Home' Community Care Review : CCR Aug-Spt 2015 Contents ...in almost every situation where
a consumer is provided with the
information they need to make an
informed decision, they come up with
the best solution for themselves.
By Richard Hearn
We fully support people having control, choice
and transparency through a CDC approach
to service provision. I am proud of the
commitment shown by Resthaven, other not-for-profits and
government, to improve services for older people.
We began designing and trialling a CDC model, working
with around 1,500 older people in 2009 and were well-
positioned for its full implementation on 1 July this year.
The major benefit of CDC is the increased control that
clients have over how Resthaven's services support their quality
of life objectives. It has highlighted the enormous diversity of
perspectives that older people have in general.
The new system has been challenging for some clients who had
been happy on their old-style package and did not immediately see
the benefit of making the change. Over time people have become
more comfortable with the monthly statement of the available funds
and the flexibility this offers them.
With CDC introduced at the same time as a stricter fees regime
and individualised budgets, it was difficult to keep separate the
concepts of co-design principles of care and services planning
(which we fully support), and individualised budgets and increased
For staff, this required learning new ways of explaining the
system in conversations with older people, working with them to
establish their priorities and ideas about services, and then working
together to establish a service plan. This has been very positive.
The range of choice and control that consumers are electing for
under a CDC model varies greatly across Resthaven's client base.
Many clients have preferred to retain similar services as before;
others are using their funds to stretch their service levels to fit their
personal interests, and planning for future support needs.
CDC delivery is constrained by the limit of supply for individuals
who wish to move to a higher level of service package if the need arises.
It has been difficult to explain to clients that individualised
budgets relate to the cost value of what the individual decides to
do with the package funds, rather than the old concept of how many
hours of service they could have from their package of care.
Everyone is learning more about the enormous range and
diversity of perspectives of older people living in our communities.
The need to understand what it costs to deliver home care has
been a significant driver for providers. Consumers have a wide
range of views about what are acceptable fees for services provided.
Managing complex expectations in this regard is a new
concept both for community services providers, and older
people and their families.
Such complexities are to be expected, balancing
the technical elements of a new system with the
importance of individual client outcomes.
As with all new systems, we hope the CDC approach
will improve and become more refined over time across
The most important point is to respect the choices,
independence and wellbeing of older people.
Richard Hearn is chief executive officer of Resthaven. n
Our existing clients are
familiar and comfortable relying
on a care facilitator for support,
so perhaps unsurprisingly the
majority of our clients are not
yet choosing to self-manage
their home care package.
We are finding that
consumers and family members
are shopping around and
are keen to choose the most suitable provider for their needs,
which means we are constantly assessing how we can be more
competitive in our care and service delivery.
Finally, in almost every
situation where a consumer is
provided with the information
they need to make an informed
decision, they come up with the
best solution for themselves.
For BaptistCare, that is the
true test of success; have we
supported and empowered our
clients to access care that they
have choice and control over? It's what you and I would want, and it
is the future of aged care.
Ross Low is chief executive officer of BaptistCare.
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