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Governance in care and human services is under unprecedented pressure, with boards balancing regulatory reform, workforce challenges and rising community expectations.
Directors are responsible for ensuring care is safe, dignified and high-quality, requiring deep understanding and timely insight into what clients actually experience.
Strengthening the sector depends on sharing lessons, mentoring new leaders and building a community of directors equipped to navigate complex governance challenges.
Boards in care and human services operate in a complex, high-stakes environment. Rising expectations, workforce pressures, funding uncertainty and regulatory reform all converge on the critical responsibility of ensuring safe, dignified, high-quality care.
Governance for care and human services has never been more demanding, nor more consequential.
Boards of human service providers are simultaneously navigating regulatory reform, workforce pressures, funding uncertainty and heightened community expectations, all while carrying what AICD CEO and MD Mark Rigotti identified as “the responsibility to deliver safe, dignified and high-quality care”.
It was against this backdrop that the AICD held its Care Governance Assembly in Sydney in February, bringing together more than 30 leaders to workshop how governance capability can be strengthened across the sector. AICD NFP Sector Lead Phil Butler hosted the session.
The conversation was wide-ranging and frank, producing not just a set of ideas, but a shared sense of direction.
Rigotti was clear about the AICD's intent. The goal, he said, is to build into the organisation's learning and advocacy the ways that boards “can better fulfil their stewardship role in environments where people are vulnerable, services are stretched and the consequences of getting governance wrong are significant”.
Three themes emerged from the day.
Care literacy is a board-level responsibility
The first and perhaps most fundamental shift identified is the need for directors in human services to treat care literacy with the same seriousness they bring to financial literacy.
Understanding how care is delivered, what quality care looks like and where harm can occur is not something that can be delegated to management. It belongs in the boardroom.
How do you build that literacy? Participants were practical and inventive. Suggestions included immersion in facilities and site visits, and direct conversations with clients. Lived experience, brought onto the board not as a token gesture, but as genuine expertise, appropriately remunerated where possible, could broaden the scope of who can serve on the board. Observerships, designed to be inclusive of all abilities, could allow even people with cognitive disability to participate in decision-making and have their voice at the table.
The assembly also surfaced something more uncomfortable — board culture itself needs examination.
The “perceived wisdom” of the board must be challenged, and what participants called “benevolent ageism” — an unconscious bias that, however well-intentioned, strips people in care of their agency and their right to run their own lives — must be actively prevented. A care mindset, the group agreed, needs to be agile and innovative, not calcified by assumption. They agreed it’s important to create a board environment of psychological safety that encourages speaking up and challenging those assumptions.
Developing a pool of directors with direct experience running care services and using mentoring to bring more diverse expertise to the table, were among the practical ideas raised to shift the dial on board composition and culture.
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Better insight, earlier
The second theme cuts to the heart of how boards receive and interpret information about care quality.
The questions that kept surfacing were deceptively simple: Are our clients thriving under our watch? Are we measuring wellbeing and are they getting what they need from our care?
Sourcing informed answers turns out to be harder than it should be. Participants identified a range of structural blind spots — the false assurance that can come from dashboards, accreditation cycles and committee reports; the tendency for care to be siloed away from strategy, finance and growth decisions; and data that is inconsistent and often built on weak signals.
Many clients across aged care, disability and child services are non-verbal. Directors may simply never know what those clients experience, unless there is a deliberate framework for surfacing that information at board level.
The “happily ignorant” cohort — those who accept management assurances that everything is fine — was identified as a genuine governance risk.
Metrics need to be designed with the understanding that it can never be “all nice”. Remaining curious, participants said, is key to maintaining the social licence that prevents governance from collapsing into box-ticking compliance.
The reframe the assembly arrived at was compelling. Rather than measuring what has gone wrong, good care governance means “designing for vulnerability” — building systems that make it structurally difficult for harm to occur in the first place.
Building a community of leaders
The third theme relates to what the AICD and its partners can do to strengthen governance across the sector and build a community of leaders.
Participants saw a clear role for the AICD in strengthening governance across the care economy, including through practical guidance and resources that address the unique governance challenges directors face, facilitating shared learnings and peer-to-peer networking.
Beyond practical guidance, participants want a community — opportunities for leaders to share ideas and experiences, learn better governance practices and mentor the next generation of leaders. Given the rapid growth of the care economy, participants see building a pipeline of skilled leaders and partnering with organisations as a critical mechanism to amplify care governance across the sector.
The assembly underscored the value of learning from past failures without flinching. Case studies of how boards have navigated difficult situations — the decisions made, the consequences that followed, the lessons that emerged — should be shared openly, so directors can apply those learnings to their own governance before a crisis forces the question.
The test one participant offered as a benchmark was: Would you place a family member at that facility after spending time there?
For time-constrained directors, the priority is resources that are immediately useful and easy to act on.
The Care Governance Assembly was a starting point, not a conclusion. The AICD is committed to translating the energy and clarity displayed on the day into practical tools, programs and peer-to-peer learning that meets directors where they are — and to building a platform to strengthen governance for everyone responsible for the safety and dignity of people in care.
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