critical care nursing, clinical governance, education and nursing professional development, she has built an in-depth understanding of the educational and regulatory needs of the Australian healthcare sector.

As the Accredited Provider Program Director (AP-PD) of the Ausmed Education Learning Centre, she maintains and applies accreditation frameworks in software and education. In 2024, Zoe led the Ausmed Education Learning Centre to achieve Accreditation with Distinction for the fourth consecutive cycle with the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation. The AELC is the only Australian provider of nursing continuing professional development to receive this prestigious recognition.

Zoe holds a Master's in Nursing Management and Leadership, and her professional interests focus on evaluating the translation of continuing professional development into practice to improve learner and healthcare consumer outcomes. From 2019-2022, Zoe provided an international perspective to the workgroup established to publish the fourth edition of Nursing Professional Development Scope & Standards of Practice. Zoe was invited to be a peer reviewer for the 6th edition of the Core Curriculum for Nursing Professional Development.