Self-management in home care packages: friend or foe?

Ms Anna Millicer1, Ms  Carmel Laragy2

1COTA Australia, MELBOURNE, Australia

2RMIT University – Social & Global Studies Centre, MELBOURNE, Australia


Many consumers and carers are seeking more autonomy in the day-to-day management of their package, but current models often fall short of meeting consumer expectations.

This complete self-management model delivers the goods, and includes capacity building and upskilling of consumers and carers to prepare them for what’s involved.

For providers, the COTA Australia model offers a guide to implementing high-level self-management which meets consumer needs and aligns with the Aged Care Quality Standards.


COTA Australia has completed the Increasing Self-management in Home Care project trial. The project builds on feedback from older people that most consumer directed care offerings do not go far enough in giving consumers meaningful choice, autonomy or control. The findings offer an evidence-based, objective evaluation of a complete self-management model, customised for home care packages.

Funded under a DACS Innovation Grant, COTA Australia’s self-management model was designed and tested by consumers, carers and providers to reflect the unique context of the Australian home care packages program.

Internationally, self-management and increased consumer control models have revolutionised the delivery of social care programs. Characteristics of the COTA self-management model are:

  • the use of a debit card to allow consumers more direct control of their funding;
  • online and mobile phone access to home care budget and spending statements;
  • option to select, employ, roster and pay their choice of support worker;
  • transparent access and input into care planning;
  • increased objectivity in decision-making over approved purchases;
  • mutual and collaborative partnership between consumers and providers including joint responsibilities and formal self-management agreement;
  • access to helpful people and resources.

RMIT University evaluated the trial using surveys and telephone interviews.  The presentation will deliver research outcomes, participant and provider case studies, and highlight the practical tools and resources developed in trial, all of which will be made freely available to delegates. The project’s risk management approach focusing on compliance and alignment to Aged Care Quality Standards will be explored.


Self-management for consumers of home care is a hot topic in the sector and attracts a great deal of interest and discussion amongst providers and consumers. COTA Australia’s evidence based self-management model explores the challenges, benefits, risks and overall outcomes of seven approved providers and 100 consumers as they test the boundaries of self-managed home care packages. The project outcomes deliver enormous value to the sector by making all the project tools and resources freely available for providers to integrate into their existing home care model. Resources designed and tested by consumers, for consumers, are also available at no cost and assist in defining a consistently applicable model that resonates with providers and consumers alike.

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