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Damning home care report only tells part of the story, says peak body

Lack of audits, high fees, poor communication and staffing issues are just some of the “systemic problems” in the delivery of home care, a new Government-funded report suggests.

Government-funded report collected home care experiences from 40 people across Australia. (Source: Shutterstock)
Government-funded report collected home care experiences from 40 people across Australia. (Source: Shutterstock)

Written by independent researcher and Director of Age Care Matters Dr Sarah Russell, the report Older People Living Well with In-Home Support features personal experiences from 40 older people and/or their support person, who describe what is and isn’t working well with their home care – covering both the Commonwealth Home Support Programme (CHSP) and Home Care Packages (HCP) program. 

Some participants receiving home care packages said trying to receive services from their chosen provider was like “pulling teeth” and fighting for their entitlements was “exhausting”.

Dr Russell says she heard many concerns regarding differences in fees and lack of cost transparency. 

“Participants said that determining how much a service should cost was difficult without any benchmarks,” she writes. 

The report showed that one provider charged $607.56 in case management and administration fees (51.6 percent of a Level 2 package) to supply one service valued at $130.22.

“They expressed concern at what they saw as inflated costs for labour, equipment and supplies… and questioned whether costs were inflated because home care packages were subsidised by the government.”

Common complaints about HCPs included “difficult to understand” financial statements, high staff turnover, underqualified staff, and increased service costs when changing from a CHSP to an HCP. 

Some participants were also concerned the Government was giving HCP licences to companies with no expertise in the delivery of aged care services.

“Some participants asked support workers to describe their qualifications, and they were shocked when they learnt that not all support workers were qualified. According to participants, some providers required only a police check,” Dr Russell says. 

“When an older person transitions from the CHSP and/or lower level HCP to a higher-level HCP, the cost of a bus trip or participation in an activity such as the Men’s Shed significantly increases… this limits an older person’s participation in local activities.

“A participant who accessed four local social activities every week for many years was forced to reduce his local activities when he accepted a home care package. This negatively affected his mental health.”

Despite the many concerns, some participants reported positive experiences, saying home care is a “Godsend” which allows them to stay in touch with their community and gives family members peace of mind, with many praising their case managers and support workers. 

Findings from the study suggest that some providers need to be more transparent and accountable, Dr Russell says.

“Participants had high expectations for the services that would be provided by a home care package,” she writes. 

“Many participants described being disappointed. Those with the best outcomes had family and community support, and without this additional support, they acknowledged they would not have been able to remain at home.”

Not the full story 

Provider peak body Leading Age Services Australia (LASA) Chief Executive Officer Sean Rooney says the home care sector is working closely with Government and consumer groups to effectively meet the needs of older Australians requiring care in their homes, and that the small study sample should not be generalised to the 90,000 people currently receiving home care.

“The home care system is being challenged by the implementation of significant changes, whilst also straining to keep up with growing demand, but overall it is meeting the needs of those receiving care at home,” he says. 

“A more robust picture of home care performance is provided by looking at a range of other satisfaction surveys which find around 80 to 90 percent of people are satisfied, including a 2017 qualitative study commissioned by the Department of Health and an earlier Australian Bureau of Statistics survey.”

Mr Rooney says LASA recognises that some issues, such as variations of some home care prices, are a concern for consumers, and encourages people to discuss issues directly with their provider.
 
“Under the Aged Care Quality Standards, home care providers must have in place processes for addressing consumer concerns, and where consumers believe that this does not deliver a satisfactory result, they can also raise their concerns with the Aged Care Quality and Safety Commission.” 

The Older People Living Well with In-Home Support report can be found here.

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