‘It’s time to refocus my North Star’: Prestige Inhome Care’s Nick McDonald on family, legacy and leadership

In a significant shift for the Australian aged care sector, Nick McDonald, Founder and Chief Executive Officer of Prestige Inhome Care, has announced his decision to step down from his day-to-day operational role.

Effective 21 November 2025, McDonald will transition to a non-executive director position on the company’s board, marking the end of an era for the family-owned provider that has become a cornerstone of in-home care services across eastern Australia.

Speaking with Hello Leaders, McDonald reflected on a 20-year journey driven by passion and a commitment to enabling Australians to age with dignity in their own homes and the emotional weight of this change.

“It’s a bit frightening given it’s been such a big part of my life. I’ve been so devoted to one sort of purpose for so long, almost to the extent of other things, that it’s a bit daunting to think about not having that.”

Yet, he emphasised the pull of family as his guiding force.

“A big part of the reason is that I’m refocusing the North Star on my family. I’ve still got three young kids and they want me around. I don’t want to turn around in another five or ten years and then get some time back but have my kids all grown up and living their own lives. I want to give some of myself while they still need it. So I guess that is helping me combat the feelings of maybe loss or fear or worry with some real certainty that it’s the right thing to do. It’s a great time for the people you love most in the world.”

He added that the business is primed for success.

“The business clearly is in amazing shape with tremendous leaders. I don’t worry that suddenly our purpose or the people that we serve are going to be negatively impacted, so that gives me a bit of comfort as well.”

McDonald stressed his continued involvement.

“It’s important that the messaging to our teams is that we’re getting a new CEO, but I’m staying heavily involved as a director. I’m still invested personally in the company. I’m not disappearing. I’m still very invested in the success of the business.”

Alongside his uncles, Tim and Paul Donohue, McDonald founded Prestige Inhome Care in 2005, pioneering 24/7 in-home support at a time when such services were still developing. As a registered nurse (RN DIV1) and Graduate of the Australian Institute of Company Directors (GAICD), McDonald’s background deeply informed the company’s ethos.

Growing up in the corridors of his father’s medical practice, he gained early exposure to healthcare. His experiences in residential aged care, hospices, clinics, and in-home personal care highlighted the limitations of institutional settings.

Under McDonald’s stewardship, Prestige evolved from a modest operation with seven team members into a trusted provider employing more than 800 care and office staff. The company now supports over 400 clients weekly across Melbourne, Geelong, the Mornington Peninsula, Sydney, and the Sunshine Coast. This growth reflects not only operational expansion but also a dedication to tailored, flexible care solutions.

McDonald, alongside his sister and Chief Operating Officer, Thea McCroary, who has been integral for 16 years, has cultivated a culture centred on quality and compassion.

McDonald’s leadership has been characterised by innovation and advocacy within the aged care industry. Prestige proudly claims to have pioneered round-the-clock in-home care, setting a benchmark for accessibility and responsiveness.

Recent developments underscore the company’s momentum. Last week, Prestige announced its assumption of management for Vision Australia’s Home Care Package (HCP) clients, effective 1 October. This transition, built on a decade-long partnership, ensures continuity for clients with blindness or low vision. Vision Australia’s case managers have joined Prestige, with ongoing training to maintain specialised services.

“We are deeply proud to continue the incredible work Vision Australia has done in supporting the blind and low vision community,” McDonald said in the announcement. “Our team is passionate about making lives better and dedicated to delivering exceptional service tailored to each individual’s needs.”

This move aligns with broader industry trends towards consolidation and specialised partnerships, particularly as the sector navigates the impending Aged Care Act.

McDonald has been a vocal commentator on these changes, particularly the highly contentious Support at Home program, which replaces Home Care Packages and Short-Term Restorative Care. The timing of his transition, he explained, was influenced by a desire to ensure Prestige’s readiness.

“It’s not the only reason, but it’s a small part of the timing for us to make sure that I could support our COO, Thea, in ensuring our company is well prepared for Support at Home. To bring a new CEO in and say, ‘Oh yeah, there’s all this change happening and here you go, good luck,’ I wouldn’t have felt comfortable. Whereas I think we’re now at a point where we’re very confident, as prepared as we can be, and there are actually a lot of really great opportunities for people who are well organised.”

In his interview, he elaborated on the uneven preparation across the sector.

“There are sort of two groups that I’m seeing. There’s one group that, when I talk to them, I think, ‘Jeez, you’re not as advanced in your thinking as I think you should be.’ And then there are others assuming it’s not a big deal, so they haven’t really put their time and attention to it. And obviously there are some like us that have been working super hard and have got their ducks in a row. But for those that need to catch up, you guys are going to have your hands full. It’s either people who think they’re organised and perhaps they’re not, or it’s people who think, ‘This won’t happen, this isn’t a big deal, it’s not that big a change.'”

He attributed much of this to “the lack of clear guidance or information from the department for the industry. We’ve heard that countless times from the peak bodies and everyone else. From journalists to politicians, it’s just been messy. We want to do the right thing, but it’s like playing sport when no one tells you the rules. You don’t go on the cricket pitch and start tackling people, do you? You’re not allowed to. It’s just not been handled well in terms of making it clear what is expected of providers, with enough time for those who are well-intentioned to comply and deliver what’s expected for people who are pretty vulnerable. So that hasn’t helped. I don’t put it all on providers that might be burying their heads in the sand or lazy or anything. I think people in this industry genuinely want to do the right thing, but it’s been a bit hard to know what that right thing is.”

Earlier this year, McDonald warned of potential pitfalls for smaller providers under the new Support at Home program, including financial pressures from direct consumer billing and the risk of an unregulated black market for care if affordability issues arise.

“The shift to direct consumer billing disrupts cash flow and debt collection,” McDonald explained, highlighting how smaller organisations may lack the infrastructure to adapt.

He drew parallels to the Veterans Home Care program, where co-payments led to inefficiencies and absorbed costs. “Smaller providers may struggle, leaving only large-scale organisations to dominate,” he cautioned, potentially reducing consumer choice and diversity in care options.

McDonald also raised concerns about rising out-of-pocket costs driving consumers towards informal, unregulated arrangements.

“If people can’t afford care through registered providers, they might pay support workers under the table, leading to unsafe arrangements,” he noted.

His proposed solutions include market-driven pricing for flexibility, higher funding ceilings for complex needs, and enhanced support for family carers through financial aid, respite services, and training.

“Family carers save billions annually, but without support, we’ll see more burnout,” McDonald emphasised.

Advocating for sustainable funding, he suggested a Medicare levy dedicated to home care.

“Why not introduce a Medicare levy for home care to stabilise the sector?”

Additionally, he stressed the need for clear government communication to manage expectations, rather than leaving providers to bear the brunt of consumer resistance.

Beyond policy advocacy, McDonald has addressed operational challenges within the industry. He has also critiqued overly risk-averse practices in home care, arguing they can limit clients’ independence and quality of life.

“Some organisations’ response to risk management is simply to avoid the activity altogether,” McDonald said, citing examples such as prohibiting carers from moving lightweight furniture or dusting high shelves.

This approach, he argued, stems from liability concerns and high workers’ compensation premiums but often results in absurd scenarios.

“The poor carer is the one saying, ‘I’m sorry, I can’t move that chair,’ even though it’s a lightweight office chair on wheels,” he remarked.

At Prestige, McDonald implemented a balanced strategy: comprehensive training, robust risk analysis, and client-directed care.

“We use tools to rate risks and apply controls, but then we ask, ‘Does this sit comfortably with us? Is this practical?'” he explained.

This common-sense philosophy empowers carers and prioritises client needs, even if it means accepting managed risks.

Looking back on two decades of milestones, McDonald highlighted the move into Prestige’s head office just before COVID as a poignant symbol of growth.

“I think moving into our head office just before COVID, moving out of quite a small space into a much bigger space, and then seeing all the people coming in there as their new kind of working home. That was one of the times that I thought, ‘Holy crap, how far have we come? How lucky am I to be part of it?’ That’s definitely something that sticks really strong in my mind.”

He also cherished acquisitions like the Sydney-based Dutiful Daughters.

“Probably the other most memorable thing is that we’ve acquired four or five different businesses. The last one was a company called Dutiful Daughters in Sydney. I look back on that very fondly. The process of working with another owner who wants to exit, and having them choose you as the one they trust to take their little baby to the next level, then working with their teams to really understand what’s great about their business and where we can add value or learn from them. Those were very exciting and enjoyable times, and fortunately we got them right. Seeing those businesses continue to thrive under new leadership is really rewarding.”

The COVID era, however, tested the organisation profoundly.

“On the flip side, anyone in our space, or everyone in the world, really, knows the COVID period was just extraordinary in terms of the distraction from core work. The need for agility and the ability to adapt quickly. Seeing some of the leaders and teams in our business respond to those challenges was the silver lining, but you can’t shy away from the fact that it was a shocking period. You weren’t sure if you were going to be able to keep people safe and alive. The rules were changing every five minutes. You couldn’t access PPE, staff couldn’t work because they had to isolate for certain periods of time. It was a horrific time to be in health.”

Yet, as a self-described “glass half full kind of guy,” he found inspiration in his team’s resilience.

“With most things, I’m a glass half full kind of guy, and seeing people’s response to that was inspiring. Coming out the other side, you take a lot of learnings, and it also helps you really appreciate the good times when you’ve seen how tough things can be.”

As McDonald steps back, he hands the reins to Mark O’Brien, who assumes the CEO role on 24 November 2025. McDonald expressed confidence in O’Brien’s talents.

“I am extremely pleased we have been able to find such a talented, passionate and kind person to continue to support the amazing work that Prestige does.”

O’Brien will be supported by McCroary and the leadership team, positioning the company for continued growth amid expanding opportunities in in-home care.

While transitioning, McDonald remains committed.

“I’m not stepping away, and I remain deeply committed to the purpose that started it all.”

McDonald’s departure signals a new chapter for Prestige Inhome Care, but his legacy of innovation, advocacy, and client-centred care will endure. As the aged care landscape evolves with regulatory changes and demographic shifts, leaders like McDonald remind us of the importance of balancing compassion with pragmatism.

The industry will watch closely as Prestige, under new leadership, builds on its strong foundations to meet the growing demand for high-quality in-home support.