In the latest hearings from The Royal Commission, witnesses revealed their experiences of being offered kickbacks for new customers, being assessed by aggressive, unfriendly auditors, being forced to hire administrators charging exorbitant fees, and a care recipient who died waiting for their home care package to come through.
A registered nurse of thirty years’ experience, who spoke under the pseudonym BC, said she started a palliative care business in 2016 to support people who wanted to die in their own homes.
She decided to become an approved provider, but found the language difficult to interpret and found there was little help available to help her with her application.
Her first application was knocked back, but after a great deal of hard work, in March 2018 her business was approved.
When the quality auditors first came to see her, BC was reassured “the visit was informal and we would be treated in a friendly way.”
However, the auditors’ demeanour were “very confronting” and “condescending”, BC said.
She said the meeting was “chaotic” and the auditors were “firing questions” at the team. The auditors didn’t slow their speaking for non-English speakers, and were “unfriendly”.
“It was very confusing and confronting,” BC told the commission.
BC agreed with the auditors that her organisation needed to improve on paperwork, but she didn’t expect to be so “heavily criticised” for it.
“I felt that – and the clients thought – the care we were giving was… exceptional,” she said.
The quality commission recommended that a revised plan for continuous improvement be written, and said that because of “non-compliance” with the quality standards, the operation posed “an immediate and severe risk to the safety, health or wellbeing” of care recipients, and sanctions were imposed.
BC said she nearly “collapsed” when she found out about the sanctions.
BC engaged administrator Aged Care Management Australia to help her comply with the quality standards.
ACMA charged BC $165,000 for the service, with a $35,000 fee up front. ACMA charged at a rate of $280 / hour.
BC borrowed the money, as she said she didn’t know how she could continue to operate, and provide services to customers who were relying on her, without ACMA’s help.
In the end, BC decided her organisation “could not work” with ACMA and they were of little help to her.
Eventually, BC decided to stop providing home care packages, and she soon afterwards “sacked” ACMA.
A second adviser also proved to be unsatisfactory, but the Department insisted another be hired. A “delightful” adviser was appointed who charged $100 / hour.
BC’s suggestion to the Health Department that administrators be better regulated for their fees and services was largely ignored.
BC then spoke about providers attempting to “buy” her customers, even though BC insisted the customers should be able to choose their own provider.
“The news that we were not going to home care packages spread rather quickly and I started receiving calls from other approved providers wanting to take the clients,” she said.
“One provider suggested that you can buy the clients, and I said that’s a bit tacky.”
BC said the provider said it was a “known practice”.
One provider told me that he had a relationship with an auditor, and wanted BC to suggest clients go with that provider.
I said, “No, it’s consumer directed”, and so I didn’t recommend any provider who had offered me money or fees for service.”
“I just said to everyone to choose who they wanted.”
BC still sees two of her clients, but does not charge them for her services.
Her business charged an administration fee of 15 per cent, which she said allowed her to make a “comfortable living” and a “perfectly adequate amount of money for any provider”.
Marie Dowling, who is 84 years old, lives alone, and is legally blind, spoke about accessing My Aged Care.
She said the font was too small for her to read, and she had never been online previously. “It’s very hard when everything’s online,” she said.
Documentation sent to her she said was “pretty vague”.
She said it was difficult having to speak to a new person every time she rings My Aged Care.
She was feeling “anguish and desperation” not being able to access the information she needed.
“I really felt… depersonalised, worthless, unable… to organise my own care, and I really felt demoralised by the entire process,” she said.
“I think it’s really useless to have My Aged Care only accessible online.”
Another anonymous witness, referred to as BA, spoke. BA is a registered nurse, and chief operating officer of a home care provider.
BA said in her first audit, her organisation failed 16 of 18 home care standards and was sanctioned, but after putting changes in place, soon met all her standards.
The auditor BA appointed charged $120,000.
BA spoke about a client who had been assessed for a level 4 package, but was only on a level 2 package. BA cared for him with the help of the local hospital, but sadly he died before the full funding came through.
Mary Petetsos, social worker, and chair of the Federation of Ethnic Communities Council of Australia, said 36 per cent of older Australians are born overseas in a country in which Enligh is not the first language.
FECCA is the peak national body that represents people born overseas in countries where English is not the first language.
She said, “Research into the needs of older people excludes people from CALD backgrounds.”
She said access to the aged care system is complicated for everyone, but “particularly for those who don’t have English as a first language.”
She said use of interpreters is “critical” as communication is a basic human right.
Ms Petetsos said some providers provide excellent services to CALD people, but simply developing a care plan that identifies language and cultural differences “is not good enough”.
The hearings continue.