Australiaâ€™s magazine on home and community-based care and support
Daughterly Care Why transparency matters
This issue: IN FOCUS
Here come the robots Time for leadership
Smart solutions for aged care Addressing the skills gap
Losing the info war Reducing injury risk
Why transparency matters Daughterly Care is a family-owned Australian business founded by a registered nurse and an accountant, which has specialised in providing in-home aged care to more than 7,000 private care clients over the last 20 years. Over 82 per cent of their care has been for high care seniors who are frail or living with a dementia and 73 per cent of all new clients are recommended to Daughterly Care by health professionals, clients or their families. Daughterly Care has been riding the consumer directed care reforms with their ‘joyful living’ approach while making sure older Australians understand their rights as consumers. KYMBERLY MARTIN reports.
perating a home care business in a reform environment is exciting and challenging and requires a need for education for both approved providers and consumers in order to avoid common pitfalls, Daughterly Care CEO Kate Lambert tells Community Care Review. Since July 1 2017 when consumer directed care (CDC) reforms introduced transparency for seniors via monthly home care statements for all government funded home care package clients, Lambert says she dived in deep to see what was happening in the SPONSORED FEATURE
industry. She says she was concerned about what she found in the monthly home care statements of some seniors. Ms Lambert says the government made it clear to approved providers in their home care package guidelines for CDC that “the format of the statement must be clear and easy to understand, should clearly state any unexpended or contingency funds, and
should be consistent with the individualised budget”. However, after auditing thousands of home care monthly statements she says she has found this is not always the case. “If a fee is not in the home care agreement then it cannot be charged”, she warns, adding “I am shocked that every client statement I have audited, bar one, has had fees charged to the client that had not been disclosed to them in their home care agreement. The largest refund I have negotiated was $29,888 for one client”.
COMMON PITFALLS AND HOW TO AVOID THEM “I am relieved that Aged Care Minister Ken Wyatt has written to the industry recently about excessive administration fees and lack of pricing transparency and comparability. However after auditing thousands of home care package monthly statements I can say it is not sufficient to focus on administration fees alone. The focus needs to be on total fees charged to the home care package and on full disclosure of actual fees charged”. According to Ms Lambert financial pitfalls can include: • Undisclosed processing fees deducted from the HCP • GST being deducted from the HCP where no GST is payable • Approved Provider fees being embedded into third party provider fees
Verlie with David, who lives with dementia.
“We understand that trust is a gift given once” – Kate Lambert, Daughterly Care CEO
• Charging the HCP higher fees than were disclosed in the home care agreement • Inaccurate accounting – deducting one client’s fees from another client’s HCP, charging a client’s HCP for the same invoice more than once, charging for services that didn’t occur, charging for whitegoods that the senior did not receive or request • Deducting the income tested care fee from the government funded income where the client is not required to pay an income tested care fee • Not organising an extra supplement for funding that had been included in the client’s individual budget Over 96 per cent of Daughterly Care’s business over the last 20 years has been private care for self-funded older Australians. “Typically our clients are financially savvy and tertiary educated. The son of our client discovered that his father’s home care package provider had inflated our live-in care fee by $100
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Verlie and Kate arrive to talk to seniors.
per day, in addition to the 35 per cent administration and case management fees they had disclosed. We explained Daughterly Care only had one fee regardless of who was paying.” Daughterly Care owners, Verlie Hall and Lambert say they decided to publish their fees online and become an Approved Provider to ensure the best for their clients. According to Lambert Daughterly Care has a 20-year history of accurate invoicing. “Verlie Hall, our managing director instilled this in our team from day one. Verlie is a great checker. She has numerous check points you have to pass. We understand that trust is a gift that is given once. Daughterly Care has signed up over 100 new home care packages since seniors had the ability to transfer their home care package. “We have to understand that consumers with government funded home care packages have the same rights and power now that private paying clients have always enjoyed, even though they don’t fully realise that yet”.
KEEPING PEOPLE AT HOME AS LONG AS THEY ARE SAFE AND HAPPY Ms Lambert and Ms Hall also made the decision that Daughterly Care would not pay any commissions to approved providers who
“Seniors and their adult children … are seeking approved providers who are accurate and ethical and who deliver good quality care, after all that’s what keeps seniors at home for longer, they need the opportunity to understand better what the issues are and their rights under CDC”
recommended or contracted work to them, disclosed or undisclosed. “We wish to be recommended and selected for the quality of our caregivers, rather than for payment of a secret commission.” Ms Lambert would like Minister Wyatt to ban undisclosed commissions in the aged care industry to protect vulnerable elderly people. “Seniors and their adult children are hungry for information and to become educated on home care packages. They are seeking approved providers who are accurate and ethical and who deliver good quality in home care, after all that’s what keeps seniors at home for longer, they need the opportunity to understand better what the issues are and their rights under CDC and then they are much more likely to negotiate better outcomes for themselves.” The monthly home care statements were introduced due to CDC have helped boost transparency, Lambert says. “The monthly statements are a brilliant idea, the fact that they go out to people who cannot yet understand them and their adult children who are too busy to read them is problematic but they are highly informative and there to shine a light on how the funding is actually spent so the seniors’ budget can be spent in the most appropriate way. In time, more consumers will become more aware of the issues and look out for them. “Daughterly Care always aims for 100 per cent transparency and accuracy because overcharging can result in a client not being able to stay in their home for as long or not being able to afford appropriate support and care. “We have to make it easier for older people. When seniors understand the power of what CDC has delivered, what their new rights are, how to read and interpret their monthly statements and see examples of what can go wrong, they are in a better position to negotiate.
Daughterly Care’s first Joyful Living Home.
AN IDEAL HOME FOR PEOPLE WITH DEMENTIA Daughterly Care will open its first 10-bedroom and 10-ensuite boutique dementia-specific home at Mona Vale on the northern beaches area of Sydney in November. Registered nurse and managing director, Verlie Hall and CEO, Kate Lambert travelled to the United States to examine the Green House Project first-hand. Hall and Lambert admired the single-level, small-scale homely model where the kitchen is the heart of the home. Inspired, they returned and built
their own vision of an ideal home for people with a dementia after more than five years’ research and drew on evidence-based research plus Ms Hall’s decades-long experience as a carer and a nurse to seniors with a dementia. Daughterly Care’s Joyful Living Homes offer internationally recognised best-practice dementia care with all caregivers and nurses being accredited in Developing Montessori Environments for Aged Care. The home has been built with living
“Educated consumers have always got a better deal and CDC when done well, delivers that. Our goal at Daughterly Care is to keep people at home for as long as they are safe and happy there and hopefully that is for all their years. We like to provide support and care with our Joyful Living Approach. “Daughterly Care looks after private clients who are often financially savvy who expect transparency. When you cannot do your accounting correctly, or don’t disclose fees, then you have lost their trust forever. Get the money side right, charge fair and reasonable fees which are disclosed. We try to put joy into peoples’ lives, and getting the financials right gives elders more freedom to live joyfully. Consumers want to stay at home and need their government funding to go as far as possible.” The organisation offers a wide range of services all focused on support that enables frail clients or clients with a dementia to remain at home for life, services such as shopping, light housekeeping, meal preparation, medication assistance, transport to appointments, companionship, personal hygiene assistance,
spaces designed to enable and support people with a dementia with short walking distances to the kitchen and lounge room from every bedroom and easy access to outdoor areas including covered verandahs, vegetable gardens, flower gardens, fruit trees, chickens and visiting dogs. Activities are person-centred with registered nurses and caregivers providing individual care, support and assistance with a high staff to resident ratio of 1:3.
in-home respite care, after-hospital care, nursing services, palliative and end of life care. Daughterly Care provides this assistance during the day, at night, overnight, 24/7 or on a live-in care basis. Daughterly Care services the upper and lower North Shore, northern beaches, eastern suburbs and north west and Hills District. Live-in care is available in Sydney and country New South Wales. n
Contact Daughterly Care: 02 9970 7333 Enquiries: email@example.com
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Community Care Review Spring 2018 - Cover Story. Daughterly Care - Why transparency matters.