Our recommendations

Home-based support services for older people.

We recommend that the Ministry of Health:

  1. collect and use meaningful and reliable information to ensure ongoing service quality and value for money of home-based support services by:
    • specifying a set of national key performance indicators for district health boards to measure service performance;
    • working with district health boards on mechanisms to ensure that performance data is reliable and meaningful;
    • using performance data to inform policies and strategies that will help district health boards deliver high quality services; and
    • sharing with district health boards good practice and benchmarks to drive continuous improvement;
  2. through district health boards, evaluate by June 2013 whether the use of a standard approach to assessment and reassessment is improving the way needs are assessed and home-based support services are allocated; and
  3. consider making NZS 8158:2003 Home and Community Support Sector Standard mandatory for the provision of home-based support services to older people.

We recommend that district health boards:

  1. work collaboratively with others in the aged care sector to develop a complaints system that enables older people to confidently raise any concerns about their home-based support services; and
  2. strengthen management contracts to ensure that home-based support staff provide high-quality services and are well trained and supervised.

Paul is 91 years old and has been receiving home-based support services for three years. He lives alone in his own home. A support worker visits every day to help Paul with his personal care and household tasks. Paul receives nine hours of home-based support services each week.

Accessing services

Paul had a stroke three years ago and spent about two months recovering in hospital. Paul recalls a social worker keeping in close contact about his progress while he was in hospital. Before he went home, she visited his house to suggest some alterations to make it safer. Paul also recalls that the home-based support services started fairly promptly after he left hospital.

Changes to services

After a few months, Paul received a letter saying that his service was being reduced. He did not recall having his needs reassessed then, and described this news as "just shattering". With the help of his general practitioner, Paul was able to show a need for his support to continue at the same level. He thinks he might have then been assessed, and his home-based support services were reinstated.

Improving services

Overall, Paul is very happy with his support worker and the support he receives. If he did have a problem, he would approach his care co-ordinator. One improvement he suggests is better communication in co-ordinating services. He experienced one (now resolved) incident of miscommunication about the days that a support worker should visit.

Being independent

Paul admitted that he needs help and said that receiving home-based support services helps him to live in a relaxed way and not to worry about anything. He is happy with his life, and living in his own home of 30 years is important to him. He commented that it is a good thing home-based support services make this possible and enable him to be independent. Paul considers that he has the right level of support to meet his needs.
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