An elderly man living with urinary and faecal incontinence will be forced to endure soiled bedlinens and floors for days at a time, or go into residential aged care, as the fallout from changes to the paid carers' working conditions creates havoc in the industry.
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In another case a man who only needs help for half an hour to get into bed in the evening will have to have a worker for two hours at a time, which his level 4 package cannot sustain.
To keep within his budget, there will be days when he will not be able to have a worker to help him. He will either have to stay in bed throughout the day, spend the night in a chair or find someone else to help him into bed. He is also facing going into residential aged care where he feels he will "just die mentally".
These cases were among many reported to the Older Person's Advocacy Network in the first couple of weeks of July, but readers have also contacted ACM's The Senior with their stories of the unintentional consequences of changes to the Social, Community, Home Care & Disability Services Award which covers aged and community care workers.
OPAN was also informed of a service provider which suggested a client take out a reverse mortgage to meet the shortfall in costs, and one charging clients a $15 travel fee for every attendance by a home care worker.
Changes to carers' award
The Fair Work Commission ruled that from July 1, a home care worker must be paid for a minimum of two hours work for each shift or portion of a broken shift even if the client only needs support for one hour or less. As recipients of home care packages are provided with a fixed financial amount for their care based on their level, it has meant that some have had days of support cut from their weekly allocation.
Providers were expected to rearrange rosters and care plans so workers could either be employed for at least two hours with one client or go from one client to another within the two hour period; but this has not occurred for all HCP recipients.
One woman from WA who contacted ACM's The Senior has lost two days from her weekly assistance for showering. Another has lost three.
For many people any increase in costs is unaffordable.
Providers are required to gain the consent of care recipients for any changes that affect them but at least one of those people who contacted The Senior said they were given no warning.
A Department of Health document on the changes clearly says that under aged care law and Australian Consumer Law, providers cannot make changes to Home Care Agreements, individualised budgets and care plans without the informed consent of the recipient.
From July 1, home care and residential aged care providers have also been forced to meet a Fair Work Commission mandated pay rise for low paid workers.
Call for the sector to work together
OPAN has called upon the sector to work together to ensure older people are not adversely affected by the changes. "It is a positive development that aged care workers are receiving more support through recent changes to the industry award, but we must ensure that older people are not worse off," OPAN chief executive Craig Gear said.
"We are already experiencing distressed calls from older people who have been impacted by the new standards set by the Fair Work Commission for casual and part-time home care workers. The changes which include two-hour minimum shifts, travel costs between jobs and a fee for "broken" shifts, are likely to affect more than 200,000 older people who receive home care packages.
"OPAN supports improved conditions to attract and retain skilled aged care workers, but these changes must be appropriately funded to ensure older people are not worse off.
"This might require additional supplements in rural and remote areas, where there are increased travel times, to cover morning and evening shifts."
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Mr Gear also urged service providers to use effective rostering and other, innovative solutions to accommodate the needs of older people, many of whom can remain independent, in their own home, with short, regular support visits.
"The delivery of the two-hour block does not have to be with the same client and it doesn't have to be at the same location, so it's up to the providers to find a solution that works best."
Industry group, Aged & Community Care Providers Association said a survey found around 90 per cent of home care providers had already taken steps to accommodate the changes through consultation with clients and staff.
The survey also found that almost half of home care providers expect their fees for clients to increase by up to 20 per cent.
Interim chief executive Paul Sadler called for more federal funding.
"Clients and staff could experience disruption for some months as providers work through solutions with clients and their staff but there must be clear communication with clients in particular before any changes are made and agreed to," Mr Sadler said.
"Where the award change cannot readily be accommodated through roster changes or by employing additional staff, we are seeking a commitment from the government to adjust how it pays providers to make sure no-one - an older person, an employee or provider - is out of pocket for complying with the changes to the Award."
If you are having problems with your residential or home care contact OPAN 1800-700-600 or opan.org.au