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The challenges of growth in the home care market: opinion

For many years now, the UK has had to adapt to an increasingly under-funded home care market, which has led to ever tighter eligibility criteria for people to be entitled to state-funded care and increasingly shorter episodes of care – an average home care visit now is less than 30 minutes in duration.

The funding squeeze has forced many providers out of business, and the not for profit sector with historically higher overheads has been hit particularly hard.

In Australia, meanwhile, the number of home care providers has exploded since 2016, with 902 approved providers as of 31 December 2018 (according to the Home Care Packages Program Data Report).

What I have found working here is that while Australia’s home care market is vastly different to that of the UK, some of the challenges around quality assurance, relationship management and speed of delivery are the same.

Most providers have to overcome industry challenges such as:

  • High employee turnover
  • Poor employee engagement
  • Capability gaps and misalignment in skills and competencies
  • Casualisation of the workforce and the difficulty of attracting talent
  • Ineffective recruitment, induction and on-boarding processes
  • Suboptimal workforce planning
  • The challenge of meeting the Aged Care Quality Standards, i.e. being more accountable for safety and quality and having an increased focus on client care and client choice.

We recently undertook a snapshot survey of the operational challenges facing home care providers in Australia’s rapidly changing market, with a view to assessing which of their growth challenges were most pressing.

Most of the providers who responded to us were growing at a moderate pace, with a sizeable percentage growing fast. They told us recruitment remained a big challenge, on a par with staff management. For a majority of home care providers, the most critical component was hiring staff with the right attitude and being able to get the right care worker to the right client on time as often as possible.

Rostering staff time effectively was recognised to be another key challenge, as was adapting to funding changes, with regulation and compliance another shared concern.

In terms of ambition, most of the providers in our survey were focused on improving the quality of their services but only a few of these considered technology to be an important part of their concerns.

In our view, providers’ view of the role of technology was not completely realistic. It did not align with the challenges they were facing in terms of growth.

My experience in the UK has shown me that process improvements – delivered through technology – can also increase home care providers’ speed of operation and communication, and so help them deliver a more reliable service.

Today, providers can actually automate all of the administrative functions involved in home care, from scheduling and rostering to billing and payments, and move them from paper or Excel to intelligent cloud-based systems.

These systems allow office-based administrators and mobile caring staff to communicate with each other, update rosters in real time and see a wealth of business data with each rostered appointment (including staff qualifications, award interpretation and client records). Some examples of new technology that can be considered are:

  • Customer engagement. Under Consumer Directed Care we can expect future consumers to be much more demanding and therefore we need to engage and look after them digitally as well as physically.
  • Plan management (for NDIS services).
  • Electronic recruitment and retention. An effective employee engagement app / portal can be crucial to ensuring employee satisfaction in a mostly unsupervised and remote role.

In short, new systems make it much easier to plan for and manage an efficient workforce and to scale up home care services to take on more customers.

In the UK, home care providers are already using tools such as optimisation engines to ensure that staff can be allocated to client visits in the most efficient manner possible. Systems such as these have seen efficiency gains of up to 30 per cent, particularly for large providers delivering a high volume of short visits over wide geographical areas.

However, many providers still opt to utilise the sophisticated and unique local knowledge built up over many years by experienced care coordinators. The human versus machine debate is never a black and white one.

I expect the newly available technology to play an increasing role in customer service-led home care over the next few years, and so I believe that home care providers here in Australia can’t afford to stand still.

Peter Longman is managing director of Ezihub, a flexible set of integrated software solutions including Eziplan designed for Aged Care, Home Care and NDIS providers in Australia. As joint founder of HAS Technology Group, Peter has been developing technology solutions for the community health and social care markets for over 20 years, first in the UK and now in Australia.

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