CDC throws up challenges for home care staff

A study has found consumer directed care is making it hard for home care workers to establish relationships with clients.

Consumer directed care is throwing up challenges for frontline staff, a study has found, making it hard to build consistent relationships with clients and leading to a lack of connectedness and isolation among home care workers.

Roland Manderson

The report is based on interviews and focus groups with 39 frontline and operational staff at Anglicare SA and Amana Living Perth. It was supported by HESTA.

The study found increased choice for consumers has resulted in increased expectations on workers, and demands are often harder to meet. It also found staff are having difficulty getting tasks done with less time and are concerned that funding packages are failing to meet the needs of clients.

“There is a clear tension within CDC, in that one group effectively has to compromise for the benefit of the other,” the report says.

“Interwoven throughout the focus groups and interviews was a belief that the challenges associated with CDC are, at their core, connected with insufficient or mismatched funding and pricing structures.

“Additionally, this study found that the nature of home care within CDC has contributed to feelings of isolation and a lack of connectedness between care workers.”

General positivity and optimism

The study found staff were generally positive about the value of CDC for clients, and that there was “significant optimism” the model will bring benefits for older people.

But it notes CDC has resulted in a shift in power between clients and service providers and significantly changed the aged care sector.

“At a time in which concerning examples of aged care have been raised via a Royal Commission, it is encouraging that all those that participated in this study demonstrated a passion about improving the service they provide and, in turn, about improving the lives of those they care for. It is evident, however, that they face challenges in doing their jobs within the new CDC model,” the report says.

“The study found that staff were concerned regarding the appropriateness of packages for some of their clients, and that managing expectations was the most challenging aspect of their role. Furthermore, participants in this study felt that there was a need to do more with less time.”

Rostering was also important and the surveys found that improved engagement with the rostering process as well as more clarity around job requirements could boost satisfaction and quality of care.

The study also said improving staff feedback and looking at using technology to improve communication and information sharing would be beneficial.

Improving care

Anglicare Australia’s Acting Executive Director Roland Manderson said he hoped the insights could be used to improve care for older people in the home.

“Staff told us that the best quality care is relational care. That means valuing and supporting workers, so they can support older people. And it means cutting through some of the red tape that surrounds them so they can spend more time caring for people.

“Our research also found that Consumer Directed Care models sometimes throw up their own challenges. It can be hard to balance the demand for flexibility against the need to build consistent relationships between staff and clients. The staff we spoke to treasure these relationships, and they are very sensitive to the needs of their clients.

“Many of them told us that they haven’t been funded to give the level of care that older people require. They want to do more, but they simply aren’t able to. That’s why we’re calling on the Government to clear the backlog of home care packages – and make sure the packages that are funded meet people’s needs.”

Recommendations of the report

  • Streamlining administration and improve access to information
  • Review rostering
  • Improve home care team connection and networks
  • Improve communication channels between staff, organisation and workers

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