Embracing new models is the key to aged care’s future

Models like Better Caring are simply responding to the shift in seniors’ expectations, and are the result of disruption in the aged care sector, not the cause of it, writes Peter Scutt.

Models like Better Caring are simply responding to the shift in seniors’ expectations, and are the result of disruption in the aged care sector, not the cause of it, writes Peter Scutt.

I write in response to an opinion piece from Paul Sadler, ‘Keeping the mission in the market’ (Australian Ageing Agenda magazine, March-April issue) to clarify some misconceptions about new care service models like Better Caring.

Aged care service provision in Australia is undergoing massive and rapid change, involving a necessary rethink of existing modes of delivery that have dominated the industry for years.

Peter Scutt
Peter Scutt

These changes to existing models are not being brought about by new players, but by the changing demographics of our ageing population and the shift in behaviours and expectations of people as they age.

Increasingly, people expect to age well and actively, empowered by choice in and control over their lives – an expectation clearly identified by older people in the ‘Conversations on Ageing’ project conducted by Council on the Ageing (COTA) Australia and former Minister for Ageing Mark Butler back in 2011-2012, and in turn reflected in the government’s consumer directed care reforms.

Models like Better Caring are simply responding to this shift. They are not the cause of disruption in the aged care sector, but the result of it. Models like ours are gaining traction as consumers seek out alternatives to what currently exists – alternatives that provide them with flexibility, better value for money and ultimately better life outcomes.

The roots of the Better Caring concept was borne out of my personal experiences in finding care for my parents, who struggled with their lack of control over the process. In establishing Better Caring, I’ve learned that this struggle is widespread. But it is not a struggle any of us want to face.

I want to be extremely clear that we do not believe that the emphasis on individual choice and control means there is no place for case management in the new aged care world. Indeed, with individualised funding and more choices than ever before, the role of an independent advisor becomes even more crucial.

At Better Caring, we strongly support the vital role that case managers play, particularly in providing impartial advice – not influenced by having a product to sell – that supports a consumer’s right to choose.

We have never suggested that cutting out the ‘middleman’ is cutting out case managers. We simply believe that service providers do not need to sit between a consumer and their care worker for every hour of service delivered.

We believe in enabling, whenever possible, a direct relationship between a care worker and their client. Consumers are experts in their own life and in the best position to judge who is right to provide services to them. That doesn’t mean they don’t require support to do so – but the level of support will differ from person to person. Recognising these differences is consumer directed care in action.

We also believe that Australian care workers should have the choice to work for individuals who have chosen them. In a society that is increasingly moving towards independent workforces, the desire for care workers to drive their own career is only going to grow. And if we are to attract the large and diverse workforce we need to support our ageing population, we need to attract a mix of people who prefer the flexibility that can come with running your own business, alongside people who prefer to be employed.

We fundamentally refute the statement that independent contractors are being lowly paid or are providing low quality care.

In terms of providing quality care, being successful in any small business is about delighting your clients. On platforms like Better Caring, where clients have the ability to provide feedback about their carers, delivering the best experiences and outcomes for clients is even more critical.

From a remuneration perspective, Better Caring enables care workers to set their own rates. Independent contractors who deliver a high quality service will be greatly in demand and their hourly rates will reflect this over time, offering them the potential to earn more. In this context, training and competency assessments will remain particularly relevant, as workers invest in themselves and their business.

As Sadler argues, in this new market-driven world, NFPs play a vital role in supporting the most needy in society. However, in a confusing and changing landscape, some of the most needy will be those with limited understanding about the choices they now have. A crucial role for NFP’s moving forward will be to enable this understanding. Both traditional and emerging players have a responsibility to provide clear, transparent information to all members of the community to enable them to make informed and balanced decisions about their own life and care.

While some traditional non-profits have chosen to see us as a challenge, many more see us as an opportunity to collaborate, evolve, and improve their offering. If we truly want to place consumers and workers at the centre, then the future of aged care must be about working together in the best interests of those who need care and support – embracing new models, rather than “taking them head on.”

Peter Scutt is founder and executive director of Better Caring.

Tags: better caring, consumer-directed-care, cota, home-care-packages, mark-butler, not-for-profit, paul-sadler, Peter Scutt, reform, workforce,

10 thoughts on “Embracing new models is the key to aged care’s future

  1. Peter – excellent comments and absolutely agree with your call to collaborate and devise new models of service. A well articulated, thoughtful proposition to the sector in these times.

  2. Like you article except let’s not call people cases. Care coordination maybe

  3. To be a sole trader in health care/community care, you will need professional indemnity insurance(in case they cause injury to their client), public liability insurance, personal health care insurance and income protection insurance (as they are not covered by workers compensation) as well as paying your own superannuation. Not to mention car/travel/communication/phone /computer costs. You state that carers will be able to set their own rates. The costs I have mentioned will be passed on to the consumer as any business would do. The current casual rate for a PCA is between $20-$25 dollars an hour. If operating as a sole trader you would need to charge at least $40-$50 an hour just to survive. In the past I have operated as a small sole trader business for seven years as a remedial massage therapist and I charged $120 an hour for home service. I have worked for the last 10 years in aged care rehabilitation as well as training PCA’s in manual handling and now working in WHS/Injury Management in an Aged Care organisation. The reality is that the majority of the PCA’s in Metro areas are born outside of Australia, speak another language other than English, have often not completed secondary education equivalent to Australian education levels and struggle with workplace language and literacy. I think it is disingenuous to suggest this model is going to benefit aged care workers, but it certainly may be more expensive for consumers.

  4. Ouch! Anonymous just shot an arrow of realism straight through the fairy-tale’s heart.

    Sugar-coated spin conveniently ignores reality. It didn’t take long for CDC to become just another honey pot. Slugging Nanna a hefty case management fee just to arrange a weekly cleaning service is money for jam. Perhaps providers should have a go at the home insulation business too?

    Just another failed consequence of paying public money to private operators to perform community services.

  5. There is a large percentage of older people who are vulnerable and are getting lost and overlooked in the new system. Great to have choice and be able to make choices when you are cognitively intact or have a very supportive family who can navigate the system or advocate on your behalf. We have a plethora of new and emerging technologies but forget that the people we are directing this to were born in an age where this is completely foreign.

  6. Dear Anonymous,

    Thank you for your comments. You raise some valid points – it is true that being a sole trader comes with added responsibility, including for tax and super, and taking more responsibility for your clients.

    As part of our service, Better Caring supports independent contractors with technology, real world meet-ups, online forums and resources to help build their capacity to run their own small business.

    For example, we arrange on behalf of the care workers professional indemnity, public liability and group personal accident insurances. We also facilitate communications, electronic time sheets, invoicing, payment collection, record keeping, shift notes etc and provide workers with personalised marketing materials.

    People choose to work for themselves for different reasons – it’s not just the potential for financial reward but it can be the fulfilment of working for someone that has chosen you and you have chosen to work for, it could be the flexibility of working locally around other life commitments.

    You are absolutely right – being a sole trader is not the right approach for every worker. Many will prefer to being employed. However, others respond very positively to the opportunity to work for themselves and we believe this has potential to attract more people to a growing sector. And, isn’t it great to give workers choice as well as consumers?

    Better Caring may not be the right solution for everyone – but for many consumers and workers, it can be a win-win. Ultimately, the important thing is that it is providing people with the choice.

    I also recognise that many older people are vulnerable and to exercise choice they need support. However, if we can provide a solution for people that have the capacity and desire to take more control that is efficient, effective and transparent, then we can free up system resources to better cater for the more vulnerable.

    I’d welcome the opportunity, if you wished, to discuss this further. Feel free to contact me directly on 1300 73 65 73.

  7. As a person with a long term interest in ageing and the workforce (and an investment in my own future) I have watched the evolution of aged care with interest. Peter Scutt makes a strong argument for a diversity of workers which I agree with as an advocate of diversity. However i agree that there is a segment (and possibly a high proportion) of the BC workforce that see employment in this sector but not not necessarily understand the complexities of the landscape. I also agree that the cost of providing care is burdensome and non-recoverable such as insurances, maintenance of a vehicle, use of the vehicle to transport clients, one’s health and safety, etc. As a care worker in a previous life, I know what it feels like to be burdened and have little or no power while doing a 2nd degree and working from the ground up. No matter how empowered I felt, there were people (and the community and the sector itself) that invalidated the person. A business model will not suddenly create a professional workforce.

    I don’t know the answer but I support the registration of care workers and ongoing professional development that is recorded. In fact I support the registration of a diversity of professions in the aged care space so that we can continue to build a professional workforce. I do agree that there is a space for both for-profit and NFPs but I wouldn’t like to see the rising dominance of FPs as ‘care’ is about people not profits at the expense of workers and clients.

  8. Dear Peter,
    Thank you for replying to my comment. It is good to know that the care workers are provided with assistance in relation to the issue I raised. We agree that this model is not for all. I am all for choice when comes to care recipients and care workers, but it needs to be well informed so they can make the right choice for them.
    P.S Sorry I did not mean to be Anonymous.

  9. Quite simply most providers have enjoyed huge profits from the Elderly for years. Alot of providers charging 40% or more for admin and case management, taking valuable dollars away from those most needing it. The intention of the funding is for care for the Elderly person, not for the fat cats in offices to enjoy. CDC is a great model of care for the Elderly as long as it is policed properly by the Government to enforce providers to share this to the elderly and to stop providers from taking advantage of the vunerable Elderly, who simply need care. Providers should not be allowed to also provide the care, it is a conflict off interest and has been for years a way to double dip on profits. Lets all embrace the new way of providing aged care services and get rid of the old style providers who have been rorting the system for years.

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