Home care complaints go unheard, report finds

Australia’s first comprehensive survey of home care clients has found a significant proportion don’t feel their care needs are being met, and it also found their complaints aren’t being heard.

The Royal Commission’s Research paper 14 Inside the system: home and respite care clients’ perspectives is based on phone interviews with 1,223 people who were receiving a home care package, CHSP respite and residential respite.

While some said their needs were always met, “a significant proportion” felt their needs were not met in one or more aspects of their care, the report says.

It also found a “high prevalence” of concerns, mostly related to finance and administration of home care packages, staff, and lack of choice and services.

Lead researcher Associate Professor Frances Batchelor, Director of Clinical Gerontology at NARI, says one of the most pertinent findings of the survey is that the concerns aren’t being resolved.

Less than 70 per cent of the 865 HCP clients shared their concerns, with 17 per cent saying they didn’t think anything would change.

Less than 0.1 per cent of home care package concerns were reported to the quality and safety commission, and about half of the official complaints that were made weren’t satisfactorily resolved.

“Despite clients having a number of concerns with the care that they receive, a lot of those concerns, when they become complaints, do not get resolved to the satisfaction of the clients,” Professor Batchelor told Community Care Review.

“There were very low rates of reporting to the Aged Care Quality and Safety Commission and other watchdog bodies.”

Associate Professor Batchelor says the survey also suggests the concept of choice in home care is not only illusionary, but that the concept of “consumer directed choice” is also letting the government off the hook for getting the system right.

Quality of care

Around 77 per cent of HCP clients felt some aspect of their care and service was failing to meet their needs all of the time, the survey found.

However, across home care and respite, 90 per cent said they were ‘always’ or ‘mostly’ treated with respect and dignity and 80 per cent or more said they mostly or always got care from appropriately trained staff.

Lack of choice was a key area of concern and HCP clients were most concerned about lack of clarity about entitlements, not being able to choose who provided their services and not being able to negotiate costs.

The report says there’s a clear need to address what it describes as systemic funding and administration issues, as well as a need for more transparency about fees and services at the client-provider interface.

“These are all fundamental aspects of choice that the aged care system should be expected to achieve, especially for HCP clients since the program is predicated on clients being able to decide how to allocate their own budget,” the report says.

The report concludes that the system for complaints in aged care is “clearly not working” with many people not knowing how to lodge a complaint or having the confidence to do so, and lacking confidence their complaint will be acted on.

It says increased measures are needed to engage this vulnerable group and empower them to speak up.

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