Monday, December 13, 2010

Aged Care Complaints Investigation Unit.

I made a few calls today to find out about care at home packages. I called the Commonwealth Respite Centre and the very helpful officer gave me information on respite options. I also spoke about my experiences with X provider of home care services and my wish to speak to someone about it. I also asked her about administering our own EACH package. She told me about Consumer Directed Care packages, where a provider still administers the program but the consumer is much more involved in designing the program. She also gave me a complaints number.

I then rang the Aged Care Complaints Investigation Team in the Commonwealth Department of Health and Ageing. I explained that according to their website an EACH package provides a subsidy of $120.50 per day towards Arthur's care expenses. The package can give up to 15 hours care a week. This, from my calculations, is over $42,000 a year that X provider gets to deliver care to Arthur.

I explained that Arthur was getting about 15 hours a week care before he went into hospital and rehabilitation this year. When he came home his hours were dropped to 7 hours a week. This is made up of 2 care-workers giving an 1/2 hour of personal care each morning. (One half hour with two workers = 1 hour).

Arthur gets his creams a lotions supplied and incontinence pads, of which he uses 2 per day. He can also have a nurse to visit and provide wound care if he has a skin breakage that needs dressing. He has not needed any of that for at least a year or so as I am very good at taking care of his skin.

I know his equipment costs about $75 per week as that is what I was told would be freed up from the funds if we bought Arthur his own equipment. (Bed pole, bed grab stick, rollator, toilet raiser and two raised chairs etc.)

For his daily wash , Arthur is supplied with some wash lotion and moisturiser which could not come to more than $5 a week.

His incontinence pads are supplied. I checked, and the cost, retail, is about $1.20 each. Providers order in the thousands a year and must get them cheaper than retail, but anyway, that works out at $2.40 per day or just $16.80 per week. Lets make it $18 to be generous.

Looking at the industry award, an aged care worker on weekly wages gets between $580 (grade 1) and $862 (grade 9) per week depending on their pay grade. They get extra for weekend shifts and a 150% loading for public holiday work. Even at the highest grade that is only $22.68 per hour. The most they can get is $56.70 per hour for working on a holiday, plus whatever other allowances there are. If Arthur had two grade 9 workers for 1 hour on a holiday it is still only going to cost about 60 or 70 dollars. For an ordinary week for his 7 hours of services, the labour charge cannot conceivably be more than 7 x $25 or $175 per week as he probably would not be getting grade 9 workers every day or every week. Even adding an extra $20 pw to cover public holidays, it is still only $195 pw. Lets make it $200. No let's be really generous, make it $220.

He is entitled to a nurse for wound-care, though I was warned that if he needed a nurse too much, he might get his hours of personal care cut down from seven. To what I do not know, nil maybe? I will allocate $50 per week for that, $2,500 per year should be enough to cover the little he may need. After all it is zero dollars now for nursing.

So lets add it up, per week.
Equipment $75
Pads $18
Creams $5
Workers $220
Nurse $50

Total = $378

So I have $378 pw as Arthur's in-home services costs.
His provider is allocated $120.50 per DAY for his care. That is $840 per week.

(Am I, I ask you, entitled to ask where the damn hell the rest of his funding, the approximately $450 a week goes?)

So I gave the gist of the figures to the lady on the other end of the phone from the complaints team, and she pointed out they only dealt with complaints about his standard of care. I advised I did not think he was getting the level of care his funding provided for and that we were getting only one visit a day. I explained that challenging X provider resulted in a toxic relationship with the family being subject, in my honest opinion, to bullying and hostility on the part of x provider.

She took on board my complaint, that Arthur is only getting 7 hours care when he should be getting more like 15 hours of care. How the EACH program is supposed to meet its aims for the client in just 7 hours a week, is beyond my comprehension. My complaint that the Dept of Health and Ageing was paying over $42,000 per year for their client, Arthur, to receive care and that it looks like he is not getting adequate services for the money, was not something her area takes on. I pointed out that between the funds being disbursed by the department to the provider and the workers walking in Arthur's door, over 50% of the funds were gone. How could it be that any government program be administered in such a way that over 50% of the funds are taken up with program costs? How is that efficient for the government who is expecting the funds to address needs? How is it fair, just and equitable for the client?

I was assured my program level complaint would be sent to the Programs area of the department and the officer also took my phone number for a callback. I hope I receive one. My complaint about care hour reductions will be investigated.

I told the complaints officer I was concerned on two levels, both as it affected our family personally and for the wider community of aged people depending on government funding packages to remain at home and in good health.

Next I am going to look into Consumer Directed Care Packages, and I am formulating my complaint about our treatment by x provider over the last year when we have been advocating for Arthur to have his level of services retained.

I will keep this blog posted with the progress.

(Note: I am not naming the provider hence the X.)

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