13. Is Consumer Directed Care (CDC) Working?
Up until 27th February 2017, in our clients’ experiences Consumer Directed Care reforms were not working as well as the Government intended them to; certainly not in line with the spirit of how the Government reform intended it to work.
However from 27th February 2017, Informed Consumers who are confident enough to assert their rights and negotiate for their RIGHTS then yes, it can work. From 27th February 2017, you don’t have to beg, plead and negotiate for your rights granted by the reforms, it’s your Government Funding now.
You have total power and control of the Government Funding now and you can transfer away from your Current Approved Provider to any other Approved Provider who delivers better value and better service to you enabling you to stay at home safely and comfortably for years longer.
On the issue of your right to have your choice of home care provider:
You shouldn’t have to negotiate under Consumer Directed Care, you should be asked … “and who would you like to supply your care?” Ronda Held, COTA
Example 1: Choice of Service Supplier not offered, care at the time requested not offered
The need: A friend of 25 years, who is a Clinical Registered Nurse; her Mother had a stroke and needed assistance with showering and dressing. As a result of the stroke she was offered a Consumer Directed Home Care Package in 2014. Her mother is an early riser who likes to shower, get dressed, have breakfast and get the day started. She wanted her assistance to shower and dress at 8am.
The offer: She was offered an 11am shower.
Comment: This is the old way of working – offering consumers services when the Approved Provider has a gap, even though it is not when the consumer wants their assistance.
Informed daughter advocates for her mother: Our friend had been educated by us as to how Consumer Directed Care was supposed to work. She explained to the Approved Provider that as her Mother had a Consumer Directed Care package she was ENTITLED to the care she needed, at the time she needed it and could choose who would supply it.
Explanation of the offer: The Organisation responded that they didn’t have staff available to do a shower at 8am.
Informed daughter advocates a 2nd time for her mother: Our friend responded, “under Consumer Directed Care Mum has the RIGHT to have her care when she needs it and if you don’t have staff available at 8am then my understanding is that you need to contract the work to another care provider, such as a private provider like Daughterly Care, who does have staff to provide personal care at 8am”.
Benefit of Consumer Directed Care: The organisation came back and said they could provide 8am showers for her Mother that meant her daughter could organise medical appointments and her mother could enjoy her full day.
Example 2: Choice of service supplier not offered, sub-standard evening meals given to client
The need: Marie (not her real name) is 99 and has a goal to live to 100 and receive her letter from the Queen. Marie cannot shop or prepare her meals and needs assistance to walk, shower and dress. Marie has 3 services a day over each meal. Marie had been on the waiting list for Home Care Package for some time and is finally given a Home Care Package. The Approved Provider is aware that Daughterly Care has been providing Marie’s care for 3 years.
The offer: Marie is not asked if she would like to continue to have her KNOWN CAREGIVERS from Daughterly Care continue to provide her evening services. New Approved Provider staff take over the evening meal preparation services. No choice was offered to Marie.
Result: The Provider’s Caregivers are writing in Marie’s Service Book that “the client ate half a pikelet” for dinner. Another night she ate “one and a half spoons of beef and rice”. Another night they wrote “two spoons of ice cream for dinner”. The client’s spirit has fallen. She had lost weight and is ‘down’ in her mood and outlook and talks about people “not really caring about her”.
Comment: This is a lady who loves her food if it is tasty food! Marie has always eaten well. Daughterly Care cooks her roasted vegetables, steamed broccoli and purees the vegetables with cooked meat so that it is easy for the client to eat. We served the client highly nutritious and delicious meals she enjoyed eating, which is important for good health. Further her known Caregiver is great company.
Education and informed advocating by niece: Daughterly Care educates the Niece on what her Aunt’s RIGHTS are and the Niece asks the Approved Provider/Funder to contract the work to Daughterly Care to provide the service because they have been caring for the client for 3 years and have a good rapport with the client and cook delicious and nutritious meals she enjoys eating.
Benefit of Consumer Directed Care: The Approved Provider / Funder contracts the services to Daughterly Care and the 99 year old lady has her known Caregivers back and delicious, nutritious meals are being prepared. Marie has put weight back on and plans are underway to celebrate her 100th birthday in 5 months’ time.
Example 3: Choice of service provider not offered, Caregivers with inappropriate skill set supplied
The need: Consumer has dementia and likes to walk. His wife is younger and has a very successful career and needs to continue working to financially support her husband.
The offer: The Approved Provider has been told by the wife that Daughterly Care has been supporting / enabling and caring for her husband for a number of years but the Approved Provider does not allow the KNOWN CAREGIVERS from Daughterly Care to continue. Choice of supplier is not offered, the wife does not know she has the RIGHT to ask for Daughterly Care.
Provider: The Approved Provider sent inappropriately trained staff to care for the gentleman. The first Approved Provider Care worker takes the gentleman for a walk and he gets on a bus and she cannot get him off. She calls the wife who leaves her high responsibility job to collect her husband. The second Approved Provider Care worker takes the gentleman for a walk and cannot get him home. She calls his wife at work who comes and collects her husband and takes him home.
Outcome: The wife rings the Approved Provider, utterly frustrated with this sub-standard care and complains and requests that the care of her husband be contracted to Daughterly Care as she has never had to leave work to rescue her husband and when Daughterly Care was supporting, enabling and caring for her husband. The Co-Ordinator says “perhaps the Caregivers we sent in haven’t got dementia experience”. The Approved Provider asks Daughterly Care to sign a contract to supply the services and life returns to normal for both husband and wife.
Benefit of Consumer Directed Care: Known Caregivers expert in caring for people living with a dementia are back caring for the gentleman. His wife doesn’t have to worry or leave work to rescue her husband. The gentleman receives expert, safe and engaging care which includes walks which he loves.