Designing the new integrated carer support service – draft Service Concept - June 2016

CPSA welcomes the opportunity to comment on the draft Service Concept for the delivery of the new integrated carer support service. CPSA represents the pensioners of all aged, superannuants and low-income retirees, a significant proportion of whom either rely on the support of an informal carer or provide informal care for a relative or friend. As such, CPSA has a keen interest in the design and delivery of services/interventions intended to improve outcomes for carers.

CPSA supports the central tenets underpinning the draft Service Concept, which identify the reasons for developing an integrated carer support service as:

  •         To help carers sustain their caring role by providing support to avoid crisis
  •         To improve the wellbeing of carers as people in their own right

CPSA is particularly supportive of

Identifying and Engaging Carers

Need to consider aged and disabled carers (who may at times require care themselves), unemployed and low SES carers, as well as the fact that carers are likely to fit more than one category (ie older CALD carer in rural area)

Improve identification and engagement with carers requires better social understanding of the role of carers and available supports – key avenues: health professionals, but also workplaces (need for carer friendly workplaces supported by Fair Work Commission, Women + Work paper proposals)

Carers of people with ST or periodic condition, whose recipient is unlikely to be covered by NDIS or aged care pkgs – how to identify/engage and what sort of supports might be necessary (need to be able to access first tier support services without assessment/application)

Integrated Carer Support Framework – Service Concept

Strongly support ‘networked’ approach to developing integrated carer supports – extensive knowledge exists and this must be retained/shared/utilised as well as capacity to provide services to carers with specific needs, must avoid one-size-fits-all approach

Eligibility? Recommend ‘first tier’ level of services available immediately ie phone line counselling/referrals, support groups (w/o registration or need to ‘prove’ circumstances), build strong ‘brand’ awareness for this level, but also capacity to develop ‘relationships’ with willing carers to provide ongoing support and assistance

Trigger for multicomponent intervention – who is eligible? Strong support for financial support in addition to Centrelink payments for practical assistance with caring role – could link in with MAC and NDIS in some cases (ie meals on wheels where carer and recipient live together)

Need to fund research into respite – how does access/availability of respite influence uptake, innovative models of respite (strong carer support for respite services suggests it is valuable in improving carer wellbeing)

Additional Matters

Many instances of insufficient evidence

Need to consider the indirect implications of other sectors/policies on carers

Shift to CDC – improves choice and control, but also increases burden on carer to support recipient in exercising this choice and control. Also issue of reduced hours for Home Care Package recipients and substantially reduced financial incentives for residential providers to offer respite beds.

Role of the paid care workforce – no clear cut delineation between informal and paid carers in many circumstances, need to promote partnership between workforce and informal carers – projected shortage of informal carers (deliotte access economics), but also projected workforce shortages in aged and disability care

http://www.carersaustralia.com.au/storage/Access%20Economics%20Report.pdf

CPSA welcomes the opportunity to comment on the draft Service Concept for the delivery of the new integrated carer support service. CPSA represents the pensioners of all aged, superannuants and low-income retirees, a significant proportion of whom either rely on the support of an informal carer or provide informal care for a relative or friend. As such, CPSA has a keen interest in the design and delivery of services/interventions intended to improve outcomes for carers. CPSA supports the central tenets underpinning the draft Service Concept, particularly the recognition of the well being of carers in their own right. CPSA understands that this discussion paper addressed high level concepts and so offers the following comments for consideration, rather than a formal submission.

Identifying and engaging carers:

- CPSA welcomes the discussion papers attention to diverse experiences of CALD carers, LGBTQIA carers, Aboriginal and Torres Strait Islander carers and young carers. We urge the Department to also consider the unique and diverse experiences of older carers, carers with disability, low income carers and carers living in regional and remote areas. CPSA also notes that many carers will belong to multiple categories, making the delivery of targeted services even more complex. Consider, for example, the unique experiences of an older CALD carer living in rural NSW whose only income is the Age Pension. It is critical that services catering to specific groups of carers are able to form networks in order to improve support.

- As the discussion paper notes, identifying and engaging carers requires a good social understanding of the role of carers and available supports. The paper notes health professionals as a key point of contact for engaging carers. CPSA notes that another possible point of engagement worth investigating is the workplace. When workplaces provide flexible working arrangements and other provisions to support carers, they send a message to their workers that the unpaid care they do is valuable and necessary. Carer friendly workplaces are a must. CPSA notes that the Women & Work Research Group has recently released a policy document with strategies to make workplaces more care-friendly.

Integrated Carer Support Framework - service concept feedback:

- CPSA strongly supports a networked approach to the proposed carer support framework, rather than a one-size-fits-all model. A networked approach should ensure that the extensive amount of existing knowledge is not only retained, but shared between service providers to ensure the specific needs of individual carers are met.

- CPSA recommends that a 'first-tier' suite of services be available to carers without the need to register or provide any contact details. Asking time-poor carers to go through a registration or assessment process in order to access basic services is likely to alienate some carers. It is critical that carers are able to access some level of support anonymously.

Additional Matters:

- The discussion paper frequently cites insufficient evidence of the effectiveness of particular support services for carers. While quite extensive international research does exist, if the Department is specifically after Australian studies, it will need to be funded. That said, strong support from carers themselves for services such as respite suggests that it is in fact a valuable service, regardless of what the limited research says. CPSA encourages the Department to engage in qualitative research with actual carers.

- There is a need to consider the interactions between the paid care workforce and unpaid carers. Both hold critical knowledge necessary to provide the highest level of care to the recipient, so it is important that the relationship between the two, and opportunities for communication are encouraged and supported.

- There is also the pressing long term projected care deficit - the increasing workforce participation of women combined with an ageing population and reduced fertility means there has and will continue to be significant declines in the availability of unpaid care. At the same time, the aged and disability care services sector is also projecting a workforce shortage over the next 10-50 years. If not addressed, the care deficit could have potentially disastrous implications.

- Need to consider how policies in other departments/areas affect carers. For example, the shift to consumer directed care (CDC) in aged care has increased the burden on carers, who must now support the care recipient to exercise choice and control by comparing aged care providers in order to determine the most appropriate. Further, the shift to CDC in home care left many recipients with substantially reduced hours, which their carers have had to cover for. In residential care, the introduction of refundable accommodation bonds for all residents has substantially reduced the incentive for providers to offer respite beds, which do not attract the same interest free loan in the form of a bond. It is critical that carers are considered when these sorts of policy decisions are made.