Evaluation of the consumer - directed care initiative - Final Report

6.2 Expectations of participants and carers

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Participant and carer motivations for participating in CDC

A consistent theme from participant and carer interviews was that participants and carers chose to participate in CDC based on the recommendation of their provider, and this is validated through survey data (as the table below illustrates).

A significant number also cited the desire for more choice of services and more control over care planning as reasons for participating in CDC. A desire for more choice of services was a particular motivation for CDCHD participants and their carers.

Table 10: Reasons for participating in the CDC initiative – by care level

Reason	CDCL	CDCH	CDCHD
I wanted to have more choice of which services I used	29%	38%	62%
I wanted to have more choice of providers	9%	21%	31%
I wanted to have more control over my care planning	35%	38%	38%
It was recommended by my care provider	72%	82%	38%
I was not satisfied with my previous community care	1%	6%	31%

Based on responses received from 124 CDC participants and 126 standard packaged care (comparison group) recipients. ‘Don’t know’, multiple and blank responses have not been reported in this table. Note that respondents could select more than one reason.
Source: CDC and comparison group surveys, conducted August 2011.

There was evidence that prior experience of packaged care influenced participants’ motivations for participating in CDC. People who had received a standard care package prior to CDC had a tangible point of comparison – they knew what they wanted to do differently. Some of these people had negative experiences with their prior package or a previous provider, and many were dissatisfied with some aspects of their package (including some aspect of their support arrangement, their support worker, frustration with a perceived lack of accountability and overly-bureaucratic approaches of some providers). Others were simply attracted to the potential for greater control and/or greater accountability offered by CDC, and saw CDC as a means of having a greater say over their supports and influence over how their supports were to be provided.

Survey data revealed some differences in reasons for participating in CDC between participants who had prior experience of packaged care and those that had not. Both groups identified recommendations by their care provider as the most common reason for participating in CDC, though a higher proportion of participants who had received packaged care before identified having more choice of services and more control over care planning as important, compared with participants who had not received packaged care before. This is illustrated in the table below.

Table 11: Reasons for participating in the CDC initiative – by package care history

Reason	Received packaged care before	Had not received packaged care before
I wanted to have more choice of which services I used	41%	30%
I wanted to have more choice of providers	16%	18%
I wanted to have more control over my care planning	46%	34%
It was recommended by my care provider	70%	75%
I was not satisfied with my previous community care	11%	2%

Based on responses received from 124 CDC participants and 126 standard packaged care (comparison group) recipients. ‘Don’t know’, multiple and blank responses have not been reported in this table.
Source: CDC and comparison group surveys, conducted August 2011.

Carer perspectives

For many carers, the perceived recognition of their central role in the participant’s care and the capacity to have their views and preferences considered in the care planning process were key factors in their decision to participate in CDC.

It is important to bear in mind that where there was a carer actively involved, participants and carers often made decisions as a unit. They recognised that the funded care and services were primarily for the participant’s direct benefit, but they saw the package as a source of support for both the participant and carer, and one of their key expectations of CDC was that carers and participants were jointly involved in planning and decision-making. Where the participant’s capacity was limited (due to dementia, for example), then the carer took the lead role though considering both their own needs and the needs of the participant (the person they cared for).

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