Oct 08, 2021

Home care in Australia is in desperate need of an overhaul

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The National Ageing Research Institute (NARI) has called for systemic reform of home care for older Australians, to ensure the long-term sustainability and effectiveness of the system.

In a newly released Position Paper, NARI analyses the Federal Government’s responses to key recommendations of the Royal Commission into Aged Care Quality and Safety in relation to home care, and identifies where more could be done.

“The Royal Commission highlighted that older Australians want to remain at home, but the current aged care system is not providing adequate access to services and supports to help them remain at home,” Associate Professor Frances Batchelor, Director of Clinical Gerontology at NARI, says.

NARI says the aged care system should be needs-based, not rationed, similar to the way in which the health care system works.

“While the Federal Government has committed to providing additional home care packages and other incremental reforms, this will only provide temporary relief. Without substantial change to the ration-based system, the waitlist will only build up again as more and more people require aged care at home into the future,” Associate Professor Batchelor says.

“Funding should be linked to individual needs and care planning. Under the current model, bundled funding is allocated to a limited number of older people in need. This model lacks flexibility and is not truly tied to the unique needs of each older person.”

“Funding needs to be better distributed so it is allocated in a more cost-effective way, to ensure every person in need of care at home is able to receive it, when they need it.”

NARI also supports the introduction of a more streamlined, effective and flexible process of needs assessment that improves the experience of older people and their families when accessing aged care services.

“One of the most pressing issues in home care is that the current process of assessing the needs of older people is constrained by resources, and often does not result in the provision of services and supports that align with what an older person actually requires.”

“There is particular need for flexible assessment processes and funding allocation based on individual needs,” Associate Professor Batchelor says.

Based on its research and experience in the aged care sector, NARI says systemic – rather than incremental reform – of the home care system, is crucial, including:

Transition to a needs-based system of funding and delivering home care services where older people do not need to wait to access the care that they need;
Funding that is personalised, flexible, and closely aligned with the individual needs of each older person (under a model that takes the form of individualised budgets or case-mix classification);
The introduction of a more streamlined flexible process of needs assessment to improve the experience of older people accessing home care services; and
Mechanisms that assist all older people to navigate and access the home care system and make informed choices, including the introduction of a network of care finders and improved quality regulation measures such as Star Ratings.

“We welcome the Government’s funding of 80,000 additional home care packages over the next two years, however, for as long as current model stays in place, older Australians will continue to wait long periods of time to access home care,” Associate Professor Batchelor says.

NARI’s Position Paper ‘Transforming the system of home care for older Australians’ is available at www.nari.net.au/position-paper-transforming-the-system-of-home-care-for-older-australians.