Cultural diversity and cultural competence in service delivery

The Australian population is incredibly diverse and multicultural. With this diversity comes the challenge of ensuring that all individuals, regardless of their cultural background, have equal access to services and support. 

Organisations providing services to the public must be prepared to respond to the diverse and individual needs of each client and ensure that the organisation and its staff are culturally competent.  

What is cultural competence?

A culturally competent organisation: 

  • understands and responds to the unique needs of individuals from diverse cultural backgrounds; and 
  • improves feelings of cultural safety for clients and staff, making them feel that their background, values, identity and needs are respected and valued for the diversity they bring to society and to the organisation.  

When a client feels culturally safe, they feel as if the organisation cares about them as an individual, and that they are seen as a person, not simply part of a homogenous group. Meeting someone’s cultural needs can indicate that an organisation will take care to meet a person’s other unique needs.

And what is cultural diversity?

Cultural diversity encompasses many forms or aspects of identity, including:

  • Cultural identity
  • Ethnic identity
  • Nationality
  • Class
  • Education
  • Language
  • Religion
  • Spiritual views
  • Gender
  • Sexuality
  • Political orientation
  • Age

Each one of these factors will contribute to a person’s identity, how they see the world and their needs when receiving services. 

It is important to note that a ‘one-size-fits-all’ approach to cultural competence will not adequately address the needs of clients, as multiple aspects of their identities intersect to create unique strengths and vulnerabilities. 

Organisations must therefore prioritise a flexible and adaptable approach to service delivery, and ensure staff are able to respond effectively and appropriately to the varying and individual needs of each client.

Strategies for cultural competence

1. Culturally diverse staff

Having a diverse workforce allows an organisation to have broad perspectives of how different actions may impact on people from varying cultural backgrounds and provide insight into changes to improve the cultural safety of clients. Having staff available who share their cultural background can help clients feel that their cultural identity and needs will be respected and valued during their time engaging with the service. In addition, a diverse workforce helps staff improve their cross-cultural communication skills, which can then flow on to better communication outcomes for clients.

2. Ongoing reflection on services

Cultural competence is not a singular action. As the diversity of the organisation’s clients and staff changes, the organisation must constantly reflect on the services it provides and whether they are appropriate for the current demographics. To improve their cultural competence, especially where client demographics have changed, it may be appropriate to partner or consult with local cultural or community groups to ensure the service meets cultural needs.

3. Client involvement in service delivery

The unique experiences of each client means that what they need from a service may be equally as unique. Allowing clients input into aspects of their experience with your organisation allows them to receive a service that is appropriate for them, improving their sense of cultural safety and their perception of the service. In residential services, this is especially important in making the service feel like a ‘home’ for residents.

Cultural diversity and compliance

Cultural diversity is increasingly being incorporated into quality standards for services. This means organisations must be culturally competent and have strategies for engaging with diverse clients in order to meet their standards obligations. 

All of the major national and state/territory standards have cultural diversity requirementsHere are just a few, by way of example only: 

  • Aged Care Quality Standards

  • Australian Service Excellence Standards

  • Human Services Quality Framework (Qld)

  • Human Services Standards (Vic)

  • National Safety and Quality Health Standards (and a number of aligned standards)

  • National Principles for Child Safe Organisations

  • NDIS Practice Standards

  • RACGP Standards

Self-assessments for all of the above standards are available for providers in SPP. 

BNG and Cultural Diversity

We’ve recently updated some of our cultural diversity and cultural competence resources to better assist service providers with their cultural competence.  

  • Good Practice Guide: Cultural Competence 
  • Info: Cultural Diversity 
  • Policy: Diversity and Cultural Inclusion

Other resources for service providers

Aged Care Diversity Framework action plans four action plans to assist aged care providers when engaging with diverse clients, Aboriginal and Torres Strait Islander clients, CALD clients and LGBTI clients. All four action plans are available as self-assessments on SPP. 

The Centre for Cultural Diversity in Ageing has developed the Inclusive Service Standards and accompanying supportive resources to assist aged care providers in the development and delivery of inclusive services to all clientsSPP also provides a self-assessment for the Inclusive Service Standards. 

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Aged Care Diversity Action Plans

The ageing population in Australia is increasingly diverse, with one in three older Australians born overseas. Aged care facilities have not always responded well to these diverse needs and often do not reflect the diversity of the wider population. Without taking specific actions to address the diversity of consumers in care, there is a risk that older people can be left feeling neglected and isolated.

A recent hearing on diversity in aged care in the Royal Commission into Aged Care Quality and Safety heard of instances where providers have failed to accommodate diverse older people. Malloy, a lesbian woman in her 80s, spoke of the discrimination that she has felt in aged care facilities, and highlighted the lack of awareness and the discrimination that she had experienced from staff.

Providing residents with choice and control is central to Standard 1 of the Aged Care Quality Standards: Consumer Dignity and Choice. To exercise this choice and control, residents need to have their diverse needs catered for.

In 2019, as part of the Aged Care Diversity Framework initiative, the government released four Diversity Framework Action Plans. These action plans outline procedures that can be taken to support all diverse groups of older people. These plans are not mandatory compliance requirements, however they guide organisations in delivering more inclusive and culturally appropriate services to all older people.

BNG has developed self-assessments in Standards & Performance Pathways (SPP) based on the action plans, to help guide your organisation in delivering a safe and inclusive service environment for individuals. There are three levels of each action plan to work through: foundational actions, next steps and leading the way. The action plans acknowledge that each provider is starting from a different place and therefore allow providers to work through three different levels according to what is most relevant to their services and client base.

The four diversity action plan self-assessments are:

This self-assessment assists providers in creating a more safe and inclusive service for all diverse older people. The action plan recognises that there is no ‘one size fits all’ approach to diversity. Taking steps to make the services more inclusive for diverse older people means better engagement with existing and potentially new consumers, improved wellbeing for consumers and new partnerships built within the community.

While the national Aboriginal and Torres Strait Islander population is projected to grow by 59% between 2011 and 2031, the Aboriginal and Torres Strait Islander population aged 65 and over is projected to grow by 200%[1]. This means that aged care facilities need to respond to the growing demand from older Aboriginal and Torres Strait Islander people. Aged care providers need to ensure that they are working to address the current barriers to service access that many older Aboriginal and Torres Strait Islander people face, and ensure they receive culturally appropriate services.

Many older CALD Australians face additional barriers to access and awareness of aged care services. In June 2015, only 18% of people in permanent residential aged care were from non-English-speaking countries, which is not reflective of the fact that around 33% of people in the wider community were born in a non-English-speaking country[2]. As a bilingual person ages, they can lose the English skills that they have acquired over their lifetime and revert back to their original language. This means that additional support needs to be provided to allow older CALD people to access aged care services, and ensure they receive culturally appropriate care.

BNG has an interpreter services policy that can be a useful resource for organisations when providing care to older CALD people.

The action plan acknowledges that many older LGBTI people have faced significant discrimination and neglect throughout their lives. This means that many older LGBTI people may be ashamed or may face significant anxiety in expressing themselves. Organisations should be considerate of this experience and build confidence among older LGBTI people by providing the support and care that they need.

The action plans have been developed to assist aged care providers to ensure continuous improvement in providing care that meets the diverse characteristics and life experiences of all clients. Completing the new self-assessments in SPP is a simple way for providers to incorporate the Aged Care Diversity Framework into their service delivery, and work towards best practice in tailoring their care to assist individuals.

[1] https://www.health.gov.au/sites/default/files/documents/2019/12/actions-to-support-older-aboriginal-and-torres-strait-islander-people-a-guide-for-aged-care-providers.pdf
[2] https://www.health.gov.au/sites/default/files/documents/2019/12/actions-to-support-older-cald-people-a-guide-for-aged-care-providers.pdf

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