Protecting seniors amid Support at Home changes – for Prestige’s CEO Mark O’Brien, culture, character and corporate strength is critical to providers meeting this moment

As the months go on, it is starkly clear that the November reform changes have brought change, confusion and challenge to a sector already tackling weighty and serious tasks. Particularly when it comes to the Support at Home changes, seniors have shared their heart-wrenching stories online about being left in the dark, to figure out the confusion and cost alone. Home care providers are needing to choose their paths to meet the moment. Prestige is a home care provider built up by nurse, Nick McDonald. Last year saw McDonald step back from the top job, and in his stead, entered Mark O’Brien. And what a time to step up. A tumultuous time for the sector with profound changes in act, rules and compliance, and a transition time from founder-leader, to new leadership was needed to be managed. O’Brien shares the story of the last few months, and through his transparency non-negotiable elements of business and integrity emerge. Corporate excellence cannot stand without character and culture-filled compassion. For a sector that has at its heart some of Australia’s most vulnerable, O’Brien shares there is an opportunity to build sustainable growth through thoughtful, truthful and accountable operations. This means going above and beyond in functional operations. As Australia’s ageing sector grapples with changes, the appetite for transparency and protection from its turbulence is set to become a key differential between providers. Having a client’s ‘back’ could well be a defining strategy in the months and years to come.

Managing turbulence

Leadership across aged care sector have wrestled with how to simply keep going amid it all. Being able to show up and protect clients means having a resilience that can weather countless reform, rule changes, and oftentimes being last minute and opaque. O’Brien is open, “everyone has a bad day at the office.”

“When a system is tested or when we face a difficult conversation. In this sector those moments carry weight because they affect real people and families. The key is not avoiding them, it is how we respond.”

For O’Brien, “what underpins resilience for me is the culture of the team. We are united by a shared purpose. There is no politics, no silos and no passengers. Everyone contributes and everyone owns the plan. When we misstep, we are accountable. We say it plainly, we fix it and we learn from it. That honesty matters.”

Far from the glossy smiling pictures of corporate robots, O’Brien shares a reality of protecting a team to voice uncertainty, to voice fatigue. Managing and thriving in a sector that asks as much of staff as aged care means a leadership team carving out space for vulnerability.

“We also have permission to be real. People can show vulnerability without fear of judgment. That creates psychological safety, which in turn creates better decision making. We challenge each other respectfully because creative tension leads to stronger outcomes. We are not afraid of debate, but we stay aligned on the mission.”

Listless conferences, or meetings with no substance cannot support a team to be as united as aged care needs. O’Brien squarely places the strength to keep showing up here, “resilience is built in that [supported vulnerability] environment. It comes from knowing that even on tough days, you are part of a team that is honest, accountable and united.”

When there are missteps, there is accountability, where there is disagreement, it is voiced clearly and respectfully. O’Brien champions building up real, vulnerable, hard-working, sincere and passionate human-beings, that is non-negotiable in meeting what is here and what is coming for aged care.

“We reflect, we adjust and we move forward together. In aged and disability care, that collective ownership and commitment to continuous improvement is what keeps you coming back and doing the work well.”

Supporting character and culture

O’Brien works to safeguard, in himself and for staff, that the work can be done well, and it can be done with a laugh, “this is serious work, but it does not have to be joyless. The combination of heart, discipline and humour is something I value deeply, and it is what makes leading Prestige both meaningful and enjoyable.”

Speaking from his team, and echoing sentiments across high-performing providers, there is and must be space to share joy in the work, “what makes me laugh most is the energy and personality of the team.”

He details how within the corporate structure, human-beings and what makes them flourish must be seen as valuable and not only that, core strategy. From times of being goofy in the office to encouraging care staff to laugh with clients, there is a way for leadership to protect its staff and clients from being battered by the waves of confusion.

“There is a warmth and sense of fun at Prestige that you do not always expect in a sector that deals with serious and emotional situations. Whether it is a themed office day or seeing a care team bring humour and lightness into a client’s home, there is a genuine ability to find joy in the everyday.”

Proximity is also built into O’Brien’s day, to be alongside front-line staff as they do the work of caring, being alongside staff is not a checkbox, it helps with his energy and overall vision, “spending time with our teams has been incredibly rewarding.”

“Being out in the field with case managers, joining care teams and NDIS clients for activities and seeing the relationships being built reminds me that while we talk about growth and governance, this business is ultimately about people.”

Strength – compassion and corporate

In hearing O’Brien’s story, it is clear there is no room for lip-service, what he says must be lived out, views and policy lived in practice by those in the business impacted by them, both staff and client.

He is clear, “compassion and corporate discipline are not opposing forces. In aged and disability care they rely on one another.”

“You cannot build a sustainable organisation without genuine respect for the people you serve, and you cannot deliver compassionate care at scale without strong governance, financial discipline and operational structure behind it.”

O’Brien shares that leadership must fight to remain grounded, to remain aligned to what is actually happening with the sector, their clients and staff. To even begin tackling the business of management, the turbulence of a new act and rules, means knowing first hand how it’s impacting the most vulnerable.

“I stay grounded by staying close to the frontline. That has meant spending time in the field with our case managers, understanding the complexity of coordinating aged and disability support in real homes and real lives”, he shares.

“It has meant joining care teams and NDIS clients for activities like going bowling, which is a powerful reminder that our work is not just about funding models and compliance frameworks, but about independence, dignity and human connection. Those experiences keep strategy anchored in reality.”

O’Brien kindly shares that his personal life has a part to play in how he leads, “On a personal level, my parents are ageing, and that perspective never leaves me.”

“They instilled many of my core values including responsibility, fairness and care for others. Watching them navigate later life reinforces why this sector matters and why decisions must always reflect the lived experience of families.”

In a sector that has been rolled by the failings of poor-providers that have caused immense harm, O’Brien is direct, for high-performers, “compassion shapes why we exist. Corporate capability ensures we can keep fulfilling that mission sustainably and at scale. In aged and disability care, the two are inseparable.”

Transition time

O’Brien shares that underpinning his taking over of the CEO role was an “alignment of values and intent.”

Honouring legacy and developing forward is far from a polarising duality, “from our earliest conversations, it was clear we shared the same commitment to culture, purpose and genuinely client first care, which is what Prestige has always stood for. It was equally important to honour the legacy Nick, Thea and the team have built over more than 20 years. This transition was never about replacing that legacy, but building on it and positioning the organisation for its next chapter.”

And what a chapter it was to be. As the new act came into action, so too did O’Brien step into the top job. He owns what was most needed, “I stepped into the CEO role in November, the immediate priority was stability and clarity.”

“The sector was navigating the implementation of Support at Home, alongside broader reform, workforce pressures and cost escalation, so the first focus was to steady the organisation and ensure we transitioned through that period with confidence.”

In a move away from the dogma of ‘strength, strength, strength’ O’Brien and team stepped into the time of transition knowing full well learning, uncertainty and pivoting would be integral. Gaining insights, making observations and taking the time to truly build relationships was important to underpin the culture that McDonald and O’Brien cherish professionally and personally.

Avoiding lip service meant earning trust through building relationships. O’Brien shares this was on his heart to action in reality, “I also felt it was critical to be visible across the organisation.”

Not just in making the time, but practically conveying that all staff are valuable to shaping the group and industry was important to O’Brien, “that meant spending time with frontline teams, building relationships, listening carefully and understanding the day to day challenges our people and our industry are facing.”

“During any leadership transition, visibility builds confidence and trust, and it gave me valuable perspective on where we could evolve and strengthen.”

Proactive

If there has ever been day to day challenges, the new Support at Home program has brought them for senior and provider alike. The new scheme has been causing concern and worry from all parts within the sector and out. Now yet again before the Senate with the Inspector-General Natalie Siegel-Brown testifying about the lack of clarity about moving away from former programs to a program not fully evidenced, hearings have brought to the fore just how difficult, frustrated and confused the changes have been for many.

O’Brien shares that from a provider perspective the Support at Home change had to be urgently met, “a key early priority was stabilising the organisation post Support at Home and ensuring the operational impacts of reform were properly embedded.”

As the changes ripple throughout the sector, off-kilter has certainly been growing as a dominant sentiment with seniors increasingly frustrated at being left out in the dark, fumbling with confusing invoices, changed services and costs. O’Brien advocates for a bold perspective of provider responsibility in the time of confusion, to go above and beyond, to utilise resources to protect and shield, to stabilise.

For this to be across an organisation takes a decision from a united leadership, for policy to reflect the compassion, transparency and corporate excellence.. How the rubber hit the road for O’Brien’s was in showing initiative. There is no place for laurels or waiting in aged care, resources need to be actioned and allotted.

“Importantly, we have kept the client experience front and centre. Our Case Managers proactively contacted each client to explain what is changing, reviewed care plans and ensured people felt informed and supported throughout the transition. For us, compliance should never feel remote or procedural. It should feel like reassurance that someone is advocating for your safety, dignity and quality of care.”

Support at Home

O’Brien shares that when it comes to the Support at Home changes, he has sought to listen, “yes, we have heard from clients.”

“What they are asking for is clarity, transparency and practical guidance to help them understand what is changing and what it means for them.”

And for high-performing providers this is and has always been an opportunity to step into excellence both compassionately and corporately. In the face of confusion from government messaging and reform, to put in extra work to walk alongside the seniors in the midst of stressful change has become ethical and business leverage.

O’Brien shares the first reactions the team had, of pragmatic preparedness and empathy to guide corporate response to the reform, “whenever significant reform is introduced, uncertainty is inevitable, and Support at Home has been no exception.”

“We understand why older people and advocates have concerns about the revised pricing model, particularly where it affects access to essential services. These are deeply personal issues that impact daily life, and they deserve to be handled with care and respect.”

He champions that providers can step up to protect and guide, “there is no single way to apply Support at Home. Each person’s circumstances, goals and funding position are different, so our role is to guide them through the transition in a way that is clear and considered.”

He shares, “that often involves bringing together our case management, client services and finance teams to review care plans, explain pricing structures and ensure clients feel informed and supported.”

The corporate evolution, based on culture, capability and compassion, has meant authenticity between corporate speak and reputation-bolstered reality. Going the extra mile, particularly with Support at Home has meant commercial and cultural currency for the group, “what clients quickly recognise is that they are not navigating this alone.”

“They are supported by a coordinated team focused on maintaining continuity of care while helping them make confident, informed decisions about their services.”

And they stay. Analysts and advocates are voicing that in this time of confusion, it is providers that prove commitment to transparency and truthfulness, by shaping policy and resources to walk alongside senior’s as they navigate the Support at Home changes, that may deeply redirect market share and growth opportunities.

As is the case with many a Hollywood story, when the chips are down, it’s those who come to aid in the tedious, in the confusing, in the stressful that make big impacts. Advocates say that seniors and loved-ones will have long memories from how providers respond in this time.

Meeting the challenge

Being honest and capable for clients has meant honesty and a lift for O’Brien and his team, “Support at Home has been challenging.”

“At times it has genuinely felt like we are building the plane while flying it.”

He shares that the team needed to commit significant resources to position themselves to not only understand, but be in a strong position to weather the changes the reform brought, “the administrative lift has been significant, guidance has evolved, and interpretation has required constant attention. We are hearing similar feedback across the industry.”

“If a well-resourced, scaled provider like Prestige has found it demanding, we know that many smaller providers are feeling that pressure even more acutely.”

There is no denying that senior and provider both have been on the back-foot, in order to be in a kind and corporate position to maintain excellence, O’Brien shares that preparedness is a non-negotiable, “for us, it has been a long game approach rather than a last minute scramble.”

He shares that in aged care, it is integral to constantly prepare for change. This is simply the industry.

“Early on, we established a dedicated working group made up of internal knowledge leaders who understand the reform in depth and can translate policy into practical action. They have played a critical role in interpreting updates, anticipating implications and guiding the operational, compliance and client facing adjustments required across the organisation.”

To be working from a position of “structure and confidence” means investment and internal change, “we have also invested heavily in future ready technology and systems.”

Underpinning clear navigation, shock-wave proof reliability and insight into care and services meant building up support mechanisms for staff as well, “for our teams, we are focused on tools that make it easier to identify emerging needs, adapt quickly and remain responsive as the reform environment continues to evolve.”

But it all comes from naming what is happening first, “the reform is substantial and complex.”

In owning the challenge, transparently and from a place of leadership, the whole team has felt included in the lift, “it has not been without its challenges, but thoughtful preparation and the right systems have allowed us to approach it with structure and confidence rather than disruption.”

Absorbing complexity

O’Brien shares that the group has embraced the opportunity of going one step further. Not only seeking to, in real-time, grapple and meet with the complexity and confusion of the Support at Home changes but to shield clients from it.

Provider leadership and industry leaders have been vocal about the position government reform has put them in. Increasingly opaque rules and programs mean parsing through legislation at great resource and time cost, sometimes right before Christmas. At the current time, this unfairness can only be faced head on. Showing up for clients is what so many in the sector want to do, for many leaders that has meant shouldering greater responsibility.

O’Brien affirms the sentiment of many of his peers, “Support at Home has been a time of genuine confusion across the sector and, at times, there has been a lack of clarity as reforms have evolved.”

He has also spent the time to clearly seek out how seniors are feeling, “you only have to read the online forums and social media groups to see the level of concern and uncertainty being expressed by seniors and their families.”

He names the frustrating reality for many in the sector, “some providers have been able to adapt quickly, while others have clearly struggled with the administrative and system changes required.”

Importantly he notes, “We recognise that this broader uncertainty has flowed through to clients, particularly when it comes to understanding invoices and how new pricing structures apply.” It is here that O’Brien shares a key compassionate and strategic opportunity providers can step into, “our job is to absorb that complexity on behalf of clients and translate it into something clear, transparent and manageable.”

The complementary duality of compassion and corporate excellence functionally exists in putting money where the mouth is, “we have invested significant effort in simplifying information before it reaches clients. That includes clearer invoice formats, plain language explanations and ensuring our teams are equipped with consistent guidance so communication remains aligned and thoughtful.”

Safeguarding staff sitting by the phone with an elderly client, having the time to truly be alongside them is what provider policy meeting need looks like, “most importantly, we have remained hands on.”

“Our client services and case management teams will walk clients through their statements line by line where needed, explaining how Support at Home applies to their individual circumstances. While the reform environment may feel complex, the client experience should still feel personal, supported and transparent.”

Far from the cutting corners with AI powered systems, oftentimes buggy beyond use and prohibitive for loved-ones let alone seniors, sn the commitment to human-based, trained-help when clients need it. This is powerful market differentiation.

“What we continue to hear from clients is that reassurance matters. Knowing there is a real person who understands the system and is prepared to advocate on their behalf provides confidence during what has been a period of significant change.”

Transparent and fair

The assumption of seniors demanding everything to be free is false, advocates and providers tracking with seniors have seen that when it comes to Support at Home prices, what they are desperately seeking is transparency and clarity.

For many seniors, there is a keen understanding of inflationary pressures and cost management for providers. However what has been behind a growing source of recoiling and sense of betrayal is the meteoric increase in home care services under the new Support at Home program by some providers. With the government allowing a free-market price setting until July 1, seniors have contacted Hello Leaders showcasing upwards of 100 per cent increases in services.

O’Brien acknowledges the current environment, “in the absence of formal price caps, there is a risk that pricing across the sector becomes inconsistent.”

He shares that in response, the group has worked to be guided by three north-stars, “our focus has been to remain steady, transparent and fair.”

“Until caps are introduced, our approach centres on responsible pricing, clear plain English communication and avoiding unexpected surprises for clients. We believe predictability and trust are essential, particularly during a period of reform.”

O’Brien advocates that on top of transparency, pricing should be guided by stability, large jumps have no place in providing trusted and dignity-based care, “we operate with a detailed and transparent cost model and regularly benchmark our pricing to ensure it remains appropriate and competitive.”

He points too, to the incoming price caps that will be introduced. Avoiding disruption, and the telling transparency of being stratospherically above what government’s price services are set at, will be a point of contention in provider reputation come July.

“We are preparing for the introduction of price caps by streamlining operations, tightening workforce planning and investing in technology. The objective is to remove inefficiencies now so they are not passed on to clients later.”

O’Brien notes, “when price caps are finalised, providers who have already done the structural work will be well positioned. Our goal is that clients experience continuity and stability rather than disruption.”

Compassion and capability

The sector needs high-performing providers that are robust in their financial management, future-proof and uncertainty ready.

For O’Brien and his team the ingredients that go into this are non-negotiable, strong cultural and character-filled team-members, working to build corporate infrastructure that will go the distance.

This means making space for uncertainty and confusion, it means proximity to those they serve, it means showing up after a string of bads days because the work is important and worthwhile.

Corporate and financial structures stable enough to weather reform-earthquakes, alongside organic vines of human-care can be the infused partnership of providers, “we combine heart with infrastructure.”

“Clients experience warmth, flexibility and responsiveness at the front line, supported by rigorous governance, strong systems and aligned leadership behind the scenes. That combination of compassion and capability is what truly differentiates us.”