CALD Implementation Test for “No Wrong Door”

PICAC Alliance Implementation Tool | Primary Aged Care Entry

Can Every Door Lead to Safe, Appropriate and Usable Support?

A “no wrong door” approach has the potential to make access to primary aged care faster, more proportionate and better connected to the people, services and organisations older people already know and trust.

More doors do not automatically create “no wrong door”.

A doorway becomes a workable pathway only when it can recognise the person and their circumstances, identify language and communication requirements, support understanding and informed decision-making, make an appropriate and supported referral, connect the person with an available provider, follow the pathway through to service commencement, and escalate the matter when the proposed pathway does not work.

The Core Test for Multicultural Older People

The test is not simply whether they may approach the system through more than one entry point.

The test is whether, through any doorway, they can be heard, understood, appropriately assessed and connected with support that is available, suitable, trusted, affordable and usable.

Why a CALD Implementation Test Is Needed

People do not always begin seeking aged care through a formal national gateway. They may first approach:

a family member or friend

a general practitioner

a hospital discharge service

a multicultural or ethno-specific organisation

a faith community

bilingual and bicultural workers

a Care Finders representative

an independent advocate

a CHSP provider

a culturally specific Social Support Group

CALD-specific CHSP Meals services, Meals on Wheels or community transport

another trusted local organisation

For multicultural older people, these relationships may do more than provide an introduction to the aged care system. They may help the person understand unfamiliar terminology, discuss choices, identify communication needs, involve family members where desired, build confidence and remain connected throughout the pathway.

The PICAC Alliance submission to the Support at Home Inquiry found that CALD providers consistently reported language and communication barriers, confusion about aged care terminology, reliance on family and peer networks, difficulty understanding service agreements and payment obligations, and problems accessing assessment, reassessment and services. Providers identified trust, face-to-face engagement and community-led outreach as key enablers of access.

A trusted relationship may therefore be an important doorway.

But a place a person trusts is not automatically an equipped, authorised and sustainably funded pathway into care.

Evidence base: PICAC Alliance Submission to the Inquiry into the Support at Home Program (July 2026 PDF)

How to Use the Test

The test may be used when designing a national or local “no wrong door” model; approving organisations as formal referral or entry points; developing referral agreements and supported handover protocols; commissioning navigation or community-access services; assessing the readiness of individual doorways; reviewing whether a pathway works for culturally and linguistically diverse older people; evaluating whether referrals lead to actual service commencement; and identifying hidden implementation work and associated costs.

For each question, record:

Yes

Partly

Unknown

Action required

Responsible party

Review date

An “Unknown” response should not be treated as evidence that the condition exists.

The “no wrong door” pathway test

A successful pathway should be visible from beginning to end. If the pathway stops at referral, registration or eligibility, “no wrong door” has not yet been fully implemented.

First contactRecognitionCommunicationUnderstanding and discussionProportionate eligibility decisionSupported handoverAppropriate provider identifiedService commencesSupport remains usableReview and learning

The Eight-Domain CALD Implementation Test

Each proposed doorway should be assessed against eight implementation domains:

Use the links below to explore each implementation domain.

A. Recognition

Can the doorway recognise the person and identify what may be needed?

Warning: Recording a person’s language is not the same as understanding their communication requirements.

Related resources
Why Language Access Is Not EnoughComing soon

Can the doorway record the person’s preferred spoken language?

Can it record the person’s preferred written language?

Can it identify whether the person reads confidently in English?

Can it identify whether the person reads confidently in the preferred language?

Can it identify when a qualified interpreter may be required?

Can it recognise communication requirements associated with hearing, vision, speech or cognition?

Can it recognise when dementia, distress, trauma, fatigue or an unfamiliar environment may affect communication?

Can it identify whether the person wants a family member, supporter, advocate or community representative involved?

Can it identify relevant family and carer circumstances without assuming that family assistance is available or sustainable?

Can it recognise when an apparently simple request may indicate more complex, changing or unmet needs?

B. Communication

Can the older person communicate meaningfully through this doorway?

Warning: Language identified ≠ communication enabled.

Related resources

CALD Implementation Test for Reasonable Pricing

Why Language Access Is Not EnoughComing soon

PICAC Alliance Support at Home Inquiry Submission
PICAC Alliance Submission to IHACPA

Evidence base

PICAC Alliance Submission to Support at Home Inquiry identifies the additional time required not only for interpreter-supported communication, but also for working through complex care concepts, family discussions, informed consent, dignity-of-risk decisions and trust in government processes. It argues that this time is a real implementation cost and should not reduce the older person’s available care.
PICAC Alliance Submission to IHACPA on interpreter use, communication time and cost collection.

Can the person explain needs, preferences, strengths and concerns in a language and form that supports meaningful participation?

Is a qualified interpreter available when needed?

Can workers distinguish between qualified interpreter use and bilingual assistance?

Is sufficient time available for interpreter-supported communication?

Is sufficient time available to check meaning and understanding?

Can information be provided in plain language?

Can information be provided in translated, spoken, visual, auditory or cognitively appropriate formats?

Can staff communicate appropriately when the person’s preferred language changes under stress, illness or unfamiliar circumstances?

Are staff able to recognise that conversational English does not necessarily demonstrate the ability to understand institutional, legal, financial or clinical information?

Can confidential or sensitive matters be discussed without relying inappropriately on family members as interpreters?

C. Understanding and Decision-Making

Does the person understand the pathway and have a meaningful opportunity to discuss choices?

Warning: Information provided ≠ information understood.

Further reading
Rights → Implementation Conditions → Delivery → OutcomesComing soon

Does the person understand what CHSP is?

Does the person understand why information is being collected?

Does the person understand what the proposed referral may lead to?

Does the person understand that another assessment may be required?

Can the person discuss options with someone they trust?

Is supported decision-making available?

Is family or community involvement based on the older person’s preference?

Is understanding actively checked rather than inferred from silence, agreement or a signature?

Can the person ask questions and receive answers in an accessible form?

Does the person understand likely fees, contributions and service limitations?

Does the person understand what will happen if the proposed referral is unsuccessful?

Can the person change their mind or request review?

D. Eligibility and Assessment Integrity

Can the doorway identify the appropriate level and type of assessment?

Warning: Assessment completed ≠ person understood.

PICAC Alliance has argued that assessment accuracy depends not only on the tool used but on communication conditions, interpreter access, cultural safety and the ability of professional judgement to consider how context affects the expression of need. If these factors are not captured, people may be under-assessed, delayed or directed to inappropriate support.

Related resources
PICAC Alliance Support at Home Inquiry Submission
Assessment Quality Depends on Communication QualityComing soon

Is the eligibility process proportionate to the decision being made?

Can the doorway identify people who may benefit from fast, direct access to primary aged care?

Can it recognise when a more comprehensive assessment is required?

Can it identify complexity that may not be immediately visible?

Are communication, cognition, dementia, trauma, family circumstances and community context considered?

Can relevant family or carer evidence be included with the older person’s agreement?

Is there a clear escalation pathway when information is incomplete, inconsistent or contested?

Can professional and clinical judgement be used where appropriate?

Can information be reviewed and updated when needs change?

Is reassessment available without forcing the person to restart the entire pathway?

Are safeguards maintained without imposing the same extensive process on every person?

E. Supported Handover

Does the doorway remain connected long enough for the referral to become a pathway?

Warning: Referral sent ≠ handover completed ≠ support commenced.

Further reading
Trusted NavigationComing soon

Is the reason for the referral explained to the older person?

Has the person agreed to the referral and information sharing?

Is relevant information shared safely, lawfully and proportionately?

Are preferred-language and communication requirements transferred to the receiving organisation?

Is the receiving provider contacted directly where needed?

Has the receiving provider confirmed that it can respond appropriately?

Does the person know who will contact them and when?

Is responsibility clear if the referral is declined?

Is there follow-up when contact does not occur?

Is there follow-up when the older person cannot be reached?

Is there escalation when no suitable provider is available?

Is unnecessary repetition of sensitive information avoided?

Does the referring doorway know whether support actually commenced?

F. Provider and CALD Micro-Market Capability

Does the pathway lead to an appropriate and available service?

Warning: Overall market supply ≠ appropriate local CALD supply.

The submissions explicitly define CALD micro-markets as language-defined, trust-dependent and often low-volume markets that may remain hidden within larger metropolitan markets. Thin-market conditions may arise from language requirements, cultural preferences, trust relationships and small-scale demand even where aggregate aged care supply appears adequate.

The submissions also identify partnership and coordination work that may not be directly client-facing or billable, but is necessary to maintain culturally safe referral and service-delivery options.

PICAC Alliance Support at Home Inquiry Submission
Revised PICAC Alliance Federal Pre-Budget Submission 2026–27
PICAC Alliance Submission to IHACPA
CALD Micro-MarketsComing soon

Is an appropriate provider available locally?

Can the provider communicate in the person’s preferred language or arrange a qualified interpreter?

Does the provider have culturally responsive workforce and governance capability?

Can the provider respond appropriately to dementia and changing communication needs?

Can the provider accommodate relevant cultural routines, food, relationships and community participation?

Is continuity of worker or communication approach possible?

Is additional communication time recognised?

Is interpreter-supported care adequately funded?

Are travel, coordination, community outreach and cultural brokerage costs recognised?

Are partnership costs between mainstream and specialist community providers visible?

Does the local market constitute a language-defined or culturally defined thin market?

Can a low-volume culturally specific service remain financially viable?

What happens if no appropriate provider exists?

Who is accountable for developing supply where unmet need is identified?

G. Service Commencement and Continued Use

Did the pathway produce support that the person could actually use?

Warning: Eligibility ≠ provider availability ≠ service commencement ≠ continued use.

Further reading
Rights → Implementation Conditions → Delivery → OutcomesComing soon

How long did it take from first contact to an eligibility decision?

How long did it take from eligibility to referral?

How long did it take from referral to provider acceptance?

How long did it take from provider acceptance to service commencement?

Did the person understand and accept the service offered?

Was the service affordable?

Was the service culturally appropriate?

Was the service communicatively accessible?

Was the service available at a practical time and place?

Did the service meet the function for which the person sought help?

Did the person continue using the service?

If not, why was it declined, delayed, interrupted or discontinued?

Did the person return to family or community organisations for further navigation?

Did the pathway reduce delay or merely move the waiting point elsewhere?

H. Data, Accountability and Learning

Can the system determine whether each doorway works?

Warning: Doorway approved ≠ doorway effective.

Which doorway did the person enter through?

Was preferred spoken language recorded?

Was preferred written language recorded?

Was interpreter need identified?

Was an interpreter offered?

Was an interpreter used? If not, why not?

Was family or community navigation required?

Was the person referred?

Was the referral accepted?

Did the referral lead to service commencement?

How long did each stage take?

Were unsuccessful referrals recorded?

Were repeated handovers recorded?

Were interruptions and discontinuations recorded?

Were affordability, communication, trust or provider availability identified as barriers?

Are outcomes reported by preferred language, cultural group, geography and entry pathway?

Can government identify which doorways work well for communities currently least visible in the data?

Are community organisations told what happened after their referral?

Is feedback used to improve pathway design, commissioning and funding?

Minimum Conditions Before a Doorway Is Formally Approved

Before an organisation is designated as a formal entry point, the system should be able to demonstrate that the doorway has:

a defined scope of responsibility

trained and supported workers

interpreter-access arrangements

culturally responsive communication capability

consent and privacy processes

secure information-sharing arrangements

clear eligibility and escalation protocols

current service and provider information

supported handover procedures

follow-up responsibility

safeguarding pathways

funding for navigation, explanation and coordination

mechanisms for recording unsuccessful pathways

a feedback loop connecting referrals, outcomes and system learning

Community organisations should not be expected to absorb these functions simply because they are trusted. Recognition without resourcing risks turning trust into unpaid implementation labour.

Funding readiness: Before a doorway is formally approved, use the CALD Implementation Test for Reasonable Pricing to consider whether the communication, navigation, coordination and community-partnership functions required of the doorway are recognised and sustainably funded.

Three Possible Outcomes of the Test

Readiness Rating Guide: Traffic-Light System

Green — Ready
Amber — Ready with additional support
Red — Not yet ready as a formal doorway

Ready

The doorway can demonstrate communication access, appropriate authority and capability, supported handover, connection to available providers, and accountability through to service commencement.

Ready with additional support

The doorway is trusted and well positioned but requires training, interpreter arrangements, technology, secure information systems, referral protocols, funded navigation, service mapping, or ongoing implementation support.

The required support should be identified, resourced and assigned before formal responsibilities commence.

Not yet ready as a formal doorway

The organisation may remain an important community contact or referral partner, but should not be assigned formal responsibilities that exceed its mandate, workforce, authority, governance, information systems, funding or safeguarding capability.

This is not a judgement about the value of the organisation.
It is a judgement about whether the system has created the conditions that allow that organisation to perform the proposed function safely and sustainably.

Suggested Indicators for Evaluation

A “no wrong door” model should not be evaluated only through the number of approved doorways, number of registrations, number of referrals, or average referral-processing time. It should also report:

time from first contact to service commencement (measured to delivery of the first agreed service)

proportion of referrals resulting in actual commencement

unsuccessful and repeated referrals

preferred-language recording rates

interpreter-offer and interpreter-use rates

reasons interpreters were not used

family and community navigation involvement

availability of culturally appropriate providers

discontinuation and non-use

reasons for declining or discontinuing support

unmet need in CALD micro-markets

additional time and cost associated with communication, navigation and supported handover

consumer understanding of the pathway

consumer experience by preferred language and entry doorway

These indicators should also inform reasonable pricing analysis by making visible the communication, navigation, market-development and culturally responsive delivery conditions associated with effective pathways. Related tool: CALD Implementation Test for Reasonable Pricing.