We’ve built an administrative system, not a care system
In this week’s issue of SATURDAY, one theme is clear: Support at Home is reshaping how care is delivered – and not always in ways that support it.
Home care is increasingly being experienced as an administrative system, not a care model.
When Consumer Directed Care was introduced in 2017, providers warned the shift risked becoming transactional – prioritising service delivery over quality.
Five months into Support at Home, the concern is no longer that care is ‘tick a box’ – it’s that care is being removed from the equation altogether.
“We’ve increased compliance, increased co-contributions and made it more complex to navigate — and it’s not delivering the intended outcomes,” one operator told SATURDAY.
How it actually operates
Providers describe building care plans based on 100% of assessed need, only to scale them back to match interim funding, which is sitting at 60%. They then wait weeks for full funding to be released before they can deliver what has already been assessed.
Clients are effectively onboarded twice: once when they enter the system, and again when funding catches up.
At the same time, staff are logging into the My Aged Care portal – constantly pressing the refresh button – to check whether package levels have changed, reworking rosters and rewriting care plans as new information comes through.
This is no longer a side issue – this is the new operating model.
More administration, less care
That administrative load is not without consequence.
As we explore in SATURDAY, the shift to co-contributions is already changing behaviour, with consumers gravitating toward fully funded clinical services while reducing or dropping higher-priced supports such as cleaning and personal care.
Interim funding is compounding the issue, forcing providers to make trade-offs about what care can actually be delivered.
The result is clear: less care for older people and lower margins for providers.
This is despite StewartBrown’s latest analysis showing prices have risen by 39% under Support at Home.
There are no winners in this equation.
Is there a way forward?
None of this means the system cannot work.
As our cover Enkindle Consulting founder Jennene Buckley outlines in this edition, there are clear opportunities to improve productivity – particularly through better systems, integration and the removal of manual processes.
But those gains will not happen on their own.
They require coordination between Government, providers and technology suppliers – and a willingness to tweak elements of the model that are not working as intended.
Under Support at Home, the system is increasingly being built around administration, with care delivery adapting to fit it.
Is the system now serving care – or the other way around?
Read more in this week’s edition of SATURDAY, available tomorrow (Friday, 17 April). Not a subscriber? Sign up here.
