Residential and in-home aged care ‘needs urgent redesign’

Inquiry told 16,000 Australians – 44 per day – died while waiting for a home-care package in 2017-18.

Aged care needs ‘urgent redesign’

Aged care is in crisis and requires a “radical redesign”, according to industry chiefs.

A report handed to the Royal Commission into Aged Care Quality and Safety and signed by about 120 chief executives is seeking the urgent appointment of a cabinet minister whose sole responsibility is ageing and aged care reform. The report says residential facilities are being forced into the red and people are dying while waiting for home-care packages.

The report also backs the development of a digital ‘passport’ for aged-care recipients and the immediate evaluation of the sector's viability. It was prepared with accountancy firm Grant Thornton and advocates for cash injections of $500 million every year for at least three years to reduce home-care package wait-lists of about 130,000 people.

“We've done modelling that would suggest $1.3 billion over the next 18 months would bring stability and confidence to the residential aged-care sector,” said Leading Age Services Australia chief executive Sean Rooney.

“[The money should be given before the royal commission ends] because we know that [finances] are constraining ... the ability of providers to consistently meet the care needs of residents in residential care, and we know that there is a very human cost of the wait-list [for home care].”

The royal commission has been told that about 16,000 Australians – 44 per day – died while waiting for a home-care package in 2017-18 even though they had received approval.

Nationally, more than 129,000 people are waiting for care. About 60 per cent are waiting to be approved for a package, the remainder have already received approval.

Home-care packages assist people who are assessed as needing extra help to stay in their home, rather than move into nursing homes. There are four levels of home care ranging from basic to high needs, and the Federal Government subsidises approved organisations to provide the packages.

However, the subsidies are capped, and demand has outstripped supply.

Coalition of the Aged (COTA) chief executive Ian Yates said the assessment system needed to be streamlined.

“The Government, in fairness, has responded to the increasing demand, partly with additional packages and partly by bringing forward packages they'd planned for future years, but it's not enough.”

Federal Aged Care Minister Richard Colbeck said that in the year to December 2018, the number of people receiving assistance had increased by 20 per cent.

“To meet further demand, the Government has invested an additional $2.2 billion into 34,000 new home-care packages since last year’s budget,” he said.

“Indications are that this increase in home-care packages has already made a difference in senior Australians' ability to access in-home care."

He acknowledged, however, that there was “more work to do” and said the Government was “committed to supporting senior Australians to access the care type that they want and need”.

The peak body for non-profit aged care providers, Aged and Community Services (ACSA), says the reported reduction in the homecare waiting lists is welcome, but there are still too many people waiting for a package.

“This reduction of around six per cent in people waiting for a package is, unfortunately, just a drop in the ocean of people desperately needing better support at home,” said ACSA chief executive Patricia Sparrow.

“This is great news for those who are now getting a package, but what about everyone else?

“Being on a home-care waitlist is not just an inconvenience. If people have to wait, it can have a lasting impact on their health. It can lead to increased pressure on already stretched hospitals, mean someone has to enter residential care, or worse that they die waiting for support that never arrives.”

ACSA is calling for an urgent boost of 40,000 packages and a strategy to ensure people can receive a package within three months.

Do you receive a home care package? Have you been approved but are on a waitlist? Is the problem just a lack of money?

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    To make a comment, please register or login
    23rd Sep 2019
    Where is the conversation about having trained staff to carry out the service provision, and the contribution to be paid by recipients. There is more to this than just handing out packages.
    23rd Sep 2019
    If the 'private enterprise' paradigm for servies is so good - why do they always need assistance from government, which then claims it has no control or part in these things, but only lays out the ground rules?

    Cheaper to run it as a public utility.....
    23rd Sep 2019
    A far more in depth conversation is, I agree with you tams, desirable, and particularly with the recipients, although a distinction between wants and needs should be included, otherwise the wants will make it unfundable.
    24th Sep 2019
    Good point, unfortunately the greedy (On Both sides) and the "Entitled" will bring the system to it's knees. Just look at the rorts in the child care system.
    23rd Sep 2019
    The whole system needs to be reviewed I have a good friend who is on a home care package.
    While that is good in principal, the so called not for profit care providers fees and charges are to me excessive. Basically I nice growth industry and a big earner for those providers, the government could save millions if it took the trouble to see who was actually benefiting from home care packages.
    23rd Sep 2019
    I agree a nice growth industry for the providers, same as with child care and NDIS apart from the rorter and fraudsters its the providers who benefit most
    23rd Sep 2019
    Our providers charges have increased by 50% since 1st July. Nice earner for doing exact same job
    23rd Sep 2019
    Yes and all supposedly not for profit
    I would like to see what thier bosses get, charges go up to reflect thier cost which of course is just passed on.
    23rd Sep 2019
    Small single person businesses will often regard it as 'helping the old folks". and charge nicely, but once it gets to the company level it is, "the shareholders need their profits", and from the company perspective, "the CEO requires his super high wage", - Unfortunately the bureaucrats that supervise this sort of stuff are generally pushed to the big companies, so that the service may require 400% more money for the same fiddling thing is not uncommon, but it does not help the old age pensioner one whit.
    For a Government department to follow a policy that severely reduces the money for the people it supposedly "serves" is unconsciable, but they have to.
    So a different policy must be introduced that gets the lowest quote, - the local guy.

    23rd Sep 2019
    "industry chiefs"... let me see now.. why exactly am I under-inspired?

    Has any of those 'industry chiefs' ever lived in one of their institutions? Do they actually KNOW what the hell they are talking about, or is this another case of "I can live on $40 a day!"
    23rd Sep 2019
    The problem as I see it is that needs are not adequately assessed. The Aged person is assessed to begin with, and a judgement is made as to the level of help required. Many people assessed as needing a level 4 package do not need this amount of services, for instance my husband has been assessed as needing a level 4 package, for which we will have to wait around 2 years. However, I have been caring for him for 9 years now without too much difficulty, and what I desperately need is some in-home respite so that I can keep in contact with family and friends, thus retaining my sanity. This could probably be achieved on a level 1 package, certainly on level 2, and this can be achieved with a much lower funding. I have heard of other clients who have their level 4 already in place, and are using money allocated on things they don't really need just in order to not lose the excess. The system is wasteful and poorly managed. Ask the carers what they NEED, and base the allocations on that. Don't allow this waste, and many more of our elderly can be helped.
    23rd Sep 2019
    Right on Jenny, at the beginning of this year after some years of build up leading to not able to walk, I was diagnosed with "Quite severe arthritis" and put on a waiting list for a new hip, so had to confront this new situation, to my horror.
    My brother, a few years younger had been working for many years as a carer, - he found that a significant percentage of these - not that much older than himself, guys, had dreams of a palatial house and saw him as the means to so achieve, so he had to build these enormous rock walls, - requiring lifting enormous rocks and carrying them, fancy verandahs with high risk drops and suss second hand materials, and on and on, usually with abuse and criticisms and no gratitude so decided this year to f*** them off and just live on his pension, and much happier, and felt, and I agree, that many were abusing their CARE entitlement.
    In my situation, having had my diagnosis, I knew that 80% of Australians have a Borax shortage, in their diet, which often causes Arthritis in most of it's forms, - not wanting to go into that, but started taking the Borax and found quite soon significant relief and getting better every week, although one never knows the future.
    My Point is, although I no longer need the hip replacement, and can do most things easily in my large veggie garden, replacing heavy pumps in my deep creek, carrying heavy loads, etc, mowing my lawn is hard on my hip, - I can't walk up steps with the hip leg foremost, - it is bone against bone, although the borax is building a bit of a barrier, it gets worse if i push it, so all I would need is some one to come out and push a mower around for a few hours and I would be fine for years ahead.
    Not saying I could not get that but just how a small thing could make a huge difference, if the 'system' could be more flexible and focussed.
    23rd Sep 2019
    I agree with the "waste" argument Jenny, but the Government paints or treats everyone with the same brush when it comes to ANY welfare provided by the government. We are all allotted into "compartments" or "boxes" that THEY label and never mind treating people as individuals with individual needs, the CES days are gone when one person got to know you situation and gave you personalized services to meet your needs. I could write a rather long essay about the last ten plus years I have been looking after my husband while under the watchful and wasteful eye of the Government and I would probably end up published and earn enough extra money to get some personal respite myself for a week....but I haven't the time! I AM BACK! lol! and now it is meds time!
    23rd Sep 2019
    I applied for a aged care package back in March this year and have had an assessment but now apparently there is a need for another one for some unknown reason ! And although I have a aged care AcCount number and although it has technically been approved I still need this further assessment to get meals on wheels etc and I also need someone to do my lawns now as I am unable to anymore and ai am on a corner block and its too hard on my shoulders as have torn ligaments in both !shoulders !
    So i am up in the air waiting to find out just when and how long it will take and as I am now 81 I may well have carcked it by the time I am officially assessed ! Dotty
    Chris B T
    23rd Sep 2019
    It amazes me How There Is Extraordinary Funds for Talk Fest and Finger Pointing.
    When all the "BS" and @ mouthing finished Nothing has Change.
    The only True Beneficiaries are The Commissioners,Staff associated with them and Legal Fraternity.
    $500 million should be used directly on those approved packages, instead of waiting for them to die.

    23rd Sep 2019
    Damned hard to get a good argument going here these days - where are all the Usual Suspects?
    23rd Sep 2019
    They're ignoring you!
    24th Sep 2019
    need to pick your battles Trebor, few would disagree with this proposition regardless whether progressive or conservative persuasion. On the other hand you might raise the dead if you posit that everything in aged care is honky dory and room to cut back regulations and service and at same time increase costs.
    17th Oct 2019
    My late husband home where we deposited $600.000 and monthly $8000 still far from perfect Calling for help could take 10 minutes before somebody appered
    17th Oct 2019
    My late husband home where we deposited $600.000 and monthly $8000 still far from perfect Calling for help could take 10 minutes before somebody appered
    17th Oct 2019
    My late husband home where we deposited $600.000 and monthly $8000 still far from perfect Calling for help could take 10 minutes before somebody appered

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