Concerns have been raised after home care recipients said they had been encouraged to employ family members by getting them to sign up to aged care platforms.

Sarah Russell

Public health researcher and aged care consumer advocate Sarah Russell surveyed 30 home care self-managers about their experiences and reports her findings in a paper titled Consumer experiences of self-managing a home care package.

Dr Russell’s survey found it was common for self-managers to engage support workers via online platforms like Mable and Careseekers, which enable them to search for and connect directly with independent workers listed on a website.

Double dipping

 Some survey participants said the platform they were using had encouraged family members to join as a support worker, and expressed concern this was “abusing the system”.

One respondent said she had received emails from an online platform encouraging her to recruit family or neighbours as carers onto their platform.

“I don’t think it’s right for a daughter who might get a carers’ pension from the government also taking money from the government’s home care package as a paid carer,” she is quoted as saying in the report.

Another respondent said an online platform had encouraged family members to join up.

“So family members were paid to take a parent to doctor appointments, shopping, gardening, cleaning etc. Sometimes the family member also received a carers’ pension,” she said.

However, others liked the arrangement.

“Our daughter is a registered nurse. She signed up with an online platform. We could then hire her as one of my husband’s nurses. This is just fabulous,” the respondent said.

Dr Russell said this practice meant the family member could potentially be paid from home care package funds while the platform took a fee from both parties.

“Using a family member needs proper checks to make sure that it’s not being rorted,” she told Community Care Review.

Inviting informal carers

Mable, Australia’s largest online network of independent support workers,  gives people who sign up to the platform the opportunity to name an informal carer who can be invited to join up.

Mable says the nominated person doesn’t require specific qualifications or certifications unless they are providing personal care or specialist medical services, or using specialist equipment.

  “If you already have an informal support network in place and want to invite them to Mable to be part of your team, we’ve made it even easier,” it says on its website.

“Maybe it’s a neighbour who gives you a lift from time to time, or a student from the community who pops around to mow the lawn for a little cash in hand. It could be a friend who helps you with shopping, or who supports you when you’re going for a night out. 

“With the introduction of the NDIS and Consumer Directed Aged Care, you can now use your government funding to pay these people via Mable as part of your formal support team … subject to a specific application process.”

A spokesman said that Mable did not directly contact people encouraging family members to be engaged.

“Each home care package client using Mable hosts their funding with an approved home care provider who remains responsible for care management and meeting aged care quality standards,” he told Community Care review.

Platforms used as a ‘selection process’

The study also revealed that some self-managed home care package recipients are using online platforms as a “selection process” to find and trial support workers that they go on to employ independently.

This avoided both the client and the support worker paying the online platform fees for each shift. However, it also left workers uninsured.

“Some people were using the platforms process to find a support worker, to interview them, to put them on trial,” Dr Russell told CCR.

“And if it worked really well for them they were actually negotiating with the support worker to get an ABN and be employed privately.”

One respondent explained how she did this.

“I use the (online platform) platform to trial support workers,” she told Dr Russell.

“If they suit me and I want them to continue, I ask them to do private invoicing. Basically, I use their hire platforms as a selection process.”

A ‘good idea’ but some criticism

People who were choosing to self-manage their home care packages described online platforms as “a great idea” – but said the reality didn’t always live up to it.

The main criticisms related to the trustworthiness of support workers’ profiles, with participants saying some profiles didn’t accurately reflect their actual skills or availability.

Some participants expressed specific concerns about the lack of qualified staff and said that support workers who advertised on online platforms were often unsuitable.

Others said many support workers registered on online platforms were transient, which meant they left when they found more secure work, or unemployed people looking for work rather than aspiring to a career in aged care.

Marissa Sandler

CEO and co-founder of disability and aged care platform Careseekers, Marissa Sandler, said Careseekers was a “values based platform” and that took a pro-active approach to establishing the quality and suitability of workers including police and NDIS screening checks.

She said Careseekers did not send emails to platform users encouraging family members to sign up to the platform as independent contractors so they could be engaged by family members.

“This is not in line with the NDIS principles nor our business strategy,” Ms Sandler told CCR.

She also said any worker involved in off-platform deals with consumers would forfeit their insurance from Careseekers and such behaviour was discouraged.  

‘Rigorous safeguards’

Mable said workers had to meet high standards before being approved for the platform.

“We pride ourselves on rigorous safeguards that require a service provider meets stringent requirements and checks before they are approved to offer services via the platform and in order to remain on the platform,” the spokesman said.

Survey participants were members of a consumer-based home care packages self-management social media group from metropolitan and rural Australia.

Nine participants self-managed themselves and 21 participants self-managed for a partner, parent or friend.

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6 Comments

  1. As a point of clarification, the participant who encouraged his support workers to work for him independently (to avoid the fees associated with online platforms) also ensured that his support workers took out insurance for Liability Cover, Medical Malpractice and Personal Accident Cover.

  2. I did this research because there needs to be a public conversations about pros and cons of self-management.

    I wish to contest the claim on the Mable website: “With the introduction of the NDIS and Consumer Directed Aged Care, you can now use your government funding to pay these people via Mable as part of your formal support team … subject to a specific application process.”

    There are 2 members of my Self-management of Home Care Packages Consumers Only Facebook group who use family members as their support workers – one is a sister-in-law, the other a daughter. They both have different surnames to the recipient. One is a RN the other has a Cert3. This morning, I asked the recipients about the “specific application process.” They both said the family member simply registered on Mable via the usual process (i.e. there was not any specific application process). It is worth noting that the recipients are both thrilled that a family member can be their support worker.

  3. Home care recipients have been encouraged to self manage their packages but hiring family on the tax payer dollar is just another example of how flawed and unsustainable the Home Care system is.
    It’s absolutely wrong for family and friends to be paid for doing household chores like above.
    NDIS is no different, a wheelchair that used to cost $600 is now thousands because the second government gets involved in any form of a purchase the price goes mad.
    Like NDIS again, the government said that no one under 65 will be living in aged care. They are still exactly where they were but now they are under the NDIS act rather than the aged care Act. An utter deception by the government and the NDIS beaurocracy.

  4. It’s interesting that self management of home care packages is almost hidden from the end users and their family. Self management allows for choice of services and provider.

    In respect to family members being paid to work in their professional capacity for family members. There’s many sides to the story but I spend numerous unpaid hours daily caring for both my parents. It uses all my skills to navigate the aged care system and the health care system.
    I attempted to get a carer payment but the bureaucracy at Centrelink cost me so many hours, I just gave up.
    I will save mum’s HCP funds to pay for external providers and resources because I’m in a position to do so.
    The process of getting care for our ageing population is very challenging.

  5. Self Management means more funds for the loved one on an Aged Care Package and more reliable care at the time that suits your loved one.
    Before self management ..Home care providers could turn up from 7am to 12.30 to provide a shower( personal care..often too early, if mum didn’t sleep well or too late and I had already helped her..we sent them away and they got paid for doing nothing!
    Now on Self Managed care..they turn up on time at 8.40am evey time! Focused on her care, not rushing off to next client..much less anxiety provoking!

    If you are over 65 and not on an NDIS funding because of a disability you may acquire after the cut off age to apply for NDIS
    you only get assessed as an Aged Care client. Aged Care is capped at different package amounts and this causes much discomfort for Aged Care Clients seeking help, as the NDIS governs the prices for those with disabilities and those on Aged Care can’t compete with the prices to get their care needs met, often having to go without the support they need, as the funding is simply not there to support them! If you apply for a higher package, the assessment team has all the power to say yes or no, and even if it’s a yes..the person may pass away before the next level of funding is ever seen..can wait 3 years..or more for more funding…NDIS will do urgent reviews based on need and evidence provided, even with the needed paper work, the reviews for Aged Care is very different.

    Don’t get old..and need help..as it may not be there.

    Only the lucky few who can read through the red tape..even know that Self Management is an option. ( The only way to get more needs met..stretch the budget.)

    I am a Carer , I gave up my Career to care for my family and I’m glad to do it but each day is a financial struggle. So if family members do get paid for the 24/7 care, that sets up Carers to live below the poverty line..I have no problem with that..as long as the People getting the care remain #1, and their needs are met.

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