Philip Livingston on aged care home modifications, NDIS compliance, and why duty of care is not optional in this sector.
Philip Livingston leads with people. Before he mentions a single measurement, standard, or schedule, he talks about privilege. He mentions the woman whose rose bush has been there for forty years and cannot be moved, not for any ramp, regardless of what the gradient standard says.
Philip is the trades coordinator at Vitalese, a Melbourne based home modification specialist working across aged care, NDIS clients, and private referrals. They are a registered NDIS provider, a VBA licensed builder, and an approved supplier under the Victorian statewide equipment program.
But titles and registrations tell you very little about the kind of work this actually is.
A Sector Most Builders Have Never Touched
Australia is ageing, and the numbers are moving fast.
One in six Australians is now aged over 65. Within a decade, the 85 and older cohort is projected to cross one million people. That group has housing needs that most residential builders have never been asked to think about.
Home modifications, the grab rails, ramps, widened doorways, accessible bathrooms, and adapted kitchens that allow older Australians and people with disability to remain safely at home, sit at the intersection of construction, compliance, and care. It is a sector with genuine demand, genuine complexity, and, according to Philip, a genuine problem with operators who should not be anywhere near it.
“There are a lot of people that fly in, fly out, but their mindset is wrong and they do more harm than good.”
Philip has seen the consequences firsthand. A client with a broken nose after a grab rail pulled clean from a plaster wall, held in by screws that were never near a stud. A wheelchair user whose access ramp was so steep it could not be safely controlled, installed by someone who had simply ignored the Australian Standard and pocketed the job fee.
“Two weeks ago, I went to a client’s place. The client had a broken nose, had a trip, fell, grabbed the grab rail. It was just held in by plaster screws. It ripped out, they went down, smashed their face up, still got the rail in their hand.”
That is not an edge case. Philip says it is common enough that he regularly walks into jobs where his first task is remediation, not construction. And the clients paying the price are among the most vulnerable people in Australia.
“They’ve been hurt twice because they’ve been hurt financially and they’ve been hurt physically because they’ve been given something that doesn’t work.”
What This Work Actually Requires
Getting into the NDIS modification space is not as simple as holding a builders licence and declaring yourself available.
Philip outlines the minimum requirements clearly: registration as a builder, NDIS registration, and then the harder work of building relationships with the ecosystem that actually controls the flow of work.
Every job begins with an occupational therapist assessment. The OT identifies the client’s needs and produces a report. That report becomes the scope. Philip’s quote is submitted against it. If funding is approved, the scope is fixed.
“Variations are a non-existent thing. It is a fixed price contract. You do what you’re told. That’s it.”
No variations means no recovery if material costs shift mid-job. No recovery if the client changes their mind. No recovery if asbestos appears behind a wall, though Philip notes Vitalese maintains clauses allowing them to apply for supplementary funding in those circumstances.
The OT does not know construction. That is not a criticism, it is simply the reality of how the system operates. Philip has responded to this by running training sessions for the occupational therapists Vitalese works with, helping them understand what is structurally possible, what Australian Standards require, and what they need to include in their reports to avoid jobs unravelling on site.
It is the kind of investment most businesses would not bother making. Philip sees it as basic practice.
The Client Is Always in the Room
Home modification work has a dimension that most residential construction does not.
The client is often there. Standing in the doorway. Watching every cut, every drill, every decision. And not because they are difficult. Because it is their home. Many of them have lived in it for fifty or sixty years. Their family grew up there. Their life is in those walls.
“A stranger coming into their home is a big deal. So they need to have that rapport.”
Philip talks about this not as a challenge to be managed but as something his team genuinely understands. If a client offers a cup of tea, take it. If a job takes ten minutes and the client wants to talk for an hour, that is fine. If you have a problem with being watched while you work, this is not the sector for you.
He tells the story of a client who would not accept a ramp through the front garden because it would destroy a rose bush planted by a great aunt forty years ago. A different operator might have argued the regulation, taken the approval, and moved on.
Philip moved the ramp.
“The rose bush has some sentimental value. I could just rip the thing out and go, who cares? But no, I have to respect what’s there.”
That kind of judgment, understanding not just what is required but what actually matters to the person on the other end, is what separates the good operators in this space from those who are just moving through jobs.
The Stakes Are Higher Than They Look
When Philip talks about duty of care, he means it in the most direct sense possible.
Some clients cannot return home from hospital until modifications are complete. The OT signs off on their safe return. The case manager coordinates the funding. The builder delivers the work. If any part of that chain fails, the person stays in a respite facility. Away from their home. Away from their partner of fifty years.
Philip described a client whose husband had a medical episode and was placed in respite care because stairs made the home inaccessible. His wife was waiting at home.
“So he’s been put in like a respite center until the home is in a condition that the OTs and the case workers feel that he can operate in. Meanwhile his wife is at home waiting for him to come home.”
That is the real weight of this work. It is not abstract. The quality of the modification, the compliance of the install, the care taken on the day, directly affects whether a person gets to go home.
“They’re vulnerable people. You’re taking advantage of that vulnerability, which I just think is low.”
Philip is not interested in building a business that exploits a growing market. He is interested in building a business that the sector can trust. The difference shows in how Vitalese recruits, how they debrief every Friday afternoon, how they have procedures for what to do if a client does not answer the door.
Three times in the past year, his team has arrived at a client’s home and found someone had fallen in the garden.
They had procedures for that too.
What Builders Entering This Space Need to Know
Vitalese is growing. Philip is actively looking for quality tradespeople across Victoria and beginning to move into New South Wales and South Australia. The demand is real and it is not going away.
But Philip is clear that the credential he values most is not on any registration form.
“A good builder is one that’s aware of their environment, aware of the people they’re dealing with, and takes pride in what they’re doing.”
Pride, in his framing, is not about the quality of the finish alone. It is about how you present yourself to the people you are doing the job for. It is about understanding why you are there, not just what you have been asked to build.
For builders considering this sector, Philip’s advice is practical: get your NDIS registration in order, but then focus on relationships. The OTs, the case managers, the home care providers. They need to trust you before work flows to you. Without that trust, you are knocking on doors.
And with it, you are building something that most construction work does not offer.
You are giving people their homes back.
Philip Livingston is Trades Coordinator at Vitalese, a Melbourne based home modification specialist. Vitalese works with aged care clients, NDIS participants, and private referrals across Victoria, with expansion underway into New South Wales and South Australia. You can hear the full conversation on The Good Builder Podcast.
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