Home care was under the Royal Commission’s spotlight on Monday, as the second set of hearings began.
Raelene Ellis, a lawyer from Caloundra, Queensland, told the commission about her experience caring for her mother, Therese Ellis, who is living with dementia.
Her mother was assessed as needing a level 3-4 package, and eventually did receive the level 4 package.
“I was over the moon,” she said when the package came through.
“It was like this sense of relief that finally mum was going to get the care that she needed.”
But Ms Ellis soon found out the package “equated to only nine hours a week.”
Ms Ellis said her mother’s administration fee amounted to 38 per cent, or nearly $20,000, of her $50,000 home care package.
“Their admin or coordination fee of 38 per cent equated to $18,845.17 a year, just straight out for their management of it,” she said.
Ms Ellis said she was also charged twice for some services.
Her mother was receiving podiatry and gardening services, which were outsourced by the home care provider which charged a $25 handling fee for each booking.
“So, essentially they’re getting paid twice,” she said.
Ms Ellis questioned how the home care money is being spent by providers.
“It’s a lot of money that seems like we could really provide care for these people.
“But it’s just – it seems to me like it’s being wasted away into profits or, you know, for the not-for-profits, then what are the CEOs getting paid. Where is the money going?” she said.
“$50,000 should not translate to just nine hours of care,” Ms Ellis said.
Ms Ellis also questioned why home care providers have to wait months to be paid by the government.
“These organisations are… doing work with no funding, at least initially, and are waiting for the government to pay that funding at a later time,” she said.
“I just don’t know why it’s not done instantaneous, which would enable providers to just have more surety and be able to provide better and certain care because they know how much money they’ve actually got,” Ms Ellis said.
Ms Ellis said she should not have been charged $80 to have her mother assessed for a dementia supplement, and managed to get out of paying the charge.
She said she only found out about the supplement through her own research. None of the many health experts she and her mother were seeing at the time told her about it.
Ms Ellis also said more needs to be done for informal carers.
In the end, Ms Ellis said she had to “give up” caring for her mother because it became too difficult while also working and caring for her own family with young children, and she decided to put her mother into residential care.
She still visits her most days, makes sure she eats enough, and organises GP appointments, even though she lives an hour away.
An anonymous witness spoke about their work at the Department of Health assessing home care applications.
The witness said many of staff in the department are contract staff, meaning there is high staff turnover. Training of new recruits was also “very ad hoc”, the witness said.
The witness said eight out of 10 home care applicants were what she refers to as “bottom feeders”.
“What I meant by “bottom feeder applicants” is there’s a very large cohort of companies that I believe see home care as a business opportunity, and not much more than that.”
The witness said “the quality of their applications is so poor, it is so obvious that they have not even taken the time to read the guidance for applicants.”
“They don’t understand what their responsibilities would be as an approved provider.”
The witness said these applications to become home care providers are distressing.
“The fact that they spend no time understanding what it means to provide home care, yet think that it’s okay to submit an application for what I suspect they think is a tick and flick process, when it isn’t, it makes me angry,” the witness said.
“It makes my team angry that we have to spend extraordinary amounts of time keeping these people out of the sector because, as I’ve said previously, I believe that they’re dangerous.”
“It’s frightening to me that there’s so many of them out there. So that’s what I mean by ‘bottom feeders’, is there’s just no regard.”