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Shift changes threaten home care help

The introduction of a minimum two-hour shift for casual and part-time workers could cause people to rethink managing their own home care package or pay for care privately.

It could also push people towards residential aged care earlier than planned.

This is because government-subsidised home care packages delivered via approved providers are a limited budget of money allocated to an individual.

The highest-level home care package is about $52,000. A self-funded retiree could be expected to contribute up to $11,700 as an income-tested fee.

Background: From 1 July 2022, the minimum payment for casual and part-time home care employees increases from one hour to two hours. This and other changes were handed down by the Fair Work Commission in January 2022 as part of its four-yearly review of the Social, Community, Home Care and Disability Services Industry Award 2010.

Introducing a two-hour shift for casual and part-time workers – a large part of the aged care workforce – could eat into package funds at a high rate without providing all the necessary care.

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It could also make working for a provider less attractive – just at a time when providers are struggling to meet demand. Casual workers often like the flexibility of shorter shifts as well as some penalty allowances.

There are plenty of home care tasks that can be delivered quickly and efficiently, which can stretch a budget sufficiently that someone can stay at home.

An example might be assistance with medication or a welfare check, which might take half an hour to an hour.

Rostering challenge

The following is an example of the impact of changes to minimum payments set by the Fair Work Commission, which takes effect from 1 July: 

Mr Pike needs someone to visit each morning to help him shower, dress and take his medication. A worker employed as a casual with an approved home care provider spends an hour with Mr Pike before attending to another client, Mrs Little, for a half hour visit.

A worker from the same provider returns at the end of the day to assist Mr Pike with his medication, which generally takes about 15 minutes, before visiting Mrs Little to assist with her evening meal, which might take an hour.

The schedule for both these clients has been carefully worked out by the provider to ensure that the help they need fits within their limited level two home care package budgets of about $16,000 a year each.

A provider charging $60 an hour to deliver weekday services is just able to make a single one-hour visit a day fit within the level two budget, which also covers a case management and administration fee.

With good rostering and some creativity, a provider can make it work – usually because casual and part-time workers are only paid a minimum one hour and no compensation for the time between shifts.

There is more flexibility with the higher-level packages of up to $52,000 a year, but then the client’s needs can be considerably more and the finite funds just as hard to manage, if someone is to remain living independently in their own home.

Providers of home care packages may need to think hard about how they roster their workers to meet the new award at the same time as keeping a person’s services going. Existing clients could expect a change to their existing routine.

Shift allowance could lift costs

A further element of the changes to the Social and Community Services Award is employers will also have to pay their employees a new broken shift allowance where their hours are spread across a day.

It could mean more unwanted help or less needed help, depending how a worker’s shift is structured.

While it doesn’t stop an employee working for one or more client during the minimum payment period of two hours, someone will have to pay for the broken shift allowance where it applies if the two-hour minimum isn’t met.

Using the example above, will the extra half hour in the morning come from Mr Pike’s package or Mrs Little’s?

The worker could be rostered on for an extra hour for Mr Pike, but what if he doesn’t want – or can’t afford – someone in his house for two hours?

Will the broken shift allowance of $17.53 be covered by the provider or split between Mr Pike and Mrs Little? It’s hard to see how the additional costs won’t be passed on to the 200,000 or so recipients of a home care package, which threatens to make stretching a limited budget worse.

Better value through self-managing

Self-managing a home package using workers via online platforms is not for everyone; but anecdotally it is gaining traction as people needing support look for the most cost-effective way to get the help they need.

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A self-managed package means either the package recipient or a close associate develops their care plan with an approved provider, but they take on the task of finding and managing the support workers.

Read more about self-managing home care.

By saving the case management fee charged by providers, a self-managed home care package effectively means ‘buying’ more hours. 

If package holders can find workers willing to do just the half hour or one hour they need, then they are already better off than with the new two hour minimum. Workers win because they get to work the hours that suit them and charge accordingly.

It makes sense for support workers to have more time with the client and to assist with other tasks around the home. Medication prompting, preparing a meal, bedlinen changes, washing and tidying up might take two hours with a shower.

The issue for clients is that no further funding for home care packages is coming though, so the added hour may mean family (informal carers) pick up the extra shift at the end of the day, or the family or individual pays ‘fee for service’ for the extra visit.

Other people may forget the home care package and approved providers and find their own workers through their own networks or one of the online platforms such as mable.com.au or careseekers.com.au.

Care workers engaged through the online platforms can negotiate directly with the people seeking carers on the hours they work and the rate.

Supporting the workers

Looking after existing aged care workers and finding ways to attract new ones has become paramount to building a workforce suitable and sufficient to look after the aging population.

Better conditions for aged care workers are key to attracting suitable carers to an industry crying out for help.

However, it’s not yet clear if this was the carrot they were looking for.

The best hope is for the Fair Work Commission to accept the call for a 25% wage increase for all aged care workers, which will hopefully incentivise more people to join the aged care sector.

The announcement on 15 June 2022 that the minimum wage will increase by 5.2% – about $40 a week – is a start but probably not the whole message we need to send to a much-needed workforce.

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