Home care providers hindered by communication issues, Commission reports

Complaints over communication and finances are the top issues for home care providers with the Aged Care Quality and Safety Commission keen to improve all home care experiences ahead of the Support at Home implementation.

These key issues have been highlighted in a recent report, Complaints about aged care home services – Insights for people receiving care. Although providers were the focal point of the Commission’s preceding report, Complaints about aged care services – Insights for providers, the latest release still provides plenty of information to help service providers.

What the stats say about home care

• Over one million people received home care services between July 1 – December 31, 2023; 267,608 through a Home Care Package (HCP) and 816,132 through the Commonwealth Home Support Programme (CHSP)
• There were 2,217 resolved home services complaints during the same period with 92% of the resolved complaints relating to HCPs
• HCP complaints increased marginally compared to the previous year, rising from 37% of all aged care complaints to 40%
• One-third of all home care providers were the subject of at least one complaint
• The top five most common home service complaints were: lack of consultation and communication (15%), fees and charges (10%), management of finances (8%), consistent client care and coordination (6%) and reimbursements (6%)

Communication and finances are persistent issues

The Commission highlighted both communication and finances as the most common issues with home care services, as seen in the top five most common complaints received. 

“Older people have told us that providers do not always involve them in planning their care or communicate well about how their services are coordinated. They can also have issues understanding fees and the way the provider charges for services. This can include problems understanding statements and invoices,” the report read.

“So, for people choosing a home service provider, or currently getting home services, this may be an area to pay special attention to.”

Janet Anderson, Aged Care Quality and Safety Commissioner, stated in the report’s opening statement that it’s not always easy to get home services right. 

The home care market is far more diverse than residential aged care, too. Many small operators lack the same depth of resources or experience to call on when issues arise. 

For example, the Commission shared a case study where a client, Leon, on a Level 3 HCP was told he had $8,000 worth of extra funds. The provider suggested he use it for extra care. Then, just four months later, the provider told his guardian, Rhonda, that they had overspent his package and a $5,942 debt was incurred. 

Despite putting in a plan to reduce the debt – which ultimately reduced Leon’s services – the debt increased drastically to $12,636 within six months of the client having a healthy surplus of funds. Rhonda promptly lodged a complaint with the Commission regarding the “confusing and inconsistent communications about the package funds”.  

The Commission contacted the provider who agreed they had not monitored or managed the package funds correctly. A $5,000 credit was offered towards the debt, however, a copy of the fee statement showed the package was still not covering the amount being spent and the debt would keep increasing. 

The Commission asked the provider to explain: 

• Why the package was still causing further debt
• Why they did not tell Rhonda about the extra increase in HCP overspending
• Why they had not told us
• How they were following the User Rights Principles 2014
• How they were going to resolve this complaint and make sure their delivery of services under Leon’s package did not cause any further debt

“The provider was not able to respond adequately to some of the above requests, including demonstrating how they were complying with Aged Care Quality Standards 2 and 8, and the User Rights Principles 2014,” the report stated.

“After some time, the provider agreed to take full responsibility for payment of the debt and excess charges. They also submitted a plan to fix the underlying issues that led to Leon’s package going into debt. 

“The Commission provided feedback to the provider on using open disclosure when handling complaints. We also recorded the issues for consideration in the next audit of the service. This will help to monitor and identify systemic issues which might impact other HCP recipients.”

With one in three providers subject to a complaint and one in three complainants unhappy with the outcomes of their complaint, there is still plenty of room for improvement. The Commission’s case study showcases that the provider struggled to respond to all concerns without further support. 

The full document can be found on the Aged Care Quality and Safety Commission’s website.