Lorraine Poulos

Lorraine Poulos and Associates

The Changing Role of the Care Manager in Home Care – What Providers Need to do to Prepare

Thursday 13 October 2022

11:45am – 12:15pm

Speaker Bio

Lorraine Poulos is the managing director of LPA. She has a long history of working in the health and aged care sectors in senior positions. Her work history includes being a member of the NSW Medical Council as a Health Minister nominee for over 10years, Board member of several aged care boards and chair of several committees including ACSA community care advisory committee, clinical governance committees and the author of two clinical care books relating to home care. Lorraine is passionate about supporting the sector in preparing for the reforms in aged care by offering practical advice and support.


The ‘Support at Home’ Program will fundamentally change the role of Case/Care Managers.   The role will focus on clinical oversight of the client’s health, social and psychospiritual needs.This transition will require providers to implement an integrated solution.

At times with the current Home Care Package model Case/Care Managers are effective ‘package administrators’ with responsibility for budget and procurement, and there are weaknesses of this model.  Firstly, diverting Case/Care Managers to administrative tasks is uneconomical.  Secondly, the sector has a critical shortage of staff, especially Registered Nurses. Ironically, an outcome of The Royal Commission into Aged Care Quality and Safety, will be more Registered Nurses in residential care, reducing the supply in home care. Case/Care Managers working within their scope of practice, can safely be trained to deliver high-quality clinical oversight to cost-effectively bridge this gap. Thirdly, Case/Care Managers are uniquely placed to collaboratively engage with clients to assess, plan, implement, coordinate, monitor and evaluate options and services to meet their needs. 

The days are numbered where care/case management is bundled into a package, regardless of needs.  In the future, care/case management will only be for clients with complex care needs, not for those who may on require domestic assistance. The value of Case/Care Managers is that their skill-set is designed to support clients with complex care needs. However, regardless of any legislative, regulatory or program changes, this model makes sense from an economic, workforce and quality care perspective.

To prepare Case/Care Managers for the transformation of their role, service providers need to start upskilling these staff now and rethinking their workforce around this model.  Skills will be required in several areas.  Firstly, health literacy skills are essential.  Educating Case/Care Managers about common geriatric conditions enables Case/Care Managers to identify and refer signs of deteriorating health.  Early identification and referral to an appropriate health professional result in interventions that halt or minimise further deterioration.  Secondly, health literacy skills support continuity of care and multidisciplinary collaboration.   This maximises the use of Registered Nurses and Case/Care Managers. Thirdly, health literacy skills have beneficial flow-on effects as clients are educated about their role in managing their health.

Evidence demonstrates that clients who are educated about their health conditions are more likely to report changes to enable early intervention. Equipping clients with health literacy skills promotes independence and dignity can reduce the risk of unplanned hospitalisations, medical emergencies, and deterioration of health.

 Services providers need to have in place the following. Firstly, Care/Case Managers must be educated about working within their scope of practice.  Their role is to support routine clinical care with clear policy and guidelines about what and when they need to report and refer to health professionals.  Secondly, systems, structures and protocols need to be established for Care/Case Managers to report, refer or escalate a matter, and there are trained professionals available to respond.  Thirdly, systemic arrangements are required to reallocate the administrative tasks. This presentation will provide delegates with the opportunity to consider what needs to change and why.

Care Managers post Support at Home reforms- what is their role? What is changing? What skills set is required?