Some elderly people in Hutt Valley say they are shocked to learn their home-help hours are being cut back without warning.
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One caregiver said she had lost eight hours' work a week across seven clients, but they knew nothing about it until she told them.
Her employer, Access Community Health, was adamant no clients would have their allocated care cut without being reassessed.
However, one couple in their 90s told RNZ they had no reassessment or any communication from the provider.
One of their caregivers, who looks after them three days a week, said the man's care had been cut from one hour to 45 minutes three days a week, while his wife's evening care had been halved, from half an hour to 15 minutes.
The man, who has an arthritic spine, was assessed as needing help with showering, dressing and taking medication.
"We're too old to be rushed around," he said.
"We're very grateful for what they do for us.
"But I'd hate to get to the stage where [she] has to rush in here, 'Go on, quick, here's your medication, we've got to get going.' So for that reason I'm not very happy about them having their hours cut."
The caregiver, whom RNZ has agreed not to name, said she was told the reduction in hours was to protect the health and safety of herself and her clients because she was working too many hours.
However the cut in hours did not mean less work, she said - just the same amount of work squeezed into a shorter time, for less pay.
"With the hours being cut, you're sort of now looking at the clock - I need to get out of here now because I'm only being paid for half an hour so I need to leave.
"But you don't, because you care about your clients and you don't want them to fall. People's lives are involved, and their safety."
Another Access client, Terence Webb, 74, said his home-help had been cut from one hour a week to half an hour, even though during his recent hospital admission a doctor had told him he needed more support, not less.
"The Access nurse turned up with the forms already filled out except for my signature, like it was a fait accompli.
"She said, 'Oh, the government won't pay for more."
Mr Webb said he insisted on making his own annotations to the forms noting his protest, and demanded they also be forwarded to Access' chief executive.
"Once Access gets the contract from the DHB, they just chisel away at our care to boost their profits."
Access' chief executive, Simon Lipscombe, declined to be interviewed but in a written response to RNZ he said client needs re-assessments were done in person by a registered nurse at regular intervals - either three months, six months or annually, depending on the complexity of each case.
"Access matches services to client needs and under this agreement, there has been an increase in services provided to clients across the Hutt Valley and CCDHB area in line with need."
Clients who were not happy with the re-assessment could appeal to Access, and a follow up assessment would be scheduled - or they could lodge an appeal with their GP, the Needs Assessment and Service Coordination service or the health board, he said.
Access' contract with the health board is bulk-funded, which means funding is not tied to hours provided per individual client.
Hutt Valley's chief executive Ashley Bloomfield said when the health board changed providers last year, it was an opportunity to bring eligibility for care in line with other health boards and make the system more fair.
Some people were getting help for things they could do themselves while others were missing out on the support they needed, he said.
But no one had had their home help cut immediately, he said.
"The same level of care is provided for six months while plans are put in place to make sure that there are alternative arrangements or the person is confident about taking on tasks around the home. The goal is for a person to increase their independence and confidence - and everything is done to support that."
