On the frontline of change: Home care, leadership, and the real cost of reform

Raised in a defence force family — her father served in the Royal Australian Air Force, and her extended family has generational ties to the military — Your Side Chief Executive Officer Danielle Ballantine embodies leadership traits of purpose, resilience, and strength.

These values have defined her career and personal life, underpinning her success across a range of industries. Known for her can-do attitude and willingness to help anyone at any time, Ms Ballantine brings a sense of mission to everything she does.

“When you grow up on base, you’re surrounded by men and women who serve a purpose greater than themselves. It’s quite intrinsic to me,” Ms Ballantine told Hello Leaders. 

“That mindset helps me elevate the voices of vulnerable Australians so they’re not lost in policy or legislation. It’s a core part of my leadership style.”

Supporting home care clients at Your Side remains one of Ms Ballantine’s biggest motivations, especially because of the joy she finds in listening to older adults share stories from their lives. 

For her, it is the greatest privilege to be invited into somebody’s home to provide care and support. She understands how rare it is for people to be invited into another’s home, and this deep connection contributes to the strong bonds between staff and clients.

“We shouldn’t underestimate the critical relationship with the worker. Workers are the glue that holds everything together. Without them, it all falls apart,” Ms Ballantine added.

After some tough years in the aged care landscape, Ms Ballantine spoke candidly about the need for a unified effort by the sector, government, and media to speak positively and constructively about care workers and their achievements.

She touched on examples of her own staff who have helped older people avoid eviction, stepped in to perform welfare checks when no-one else could, or even cleaned up mould that went ignored by a social housing provider. 

“There are many amazing stories within the industry that should be amplified,” she said. 

At a recent public event, a group of passionate clients proudly wore Your Side-branded polo shirts, manned the stall, and enthusiastically spoke to passersby about the care they receive — all without telling the staff what they planned to do. It highlighted what positive relationships can achieve. 

“It made me so happy to know that the team is doing such a wonderful job, that it’s positively impacting on clients and they want to shout it out,” Ms Ballantine added.

Support at Home is coming, but who will bear the real cost?

With just two months to go until the rollout of the Support at Home program, there is one decision that Ms Ballantine fears could not only impact staff and clients, but also families: the government’s decision to halve the care management fee cap from 20% to 10%.

“Care management is a service in itself, it’s not administration or overhead. Reducing it from 20% to 10%, essentially giving it a 50% discount, has consequences,” she said.

“If you look through reports from OPAN and the Aged Care Quality and Safety Commission, criticisms often sit in areas where a care manager should be stepping in and doing that work. “If the sector’s struggling to meet those expectations now, how does reducing it by half drive improvements in areas where there are complaints?”

Lower funding could make services overly prescriptive, cutting out tasks that can no longer be covered under reduced funding. This risks undercutting skilled staff, jeopardising quality of care, and limiting career opportunities. 

“It has quite a significant risk. There’s going to be an erosion of skilled case management, which means clients will fall through the gaps,” Ms Ballantine stated. 

“We know many direct care workers see care management as a career pathway. Reducing the care management aspect of the role will dull job satisfaction and limit the career development opportunities for staff. 

“The resulting recruitment and retention issues for the industry will cause inefficiencies which will impact the sector and the community. We risk losing the attraction of people with the passion and dedication to quality care that aged care needs most.”

Ms Ballantine highlighted the issue further while discussing the importance of care management. This, she explained, is the work experienced Care Partners do for their clients in care planning; e.g. service coordination, monitoring, review and evaluation, advocacy, and support and education. 

A Care Partner within a robust care management framework can create better care plans for participants, not just within Support at Home, but also with adjacent services to support people to achieve the best outcomes from the aged care services they receive.

However, she warned that eroding skilled case management could ultimately lead to greater pressure on informal carers — typically women, including partners or adult children in the sandwich generation. 

“The 10% care management cap is not just a cost borne by providers. It’s a cost borne by women. I’m very concerned about the long-term implications,” Ms Ballantine added. 

“Some might see care management as something that families can do. But it is skilled work. Care managers bring incredible value to the role. 

“To push that responsibility onto families who are in that sandwich generation, we could again see women moving from full-time work to part-time work. That affects their earning capacity, their financial capacity later in life in terms of superannuation.” 

Uncertainty looms large for providers and clients

The new Support at Home program has made its presence known — but many of its key features remain unclear, leaving providers scrambling to prepare.

“There’s still a lot of detail to be released, and we’ve got a very short runway to get ready, particularly for things like digital transformation and client communication,” Ms Ballantine said.

“I’m conscious that we have the shortest amount of time available to prepare our infrastructure. That means clients have even less time to understand what’s going on.”

Informing and educating clients is critical to the success of Support at Home. Yet that responsibility adds pressure to staff working with an already tight timeline.

A key challenge will be managing new client agreements, with changes to fee structures potentially creating “cost shock”. 

Charges that were once standalone, such as care management, will now be bundled, and many clients will face co-contributions for the first time.

“It’s care partners or care managers having those one-on-one conversations, going through budgets and service agreements. We don’t know how older people are going to react,” she explained.

“People are looking for assurances. As a sector, we can’t provide them yet, because we simply don’t know everything.”

Despite these challenges, she’s optimistic about the long-term benefits, as Support at Home will reduce barriers to care and system inefficiencies. It places older people’s rights at the centre of legislation, giving them more choice and giving providers more opportunities to meet their needs. Your Side is committed to supporting and informing all clients, even with the uncertainty that hangs over the sector.