Four things that your home care provider can’t do
For many older Aussies, finally getting access to an aged care home care package feels like winning the lottery. With over 100,000 people on the waiting list for home care, seniors can wait as long as two years before getting the package they’re eligible for.
But although a home care package can be a valuable resource to help meet your needs for support to continue living at home, it may not be the cure-all you’re hoping for. Home care can provide you many essential services, but there are limitations on what providers are able to offer. Here’s what you need to know about what your home care provider can and cannot do for you.
The core obligation of your home care provider is to manage your package funds appropriately and provide you the services outlined in your care plan. Your provider is required to follow both the Charter of Aged Care Rights and the Aged Care Quality Standards. These guidelines ensure that providers meet a high standard of quality care and that they give you choice, flexibility, and control over the services you receive.
However, your home care provider’s responsibilities don’t end with you. They’re also required to meet standards of workplace safety for their workforce. Since your provider employs carers who work in your home, managing safety regulations for their workers can mean they have to place limitations on the services they offer you.
Workforce safety in Australia is guided at the national level by the Model Work Health and Safety laws (WHS) and their accompanying model Codes of Practice. These are not enforceable laws; they are model laws that Commonwealths, states, and territories are encouraged to adopt. As of February 2021, the model laws have been implemented in the Australian Capital Territory, New South Wales, the Northern Territory, Queensland, South Australia, Tasmania and the Commonwealth.
The specific regulations that your provider needs to follow depend on where you live and are receiving services. Generally, however, they are required to take steps to ensure that your home is a safe environment for the carers and other workers they employ. This could include assessing your home, asking you to make changes in the layout or organisation of your home, and placing limitations on certain types of activities or services.
There are several specific types of services and environmental characteristics that the WHS Model Codes of Practice identifies as likely workplace hazards for employees who work in private homes. These are the areas where your provider is most likely to place limitations on services for the safety of their workers. Here are some of the key things your provider needs to avoid to follow WHS guidelines.
1. They can’t put your carers at risk of musculoskeletal injuries
Musculoskeletal injuries are one of the most common workplace hazards for home health carers, and reducing the risk of these injuries is an important responsibility of your provider. The WHS Model Codes of Practice require employers to manage the risk of hazardous manual tasks.
Hazardous manual tasks are defined as any task that requires a worker to move or hold an object or person in a way involving repetitive or sustained force, high or sudden force, repetitive movement, sustained or awkward posture, or exposure to vibration. Any manual task that requires one of these types of movement could put your carers at risk of injury.
The WHS codes state that whenever possible, an employer should eliminate the risk of musculoskeletal injuries. If it’s not reasonably practical to eliminate the risk, then the employer should minimise risk as much as possible. Your provider has flexibility to define guidelines for their workers that will minimise the risk of injury.
For example, vacuuming under furniture could require moving heavy furniture, which requires “sustained force” and could be unsafe for one person to do alone. Your provider could set a guideline stating that cleaners are only allowed to vacuum around furniture and that they are not allowed to move it.
Another example could be washing walls, which could require repetitive movement in an awkward posture. Your provider could set a limit on cleaning height and state that cleaners cannot clean anything above shoulder height to avoid requiring awkward posture for extended times. Alternatively, your provider could limit the amount of time required for a specific cleaning activity and state, for example, that cleaners can only work on cleaning walls for 30 minutes at a time.
A third example is lifting or moving you if you are not mobile. This could also require your carer to use force in an awkward position, and your provider could set a guideline that two carers are required to move you from your chair to your bed. This would mean that if only one carer is in your home, they wouldn’t be allowed to help you move.
2. They can’t make last-minute changes to your carer’s schedule
All workers in Australia, including the carers employed by your Home Care Provider, are protected by a Fair Work Australia Award, which protects the rights of all workers in Australia. There are two rights that are particularly important for home care workers and scheduling your care.
First, shift workers have the right to at least a two hour shift. That’s because a shift worker needs time to get ready for work and drive to their workplace, so they have the right to be paid for at least two hours of work. If you only need a little bit of care, you might want to schedule a carer for an hour at a time. This could save you money and be more convenient for you. However, although your provider is allowed to offer a one hour shift to your carer, they aren’t allowed to require it. Your provider will only be able to schedule short shifts like this if your care worker agrees.
Second, your carer has the right to 24 hours’ notice if a shift is canceled. If you need to cancel a shift with less than a day’s notice, your care worker is still entitled to full pay for the scheduled shift. Since your provider is required to pay the carer, they have the right to pass that cost on to you and charge you for a care shift if you cancel with insufficient notice.
3. They can’t put your carers at risk of work-related violence
Violence is another risk that carers and other service providers could face while they are traveling to or in your home. Your home care provider is obligated to eliminate or minimise the risk of violence as much as possible for their employees.
Violence is a risk for home health workers because they often come to your home alone. If you live in a high crime area or in a very remote area, they could experience violence while walking from their transportation to your home, especially if they are scheduled to visit you late at night. There could be other people in your home, such as other workers or even friends or family members who might pose a risk for violence. There could also be situations where the person receiving care could be a risk for violence against carers, such as if a person did not receive medications on time and is confused, or if a misunderstanding about service expectations creates frustration and anger.
Your home care provider has the responsibility to set guidelines for their employees that will reduce this risk. For example, if you need overnight care, your provider might require the night shift to begin in the early evening so the carer can arrive at your home before dark. Your provider could also require two carers to be present for your care appointments, which would make care more expensive for you. In addition, your provider can exit you from their service if they decide they cannot provide adequate care for you with the resources available.
4. They can’t put your carers at risk of falls
Falls are another common risk in home settings. In addition to being one of the most common causes of injuries for seniors, falling is a risk for home care workers as well. The good news is that your care provider should assess your home for environmental hazards that could make falls more likely, and fixing those hazards will make your home safer for you as well as for the service providers who come to your home.
If there are any hazards in your home that increase the risk of falls, your provider can suggest ways to make your home more safe. Many hazards can be solved with very simple solutions, such as adding lighting to dark stairways and adding non-slip treads on outdoor stairs. Solutions like these can also be paid for out of your home care package funds.
Your provider might also require that your carers follow practice guidelines to reduce falls. For example, they might require your housecleaner to clean floors at the end of their shift to minimise walking on the recently mopped floor.
It’s important to keep these limitations in mind when you’re choosing a home care provider. If you have specific care needs for your care that might involve potential hazards for carers, discuss them with potential providers before you sign a care agreement. Knowing ahead of time exactly what services your provider can and can’t offer will set a foundation for a good working relationship.
Remember: Home care involves a relationship between you, your provider, and the carers hired by your provider. Your provider has responsibilities both to you and to the carers they employ. By prioritising the health and safety of your carers, your provider is not just fulfilling their legal responsibilities as an employer; they are also safeguarding you. Service workers whose rights and safety are protected will be able to focus on giving you the best quality care possible.
This article was written by Gareth Mahon, the co-founder and CEO of The CareSide, a company based in Perth that provides home care and disability care services throughout Australia.
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