The StewartBrown Senior Partner has predicted retirement villages will be at the forefront of Australia’s aged care transformation – but there are risks for operators, a panel session for Retirement Living Council members has heard.
The session – filmed on Thursday 15 October 2020 – saw Grant give an update on what the village sector can expect from the Royal Commission as well as changes in home care policy alongside Janene Eagleton, the General Manager Care Development at Ingenia Communities and Anita Courtney, Aged Care & Home Care Principal at Russell Kennedy Lawyers.
Noting that StewartBrown’s latest home care data shows that average profitability and care hours are both declining, Grant said less than 50% of home care clients actually transition to home care – meaning more than half pass away at home.
‘Continuum of care’ doesn’t always exist
This indicates that the frailty of people receiving Home Care Packages (HCPs) is increasing – and with that comes the expectation that they will be able to have care delivered into their home, including retirement villages.
The time that older people receive home care has also risen to four years, with the average age of those receiving home care between 83 and 84 – the same average ages as people in residential care and in the CHSP.
“The continuum of care doesn’t always exist,” said Grant. “People get assessed for one and stay.”
Grant says villages will therefore play a very important role in the aged care sector going forward.
With many residents likely to have dementia or require sub-acute or palliative care that can’t be met in their own home, there will be a shift back into the environment of assisted living, he said.
Add in the shortfall in aged care homes forecast by the Aged Care Financing Authority (ACFA), Grant says village operators are the likely contenders to pick up this gap.
Ingenia attracting more residents to its home care program
Janene agreed with this assessment.
She said villages and seniors’ communities offer so many benefits including the community which assist with the social supports that many people are having to get from aged care providers.
Ingenia’s care program attracts between 120 and 150 new home care clients annually with many new residents looking for additional services to maintain their independence, though social supports are still the most common service accessed.
Grant said village operators looking to become approved home care providers need to look at what services they will offer – and which they will outsource such as clinical care and allied health.
He adds that providers also need to make sure they have the right expertise in the form of a good case manager.
Warning on fees and charges – and letting residents stay too long in the village
Anita also cautioned that operators need to be aware of their obligations given the increasing compliance activity in the home care space, in particular around fees and charges which attract the most complaints.
She cites a number of examples where decision making had been inconsistent, for example, a provider being told that they cannot take additional fees from a client for topping up their services even though the client had agreed to the extra charge.
Janene also acknowledged that the risk for operators from people receiving home care in the village staying too long when they may need to transition to residential care.
Anita warned against the temptation to let residents stay longer as they need increased care because this can create a greater duty of care for the operator, particularly if the resident refuses to enter residential care.
“Duty of care comes down to the nature of the service contract,” she said, but agreed that the higher-level packages are complicating this issue.
Almost impossible to move residents out
People are also entering villages with greater expectations, while the media and the public still have difficulty understanding the difference between villages and aged care, she added.
“Operators need to be very clear about what services you do,” Anita stated. “Providing pro bono type services is where you may create a messy situation and the duty of care may need to continue.”
Despite security of tenure arrangements creating the right for an operator to terminate a contract when a resident’s care needs increase, Anita said the reality is that this is almost impossible if a resident refuses to leave.
The other option in this case is to obtain a guardianship order – this can take some months, she said, but is preferable to the negative that can come from taking a resident to the tribunal to ‘kick them out’.
You can watch the full, 55-minute session here.