6th Mar 2019
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Home-care industry rife with ‘systemic problems’: report
Author: Janelle Ward
Home-care industry rife with ‘systemic problems’: report

As the Government commits $967 million to residential aged care, a report commissioned by Aged Care Minister Ken Wyatt has put the spotlight on potential widespread rorting and dissatisfaction within the at-home aged-care sector.

The report highlights “systemic problems” in the burgeoning industry as a generation of baby boomers swell retirement ranks, putting pressure on aged-care providers.

Key problems highlighted in the report included extortionate fees, untrained staff and unnecessarily complex procedures.

Dr Sarah Russell, an independent researcher, director of Aged Care Matters and report author, said the findings based on interviews with 40 recipients or relatives of recipients of Commonwealth Home-Care Support or Home-Care Packages “absolutely shocked me”.

“I was expecting home-care packages to enable people to live well at home and was very surprised to find some people quite traumatised by the experience,” she said.

While those interviewed described the packages as a “godsend”, in that they provided funds to help keep people at home as they aged, they also said the procedures were often confusing, expensive and easy for providers to abuse.

Two years ago, the home-care system was revamped. Consumers now choose their provider and there are about 870 in the marketplace. At-home services will cost taxpayers $2 billion this year, according to Fairfax Media, which also reports that profits in the sector grew in one year alone from $142 million to $185 million.

The most concerning issue identified by Dr Russell was the high turnover of unqualified, inexperienced and untrained support workers entrusted to perform intimate personal tasks. They are often young, poorly trained and have no aged-care qualifications beyond a police check, she said.

The complexity of the packages was also a key concern, with Dr Russell saying that even those with business and accounting experience found the system “bamboozling”.

“If you're an old person on your own, with no family to help you, I seriously can't understand how you could manage these packages, particularly when someone is taking 50 per cent of the total funding in fees,” she said.

She was also troubled by what she described as the “commodification of the elderly”, with providers adding big percentages on top of the cost of services to boost profits.

The Federal Government recently announced funding for 10,000 new high-level home-care packages, but the waiting list can be lengthy with around 127,000 waiting more than a year to receive care.

Dr Russell said that, as the population ages, demand for home care will skyrocket and expansion must be managed correctly.

“There were people in my sample who were very grateful and were receiving really good services,” she said. “It was mostly from the local smaller providers. So in my view, we need to get the unscrupulous providers out of this sector. The only way I can think to do this is with good regulation."

Mr Wyatt told Fairfax Media he was “concerned with the practice of some providers charging high levels of case management and administration costs”.

Have you had experience in seeking or helping someone obtain a home-care package? Was it a difficult process? Do you believe staff are adequately trained? Have you been waiting some time for a package?

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    COMMENTS

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    6th Mar 2019
    10:33am
    Home care packages are being rorted on a massive scale by OAP's living in McMansions . If there ever was a case for including the family home in the eligibility criteria, the home care package is it.
    TREBOR
    6th Mar 2019
    10:40am
    Give some examples. SHOW me! Please explain?

    Troll.

    The rorting is not by pensioners dopey... could you just go away and leave this site in peace without your nonsense?
    Anonymous
    6th Mar 2019
    10:53am
    You seriously don’t expect me to post the names of the people I know who live in multimillion dollar homes ,divested their assets to their kids so that they get part pension and all the other benefits including home care packages to get their house , yard and pool cleaned .
    It’s all above board ,thanks to our silly pension system.
    Either give everyone the OAP or include the home in the asset test
    TREBOR
    6th Mar 2019
    11:19am
    Nothing to offer, huh? Not unusual. Just empty bulldust from someone who steals cattle from the ATO corral and talks himself mighty big, Pilgrim... your comments maybe as sweeping as them thar plains, Pilgrim - but they're just as empty....
    jackie
    6th Mar 2019
    12:19pm
    Lothario...The rich will always exploit the system but there are genuine people too.

    I can't understand why the packages are so expensive. I think they are a ripoff. It would be cheaper for people to get care on a cruise liner.
    Rae
    6th Mar 2019
    1:00pm
    jackie half of the billion dollars is going to providers to fill in forms and data bases. Not a cent of that money is used to do a single chore or care for a person. It's a stupid system designed to benefit business like the job providers or any other of the "providers" receiving billions in tax dollars for nothing much except paperwork.

    The carers doing the work are getting very little reward for their efforts.

    6th Mar 2019
    10:33am
    Home care packages are being rorted on a massive scale by OAP's living in McMansions . If there ever was a case for including the family home in the eligibility criteria, the home care package is it.
    Knows-a-lot
    6th Mar 2019
    5:24pm
    The Loathsome Lieberal Troll strikes again...
    TREBOR
    6th Mar 2019
    10:38am
    'systemic problems' - yes it's called the paradigm of greed is good, profit first, and love your shareholders and not your meal ticket. It's also about unqualified and socially-unqualified for Australia people working the floors, cost of training and employing first rate people, and the ages-old concentration camp guard attitude that inevitably develops in those suddenly handed power without (or with little) real responsibility but a clear mandate to abide by the house rules (which may not accord with the rules of civilised behaviour).

    Add to that the lack of genuine oversight, the introduction of 'global economy' types with a massive money first attitude who require billionaire status within a year, and the stage is set for a ghastly existence for those unfortunate inmates of these aged prisons.

    Add to that the relative indifference of families these days, and their often contempt for those who built them a fine life - finer than those oldies ever had.

    As a side-note, we (the ex and I) moved here from way down south to be less than an hour from her children and their families - thinking that with three of them, (her children) a visit once every three months from one lot would not be a burden - hardly see them at all.

    Just an insight into the way the generation below us, in many cases, view their parents... as disposable items with little sense and a hassle to listen to. My kids are not like that, but they are a lot further away, but we (the ex and I) are moving to somewhere WE want, not to suit them.
    Anonymous
    6th Mar 2019
    10:41am
    When do you move. Does that mean we won’t be hearing from you any more .
    One can but hope .
    Good luck on the move
    TREBOR
    6th Mar 2019
    10:46am
    When it comes to trust, the only thing you can count on these days is your fingers....
    TREBOR
    6th Mar 2019
    10:48am
    No, my son, I'll be moving to an area with FTTH which is faster... in the meantime you will undoubtedly offend enough people that they will be baying for your release from your YLC mortal coil... can't say I blame them... look at the first nonsense you posted today.
    patti
    6th Mar 2019
    10:51am
    I was a social worker, and used to advocate for, and help people walk through the bureaucracy of Centrelink and other government systems. But when I look at the Aged Care packages, I am somewhat overwhelmed. Difficult to navigate, also expensive if one needs several services. As my only income is the Aged Pension, not sure how I would manage financially when my turn comes. I have no family close by to help. Better focus on staying healthy for as long as I can I guess.........
    Linda
    6th Mar 2019
    12:28pm
    The one thing I can say Patti, is that if you should become ill and need some help to stay home, the first thing to do is book an assessment. Even if after it, they decide you are not eligible. By the fact of already being in the system, if things deteriorate for you, then you are already on the books and can be reassessed. That assessment is the key to being eligible for the packages. There are some concerns who offer low level support without the need for an assessment to be eligible, which is another less direct way to get placed for an easier time going forward. I say this from experience. Also, gradually, over time, look at the websites of various organisations in your area, talk to social workers, as it is best to be prepared but hopefully time is on your side.
    Rae
    6th Mar 2019
    11:02am
    Another example of privatisation allowing writers and privateers to steal tax dollars and often abuse workers as well.

    Just allow the aged to employ carers directly within the community.

    There are plenty of people paying directly for home help who are not having these problems. They don't need providers doing nothing but taking half the money for profit.
    Rae
    6th Mar 2019
    11:13am
    I wrote grifters not writers. The AI obviously doesn't like my cynicism haha
    TREBOR
    6th Mar 2019
    11:21am
    Beware of freaks bearing grift....
    Marty1
    6th Mar 2019
    11:27am
    Unfortunately I’ve had to apply for aged care help, the people who assessed me were just wonderful and very caring & a wonderful report was sent through for a level 4 package. I received a letter to say that I was granted a level 1 package as there was no level 4’s available. I rang aged care & asked who were the providers that I needed an agreement with, I was told that their were no providers in my area & they couldn’t help me and maybe try the local council. They weren’t very helpful either maybe the package wasn’t enough for them so I ended up having the package withdrawn but when I spoke to the original assessor he said that it would be a blessing as now I would probably get a level 3 package & he organized for a lady from CSHP I think & she was very helpful but could not understand a lot of the paperwork and phone conversations with the people at my aged care was so difficult as some of the call center staff didn’t have answers plus the system was very inflexible & frustrating.
    I now have a provider whom I pay about $360 per month, but recently I’ve been withdrawing from Some Fentynl due to my spinal injury & a widower with no family near to help I emailed the providers asking for them to get me some meals,I also made a couple of phone calls but couldn’t get to speak to my case manager but I left messages for her to call me back. Then I asked to speak to the manager and he was at a meeting so I asked for him to call me back, that was last Thursday and still no reply from him. Frustrated with all this I got out of my sick bed & went to a wonderful company that supplies meals & the lovely lady told me that my provider had to set that up for me but I had my details regarding my package and pension and she saw how sick I was and she tried to call the providers & ended up on hold about 15mins so she told me to go back home & she would sort it out for me & call me back. She said that this was the worse provider she had ever had before & that I should try a new one.
    The meals arrived on time a lovely gentleman and put them in the fridge for me.
    I understand that things can have teathing problems but the age population didn’t appear over night and the government departments have been working on this for many years now so they should have ironed out the problems by now.
    I’m wondering if providers should have been a private company’s as they can charge what ever they want, it at least should have been regulated and what’s the point of the government giving me a package and the providers take a chunk out of it and I also have to pay them. We have to get a fair go maybe a deeper inquiry would help.
    Marty
    Linda
    6th Mar 2019
    12:07pm
    Marty, the higher level packages 3 and 4, do offer substantial funds for getting support. The usual and required steps is to set out a care plan. I presume that happened but at level one maybe not. The care plan is a contract that they will ask you to sign. If you get one of those, then read it carefully and critically as that is where they spell out various policies of their service. I am a carer, of my partner, we had a very nasty first experience where a nursing home business branched out into home care packages. It was all about their profits and they took over 50 percent of the tax payer funds for their admin and case management and then the things we needed were not covered by the package (because they took so much for themselves, there was no money for what we needed). Every tax payer should be very upset by the way the designated funds are used. I may add, for the benefit of the troll, that by me, doing my duty, as I see it, the fact that I have been caring for over 10 years now, and only the last few have included meaningful support from a home care package. I can't work out of the home because I am needed here. As my partner declines and his memory is not the only problem he is losing his ability to talk, and is easily confused and needs lots of help during the day, and that means the responsibility and jobs for me only increase. I do it because I want to, I want to keep him home as long as possible, however the chances of me burning out increase every single day, because it is more than one person can do now that he is at this stage.

    It is common here to have problems contacting someone by telephone. I have found using emails to communicate very satisfactory. I can notify the providers of the issue and they usually get back within a day or so.

    Your take on the system tells me that since they started, it is just luck if one tries to contact my aged care and you end up with a person who actually knows things about the program. I have telephoned with a question more than once, this was when they first started the my aged care website. Every time I called I got a different answer to the same question. The site is complex to use and I try to avoid it. As I understand things, as a consumer, you have the right to change providers. It is good to try and find out what others think of the various providers in your area. I am sad that my aged care still does not have their act together and are still misinforming people and not helping, they have had enough time to fix it. I believe this is mostly because the government does not bother after a program is launched to roll it out properly, and unless they are forced will just let bad and inappropriate things happen. In my case I contacted the minister's office more than once and it took a full year for our problem to be fixed.

    I am glad you got your meals. If people try to manage at home and succeed, we are saving the taxpayers of this country piles and piles of money and at the same time we are able to be sure our loved one gets proper attention. And...it is 168 hours a week of responsibility, especially for all holidays. Being on your own makes it even more important that you have an excellent provider. I gather it is possible to have an advocate help you get a good provider and they can help with the contracts and the fine print that spells out how much of the package goes to you and how much the provider gets for uh providing. ha.
    Not a Bludger
    6th Mar 2019
    11:31am
    Well done Liberal Minister Ken Wyatt for shining a torch on this difficult but very important area - you seem to be one of the few who have an understanding of what is needed for we oldies into the future.
    Marty1
    6th Mar 2019
    11:37am
    Lothario.
    I certainly don’t live in a mansion, I have a 2br unit which requires some repairs & I pay for the gardening services gutters cleaning and windows cleaning out of my own pocket, I have a serious Spinal injury suffered in 1983 & kept working until 2001 when I was layed off as I couldn’t do my job or any job, it broke my heart having to quit.
    I’m not a Bludger mate spend an hour in my shoes.
    Anonymous
    6th Mar 2019
    12:09pm
    Marty1 - I’m sure you are in genuine need of hone help

    But there are many undeserving who rort the system hence my advocating That their homes be included in the asset test
    TREBOR
    6th Mar 2019
    12:50pm
    Dob them in, Lothario.....

    'their homes' - so there should be a lower limit dependent on value of home within a given area? Most fall below, but if you've lavishly laid out your home to lower your assets test...

    Perhaps it has to become mandatory that you retain all receipts and such for home improvements for ten years before retirement - a bit unwieldy, though. You'd have to look at the tens of thousands we've spent, for example, on improvements to cater for disability.

    It's not an easy call.
    KSS
    6th Mar 2019
    1:01pm
    Marty, if you are in a unit why are you paying for gutter and window cleaning out of your own pocket. Surely they are both Strata issues (except internal windows) and should be paid from from your Strata fees?
    Herbie49
    6th Mar 2019
    11:42am
    I hope to God I never need a home care package, I have a very good friend who receives a level 4 home care package. He shows me his “statement” every time I see him, the service provider is a well known and so called not for profit organisation, but they double dip him at every turn, for instance he has a cleaner who comes in twice a week for three hours, she is paid $26 an hour the service provider charges his package $52 an hour.
    On top of so called management fees and a raft of other double dippers.
    The government could save millions if it allowed the recieptients to manage their own affairs, seems you can’t do that, must have a provider.
    Talk about a golden egg, beggars belief
    Anonymous
    6th Mar 2019
    12:11pm
    Herbie49 -why not use it if you need it . Is your friend out of pocket in any way .if not what does he care how much his package is charged .
    Linda
    6th Mar 2019
    12:21pm
    The providers all double the rate or more for the actual service rendered, some of this is to cover their oncosts because they have to pay superannuation and also do certain legal things regarding selecting and having people on their books, police checks, training, etc.

    Your friend could possibly find a different service provider, that is less rapacious in their billings. It is all lined out in the contracts. Our first one charged 55 percent of the package value for their admin and case management, the second one charges 27 percent or less. When we signed up to the first package, I was far too trusting and it caused untold strife as I began to understand what they were doing on their behalf instead of ours. Since I am the carer, and am younger I am able to look things over properly, but for others, who don't have anyone to do that, there are advocates, and they can help with contracts and issues that are not being resolved. It is too bad that vulnerable people in our community can so easily be ripped off at the expense of their health and ability to manage. For me, this is down to poor oversight by regulators and government and very poor understanding of the circumstances of people who badly need in home support. By getting proper in home support, the massive expense to government of nursing homes is avoided and the consumers get to live in their own homes. It is potentially a win win but only if the settings are right. That is difficult because everyone has such different circumstances. I feel concern that the review may end up with a reduction of some kind because often the reviews turn into ways to rationalize a service, redefining the scope, and such.
    Herbie49
    6th Mar 2019
    12:29pm
    Lothario
    The point is more than half his package is spent on admin and management fees a bit like Linda’s comments above.
    And no he is not out of pocket but has to argue for those things that they perceive are not covered by his package such as home repairs, his oven has not worked for over a year and he was told it is not covered as he is responsible for repairs etc. He told them he has to eat and asked for meals to be provided, the oven has now been replaced, ditto collapsed brick paving which his wheelchair could not navigate etc etc eventually when he asked who he should sue if he falls it was done.
    In theory the home care packs are a great idea and keep people in their own homes which they are used to, my only point is that the provider takes more than half, when the bulk of it should go towards keeping people independent and not in aged care facilities.
    TREBOR
    6th Mar 2019
    12:51pm
    Tie me to the wheel of the yacht and show me that horizon..... adios muchachos, muchachas....
    Anonymous
    6th Mar 2019
    1:04pm
    I know most people on here would rather tie you to the anchor to shut you up
    TREBOR
    6th Mar 2019
    3:00pm
    Never happen...

    Wall, Pilgrim - fer an hombre what makes a livin' stealin' cattle from the ATO Corral, you run yer mouth mighty big here..... they useta hang cattle thieves.... but times have changed....

    (snuckles)...
    Old Man
    6th Mar 2019
    11:44am
    Reading this article leads me to think that most recipients are doing OK with a small number rorting the system. Whenever there is government money being offered, the usual suspects pop up with their hands out and, I suppose, the best way is to reduce that number. I'm not sure if the system will ever get things right but at least there has been an effort to identify the problems. The crucial next step is to close the loopholes and remove those from the aged care sector who are doing the wrong thing.
    Linda
    6th Mar 2019
    12:23pm
    Yes I agree. There are consumers that game the system and there are providers that game the system. I think mostly it is the providers. When the boss of a home care service makes nearly 200K pa, I just wonder where their hearts are. Perhaps in their pockebook.
    TREBOR
    6th Mar 2019
    12:53pm
    Yes, somehow it seems that those with enough already have the time and the energy to immediately pursue any freebies, meaning that people who hang back and wait until they can't go on without help then find there are no top spots available.

    It seems you just need to be first in and have a good line, and you're in.
    TREBOR
    6th Mar 2019
    12:55pm
    Conclusion:- honour has no part in this process.... much the same any many others... many a Digger should be on TPI but I know some who got in early on PTSD who are blatant drunks and have other 'issues' and even businesses etc, some from long before service... but I ain't sayin' nuthin'!

    First in, best dressed.
    Old Man
    6th Mar 2019
    12:59pm
    Interesting post Bob, Australia is a nation of non-dobbers. It's not a national thing to dob people in and maybe we should change although the way that whistle blowers are treated maybe we shouldn't. Maybe it has something to do with supporting the "underdog" although many don't realise that "pulling down tall poppies" is the other side of that same coin.
    TREBOR
    6th Mar 2019
    3:03pm
    Too true... I had the funniest family - me dad was high in the firies and his brother high in the coppers, but my mother (a Catholic) always warned that the coppers wuz always out to get ya... she also said the IRA were a bunch of shiftless ne'er-do-wells... not dobbing and such is part of the Oz way...

    I've been underdog and tall poppy.. makes no difference... today's peacock - tomorrow's feather duster...
    Oj.
    6th Mar 2019
    12:30pm
    I am very greatfull for the service HCP. it keeps us in our home a bit longer
    Having said that I have had untrained staff in my house that didn’t know the basics in hygiene or simple cleaning, the reason being the workers were untrained.
    That the staff is untrained should be addressed by the provider, as they charge the account and do very well out of us oldies. The system is open to over charging and profiteering but not by us oldies.
    BrianP
    6th Mar 2019
    12:42pm
    Is it not time to step back and see the way we are going in Australia? Big questions need to be asked about our priorities in life.

    We need a government where Ministers accept responsibility for doing the best for us. For example it is not acceptable just to say how surprised they are to find rorts and corruption in the care of vulnerable people.

    The buck stops with the minister when the care industry hides behind complicated rules and regulations to rake off profits and treat vunerable elderly so badly. Come on, do the right thing and set a good example.
    KSS
    6th Mar 2019
    1:06pm
    Has a copy of the report been lodged with the Royal Commission into Aged Care?
    Knows-a-lot
    6th Mar 2019
    5:22pm
    There is a chronic shortage of workers in the sector, and many in it are grossly inadequate.
    sunnyOz
    6th Mar 2019
    9:04pm
    Strongly dispute where this article states - "no aged-care qualifications beyond a police check". I cared for my elderly aunt for some years (including catheter changing, wound dressing, supervising medication, etc), before she chose to go into an Aged Care facility. So I applied to many places to do casual care. They all told me I needed to have a Certificate, none would even consider me. I would probably have more experience than most carers, but seems you need to do a course, and get certificate for even cleaning, or shop assistant, now. Experience and life ability means very little.


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