A Helping Hand: Home-based Services in Western Australia
Report No 6 - June 2007
Background
Many of us will require assistance with aspects of daily living over
the next 10 years as a result of ageing, disability or illness. The State
and Commonwealth governments have allocated approximately $240 million
in 2006-07 to assist people in these circumstances to live at home. Types
of assistance include help with self care, communication, mobility, meal
preparation, transport, property maintenance and treatment of some medical
conditions. By providing this assistance, people who otherwise might need
to relocate to a hospital or other facility, can remain in their home.
We reviewed five home-based services administered by the Disability Services
Commission (DSC) and the Department of Health (DOH) by focusing on three
key questions:
- Are people able to access home-based services when needed?
- Are home-based services of reasonable quality – do home-based
services help people with daily living tasks and, by doing this, do
the services improve people’s overall quality of life?
- Do the community and government get value for money from home-based
service funding?
The Home and Community Care, Hospital in the Home, Chronic Disease Management
Team, Community Aids and Equipment Program and Supported Community Living
services were the five home-based services reviewed.
What the examination found...
- Information about home-based services is widely available and there
are many opportunities to apply for or be referred to individual home-based
services.
- However, people who need home-based services face multiple government
agencies with different application, referral and assessment processes.
This can be confusing for many people.
- People who acquire a disability after 60 years of age have fewer
home-based service options than those in other age cohorts.
- Four of the five home-based services examined have assessment processes
which are open and accountable.
- DSC is trialling a new assessment process for its Supported Community
Living service that if introduced should provide consistency in assessment
and greater accountability for the funding decisions.
- DSC’s new assessment process will continue to lack the transparency
about decisions that are normally provided by government assistance
programs. DSC has agreed to consider alternative feedback mechanisms
that will reduce the current frustration that exists amongst applicants.
- Only two of the five home-based services examined have processes
that govern the quality of service provided:
- the two services for people with medical conditions have quality
of care accreditation processes
- the other three services have standards that govern service administration
but not the quality of service provided.
- However, developments are underway to bring a greater focus on quality
of service.
- The five home-based services need better effectiveness measures.
- All five home-based services have adequate cost and demand information.
What the examination recommended...
The DSC and the DOH should:
- adopt processes for monitoring the quality of home-based services
received by people who are frail aged and people with disabilities
- work collaboratively to improve home-based service interfaces across
the aged care and disability sectors
- adopt key effectiveness measures that are directly linked to improvement
of the wellbeing and quality of life of people in home-based services
- monitor timeliness of service delivery to clients
- conduct joint planning to ensure that the entire suite of home-based
services most effectively meets the needs of the Western Australian
community.
The DSC should develop mechanisms with stakeholders that provide more
suitable feedback to applicants who have unsuccessfully applied for Supported
Community Living services.
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