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Posted: 2022-08-19 02:30:16

It hasn't been easy for Maggie to live at home since she had a stroke in 2015.

"I'm 77 this year, and cognitively intact, but obviously physically challenged," she said. 

Maggie uses a wheelchair, and lives on her own in regional Victoria, with her dog Hamish.

She has been receiving help to stay in her own home through a home care package, which gives her three visits a day from a carer, plus some shopping and domestic help.

"It's actually been terrific for me to continue a degree of independence," she said.

Each care visit is about half an hour — once in the morning to help her dress, a lunchtime visit for the bathroom, and then a carer helps her into bed in the evening.

"I don't need any more than that."

Woman wearing a black top and pants, sitting in a wheelchair with her hands clasped.
Maggie has been receiving help through a home care package since 2017. (ABC News: Andrew Altree-Williams)

Home care packages for older Australians range from about $9,000 a year in federal government subsidies, to $53,000 for the more complex Level 4 package Maggie is on.

However, a recent Fair Work Commission ruling means Maggie's home care package no longer covers what she needs.

The Social, Community, Home Care and Disability Services (SCHADS) award covering many part-time and casual home care support workers changed on July 1, with the minimum shift time increased from one hour to two.

It means home care workers either need to complete a two-hour shift with one client, or providers need to schedule back-to-back appointments so the worker can see multiple clients in the two-hour window.

An out of focus shot of an elderly man holding a young girl's hand on a deck outside.
The award that covers the bulk of part-time and casual home care support workers changed on July 1. (ABC News: Natasha Johnson)

However, Maggie lives in a regional town, and her provider couldn't find another client to fill the rest of a two-hour shift, three times a day.

"I'm angry. I mean it sort of fills you with trepidation," she said.

"I have to weigh up: what's going to happen next — do I sell my place and go into care?"

She has previously been in a nursing home for two weeks.

"That experience was shocking, and so the thought of having to repeat that again really fills me with dread."

'This is only a temporary solution'

Paul Sadler from the Aged and Community Care Providers Association (ACCPA) said many home care providers had been able to book back-to-back visits for their workers, but rural and remote areas were proving challenging.

"The client might only need an hour's worth of service, but then you can't roster a second person because of the travel time," Mr Sadler said.

CEO Aged Care and Community Services Australia Paul Sadler
Paul Sadler says the Fair Work decision has been challenging for providers in rural and remote areas. (Supplied)

"Then the challenge is: who pays the extra cost of the minimum two-hour engagement?"

He said clients and providers were able to use any unspent package or grant funds to cover extra costs created by the award change, but not everyone had unspent funds.

"So, really, our key message to government is: This is only a temporary solution," he said. 

In Melbourne, Elizabeth Drozd is the chief executive of Australian Multicultural Community Services, whose clients often have specific language and care needs.

"Often what happens with changes to policy or other government changes in relation to home care and aged care, is those who live in regional areas are affected and those from various culturally and linguistically diverse backgrounds," she said. 

A woman wearing glasses and a white top.
Elizabeth Drozd says there are unintended consequences of the award change that need to be addressed. (ABC News: Andrew Altree-Williams)

Ms Drozd said the intention of the award change had been good for workers, but it was having unintended consequences.

"Those that are on pensions, those that do not have family support, those that have high care needs, they have been particularly affected by the change," she said.

"The government should attend to this matter as a matter of priority."

Home care worker Teresa Hetherington is not on the SCHADS award, but is a union delegate and runs two social media groups for home care workers.

Woman wearing a black top with her hands in her pockets.
Care worker Teresa Hetherington visits aged care clients in their homes, but she's on an award that allows her visits to be split across the day.(ABC News: Michael Nudl)

"As you can imagine, having a two-hour minimum sounded like a great idea," Ms Hetherington said.

"The problem has been the way that it has worked out.

"Different employers interpret it differently. They behave differently, and [workers] are finding that they're actually losing work rather than getting more work as employers decide that it's not financially viable for them to send us out for short shifts.

"And clients are having to cancel shifts or choose which of their services are the most important to get that day."

Aged Care Minister Anika Wells said there had been a "full spectrum" of responses to the award change.

Woman wearing a blue blouse with a jacket.
Minister for Aged Care Anika Wells says huge reforms are needed in aged care. (ABC News: Michael Lloyd)

"There's people trying to do the right thing, who are scrambling now to make their rostering system more efficient, right through people who will just pass on the cost and who are doing the wrong thing, and that we need to go after," she said. 

"I'm under no illusion that aged care is in crisis and home care, in particular, needs a huge reform to make it work better for everybody.

"That's why we are going to reform support at home."

Family members taking on the task of home care

Tina Westra is another of those dealing with the unintended consequences of the award change.

Her mum, Trijntje, has been living in a unit in Tina's backyard since she broke her hip a few years ago.

Woman sitting next to her elderly mother.
Tina Westra has been caring for her mum after the Fair Work Commission decision. (Supplied)

"We're fortunate and privileged enough to be able to do that for her," Ms Westra said.

"I knew the stress of a nursing home and that not being around family would really be sort of the end of her."

Trijntje is on a level 4 home care package.

She was previously receiving a care visit every morning, plus six lunchtimes and three afternoons a week.

Each shift was one hour.

"Some of the service providers can still, and have still, kept that one-hour service," Ms Westra said. 

"But others … it was just: 'No, this is the way our roster works'.

Trijntje's family was already paying $690 a fortnight on top of the home care package, and couldn't afford to cover the cost of most of those shifts becoming two hours.

Instead, Tina Westra has taken on caring for her mum four days a week.

"So it's a huge change and a huge, I guess, pressure for us," she said. 

"I'm not young anymore."

Elderly woman in a bright pink sweater sitting in a backyard.
Trijntje is on a level 4 home care package.(Supplied)

She is apprehensive about how it will go, but is determined to keep her mum out of residential care as long as possible.

"I'm totally for the carers getting the best conditions because the work they do, they deserve double, at least, what they get," she said. 

"I'm disappointed that there wasn't more consultation as to how [this change] would land on the ground."

Back in regional Victoria, Maggie has some unspent funds, but was hoping to use that to replace her wheelchair.

She's now hoping she and her son can manage her package and directly hire carers themselves.

"I see myself as a victim now," she said.

"Because I'm really at risk of having to sell my home and going into care."

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