Standards and Funding - Home Care
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Standards and Funding

Aged Care Quality Standards

The Aged Care Quality and Safety Commission expects that organisations providing aged care services in Australia will comply with the Aged Care Quality Standards (Standards), which include end of life care and advance care planning.  For more information on the Standards, see the Guidance and Resources for Providers webpages.  ELDAC has resources to help aged care staff and organisations meet the eight Standards.

Aged care quality standards

Source : Aged Care Quality and Safety Commission website www.agedcarequality.gov.au. The use of this image does not constitute an endorsement by the Aged Care Quality and Safety Commission of ELDAC activities.

Standard 1 underscores the importance of valuing diversity where every consumer should be treated with dignity and respect, especially in terms of their identity and culture.  The Advance Care Planning page has resources for different population groups including: religious and cultural backgrounds; people living with dementia; Aboriginal and Torres Strait Islander Peoples; and LGBTI groups.  There are also resources for supporting families around communication, decision-making about care and involving others in their care.

The Assess Palliative Care Needs and Provide Palliative Care domains of the Home Care Toolkit has materials on providing care that is culturally safe and offers information on supporting holistic care, including psychosocial and spiritual wellbeing.

Standard 2 focuses on ongoing assessment and planning with consumers.  It explicitly identifies that this should include advance care and end of life planning, if the consumer wishes.  The Advance Care Planning page of the Clinical Care section has general information and links to specific states/territories resources for end of life planning.  There are resources to assist healthcare staff begin the conversation with clients about how they want to be cared for and what their wishes and preferences are for their end of life.

The Work Together domain under the Clinical Care section of the toolkit highlights care coordination as essential and inclusive of all health professionals, the client, and the family regarding care goals.  Palliative care case conference information and templates are available to help document the multidisciplinary team meetings.

Standard 3 is concerned with personal and clinical care so that a person’s needs, goals and preferences nearing the end of life are recognised and addressed.  This includes consumers’ comfort being maximised and their dignity preserved and that staff recognise deterioration and respond in a timely manner.  The Home Care Toolkit addresses these areas in the Recognise End of Life, Respond to Deterioration, Manage Dying and Bereavement clinical care domains.
Standard 4 emphasises the importance of the organisation providing safe and effective services and supports for daily living that optimise the consumer’s independence, health, well-being and quality of life.  The Clinical Care domain on Assess Palliative Care Needs has resources to measure and promote client's emotional, spiritual and psychosocial well-being, which are based around The Palliative Care Needs Assessment Guidance.
Standard 5 does not apply to home care services where the environment is the consumer’s home.
Standard 6 requires an organisation to have a system to support all consumers to make a complaint or give feedback.  Providing palliative care and advance care planning for clients and their families requires a coordinated approach.  The Support Systems section outlines five actions that will assist your organisation in continuous quality improvement leading to better outcomes.

Standard 7 states that organisations have and use a skilled and qualified workforce, sufficient to deliver and manage safe, respectful, and quality care and services.  The Education and Learning section of the toolkit offers an opportunity for you and your staff to evaluate your individual learning and development needs in providing end of life care with the ELDAC Personal Learning Assessment and create a Personal Learning Plan.

There are links to online education modules to help you and your staff improve your knowledge, skills and confidence in palliative care and advance care planning.

Standard 8 is about embedding within organisational governance delivery of safe and quality care and services.  The Organisational Support section features three audit tools to support quality improvement in your service, which include the:

  • ELDAC Palliative Care and Advance Care Planning Organisational Audit
  • ELDAC After Death Audit
  • Advance Care Planning Continuous Quality Improvement Audit Tool
National Palliative Care Standards
Palliative Care Australia have released the 5th edition of the National Palliative Care Standards (371kb pdf). These standards are useful to refer to when reviewing palliative care and advance care planning in your organisation.
Aged Care Service Funding

The Government pays for the majority of aged care services provided in Australia by paying subsidies and supplements for care to providers.

The Commonwealth Home Support Program (CHSP) provides entry-level home support for frail older people who need assistance to keep living independently. Services include social support, transport, help with domestic chores, personal care, home maintenance, home modification, nursing care, meals and allied health services. Clients pay a contribution (which varies between providers) towards the cost of services and CHSP providers receive Australian Government funding through grant agreements. The CHSP operates in every state and territory except for Western Australia, where the Western Australian HACC Program continues to provide basic support services to older people as well as younger people with disabilities. CHSP clients are able to receive specialist palliative care services from their local health system in addition to their home support services but this needs to be arranged by the person’s GP or treating hospital.

The Home Care Packages Programme (HCP) is available for people who require more care than can be provided by Commonwealth Home Support Programme (CHSP).  HCPs assist older people to stay at home (rather than entering residential aged care) and provide ongoing personal and support services and clinical care. Each package of services is individually tailored to the client’s needs according to the principles of Consumer-Directed Care (CDC).

There are four levels of HCP, ranging from Home Care Level 1 (supporting people with basic care needs) to Home Care Level 4 (supporting people with high care needs). Clients are expected to contribute to the cost of their care. People receiving HCPs are able to receive specialist palliative care services from their local health service.

Page updated 01 July 2019