The voice of aged care Winter 2018 | www.lasa.asn.au
Aged Aged Care Reform:
Are we on track?
Who is the next generation of aged care leaders? 2018â€“19 federal Budget: a step in the right direction but more needs to be done Embracing generational change
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CONTENTS The voice of aged care Winter 2018 | www.lasa.asn.au
OPINION 5 Chair National Update 7
CEO National Update
Minister’s National Update
NATIONAL UPDATE 10 2 018–19 Budget: A mixed bag and more needs to be done
Increasing consumer contributions: The changing tide in an open home care marketplace
16 Introduction of unannounced
Heather Wallace Leading Age Services Australia Ltd T: 02 6230 1676 E: email@example.com
19 R etirement living: How a care strategy adds to your value proposition
MANAGER CORPORATE AFFAIRS
22 C reating new aged care markets: Technology, disruption, and existing consumer traps
Gerard Delaney Leading Age Services Australia Ltd T: 02 6230 1676 E: firstname.lastname@example.org
25 D o you know about My Health Record?
ow innovative technology H can solve the pain point of filling staff shifts
In camera sessions: don’t wait until there is a crisis
isk management must be R practised from the top down
Who is legally in charge?
EARLS of wisdom help fight P anxiety and depression
MEMBER STORIES 64 International collaboration: When it’s good, it’s very, very good
66 C onnecting communities across generations
68 M ontgomery House and Hall opens doors after multi-million dollar restoration
69 A picture paints a thousand memories
72 T he Pioneers Lodge: Building a
AGED CARE REFORM: ARE WE ON TRACK? 27 E mbracing generational change
First Floor Andrew Arcade 42 Giles Street Kingston ACT 2604
28 What’s next for the aged care workforce?
30 Sector’s financial viability hinges
ADBOURNE PUBLISHING PO Box 735, Belgrave, VIC 3160
Melbourne: Neil Muir (03) 9758 1433
Adelaide: Robert Spowart 0488 390 039
Emily Wallis (03) 9758 1436
on increasing revenue streams
32 Gone are the days of working ‘quietly behind the scenes’
35 C reating the future by doing less, but doing it better
37 21st century vision: an age services industry model for Australia
Administration Tarnia Hiosan (03) 9758 1436
41 C ommonwealth nations meet in London to discuss ageing issues
Cover photo: LASA’s NextGen forum in Perth brought emerging leaders together from across the aged care sector, including Sam
Talkin’ about my generation …
Read more on page 45.
INSIGHTS FROM INDUSTRY 49 W histleblowing and fighting fraud
Image courtesy of Scene Team.
Singh, Lifestyle Manager from Berrington.
DISCLAIMER Fusion is the regular publication of Leading Age Services Australia (LASA). Unsolicited contributions are welcome but LASA reserves the right to edit, abridge, alter or reject material. Opinions expressed in Fusion are not necessarily those of LASA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Fusion may be copied in whole for distributed amongst an organisation’s staff. No part of Fusion may be reproduced in any other form without written permission from the article’s author.
hange management makes the C difference in aged care
sense of home and belonging for residents
75 D iscussing incontinence with older Australians
76 Intimacy in an aged care setting OUT AND ABOUT 79 Great vibe at LASA’s NSW/ACT conference
81 ‘State of the industry’ breakfasts allow reflection on trends and issues
82 R etirement Village Manager of the Year 2018
84 E xcellence in age services celebrated around Australia
89 S ixth Asia–Pacific Eldercare Innovation Awards
90 WHAT’S NEW
Technology supporting resident safety From cumbersome to safe and streamlined Webstercare’s RxMedChart system continues to generate improved safety and efficiencies for residential aged care facilities. Baptist Care Morven Gardens Residential Manager Kathryn Mussing explains, “The system we were using previously was cumbersome and difficult for all medication trained staff to follow, including the RNs”. This all changed when the facility turned to Webstercare’s RxMedChart computer generated system. “Medication safety has improved enormously. We have gone from an unacceptable number – both packing and administration errors – to virtually zero now,” said Ms Mussing. “The do-not-crush alerts on the charts and the Unit Dose 7 packs are important. Our previous system did not have this capability. The image of the pills and their colours on the medication charts and packs are a great safety awareness. There are less signing omissions, as the charts are so much easier to read now. Ms Mussing identified a number of concerns they had with their previous system. “Staff had difficulty reading the doctors’ writing with the previous system. They had difficulty flipping over several pages to find the nonpacked medications, as these weren’t identified like they are on the RxMedChart. The stop dates weren’t clear and the doctors hated having to rewrite all of their medication orders every our months.” It has also led to improved communication
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with staff, the pharmacy and doctors. “It has saved time for us. It has made communication more streamlined and faster all round. The doctors love the system compared to the old system we used,” said Ms Mussing.
“This system drastically reduced the risk of medication incidents, improved time management, streamlined ordering process, bolstered our communication and monitoring process, and has given great confidence to staff.” “The staff love the new system and now find it so much easier to do medication rounds. They feel more confident to be medication trained and attend medication rounds,” said Ms Mussing.
Ready to go paperless? The MedSig eSigning system was implemented by
Ardrossan Community Hospital early November 2017 following an investigation of what systems were available to alleviate staff stress and reduce the risk of harmful medication incidents. “We are extremely lucky with our local doctors. But everyone knows that doctors’ handwriting can be very difficult to read. This was a recurrent challenge, especially in relation to clarifying what the correct medication was to be administered”, said Jodie Luke, Executive Officer/Director of Nursing. “So we needed to improve our medication systems and decrease the amount of time and associated stress endured by staff to complete a medication round.” The implementation ran smoothly, with Webstercare supporting the process before, during and after implementing MedSig. “Webstercare staff attended our hospital in November and trained all staff. Even those who felt challenged about using the tablet were impressed with how easy it was,” she said. Once up and running, Ms Luke found that their new MedSig Electronic Signing system did far more than significantly speed up medication delivery. She noted that by communicating directly with the pharmacy via a secure data centre, the system updated medication details with new levels of efficiency, simplicity, speed and security. “It flags if a patient hasn’t been given their medications and rounds cannot be completed without all medications being signed or accounted for”, she said.
CONSUMER-CENTRIC AGE SERVICES CREATING LONGER, HEALTHIER AND MORE PRODUCTIVE LIVES
LASA leadership openings provide opportunities to shape national delivery agenda.
s the Baby Boomer generation ages, we are on the cusp of a ‘new normal’ when it comes to the number of older Australians in our society. This positive outcome signifies our nation’s success in enabling people to live longer, healthier and more productive lives. With this increasing number of older Australians, comes increased demand for consumer-centric age service delivery models. These must be delivered within a dynamic regulatory environment influenced by Australia’s aged care reforms process. To forge the aged care system that older Australians and their families need—and our industry wants to deliver— Leading Age Services Australia (LASA) must lead the way. There is much more work to do to mitigate threats our Members may face in meeting the current and future demands and needs of older Australians. These threats include the rising cost of doing business and the impact of successive funding cuts, particularly on residential care. Other issues include the lack of subsidised home care packages available to older Australians—despite this year’s boost to home-care packages—and ongoing issues with attracting, developing and retaining an appropriately qualified and experienced workforce. More work needs to be done to address these fundamental issues in the aged care system, and LASA Board directorships are an exciting opportunity to contribute to a thought-leading and authoritative national organisation that leads the way. This year LASA has exciting opportunities with two directorships available subject to election. As a LASA director, you will have the opportunity to influence our organisation’s future direction and contribute to shaping an aged care system for our valued Members, providers and older Australians.
Dr Graeme Blackman AO FTSE FAICD, Chair, Leading Age Services Australia
In early August a call for nominations will go to all Members for Western Australia and New South Wales/Australian Capital Territory representative director positions. I encourage Members to consider nominating for these directorships. Should an election be required, it will be held by ballot and an independent returning officer will oversee the process. The result will be announced at LASA’s annual general meeting (AGM) on 28 October 2018. Chief Executive Officer of the Bethanie Group, Christopher How, was recently appointed as LASA’s Western Australia representative director following the resignation of Michelle de Ronchi. Christopher has over 20 years’ management and senior management experience across a number of industry sectors. He will serve until LASA’s AGM in October. I extend my thanks to Michelle De Ronchi for her service on the Board since May 2014, a period which saw LASA through our national unification process and beyond. During her time on the Board in a period of significant change, Michelle demonstrated a robust commitment to the work of LASA for the benefit of our Members. We wish her well in her future endeavours. The AGM will be held at the opening of LASA’s national congress in Adelaide. LASA Congress 2018 is the largest age services event in the southern hemisphere and is regarded as the most comprehensive and thought-provoking aged care event of the year. LASA will inspire the aged care sector to rise to the challenge of ‘Ageing Transformed … the dawning of a new era’. The congress theme will capture the ‘ageing transformed’ conversation, with three days of interactive discussions and presentations shining light on an era of new thinking, practices and models of age services for the next generation and beyond. If you only attend one event this year, it has to be LASA’s national congress in Adelaide from 28–30 October. ■
FUNDING AND WORKFORCE REFORM
MUST BE A KEY FOCUS OF
THE ‘NEW NORMAL’ IN AGE SERVICES ‘Care’ is more than arbitrary numbers and staff ratios when it comes to meeting older people’s needs. Sean Rooney Chief Executive Officer Leading Age Services Australia
ur industry in Australia is clearly in a state of transition.
The ‘new normal’ will require a major shift in the way we think about the aged care workforce. The Productivity Commission estimates that by 2050 the aged care workforce will need to have grown to almost one million, an increase of 168 per cent. This presents the industry and the nation with a massive challenge that must be addressed holistically and strategically.
The government will soon be considering a wide-ranging aged care workforce strategy developed by the Aged Care Workforce Strategy Taskforce, led by Professor John Pollaers. It will focus on ensuring a ‘fit-for-purpose’ workforce for older Australians, now and into the future. Professor Pollaers’ 15 draft strategic actions help to define the likely scope of required workforce reforms including: reimagining care work and care workers; revising training and qualification requirements; defining new career pathways; improving workforce planning; and dealing with salary deficiencies and issues of attraction and retention. Leading Age Services Australia (LASA) strongly supports a holistic response to workforce development informed by this work. Optimal staffing models that consider the different roles within aged care, required capabilities, and initial and ongoing training, is part of this. New models of care and the use of new technologies will also result in us working very differently in the future, which in turn affects the number, mix and competencies of the age services workforce going forward. We must remember quality of care is not as simple as the number of staff on duty or arbitrary staffing ratios. The needs of people in residential aged care are highly variable and, within a stringent quality control system, a flexible staffing mix can deliver the best quality of care targeted at individual care needs.
Furthermore, an evidence-based approach is required to drive continuous improvement in aged care, and we welcome Professor Pollaers’ proposed idea for an Aged Care Industry Growth and Research Translation Centre. LASA believes research that examines optimised models of care linked to the required outcomes under the aged care standards, should be a priority for the industry, government and other stakeholders. While the Australian Government’s May Budget signaled some progress, much more work is needed in the funding space. The Budget provided some good news for older Australians seeking care in their own home with more than 14,000 new high-level home care packages funded over four years, following on from the extra 6,000 high-level packages delivered in the second half of 2017. However, funding cuts by successive governments to residential aged care services, combined with rising operating costs and growing acuity/complexity of residents, means we still face a crisis of sustainability, with an estimated 40 per cent of residential aged care facilities recording financial losses last financial year. Appropriate and sustainable funding is vital to implement bestpractice models of care. The situation is even more serious in rural and regional settings where access to staff and higher costs further compound the situation. Safety and quality in aged care is not negotiable and we welcome the government’s Budget announcement of $50 million to assist residential aged care providers to transition to a new quality regime. Resolving aged care funding for the next two decades as our country transitions to supporting the Baby Boomer generation to age well, is critical. Ultimately, what Australia requires is the development of a long-term, sustainable funding strategy to ensure that the needs of older Australians can be met. ■
AUSTRALIAN GOVERNMENT ANNOUNCES
MORE CHOICES FOR A LONGER LIFE Being able to choose what care best meets our individual needs is crucial, says Minister for Aged Care, Ken Wyatt.
he More Choices For A Longer Life package announced in the recent federal Budget flags a new era for older Australians â€“ more choice, opportunity and certainty, with a focus on helping people live independently for as long as they want. The Turnbull government has committed to funding aged care at record levels, with an aged care budget increase of $5 billion over the next four years. There will be a rapid rollout of an extra 14,000 high-level home care packages, with the number of high-care packages rising to more than 74,000 over the next four years.
At the same time, residential aged care will also see record growth, with 13,500 new residential places and 775 restorative care places to be allocated this year, prioritising regional, rural and remote care, plus a $60 million capital investment. Over the next four years aged care funding is up, home care packages are up and residential aged care places are up. Residents and their families can have confidence in aged care and the protection of their loved ones. The new Aged Care Quality and Safety Commission is currently being established and will create an independent, one-stop-shop to ensure older Australians receive the best possible care.
During this time, the overall number of home care packages will rise from 87,000 to 151,000.
Minister Wyatt attended LASAâ€™s NextGen leadership forum in Perth, read more on page 45. Image courtesy of Scene Team.
The Hon. Ken Wyatt AM, MP, Minister for Aged Care
My Aged Care will be improved with a significant investment to make it easier to use, along with simplifying the forms required to apply for aged care services. Choice will also be made easier through a new user-friendly online aged care provider comparison system and there will be a trial of information hubs and personal navigators, to help people choose the aged care services that suit their needs. People over 65 will be encouraged to get active, with grants to local sporting groups to deliver new and engaging programs for older Australians. A new re-ablement program will also aim to get people who have had physical or medical challenges, to get back on their feet and live as independently as possible. There is record investment in mental health support for older Australians, including an $82.5 million residential aged care program plus a $20 million community pilot program to prevent social disconnection for people over 75 and a $5.3 million dementia innovation trial. We are also investing more than $46 million in the Community Visitors Scheme, a major national program to combat loneliness.
As the Budget funding and reforms roll out, a key focus this year will be the Aged Care Workforce Strategy. Professor John Pollaers and the Aged Care Workforce Strategy Taskforce have been busy reaching out to older Australians, community organisations and those working within the aged care sector, to get their views. Crucial to this is building capacity within the workforce, and a strong focus on staff retention and professional career paths. The taskforce has already achieved much, with the formation of an industry reference committee to guide training and career development, and an industry accord for the remote aged care workforce, already underway. In summary, the breadth of these reforms represents a significant milestone for aged care and ageing in Australia. The Turnbull government is committed to working with older Australians, their families and the aged care sector to ensure ageing people receive the protection, support, care and certainty they deserve. For additional information on More Choices For A Longer Life go to www.longliveyou.gov.au. â–
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A MIXED BAG AND MORE NEEDS TO BE DONE LASA continues the call for a nationally sustainable aged care funding strategy.
s Leading Age Services Australia (LASA) prepared for the Australian Government’s federal Budget on 8 May, we saw it as an important milestone responding to the needs of our older Australians. Yet even before Budget night, we were anticipating it would fall short of what is needed for sustainable aged care, now and into the future.
The cornerstone for the aged care industry was the government’s commitment of $5 billion over five years. However, LASA is seeking a transparent breakdown of this figure as it appears to include funds that were previously set aside for residential aged care. The Department of Health confirms LASA’s assessment (see table) that growth funds for residential aged care have been redirected to growth in home care. This move does not support the viability of current residential care places and LASA had sought $350 million per annum for immediate sector stabilisation.
LASA has long-advocated that the needs of growing numbers of older Australians, combined with a system experiencing significant change, cannot be ignored. Recent changes to residential care funding arrangements have contributed to a squeeze on the cost of delivering care and on service providers’ sustainability.
The department has told LASA that the demand for, and hence expenditure on, residential care places has been tracking below Budget estimates.
Funding reductions are compounded by the growing complexity of care recipients’ needs, changing consumer and community expectations, and rising operating costs. All of these are placing increasing financial pressure on residential care providers. This is particularly true in rural and regional settings where the viability of many providers is being threatened. We also advocated for funds to respond to the 60,000 people who are waiting for home care packages plus another 40,000 people who are receiving care, but below the level they need. The Budget is a step in the right direction in ensuring 2018–19 is the year of action in aged care, but much more work needs to be done.
Instead of unused funding being returned to consolidated revenue, it has been retained by the portfolio in a new combined residential care and home care program supporting more home care places. The legitimacy of the $5 billion in ‘new’ funding was the subject of Estimates Committee hearings in May and it was widely recognised there that funds have been moved from residential aged care growth to home care growth. With additional funding for home care, overall places over the next four years are as follows: o 87,590 for FY18 (estimated based on data as of 2/5/18) o 111,500 for FY19 o 134,500 for FY20 o 144,500 for FY21 o 151,500 for FY22
2017–18 Budget forward estimates Aged Care Act 1997 – home care packages
Aged Care Act 1997 – residential care
$11,429 m $12,059 m
Residential and home care – combined in the latest Budget
2017–18 Budget forward estimates
$13,396 m $14,352 m
$12,871 m $13,554 m $15,528 m $16,525 m -
2018–19 Budget forward estimates $13,468 m $14,296 m
$15,540 m $16,584 m $17,807 m
Difference between sets of forward estimates
Net difference over 4 years
LASA is asking when the extra places will be released, and we will keep Members informed. We will also be working with the department on the details of the roll-out of some key Budget initiatives. These include: • $50 million over two years for residential aged care services to assist with transition to the new Aged Care Quality Standards, developed as part of the Single Quality Framework (SAQF). • $82.5 million over four years in new mental health services for people with a diagnosed mental disorder living in residential aged care. • $32.8 million over four years to deliver comprehensive palliative care in residential aged care through increased capacity in aged care, improved care coordination and better clinical governance. Informal government advice is that this will go to state palliative care services to provide outreach to those in residential care and home care. This is contingent on the states matching the funding. • $40 million over five years for infrastructure investment for regional, rural and remote aged care that responds to both service and consumer demand. Informal government advice is that this will be a specific Aged Care Approvals Round (ACAR) for designated locations but will be separate to the main ACAR in 2018–19. This could also be used to support eligible home care investments.
• $61.7 million over two years for improvements to My Aged Care, providing better information that is readily accessible on the issues that matter the most for those in care, their families, health providers and service providers. • $106.8 million from 1 July 2018 for an initial 18 months of an eight-year program to stabilise and consolidate health and aged care systems. Overall, the federal Budget provides an optimistic forecast for Australia’s economic future, with increased revenue and several new funding announcements, as might be expected of an election-year Budget. However we still need a national conversation on meeting the demand for aged care and a sustainable funding strategy that looks at all the funding levers. These include the Tune recommendations on consumer contributions, possible changes to the Medicare levy, private insurance products and incentives to save for aged care. ■ Kate Lawrence-Harvey is LASA’s General Manager, Policy and Advocacy.
• $8.8 million over four years to introduce performance ratings for residential aged care service providers. • $4.8million four years for the Australian Government to strengthen standards and guarantees for refundable accommodation deposits in residential aged care. This includes: o introducing a compulsory retrospective levy on residential aged care service providers where defaults exceed $3 million in any fiscal year o developing stronger prudential standards applied to accommodation payments held by residential service providers o raising the government’s prudential regulatory capability to better protect the growing pool of accommodation payments. LASA wants to understand to what extent Ernst and Young recommendations on further prudential controls, including limiting the use of trusts, will be adopted. • $0.3 million in 2018–19 to undertake an impact analysis to understand the effect of transitioning the allocation of aged care places to alternative arrangements that provide real choice for older Australians. This relates to consumer directed care. • Better access to care – aged care system navigator provisions.
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INCREASING CONSUMER CONTRIBUTIONS: THE CHANGING TIDE IN AN OPEN HOME CARE MARKETPLACE
Research shows many older Australians must decide between spending on leisure consumption and future care.
n its 2017–18 federal Budget, the government announced it would will make it easier for Australians aged over 65 years to contribute up to $300,000 from selling the family home into their personal superannuation fund. The move encourages downsizing of the family home and releases equity to support financing of late life expenses. This year, the 2018–19 Budget included changes being made to the government’s Pension Loan Scheme. The scheme is being expanded so that anyone of pension age who owns their own home can draw down against their home to increase their
access to disposable income, up to one-and-a-half times the full pension rate1. A couple on the full pension can opt to receive an extra $17,800 a year (or $342 per week). With just 650 Australians using the current system, the government’s aim is to encourage older Australians who are asset-rich to release equity from their asset base to assist with financing late life expenses. The government hopes the idea of borrowing against the family home in retirement will become the new normal. Continued on page 14
NATIONAL UPDATE Continued from page 13
The 2017 Legislative Review of Aged Care2 (Tune report) references these proposed schemes and indicates that in order to meet projected future demand for aged care, the government will be required to source additional investment beyond that currently planned. As such, a bipartisan approach is required to consider the dynamic of consumer contributions and government funding. This includes examination of a number of Tune recommendations on increased consumer contributions for people who can afford it, which the government has so far left dormant. Leading Age Services Australia (LASA) continues to advocate for an age services sustainable funding strategy as a national solution to fund the growing cost of aged care. Increasing consumer contributions among those who can afford to pay will be an inevitable component of this. Key questions exist for home care providers offering government-subsidised home care services: • Will this mean that provider and client interactions will become increasingly characterised by a decreasing reliance on access to the full contingent of government funding equivalent to a consumer’s assessed level of need? • Will this mean an increasing reliance on clients contributing to the cost of their care to make up the difference between
the assigned level of government funding and care required? • Will we see the interface between the Home Care Package program and Commonwealth Home Support Programme start to tighten up in respect to consumers accessing funding across both programs to gain the care they require? • How can I, as a home care provider, prepare? In the near future, on-boarding of consumers to home care packages will be characterised by three different types of clients: 1. those who can afford to and are willing to pay 2. those who can afford to and are not willing to pay 3. those who cannot afford to pay. Providers need to be able to clearly identify which of these three client profiles a consumer most closely reflects. This includes developing a targeted engagement strategy to account for the client’s capacity and willingness to contribute to the cost of their care, and a financial assessment and referral processes as part of consumer on-boarding. Discretionary waving of client fees, seeking supplementary funding from alternate funding sources and offering broad-based benevolent support may become more constrained, indicating a changing tide that home care providers need to consider.
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Currently, LASA Members report that only a small proportion of their home care package consumers have both the capacity and willingness to pay for additional care in response to care needs for which the limits of government funding cannot provide. In contrast, many of their home care package consumers currently align with the remaining two client profiles: unwillingness and incapacity to financially contribute to access additional care. Instead, they seek access additional care through an alternate arrangement. For those unwilling to contribute to the cost of their care but who have capacity to do so, motivational interviewing techniques3 provide an evidence-based method for consumer on-boarding and client engagement. Research indicates that among older Australians it is unclear how realistic their expectations are concerning the cost of care and treatment at advanced ages and what is needed for a comfortable, even satisfactory lifestyle. The research also indicates that there is often a contest between consumption of leisure, such as in travel, versus providing for better care in later life4. Each client’s readiness to contribute to the cost of their care needs to be sensitively approached on initial engagement. Where an unwilling client is encountered, coaching can address expectations and support a client’s graduated shift in readiness to contribute to the cost of their care over time.
Alternatively, an unplanned crisis event may create a rapid and often reluctant shift in their readiness to contribute to the cost of their care. Once client contributions commence, however, this will often become an acceptable client behaviour that will no longer impede their access to care where capacity to contribute exists. For those clients who cannot afford to contribute to the cost of their care, LASA looks to the government in respect to an age services sustainable funding strategy to ensure that appropriate safeguards are in place for those least able to contribute to the cost of their care. A key element of the strategy will be ensuring that higher-level home care packages are prioritised for assignment to this group in a fiscally tight funding environment. ■ Troy Speirs is LASA’s Principal Advisor, Home Care
References 1. https://budget.gov.au/2018-19/content/factsheets/3-financially-prepared. html#expansion 2. https://agedcare.health.gov.au/legislated-review-of-aged-care-2017-report 3. http://www.dhhs.tas.gov.au/publichealth/health_literacy/health_literacy_toolkit/ motivational_interviewing 4. https://nationalseniors.com.au/be-informed/research/publications/hope-bestplan-worst-insights-our-planning-longer-life
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INTRODUCTION OF UNANNOUNCED REACCREDITATION AUDITS Unannounced audits were a key recommendation of the 2017 Carnell/Paterson report and will be introduced from 1 July 2018.
rom 1 July 2018 residential age care service providers will be subject to ongoing accreditation, with unannounced visits, to assure safety and quality of residential aged care.
This was a key recommendation of the October 2017 Review of National Aged Care Quality Regulatory Process Report by Professor Ron Paterson and Ms Kate Carnell, to: • ensure a focus on quality outcomes for care recipients every day • support continuous improvement • ensure that accreditation becomes evidence of good management and ongoing quality of care and services rather than a tick-and-flick audit.
Under the Quality Agency Principles 2013 (registered March 2018), this will apply to service providers that: • are due to apply for reaccreditation from 1 July 2018 • have an accreditation expiry date on or after 1 January 2019. The Australian Aged Care Quality Agency (AACQA) will conduct the audit process, which involves the following steps. 1. The provider will receive a reminder notice. This will include: • a specified date by which to submit application for reaccreditation • the application form and self-assessment template • a poster to place around the home and the ‘form of words’ to notify care recipients and their representatives about the site audit. 2. The provider will submit an application with a selfassessment that includes: • the completed application form • the self-assessment information • the consent form for an assessment team to access the property, and if necessary, • a list of dates that are not practical for an audit, with the reasons why. 3. The provider will inform care recipients and their representatives. This includes: • notifying care recipients in writing about the upcoming site audit and the period in which it could occur
• displaying the poster informing care recipients and their representatives on how to contact AACQA prior to the site audit. 4. The unannounced site audit will be conducted without prior notice, and providers will: • receive a written notice from the AACQA’s chief executive officer with the team member names • need to take reasonable steps to notify care recipients and representatives that the site audit has commenced • nominate the ‘person in charge’ of the service with whom the team will meet. 5. The process includes an exit meeting and reporting requirement, where: • the person in charge of the service attends the exit meeting with the team • the assessment team will discuss the key issues identified during the audit • the team leaves the site and writes the audit report with evidence to support the findings
• the audit report with evidence attached is sent to provider for review and consideration • the provider has an opportunity to respond to the report’s findings and evidence. It is crucial that service providers have submitted their application with all the supporting documentation by the date stipulated. AACQA’s principles now state that if the application is made late, AACQA is not required to complete the reaccreditation process before the services ceases to be accredited. Leading Age Services Australia recommends Members ensure that contact records for representatives are up to date and easily accessible. Maintain a list of residents and/or representatives who have indicated that they would like to meet the team. As the process now refers to the ‘person in charge’ of the service, this will be the most senior person on the day. It is of important therefore, to consider involving all senior staff in the self-assessment process. This will ensure that they have access to all relevant information during the audit process. At the exit interview, there will no longer be a written report indicating that you have met 44/44. The site audit will be provided to AACQA within seven days and then to the provider. As the provider, you will have 14 days in which to submit your response to the report. AACQA’s chief executive officer will then make a decision. ■
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For further information go to www.aacqa.gov.au/providers/ news-and-resources/moving-to-unannounced-re-accreditationaudits/key-changes. Sharyn McIlwain is LASA’s Principal Advisor, Residential Aged Care.
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HOW A CARE STRATEGY ADDS TO YOUR VALUE PROPOSITION Home care services can be added to maximise operating efficiencies.
etirement living has seen unprecedented change and reform over the past 12 months with enquiries and legislative amendments in most states. Consumer Directed Care (CDC) has provided those living in retirement villages with greater choice and independence and the ability to stay in their apartments longer. Potential residents are asking: â€˜what if I need care and/or servicesâ€™? Operators without a care strategy in their business model, run the risk of missing out on new clients. Retirement villages are the most cost-effective and efficient housing options for the delivery of home care and services to residents. Retirement village operators co-located with a residential aged care (RAC) are well-positioned and can easily
scale up their RAC roster to provide care and services to their village at a fraction of the cost that a home care provider would face delivering the same services in the suburbs. There are no cars on the road, no time travelling between clients and the admin costs are minimal. Efficiencies will increase with scale. If they choose not to be an approved home care provider, a village operator may decide to form a partnership with an external approved provider. There are several advantages to partnering, such as expanding service provision beyond your own capabilities, less regulatory burden and reduced set-up and establishment costs. Conversely, there are several disadvantages such as less control over quality and service, reduced financial returns, Continued on page 20
Sandra Nugent, Dementia Australia, speaking at the National Integrated Seniors Housing conference.
NATIONAL UPDATE Continued from page 19
Megan Walker, Market Savvy, speaking at the conference.
declining knowledge of residents’ wellbeing—and your relationship with them—and threats to your brand. Either way, your purpose should be to enhance the lives of residents in your community through quality care and service – adding a competitive advantage to your value proposition.
Integrated Seniors Housing conference Leading Age Services Australia (LASA) held its National Integrated Seniors Housing conference on the Gold Coast from 14–15 June. Integrated seniors housing describes a variety of housing types which purposely make available a range of support and care services for people in later life. Housing such as retirement and lifestyle villages, independent living units and manufactured home or land-lease communities are now, through demand, becoming more integrated with care and service delivery options. They have been identified as the new ‘low-care’ of aged care in Australia. The conference addressed the changing landscape in retirement living and seniors housing. It was evident that the value proposition and competitive advantage for operators was having a care strategy to enable residents to age in place and live independently in their apartment for as long as possible. Sandra Nugent, Regional Director of Dementia Australia examined living independently with dementia through supported living and asked if the institutional models are being rejected due to their inability to meet resident expectations. Megan Walker, Director of Market Savvy addressed the decline of mutual trust and confidence in the sector over the past 12 months due to negative media, arguing that ‘brand and reputation is everything’. Megan highlighted how easily a brand or product can be damaged, often due to a lapse in honest and transparent representation (marketing) of your products and services, where the pre-sales rhetoric does not match the after-sales reality.
Building Better Futures update Eight months after the Queensland Parliament passed the Housing Legislation (Building Better Futures) Amendment Act 2017, the Queensland Department of Housing and Public
Works has released a timeline for the implementation of the remainder of the amendments. Changes will be implemented by January 2020. The minister’s office has formed a Housing Legislation Amendment Act (HLAA) consultative committee. Leading Age Services Australia’s (LASA) Principal Advisor for Retirement Living & Seniors Housing, Paul Murphy, will be part of that consultative group representing Members’ interests and concerns. The amendments will be introduced over three stages: Stage 1 Consultation: May—June 2018 for: • pre-contractual disclosure • access to documents • reinstatement of unit. Stage 1 Implementation: August—October 2018 Stage 2 Consultation: October—December 2018: • change in village operators • retirement village contracts. Stage 2 Implementation: April—June 2019 Stage 3 Consultation: April—July 2019: • standard financial reports and budgets. Stage 3 Implementation: November 2019—January 2020 At the time of going to press the residential tenancies, manufactured home parks (MHP) and retirement village documents (stage 1 consultation) have been distributed to Members. Members should advise Paul Murphy, LASA’s Principal Advisor if they have any concerns with documentation from stage 1 of the amendments. LASA will keep Members updated through e-news and e-alerts as the department releases new forms and related documentation. ■ Paul Murphy is LASA’s Principal Advisor, Retirement Living & Seniors Housing.
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CREATING NEW AGED CARE MARKETS:
TECHNOLOGY, DISRUPTION, AND EXISTING CONSUMER TRAPS
A shift in consumer power generates fresh productivity challenges for providers. The problem, to be quite honest with you, is that
the motion picture camera, but they didn’t invent
you’ve never actually known what the question is.
the movie industry.
(Deep Thought, The Hitchhiker’s Guide to the Galaxy by Douglas Adams).
or a long time, digital technologies were laughably bad. Then, in what felt like an overnight turnaround, they became exponentially good—computers started diagnosing diseases, vehicles started driving themselves, and artificial intelligence is now a ubiquitous black box. Technology is transforming industries, redefining careers, and changing forever the way we do things. And looking at this from the aged care industry, it is perhaps no wonder we often forget that technology should be the handmaiden of our commercial success. There is much talk of technology’s incredible power, and mixed in with this is the doom and gloom verbiage of disruption. This combination of awe and fear is nothing more than a symptom of us forgetting that technology is essentially a tool. Sir John Hegarty, founding partner of advertising agency Bartle Bogle Hegarty, said it best: Gutenberg may have invented the printing press and movable type, but he didn’t create the publishing industry. The Lumière brothers may have invented
As market power has shifted from organisations to consumers, with ever-increasing levels of competition and decreasing levels of funding, organisations are faced with steep productivity challenges. Success is not won by those who compete best in a largely homogenous industry. It will be won by those who can generate new demand, and create and capture new market categories. This has strong parallels to the aged care industry, and as we continue with industry reforms, and be more market-driven, the key is to avoid being trapped in old markets fighting the same fights for the same consumers. In order to transcend old markets, we need to consider three potential barriers. Business School INSEAD’s Blue Ocean Strategy Institute co-directors, W Chan Kim and Renée Mauborgne, frame it best with the following insights. First, developing new market strategies through consumer-led approaches: … which causes them (organisations) to reflexively stick to their focus on existing customers and how to make them happier … Noncustomers [sic], not customers, hold the greatest insight into points of pain and intimidation that limit the boundary of an
industry. A focus on existing customers, tends to drive organisations to come up with better solutions for them than what competitors currently offer. Second, equivocating technology with innovation, and mistaking technology innovation as a pathway to creating new markets, where: Value innovation, not technology innovation, is what launches commercially compelling markets. … But when companies mistakenly assume that market creation hinges on breakthrough technologies, their organisations tend to push for products or services that are too ‘out there’, too complicated, or lacking an ecosystem. Third, equating disruption for market creation, forgetting that: Many market-creating moves are non-destructive, because they offer solutions where none previously
The quote I started with, from Deep Thought in the Hitchhiker’s Guide to the Galaxy, is quite helpful at this junction. It teaches us that, if you can properly phrase the question, then the answer is the easy part. It also hits home the reality that conventional wisdom may only seem inadequate in hindsight. Still, having a consumer focus is key to improving products and services. Likewise, technology innovation is an important element of industry productivity, and greater abundance—at times, even a source of disruption. However, if your intent is to create new markets, the previously mentioned approaches involving consumer-led approaches, technology, and disruption are better aligned with competing in old markets. As chess grandmaster, José Raúl Capablanca, framed it: “(to succeed) you must study the endgame before anything else”. ■ Merlin Kong is Leading Age Services Australia’s Principal Advisor, Innovation.
existed. … Conflating market creation with creative destruction not only limits an organisation’s set of opportunities, but also sets off resistance to marketcreating strategies.
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DO YOU KNOW ABOUT MY HEALTH RECORD? Before the year’s end, all Australians will have their medical information digitally documented unless they choose to opt out.
y Health Record is here and by the end of 2018 a record will be created for every Australian, unless they choose not to have one.
Having a My Health Record means your important health information such as current conditions and treatments, medicine details, allergies, pathology reports and diagnostic imaging reports can be digitally stored in one place and allows your nominated heath care providers such as GPs and specialists, access to a summary of your health record as needed. It also allows you to take more control of your health and wellbeing, manage your children’s health, and upload important documents, like advanced care directives. My Health Record provides real assistance if you need to see a doctor, visit your pharmacist, or if you have an accident. It is especially valuable for older people who often have to remember their medical history and medicines in dealing with doctors and health professionals.
“By enabling information sharing between the various parts of the Australian health system, including aged care, digital health has the potential to enable programs and initiatives that integrate care, wrapping it around the needs of patients.” Australian Digital Health Agency CEO Tim Kelsey said the implementation of My Health Record nationally this year will deliver a system that provides universal functionality, clear and concise content and, critically, a safe and secure clinical health service for all Australians wherever they are. “My Health Record can reduce the risk of medical misadventures by providing treating clinicians with up-to-date information,” Mr Kelsey said. “The benefits of digital health for patients are significant and compelling. Digital health can improve treatment and help save lives for all Australians right across the country.” ■ For more information, go to www.myhealthrecord.gov.au.
My Health Record provides useful details, such as medicine types and doses, when discussing health issues with your health care providers. Already 5.9 million Australians have a My Health Record. Before the end of the year, the Australian Digital Health Agency—the operator of My Health Record—will offer every Australian with a Medicare or Department of Veterans’ Affairs card a My Health Record, unless they choose not to have one. There will be a three-month opt-out period that will run from 16 July to 15 October, 2018. If you do not want a record, you will be able to opt out by visiting the My Health Record website or by calling 1800 723 471 for phone-based assistance. Real and ongoing benefits from My Health Record will be felt over time as more and more health information is added to your My Health Record. Leading Aged Services Australia Chief Executive Officer (CEO) Sean Rooney said it is well accepted that providing integrated care for patients as they transition across the primary care, acute care, mental health and aged care sectors is of benefit.
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AGED CARE REFORM: ARE WE ON TRACK?
EMBRACING GENERATIONAL CHANGE Andrea Coote from the Aged Care Quality Advisory Council reflects on the pressures the aged care sector faces.
n the much-hyped digital utopia, we are led to believe that the time may soon come when our thoughts are automatically transmitted to the robot that has the ultimate responsibility for responding to our request or care need. Until that time, it is important to reflect upon the known pressures of communication in our immediate future, and to remember that our core business is people. As the generations of people in aged care evolve and we have an even greater focus on consumer-led care, the differences in communication requirements and preferences resulting from generational change cannot be underestimated. This point was made even clearer to me recently when I spent time chairing a series of roundtables with providers across the country as part of a partnership between the Australian Aged Care Quality Agency and providers from Leading Age Services Australia (LASA), Aged and Community Services Australia (ACSA) and the Aged Care Guild. Communication was one of the major issues that emerged during the roundtables. This topic generated much discussion about the changing generations of people receiving aged care now and into the future, and how we might communicate with them to best meet their needs. The current depression- and post-depression-era consumers’ aged care needs, and communication preferences, are very different to those of the Baby Boomers. Then, beyond that, we must consider the needs of generations X, Y and Millennials. These consumer groups will: • be much more technologically-savvy • be more willing to ‘speak up’ generally • demand more of their care
• have family and friends who will also have greater expectations of their loved ones’ care. We need to consider the immediate nature of communication (for example, social media) and its impacts. We need to be ahead of the curve as an industry – especially in regard to how quickly people find out about an issue or concern that has been raised, in the public domain.
Our future will be even more focused on consumer-centred care than is already the case. Ongoing innovation in technology will help us to deliver this. But even what we know now could be very different in five to 10 years’ time. In addition to technology impacts, generational change will mean differences in how we address cultural differences and spiritualism in aged care. The Australian Aged Care Quality Agency encourages innovation through its Better Practice Awards. At the 2017 awards, the Ti Tree at Village Glen in Victoria won a commendation for its communications app, a real-time app providing access to information. Through it, there are no limitations on the number of family members and friends of residents who can choose to receive information about the facility and what is happening on a day-to-day basis. We need to see more of these innovations. Openness and transparency will be the hallmark of our communications going forward. In the future, and largely due to advancing technology, communication may be virtual, which will in turn be both a challenge and an opportunity. I fully appreciate that for so many of you working through the recent sector reforms and about to embark on the latest reforms, casting your minds forward is possibly too great an ask. Perhaps this is a golden opportunity to establish some positive relationships with the younger generation … our consumers of the future! As a peak organisation, LASA is well placed to encourage some working partnerships with secondary and university students, for example, to explore opportunities. Somewhere among those students will be the future leaders in aged care. I feel exceedingly positive about the direction our aged care sector is taking. After meeting with so many of the LASA Members through the recent roundtable experience, I am confident that we are in good hands. As a sector, I am confident we can work together to ensure we keep the focus on the consumer as we transition into the digital utopia and the impending generational change in aged care. ■ Andrea Coote is the Chair, Aged Care Quality Advisory Council.
AGED CARE REFORM: ARE WE ON TRACK?
WHAT’S NEXT FOR THE AGED CARE WORKFORCE? Professor John Pollaers, Chair of the Aged Care Workforce Strategy Taskforce, outlines what is needed for lasting change in aged care.
ow, more than ever, is the time for real, transformative change for the aged care industry and its workforce.
With the Aged Care Workforce Strategy, we have an executable plan that sets the industry up for the next five to seven years. The strategy was developed with the industry, for the industry. It sets out the pragmatic actions to bring about lasting change for the people who matter most – consumers and the workforces that look after them.
However, the next step in enacting change, and bringing the strategy to life, requires a concerted effort by industry, the workforce, the community and governments. During nine months of extensive consultations, the taskforce uncovered many challenges confronting the sector. Some of these, such as funding, legislation and regulatory frameworks, all impact on our workforce dilemma. They are difficult issues and can only be addressed effectively through collaboration among industry, employee representatives, government and the community.
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AGED CARE REFORM: ARE WE ON TRACK?
One of the central features of the strategy is an industryled voluntary code of practice. This tangible, first step is an opportunity for the industry to strive for aspirational change and define a shared vision that celebrates the journey of ageing. A code of practice allows the industry to get ahead of consumer and community expectations and show it is taking responsibility for the quality of aged care in Australia. It starts with principles, evolves over time and supports continuous improvement. The principles guiding the code include: â€˘ consumers at the heart of care planning decisions â€˘ a focus on consumersâ€™ quality of life â€˘ integrated care across the aged care and primary health systems â€˘ Board governance â€˘ best practice sharing â€˘ workforce planning and accreditation.
John Pollaers at the home of Marilyn Busietta, of Melbourne. Marilyn receives home care services from Benetas. Image courtesy of the Department of Health.
Some challenges, however, are firmly in the power of the industry itself to solve. I am a firm believer in personal accountability and the responsibility individuals have in bringing about change for the greater good. This personal belief has also shaped my professional career. I have steered the businesses I have led on a path of social and corporate responsibility, bringing about change from within. The aged care industry now has the opportunity to shape its own destiny by bringing about sustainable, lasting change. Fundamental to the execution of the strategy is the need for the industry itself to unite and to show greater leadership.
Unified leadership through an industry-led code of practice will help better equip the workforce in their essential role of caring for some of the frailest, most vulnerable members of our society. I would like to thank Leading Aged Services Australia Members for their support and input into the Aged Care Workforce Strategy. With your support and leadership we have developed a workforce strategy that can make a real difference to the quality and safety of aged care in Australia. For too long aged care has been in the news for all the wrong reasons. The time is right for the industry to enact change so we can celebrate our successes and help elderly Australians to live and die well. â– Professor John Pollaers is Chair of the Aged Care Workforce Strategy Taskforce. For more information go to www.agedcare. health.gov.au/reform/aged-care-workforce-strategy-taskforce.
AGED CARE REFORM: ARE WE ON TRACK?
SECTORâ€™S FINANCIAL VIABILITY HINGES ON INCREASING REVENUE STREAMS
Regulatory changes and staff costs put undue pressure on residential facilities operators.
he aged care sector is currently undergoing rapid transformation in respect of the aging population, consumer expectations and requirements, demographic influences and moving from a funded model to more of an equity model. It is clear that the costs associated with appropriately servicing increased resident and consumer acuity in residential aged care and in-home care will require increased revenue streams to ensure the ongoing financial viability of the sector.
Residential aged care Residential aged care has shown a marked downturn in operating results due to a combination of the Commonwealth Own Purpose Expenses indexation freeze, amendments to the Aged Care Funding Index (ACFI) scoring matrix, ACFI downgrades and increased costs. In fact, average ACFI income has remained neutral at $171.85 per bed day for the six months to December 2017 compared with $171.13 at December 2016 and $171.84 at June 2017.
The anticipated equity and private investment into residential aged care has slowed, predominantly due to legislative and policy uncertainty, and more directly due to the low financial returns. The average earnings before taxes return on assets employed (ROA) was a mere 0.5 per cent and after excluding non-recurrent revenue streams such as revaluations and fair value gains on property and investments, the ROA represented a negative return of (minus) 0.1 per cent. The financial viability of outer regional, rural and remote aged care providers is reaching a pivotal point. Some 56 per cent of residential facilities in these geographic locations are operating at a loss, with 33 per cent now operating at a cash deficiency before investment income. There are few opportunities for existing providers to merge or sell their facilities to larger providers, meaning that remedial funding will be essential in our opinion. ACFI residential care subsidies are now increasing at a lower rate than the costs of providing direct care (refer below graph)
The impact of the regulatory changes and cost pressures (particularly staff costs), has resulted in the alarming statistic that 41.3 per cent of residential facilities reported an operating loss for the six months to December 2017, and even more disconcerting is that 21.3 per cent of facilities had negative earnings before interest, taxes, depreciation and amoritsation (indicating a cash loss from operations). Of further note is that the direct care staffing hours per resident per day increased from 2.91 hours to 3.06 hours. With no additional revenue to compensate for these increased staffing hours and combined with wage rate increases from preexisting enterprise agreements, rising staff costs have been a major contributor to these results. Occupancy levels in residential care facilities has remained steady at 94.4 per cent average occupancy, however, should there be facility closures due to financial stress it would heavily impact the vulnerable aged requiring high care accommodation.
2007 $pbd 2017 $pbd Cumulative Increase ACFI & Supplements (including Meanstested care fee)
Expenditure â€“ Direct $71.63 Care services
AGED CARE REFORM: ARE WE ON TRACK?
and this will create further financial tension and risk the need to actually reduce staffing costs in an attempt to remain financially viable.
Home care Home care did not escape the performance downturn with a revenue decline for the six months ended December 2017 of 5.03 per cent underpinning an overall reduction in profitability of 39.7 per cent. Staffing hours per client per day were maintained at existing levels in this period. Since June 2016 the number of approved providers in home care has increased nationally by 307 (61.5 per cent increase), however, the number of operational packages has only increased by 2.77 per cent since deregulation in February 2017 (from 72,272 packages to 74,205 packages).
Emerging trends The new paradigm is leading to the merging of the various segments – residential; Home Care Packages (HCP); Commonwealth Home Support Programme (CHSP) and seniors housing in many of the new developments. Similarly, more flexible staffing management will focus on technology, mobility and specific skills and experience. Direct care staff including allied health will provide services to consumers in different areas of accommodation (similar to home care currently), which may mean residential, in-home, independent living units or even day care centres. A number of the recommendations from the Legislated Review of Aged Care 2017, conducted by David Tune, are worthy of serious consideration, particularly those in relation to increasing revenue options such as de-regulation of the basic daily fee (residential), compulsory client contributions for CHSP
and compulsory to levy the basic (care) fee for home care packages. The above recommendations relate to the current funded model, however the future provision of aged services will also incorporate a greater diversity of equity models whereby the consumer will pay for service and accommodation delivery, often using their homes and superannuation funds to provide for this. ■ Grant Corderoy is Senior Partner, StewartBrown Chartered Accountants. StewartBrown is an Affiliate of Leading Age Services Australia, www.stewartbrown.com.au.
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AGED CARE REFORM: ARE WE ON TRACK?
GONE ARE THE DAYS OF WORKING
‘QUIETLY BEHIND THE SCENES’
The sector must actively lobby if it is to achieve much-needed change.
t is easy to become frustrated and disenchanted with the challenges facing the aged care sector today. The Australian Government’s investment in care per older Australian has declined since 2015–161. A sharp decline has been in Commonwealth expenditure in workforce, quality and service improvement which shrank year on year to less than 40 per cent of the 2012–13 spend until the Oakden investigation in 2017. It is also easy to become cynical when we hear the Budget spin on the government’s commitment to older Australians while it achieves savings through shortfalls in its own allocation targets. Few outside the industry fully appreciate why the home care waiting list of 100,000 people will only grow from here. Beyond these serious challenges, we know that change is inevitable, and the future is full of opportunity.
Government’s tight control over supply and pricing is considered necessary because of taxpayers’ huge contribution to care services. At current levels, government spending on aged care will soon exceed expenditure on hospitals2 and we know that at some point something has got to give. As Peter Costello predicted in the Intergenerational Report a decade ago, the government will have to address our unsustainable means testing arrangements. This will be a trigger to genuine reform across the sector.
competition and the next generation of consumers are the architects of ‘consumer choice’. Increased client investment in their services will also see independent, member-funded consumer groups increase their advocacy. This will facilitate appropriately held conversations, between consumers and care providers, rather than providers and government. The removal of supply constraints will accelerate the redundancy of older, institutional nursing homes and shorten the life of newer homes built to traditional models. This will bring challenges for sector capital flows as resident deposits are drawn away from homes that were protected by supply constraints. In this environment, home care options will replace residential aged care in numbers greater than the government has projected. Establishing a single, consumer-based assessment instrument will facilitate less rigid, program-driven transitions for consumers. Innovative, purpose-built accommodation will evolve to meet the individual’s needs and preferences. Need for residential aged care will still exist, however, further subsidy access will promote demand for innovative seniors’ housing and integrated home care models. Proportion of persons 65 years and over receiving long-term care in institutions, 2016 or latest available year.
The future In a less subsidy-dependent system, the rationing of residential aged care supply can be relaxed and providers will be able to invest in new services where they are needed. By easing pricing constraints, investors will be able to move forward on capital developments with more confidence (if they remain competitive), with less exposure to government austerity measures and policy changes. More equitable means testing arrangements will facilitate rapid growth in home care supply, direct subsidies towards those who most need the support and release a new generation of innovative, user-pay and subsidised care offerings. This will not be an environment for the faint of heart. Consumer expectations around service quality and flexibility will grow exponentially when they are paying for more of it. Nothing encourages consumer-centric behaviours more than
Source: OECD health data
When supply restrictions are relaxed, the proportion of older people remaining at home will increase every year. Within a highly competitive market, the focus on quality compliance will be less intense and the role of government will be much more proactive and consultative. This will facilitate
AGED CARE REFORM: ARE WE ON TRACK?
growth in innovation and access to best practice and in turn enhance service efficiency and effectiveness while helping address unmet need. Assessment models will be adapted accordingly with subsidies directed toward that need.
Realising the potential As the government contemplates over a dozen major reviews, there is no shortage of opportunities for the sector to become consumed in collaborative processes. While these initiatives can be useful in improving systems with solid foundations, they rarely lead to the level of change now required to move the sector from its current predicament. Given the government’s response to the Tune Report in 2017 and more recently the federal Budget, it is clear that serious investment in the sector is not a priority. This means that change must be delivered either through active lobbying or as a response to sector-wide failure. The latter option is a very real possibility given the challenges facing the system. Most critical is the impact that current policy is having on more than 100,000 Australians who cannot access the care they need.
The government will be keen to keep the industry silent. In my view, this is not a time to ‘work quietly behind the scenes’. The industry has just endured one of the most challenging years in over a decade. Through countless reviews and investigations, funding cuts and compliance overhauls, the industry has remained responsible for the direct care of over a million Australians. It has an important voice to be heard. This is the time to use it. ■ Cam Ansell is the Managing Director, Ansell Strategic.
References 1. Productivity Commission 2018, www.pc.gov.au/ research/ongoing/report-ongovernment-services 2. Department of Health Portfolio Budget Statement (2017–18)
The election won’t be won or lost on the issue of aged care, but it is certainly one that must be addressed if confronted.
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WHAT IS NEXT FOR AGED CARE?
“I want a super fund that’s an expert at managing money.” Vindhya Mendis, Aged Care Professional
We’ve been awarded a 15 year platinum performance rating from Australia’s most respected super research company, SuperRatings. That means we’re not only one of the largest super funds in the country, we’re also one of the best.
Product ratings are only one factor to be considered when making a decision. See hesta.com.au/ratings for more information. Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant product disclosure statement (call 1800 813 327 or visit hesta.com.au/pds for a copy), and consider any relevant risks (hesta.com.au/understandingrisk).
AGED CARE REFORM: ARE WE ON TRACK?
CREATING THE FUTURE BY DOING LESS, BUT DOING IT BETTER Those who have knowledge, don’t predict. Those who predict, don’t have knowledge. Lao Tzu, ancient Chinese philosopher.
hen I reflect on our industry, the first thing I recall is that age services in Australia today have evolved in an ad hoc way over the past century, from community-based self-help and charitable organisations. The funding and regulatory environment we operate within reflects this organic and on-going evolution. Too often ‘ageing’—which is not a disease—is conflated with ‘aged care’, which is a sub-sector of the health and welfare system. Aged care, in turn, is often confused (especially in the business media) with retirement living, which is a sub-sector of real estate development.
As a result, aged care policy discussions tend to involve a relatively small number of interest groups, each with their own agendas and fixed positions, arguing about narrow funding, regulatory, industrial or technical matters. While these interest groups represent older people, workers, providers or other stakeholders, our direct voices and complex experiences
become mediated, interpreted and simplified during the process. When the debate becomes repetitive and sterile you can either allow yourself to become dejected or you can follow your own path. In 2010, I made exactly that decision and bought what was then a small home care business in my home town of Armidale, New South Wales. I was following the advice of one of my bosses, who always quoted Peter Drucker: “The best way to predict the future is to create it”. At that time the business did some brokerage for a local council, a bit of disability work, and quite a lot of Department of Veterans’ Affairs (DVA) nursing and home care. I saw our future in doing less, but doing it better. We set out to be a specialist in providing high-quality home care for older people, funded by the Department of Health Commonwealth Home Support Programme (CHSP) and Home Care Packages (HCP). Continued on page 36
The Home Nursing Group’s Jacaranda Social Club meets regularly. The group was recently entertained by students from Armidale High School. Image courtesy of Home Nursing Group.
AGED CARE REFORM: ARE WE ON TRACK? Continued from page 35
• We successfully tendered for CHSP funding in both 2014 and 2016, establishing a pipeline for future HCP growth as well as being able to enter new geographies.
The Home Nursing Group’s Jacaranda Social Club meets regularly. Image courtesy of Home Nursing Group.
At the same time, we also expanded the range of services we offer to include thetraditional domestic assistance; personal care and transport; advanced medication management; palliative care; allied health, dementia care; and social groups focused on wellness and day outings.
Over the past eight years, we have transformed the business, now called Home Nursing Group, based on that vision: • We have exited the disability, brokerage and DVA markets. • We successfully tendered for HCPs in the Consumer Directed Care pilot and then in subsequent allocation rounds, giving us a pre-‘Increasing Choice’ base of established HCP customers and experience.
Early on, I made a commitment to invest in the business, our people, our systems and our infrastructure. We employ all our own staff on above-award wages, we employ more permanent part-time staff and more registered nurses than across the industry; we invest heavily in training and development to build skills and improve retention. We built a proprietary policy and procedure suite from scratch; based on business principles, consumer-directed care and wellness. We have made a significant commitment to the digital future of IT, automation, data analytics and artificial intelligence to drive productivity and improve the customer and job experience. Has it worked? The business is on track to be 10-times larger in 2020 than it was when I bought it. From our first base in Armidale, we have expanded to Coffs Harbour, Taree, Port Macquarie and Tamworth. Already, our HCP occupancy is up threefold in just 12 months, and CHSP co-payment collection rate is ahead of the government’s suggested 15 per cent target. We have embedded wellness and reablement into our processes and look forward to an integrated home care program. Most importantly, staff turnover is well below the industry average; customer and staff satisfaction rates are high; and we are confident that Home Nursing Group is delivering highquality care, great customer service and real value for money for over the more than 1,800 older people who count on us for home care services.
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The history of aged care in Australia speaks to me. It is a story of innovation in response to unique circumstances; of how hard it can be in a democracy to do policy well; of how complex industries—no matter how important—struggle to be understood by the public and by politicians. By learning from that, and choosing to stand aside from that, I have created space in my mind to build something with the group of like-minded and equally passionate people I am so proud and lucky to have as my colleagues. Each of us can take control of our own destinies. Aged care in Australia is a growing and increasingly diverse market. Find your own way, carve out your own niche, ignore the noise, do a good job and focus on what you can deliver. No one can predict the future. But you can build your own. ■ Gorm Kirsch is the Managing Director, Home Nursing Group. For more information go to www.homenursinggroup.com.au.
AGED CARE REFORM: ARE WE ON TRACK?
21ST CENTURY VISION:
AN AGE SERVICES INDUSTRY MODEL FOR AUSTRALIA As Australia’s population ages, aged care is increasingly a customer services industry.
uch has been said about the quality, cost and sustainability of the Australian aged care system over the last 12 months. The industry has endured review after review with little evidence that they will bring a meaningful change. The current aged care system is not a deliberate construct, rather it is the result of progressive mutation. Historically ‘nursing homes’ were established primarily as a means of addressing issues of bed capacity in hospitals – nursing homes were, in effect, sub-acute hospital facilities. To this day much of the discussion still centers around hospital bed capacity and having enough beds in nursing
homes (now referred to as residential aged care facilities or RACs) to ensure that the frail elderly can be moved out of hospital as quickly as possible once they no longer require acute healthcare services. The perspective of aged care as part of the healthcare industry has perpetuated to the detriment of the industry and more importantly, the consumer. Aged service is a customer service industry, albeit comprised of social support services. As Australia’s population ages, the number of taxpayers diminishes and the burden on the public purse is set to escalate. Continued on page 38
AGED CARE REFORM: ARE WE ON TRACK? Continued from page 37
Australia urgently needs to consider a new aged services industry model. There is no point in just building more residential aged care beds. First, the consumer base makes it very clear that they don’t like to RAC product, they use it only because they lack an alternative. Second, the RAC model is simply financially unsustainable.
Subsidy recipients would continue to choose their service provider, with the ability to change providers as they wish, regardless of their age, frailty, level of aged service subsidy or choice of accommodation. As is the case with the CDC HCP model, service delivery and accountability model would be individualised, irrespective of the accommodation setting.
So, we have a product the consumer no longer wants, at a price the taxpayer can’t afford.
This alternative sees nursing professionals as expert clinical practitioners, not service managers or administrators. Nurses would be considered clinical experts supporting healthcare needs, and be highly skilled and highly paid as allied health professionals.
Australia’s older adults have made it clear they want to age in their homes and to have support services come to them, allowing them to choose: where they live, what services they access and who provides those services.
The alternative: an age services industry model Consider first that there may be a genuine need for ‘sub-acute healthcare facilities’ that sit somewhere in between acute care (hospitals), inpatient rehabilitation facilities and primary care, but they are not part of the aged services industry. Certainly, the bulk of the ‘patients’ in such a sub-acute facility may be older adults, but they would primarily require the services of healthcare professionals, due to severe, long term chronic illness, disease or injury, not simply because of their increased age and frailty. Patients in such sub-acute facilities would likely require highly level resources and have shorter average length of stay than current RAC residents. They will either improve and be discharged to an aged service or pass away. Some existing RAC facilities may be ideally placed to transition and fill such a need. Subacute healthcare facilities would fall under healthcare, healthcare regulation and the healthcare budget, not aged services. All other older people—consumers of aged services who are not accommodated in such a sub-acute facility—would make their own choice of accommodation type and service provider/s. This is not a new concept. It is the consumer directed care (CDC) Home Care Package (HCP) model. Under CDC, subsidy recipients provide their own accommodation, they own their home or pay rent, plus or minus rental subsidy. This should remain the case, no matter their age, frailty, level of aged service subsidy or choice of accommodation. In addition of choice, the benefit in requiring all older adults to continue to fund their accommodation is that several billion dollars a year in tax-payer funds currently allocated to RAC accommodation would be freed up. These funds could then be ‘recycled’ to meet the increasing number of service subsidy recipients as the population ages. Next, we must consider a single system of service subsidy based on the HCP model—no Aged Care Funding Instrument, no Commonwealth Home Support Programme. This sole subsidy system would require initial assessment and allocation of subsidy level by an independent third party (not the provider) and reassessment by that independent third party as service needs increase, requiring higher levels of subsidy. Access to the subsidy would continue to be means tested.
Risks and opportunities As we think about where to from here, we need to consider the risks and opportunities. 1. The discussion about accommodation needs to be much broader, covering all forms of seniors housing and their appropriateness as living and work environments for delivery of increasing levels of aged services. 2. The greatest threats to a system-wide CDC model in all forms of accommodation currently are the aged care industrial awards. Based on outdated practice and service models these instruments are profoundly inflexible and provide possibly the greatest challenge to the financial viability of any aged services model in Australia. 3. The CDC framework puts the recipient and family in the driver’s seat. They become the customer, instead of government departments such as the Australian Aged Care Quality Agency. With choice and control in the hands of the consumer, transparency and markedly improved quality of service provision will be the inevitable outcome. 4. Broadening the concept of accommodation to consider all forms of seniors housing potentially invites more innovative funding and operating models and importantly will attract much-needed capital from the private sector. 5. There will be industry casualties; some operators may not be able to make the transition. 6. A CDC-type model, irrespective of the choice of accommodation, removes the need for discussion of ‘staffing ratios’. Each individual has the appropriate allocation of resources to meet their personal service requirements—the right amount of staffing resource. In accommodation models of scale, to support large numbers older people (a clustered population)—for example what we currently recognise as ‘retirement living communities/villages’—a minimum staff requirement may be prudent. 7. We must accept that it is okay for providers to make a profit. Age is not a disease. The longer people live, the more likely they are to require regular access to healthcare services.
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We must transform our thinking to meet the challenge this presents. ■
Nick Loudon is the Managing Director of Seasons Aged Care. For Contac more information go to seasonsagedcare.com.au.
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LASA NATIONAL CONGRESS 28-30 OCTOBER 2018 | ADELAIDE CONVENTION CENTRE
AGEING TRANSFORMED ... THE DAWNING OF A NEW ERA
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AGED CARE REFORM: ARE WE ON TRACK?
MEET IN LONDON
TO DISCUSS AGEING ISSUES A shared ageing vision can bring with it more opportunities for older people to contribute to civil society and policy development.
s Australia joined other Commonwealth heads of government in London this April for their annual meeting of the 53 member States, the first Ageing In Common: International Perspective Conference was held concurrently to discuss common ageing issues.
Participants at the Ageing In Common conference, held in London, 16â€“18 April 2018. Image courtesy of Samantha Bowen.
Representatives from 23 countries attended, including 17 leaders from 12 developing nations who were awarded bursaries. All participants shared information and highlighted the common ageing challenges (and opportunities we are all facing). Despite the enormous diversity in population dynamics across the countries of the Commonwealth, they all share one important common trend: the older population is set to grow more quickly than the total population. In the majority of Commonwealth countries, the absolute size of the older population will increase by at least 100 per cent over the next 25 years. These are mostly low- and middleincome countries. With voices from advanced and disadvantaged economies coming together to create a shared ageing vision, and understand the opportunities we are facing, it was clear that no one society or country has the perfect answer. While we all have the same demographic challenges, each culture deals with these in its own way. Ageing and its associated challenges are issues for all nations, no matter the diversity of voices, economies or health issues. Those who work in the field of ageing know this well, and continue to advocate for all governments and institutions to recognise and appreciate the rights, needs and contributions of older people. There is vital work to be done to help the Commonwealth to understand the support needs, demographic population trends, and the potential of older people to contribute to civil society and policy development in all 53 member countries.
The Ageing in the Commonwealth research report (http://www. commage.org/wp-content/uploads/2018/03/CommonAgeResearch-Report-Final.pdf) demonstrates population ageing affects all countries across the Commonwealth, even those with predominantly young populations. However, as long as people in all countries remain healthy and well, they also have the capacityâ€”long into their retirement yearsâ€”to contribute their wisdom, skills and experience to their communities. They should be encouraged to do so in a Commonwealth that rejects ageism in all its forms and in a Commonwealth that respects them and affords them the dignity of a safe and secure environment in which they can live and age well.
Continued on page 42
AGED CARE REFORM: ARE WE ON TRACK? Continued from page 41
Diverse speakers at the Commonwealth forum highlighted the challenges and opportunities that staff and communities face in supporting older adults to find meaning. Dr Donald Magaskill spoke of Scottish Care’s funding needs, and how it was difficult to support increased wages for their frontline staff, and also provide more quality services for their elders. This raises important questions: as our organisations seek to prolong life—either in residential facilities or client homes—how are we helping them to remain included and find meaning? How are we helping them (and our community) to build a cohesive and generationally inclusive society through all we do? As Australia’s population continues to age, our path in making aged care better needs greater foundation. Australia, and the Commonwealth of Nations, must work towards creating a social movement; doing more to create positive and healthy ageing messages. Dr Magaskill noted that Scotland’s social care sector feels that things are being done to them, not with them. Staff feel undervalued, and organisations are fighting for contracts by offering the cheapest services. Many of the developed nations at the conference expressed similar sentiments.
I hear it every day from the young people in organisations: if we do not include our young leaders in our ageing conversations, how do we expect them to care about aged care’s future? We are a social movement that can work together with our older and younger citizens to create an ageing agenda that is sustainable, generationally inclusive, and builds strong relationships with our elders at every opportunity. If we value things, we need to plan and action to retain that value and work together to build the best vision for our future. No Commonwealth nation has a solution. However, our future must include passionate optimism—without it, we cannot inspire others to join us on this ageing journey. All of us must continue to speak up and raise awareness of opportunities for us all to be part of this discussion, no matter our age, and create a future that will support us all as we age. ■ Klaus Zimmermann is the Chief Executive Officer, Australia and founding director of CommonAge. CommonAge is an accredited Commonwealth not for profit and non-government organisation. For more information go to www.commage.org.
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AGED CARE REFORM: ARE WE ON TRACK?
TALKIN’ ABOUT MY GENERATION … Forum delivers message that emerging industry leaders must be defined by attitude, not age.
oo often, conversations about the challenges different generations face descend into arguments about housing prices and smashed avocadoes. Leading Age Services Australia (LASA) showed there is much more to the discussion at its NextGen forum, examining support for the emerging leaders in aged care. Participants attended the NextGen forum held at Perth Arena in Western Australia on 15 May 2018 to hear from current and emerging leaders in the field. The federal Minister for Aged Care, Ken Wyatt opened the forum, calling on young Australians to consider diverse and exciting new careers in the rapidly growing aged care sector. “Today, Australia’s aged care workforce is around 366,000 people but by 2050 we will need that to grow to nearly one million to meet demand,” he said.
“Forums like this are crucial, to highlight the aged care sector’s potential and to canvas ideas from young leaders about getting the message out. “Opportunities are growing, from health professionals to project management, administration, robotics, information technology, marketing, specialised construction, horticulture, interior design, fitness, catering and languages,” he said. From the start of the forum it was clear that no one generation dominated the industry. Forum participants were asked to stand and identify their generation with physical movements. Baby Boomers put their hands on their hips, Generation X crossed their arms over their chests and Generation Y raised their arms over their heads. After the laughter at looking like a flash-mob, discussions followed about defining and identifying emerging leaders. Continued on page 46
Participants at LASA’s NextGen forum identify their generation with body movements. Images courtesy of Scene Team.
AGED CARE REFORM: ARE WE ON TRACK? Continued from page 45
Minister for Aged Care, Ken Wyatt, with emerging leaders from the aged care industry.
Several Gen Xers remarked that their cohort is often overlooked when new leaders are being encouraged, despite also needing support to reach the next levels of their careers, or to change career paths and enter the aged care industry. Representatives from the Baby Boomer generation described how most conversations that mention them in connection to ageing focus on their future care needs, not on how they can continue to participate in the workforce and share their extensive knowledge. In comparison, some of the Gen Y attendees outlined the difficulties they had experienced in challenging existing mindsets and models associated with aged care. The two-way conversation between the current and future leaders was a chance to address key issues such as recruitment and engagement, career path and mentoring programs. Samantha Bowen, Managing Director of the Acorn Network, spoke about the role mentoring plays in career development. “NextGen is a great initiative that focuses on our young Generation Y employees, but we must also consider how we support all ages to be included in these initiatives,” she said. “Aged care is about intergenerational connection. The better we get at creating opportunities and supporting connections between all ages in our workforce, the more empowered we become to take on the future.” The overwhelming message by the end of the day was that each generation has something to learn from each other. Emerging leaders are defined by their attitude, not their age.
Samantha Bowen from the Acorn Network.
LASA is now looking at opportunities to hold similar discussions in other parts of the country, bringing together a strong network that encourages and supports each other as the aged care industry changes and transforms. ■
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WHISTLEBLOWING AND FIGHTING FRAUD Creating a culture where people feel confident to speak up as early as possible is important to combat fraud and misconduct.
orkers and those in your care have the right to speak up against unethical practices and wrongdoing. It seems a simple idea, but in reality it can be difficult to execute correctly.
Despite how far we have come, there is still no shortage of media coverage outing misconduct in the aged care sector. From fraud, theft, bullying and elder abuse/neglect to unethical practices, the spotlight on bad behaviour has never been stronger and the need to ensure proper reporting frameworks never greater. On the matter of fraud, the Association of Fraud Examiners (ACFE) recently released its 2018 Global Fraud Report, (http://www.acfe.com/report-to-the-nations/2018/) finding: • organisations generally lose five per cent of annual revenue to fraud • the median duration of fraud was 16 months • b usinesses with fewer than 100 employees lost almost twice as much to fraud than larger businesses • f raudsters who had been with their company for five years or more stole twice as much as others • employee tips are by far the most common detection method at 40 per cent compared to the nearest detection method, internal audit, at 15 per cent. • organisations that offered a whistleblowing service detected fraud more often (with 46 per cent of cases identified via tip-off), earlier and experienced a lower financial impact than those that did not offer the service. The ACFE report demonstrates the risks all organisations face, especially those with less than 100 people, and the importance of early detection. Combatting elder abuse and neglect is complex, and its private nature often makes it difficult to detect. It is also difficult to measure its prevalence within the sector or institution. Alarmingly, some studies suggest that neglect could be as high as 20 per cent among women in the older age group (across abuse types and in/out of institutions).
Many strategic plans are in place and organisations are acting to reduce the risk of elder abuse in Australia. So, what can we do at an organisation level? There is no silver bullet. Leaders must accept that misconduct cannot be eradicated entirely. However, a structure can be put in place to help mitigate the risk and learn of issues sooner. Create psychological safety to provide individuals with the confidence to both speak up (even when in doubt) and the certainty that proper action will be taken without personal ramifications.
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INSIGHTS FROM INDUSTRY Continued from page 49
In the planning stage, place your stakeholders at the centre of the strategy. Consider what problems employees, contractors and those under your care will face; identify the risk areas; and what reporting pathways will they require. If possible, conduct surveys for a greater understanding of staff issues and experiences.
Consider all legal and regulatory obligations to ensure processes are best-practice and compliant. The framework could include:
Prevention • Integrate misconduct questioning in surveys to measure current climate/ attitudes/perceptions/blockers. • Include communication and support for speaking up into
organisation-wide mediums, e.g. intranet, team meetings, bulletins. • Tailor misconduct training to all levels of employees. • Focus on tailored communication and reporting mechanisms for those in care. • Introduce surprise audits at locations.
Detection • Establish multiple reporting pathways at various levels of the organisation.
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• Offer an externally-managed anonymous 360-degree discrete reporting service. • Demonstrate your organisation has policies and procedures in place to adequately capture and act on allegations of misconduct. • Demonstrate protection and support is available to those who speak up. • Train site managers in handling difficult conversations, and correct reporting procedures.
Responses • Ensure the presence of up-to-date, robust policies and procedures. • Provide scenario training for those required to investigate misconduct. • Set investigation processes and risk assessment procedures. • Act quickly and reassure individuals involved. • Measure the program.
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Regardless of your chosen strategy and operational framework, ensure you remember to keep it transparent and defensible, and most importantly of all, put people first. ■ Nathan Luker is Chief Executive Officer, Your Call Whistleblowing Solutions. See www.yourcall.com.au for details. Your Call Whistleblowing Solutions is a Leading Age Services Australia Affiliate and PurchasePOWER supplier.
INSIGHTS FROM INDUSTRY
CHANGE MANAGEMENT MAKES THE DIFFERENCE IN AGED CARE
Embracing a new approach can bring unprecedented value if done effectively.
hen dealing with disruption and innovation, change management is the difference between struggling and thriving. Change management is the combination of planning and practices that help people and organisations adapt to and embrace the new things they have to do or use. This makes it very important for the aged care sector.
In the last decade I have repeatedly listened to aged care leaders talk about the unending conga line of changes moving through the sector. With change such a priority, it is
reasonable to assume there is extensive research on how the sector can manage it. Yet when I conducted a recent search for peer-reviewed articles on aged care and change management, there were no results before the year 2000. I found a total of 136, and yet a general search on change management alone produced 26,602 results. In addition, most of the 136 articles werenâ€™t about aged care at allâ€”the sector was only mentioned as part of health services or some other context.
Continued on page 52
INSIGHTS FROM INDUSTRY Continued from page 51
The bottom line is that for a sector continuously immersed in change, there is very little evidence-based research about how to manage it in an aged care context. What we do know is challenging. In 2007, Chris Shanley (https://www.emeraldinsight.com/doi/ abs/10.1108/02621710710833414) published a study about the way change management was applied in the sector. It showed limited use of change management methods, with a fairly generic approach that was not nuanced to specific situations. It was seen as a management role but there was very little support for the managers. They were largely selftaught and they found managing change very stressful, and at times traumatic. This has to be understood in the context of evidencebased research into the effect of change management on successful outcomes. A McKinsey study in 2002 (https://www.mckinsey.com/ business-functions/organization/our-insights/helpingemployees-embrace-change) showed that little or no change management activities resulted in organisations capturing as little as 35 per cent to 68 per cent of the planned value the change was meant to create. When change management was done effectively in all or most parts of the organisation, the organisation captured as much as 129 per cent to 143 per cent of the expected value. The difference in results is striking. To reinforce this, the Prosci organisation runs continuing research about how change management affects outcomes. Its 2018 results are based on responses from more than 1,700 participants. The same trend is exhibited, with only 15 per cent of organisations with poor change management meeting or exceeding their objectives. Conversely, 93 per cent of organisations with excellent change management met their objectives. The consistency of results over 16 years from different research projects should grab the attention of every leader in the aged care sector. Whatever improvement or innovation you are implementing, if you want to look your board, chief executive officer or staff members in the eyes, you have to demonstrate well-implemented change management. So coming back to our sector, what does more recent research indicate is happening? We see that some support is being provided to leaders in the sector. We see that there are still significant shortfalls in achieving objectives. The staff in residential aged care seem to be more proactive in implementing change than their clinical peers outside of the sectorâ€”and well done to them! However there seems to be evidence from similar jurisdictions outside of Australia that culture change around care practices is lagging, which means that is an issue worth watching here in Australia.
External support for change management is available and important. For me, one of the most important pitfalls is to think that change management is something that is done as a part of a project. The truth is the exact opposite: projects are a tool for change management. They build the resources, procedures, skills and plans to implement the change but it is the change that initiated the project and the change will continue for months or years after the project to consolidate it. Another pitfall is to overlook the important role that supervisors play during change. This is especially important for large organisations. Supervisors have influence at the management level and at the individual contributor level in organisations. No one else has the depth of interaction with staff that supervisors have. Work closely with them, invest in them and help them adapt to the change and they will amplify the effectiveness of your change program. Effective change management is not only important because of the financial implications of not doing it well, it is important at a human level. Remember the 2007 findings that Australian aged care managers found their roles stressful or even traumatic? Our people are too important to let that continue. Excellent change management practices can help reduce the stress on our leaders and also help the sector to flourish in the face of its considerable challenges. â– Paul Hegerty is the Director, Grevillea Consultants. For more information go to www.grevilleaconsultants.com.au. Grevillea Consultants is a Leading Age Services Australia Affiliate.
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HOW INNOVATIVE TECHNOLOGY
CAN SOLVE THE PAIN POINT OF FILLING STAFF SHIFTS
Managing workforce supply and fast-changing rosters are the top two issues in aged care workforce management today.
ith changes to aged care funding placing cost pressures on the industry, providers need to constantly re-think how they deliver a greater customer experience. This in turn shines a spotlight on workforce management. Providers are now prioritising employee engagement and sharing the best staff to develop a customer-centric business model to meet the challenges of a dynamic aged care industry. While many staff rostering technologies are available and affordable, solutions are being developed that will vastly improve workforce management in aged care and help tap into the growing workforce supply issues. This will empower both operators and workers to deliver the highest quality of care for their residents. Emprevo is one such technology solution. Developed by Australian operator, Sapphire Care, the platform provides an innovative and cost-effective communication solution to tackle the pain in workforce management. Built initially to reduce Sapphire Care’s own workforce management costs, Emprevo is an extremely intuitive shiftfilling and communication platform, now available to all employers in the aged care industry. Emprevo allows shift managers to fill shifts quickly by posting shifts to all available workers who want work. They can use their desktop computer at work but also their tablet or mobile on the go, allowing them to fill shifts whenever and wherever they want.
It lets workers specify where and when they would like to work and accept shifts in real time, anywhere and at any time. They do this primarily on a mobile app on their smartphone but also on their tablet or computer if they prefer . The cost of managing its workforce was the biggest pain point for Sapphire Care. “Staff turnover was at 24 per cent and the fortnightly roster changed between 35 to 50 per cent,” Managing Director, Ernest Medina, explained. “Filling outstanding shifts was a constant scramble, and meant back and forth use of phone calls, text messages and
recruitment agencies—becoming both was time consuming and costly. It took precious time away from our service of delivering care. In fact, our agency spend was almost $100,000 a year for each residence. “At the same time, we were under-utilising part-time staff and unable to share staff, because of the difficulty communicating with our workforce across different locations.” “We wanted a simple, yet effective, communication system for our entire workforce,” says Ernest. “Emprevo was born because we wanted efficiency and cost-effectiveness by filling shifts fast internally. It has saved us $690,000 a year in agency cost alone.” Sapphire Care’s experience isn’t unique, and many providers share similar stories. HESTA’s latest industry report (https:// www.hesta.com.au/transformingagedcare) finds workload pressures and fast-changing rosters are the top two issues in aged care workforce management today. Feedback from early adopters has been extremely positive. James Simon from Baptcare says it has improved after-hours shift fill rates, “It was a natural fit to our business needs and the set up and configuration was a breeze.” For Kerrie Rivett, Chief Executive Officer of Shepparton Villages Aged Care, Emprevo’s logical step-by-step process makes staff replacement “easy, efficient and effective”. Emprevo is now used by providers in more than 650 locations across Australia. Results have shown that providers can: • post hundreds of shifts in seconds • fill 90 per cent of shifts within minutes • cut agency cost by up to 75 per cent • reduce staff turnover by 50 per cent • save up to 14 hours a week filling shifts for residential managers and administration staff, and • cut telco costs by up to 90 per cent. ■ For more information, visit www.emprevo.com. Emprevo is a Leading Age Services PurchasePOWER supplier.
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IN CAMERA SESSIONS:
DON’T WAIT UNTIL THERE IS A CRISIS ‘Closed door’ discussions can offer a safe and respectful environment for new directors to ask questions
n camera is a legal term derived from Latin and meaning ‘in private’. The same meaning is sometimes expressed in the English equivalent: in chambers. Generally, in camera describes court cases, parts of it, or process where the public and press are not allowed to observe the procedure or process. Across the sectors Governance Evaluator works with, we have identified many boards with up to 40 per cent new directors. We have seen an increase in the number of directors responding ‘unsure’ in our governance evaluation questionnaire. Many of these directors are very high calibre and skilled, however we all know how long it takes to understand the business when you are a new director. One great tip we can offer is the usefulness of starting each board meeting with an in camera session, allowing new (or any) directors to ask ‘those questions’ that we just don’t like to ask in the full board meeting for fear of disrupting things or looking silly. In camera sessions involve only independent members of the board i.e. those who are not members of the senior administration team. Board-only sessions involve all members of the board, including the chair, but do not include the chief executive officer (CEO) or executives. In camera and boardonly sessions provide the opportunity to discuss sensitive matters, internal board governance matters, and for board members—in particular, those who are new to the board— the opportunity to speak more freely about areas of concern or enquiry. Traditionally there is a stigma or a perceived issue relating to in camera board sessions. This has led to a lack of boards wanting to use or ask for them on agenda because they are only used when ‘something bad’ needed to be discussed about executive and they do not want to upset anyone. Some managers/CEOs are voting members or executive directors of the board and would like to be included in the in camera session. However, we recommend that they despite wearing both hats, they do not attend. This helps to ensure the comfort and freedom of speech of the new and other directors. This concern will diminish with a good in camera policy. Many new directors only identify the burning background or contextual question they need to ask at the time of the board
meeting conversation, but the already full and busy agenda doesn’t allow the time required to give them this information. Often these directors do not want to appear to be asking ‘stupid’ questions or wasting time or offending the executive and/or other directors. Some clever boards have addressed this by having a quarterly board meeting over a longer time, with a meal prior to allow for new directors to ask background and contextual questions about the agenda matters for decision and discussions. Why not start every board meeting with an in camera session? • Start with a policy that everyone (CEO/executive and board) agrees to and endorses. Implement it well so everyone will have a positive experience and take away those traditional fears. • Make it a positive time for directors – one where they can ask all those questions and for whatever other items they may wish to discuss. • M ake sure the chair leads the session and encourages new directors to feel comfortable to engage in discussions. • As they come back into the room after an in camera session, make sure the chair tells the CEO/executive about any immediate requests or topics directors may have raised. We recommend making in camera and/or board-only sessions a regular part of your board meeting structure. To help we’d like to share our latest copy of the Governance Evaluator in camera policy to follow and try. It is available from http://go.governanceevaluator.com/in-camera-policy. ■ Fi Mercer is the founder of Governance Evaluator, a Leading Age Services Australia PurchasePOWER supplier.
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MUST BE PRACTISED FROM THE TOP DOWN
ceiling fire forces the temporary closure of a wing. An approaching cyclone, flood or bushfire sees your site having to prepare or evacuate. A burst hot water pipe, power outage, gas leak, security breach or workplace injury conspires against your business operations—and perhaps, even affects your brand.
Based on a dynamic structure of policies and procedures designed to deal with risk events, managers will be required to immediately allocate resources and responsibility, assert authority and accept accountability. Given crisis events can take place at any time of the day or night, managers may need to initiate procedures remotely and outside normal business hours.
All of these events point to why there is an ever-increasing focus on risk management systems and processes based on the AS/NZS ISO Standard, (https://www.finance.gov.au/sites/ default/files/COV_216905_Risk_Management_Fact_Sheet_ FA3_23082010_0.pdf). Having a system in place is one thing, but it only works when it is practised from the top down.
Importantly, plan, action and follow through with decisions, and continually assess performance and implement improvements
During our time working within the aged care industry, Emcorp Group has seen risk in all its forms, from the movement of entire resident populations to the impact of more localised internal emergency, security and safety threats. Our experience has shown us that the impacts and outcomes from an initial incident can rapidly expand ‘upward and outward’, or penetrate to cause real harm in an ‘inward and downward’ fashion. That is why we see risk management as being everyone’s responsibility, from the chief executive officer to those on the ground who possess the tools and knowledge who are responding and reporting back up. Prepare for the unexpected and do not to be afraid of testing your organisation’s resilience. Include risk-based events that can be classed as incidents that lead to emergencies or crisis. In these verticals, include scalable operations leadership and ensure that senior management commitment is visible.
In all-too-common failures, communication is the critical factor. You need to ask: is your communications framework dynamic and scalable? Is it based on a variety of methods; does it include specific check-listed approaches with procedures that can be applied to a variety of risk events? A vital action may be contact with external agencies, such as police, bushfire or ambulance, so consider when and how you activate their involvement. Consider recording actions and outcomes as they occur, even just on a mobile phone camera. This footage can be reviewed to help learn from mistakes or validate existing procedures. Reviewing will also help identify if, or what, additional education is needed for all levels of the organisation. Ultimately, it is leadership in aged care that is required to be forward thinking, be responsive, and open to using a range of toolsets to deal with both the every day and the unexpected. By doing so, not only will the various risks be mitigated and the site compliant, but you will develop a team that is now equally confident and competent. ■ Richard Stevens is the Director, Risk Services, Emcorp Group. For more information, visit www.emcorp-group.com. Emcorp Group is a Leading Age Services Australia PurchasePOWER supplier.
INSIGHTS FROM INDUSTRY
WHO IS LEGALLY IN CHARGE?
ithout a doubt there are challenges for providers and carers in the consumer-directed care environment.
Aged care providers are often torn between the clinically assessed care needs of residents and the consumer demands made by others close to the residents/clientâ€”either with or without legal authority. Identifying who is in charge can be a challenge for providers and their staff. Who has the authority to direct care for the resident/client? Many would say the resident/client is in charge of their care decisions unless they lack capacity. While this is the correct response, it is rarely as simple as that.
A provider must determine not only whether there is a substitute decision maker and if that person has an enduring legal power, providers must also determine the values and preferences of the resident. To complicate matters further, a resident/ client may be dissuaded from a particular course of action or treatment by their substitute decision maker. In many instances, despite having capacity, a resident/client may abrogate their own decision making to another person, either formally or informally. The laws regarding powers of attorney and substitute medical decision makers vary from state to state and territories. Many states have more than two versions of such legislation operating simultaneously. Providers should make every effort to determine the care and service expectations of a resident/client and any substitute decision maker. Articulating and having a record of the powers of any family members is crucial. Where
there is disharmony in a family, the provider should determine who has the authority to make decisions on behalf of the resident/client. Advance care directives are a means by which a provider may be able to determine whether the expectations of a resident can be met, but advance care directives are far from prolific at this stage and reliance is often placed on the accounts of the family members. In Victoria we have seen the introduction of the Medical Treatment, Planning and Decisions Act 2016 which enables a person to make a legally binding advance care directive that health care practitioners must consider. However not all states apply the same imperative on compliance with the values and preferences of residents/clients. For example, New South Wales also has provisions for advance care directives, however, these are not considered to be legally binding. Each jurisdiction has the ability to refer matters to an administrative tribunal, which places additional financial and human resource expenditure on a provider. For this reason, along with the confidence that a resident/client is receiving the care they need and want, providers must ensure their preadmission and admission information is current and relevant to the needs and wants of the resident/client, not third parties. Where there are conflicting demands and information, staff should document discussions clearly and seek to determine all partiesâ€™ expectations. â– Sabine Phillips is a Partner at Gadens. For more information go to www.gadens.com. Gadens is an Affiliate of Leading Age Services Australia.
2018 BETTER PRACTICE FOR THE FUTURE NATIONAL CONFERENCE
22-24 August 2018 Living Sydney the life I choose aacqa.gov.au/events Safety, health & wellbeing
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Our 2018 conference is designed to explore the quality journey and how aged care services have partnered with consumers. The program is also aligned with the new Aged Care Quality Standards and regulatory framework. This year there are some exciting new additions including a pre-conference workshop, Better Practice Awards dinner and Digital Poster displays. Registrations are now open. Discounted conference rates will be available for groups and early bird registrations. To register, visit: www.aacqa.gov.au/events
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PEARLS OF WISDOM HELP FIGHT ANXIETY AND DEPRESSION
Swinburne University’s Program to Enhance Adjustment to Residential Living (PEARL) is improving quality of life for older Australians.
he transition to an aged care facility is often highly stressful for older people and their families. Many older adults leave their home at a time of crisis, for example following a hospital admission, and in some cases against their wishes. Feelings of anxiety and distress are common, and a very high number of newly admitted residents show symptoms of depression. Researchers at Swinburne University of Technology learned that aged care facilities typically don’t have formal programs in place to support newly admitted residents during the transition period. Facility staff commented they would particularly welcome assistance in providing a care plan that not only addresses older people’s physical care needs but also their psychological needs. The university developed the Program to Enhance Adjustment to Residential Living (PEARL) to meet these challenges. PEARL applies the findings of Swinburne’s research to help improve older people’s resilience against depression through tactics such as increasing the autonomy in their day-to-day lives; giving them a sense of mastery and control over their lives; providing access to meaningful activities; and assisting them to make genuine social connections with other people. According to psychologists, these aspects are fundamental to psychological wellbeing throughout the lifespan, but too often they receive limited attention in residential aged care settings. PEARL was designed to target this problem and improve the quality of life for older Australians. The PEARL team’s trained mental health clinicians meet newly admitted residents over five sessions. During these sessions, the clinicians identify the residents’ individual psychological needs and design ways to meet these needs. The clinicians also provide professional development and ongoing support to facility staff in how to implement this person-centred care approach, helping them develop their skills in enhancing psychological wellbeing that can be applied in turn to other residents.
For Len, who moved to an aged care facility when he was 90, the PEARL team helped overcome a tense situation. Len was fairly independent and could do many activities without help. But after the unexpected death of his wife, he was worried about living on his own without support. Unfortunately, the experience of residential life didn’t meet Len’s expectations, as facility staff didn’t recognise his desire for autonomy. The standard routines in the facility didn’t fit well with his lifelong patterns, such as when staff regularly interrupted his morning prayers with requests for him to shower. Facility staff also made it difficult for Len to get out into the community, for example, to visit his family general practitioner, hairdresser, and friends. Len was left feeling frustrated, bored and socially isolated. When the PEARL clinician sat down with a staff member involved in Len’s care, it became clear that Len was seen as aggressive and resistant. Staff were monitoring his ‘challenging behaviour’ using charts designed for people with dementia, and were surprised to learn from the clinician that Len had high cognitive functioning. The staff viewed Len’s behaviour through a medical lens, rather than recognising it as a response to an inflexible environment.
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As Len explained to the PEARL team, “My problem is that I am different from the people here. I can still go out, I am still quite fit. The staff here do not understand this and there seems to be an issue with their mindset—a mindset that everyone here is the same.” A staff member, Jude, was invited to join the PEARL sessions with Len, and committed the time to listen to Len’s needs and understand why it was important for him to remain independent. Jude helped to write a more flexible plan to assist Len with his daily activities, with minimal intrusion, and to make it easier for Len to come and go. Len was encouraged to join a men’s group, where an effort was made to match the participants according to their level of cognitive function and interests. Len enjoyed these groups and began to form friendships. Len was also invited to write for the facility newsletter. Len’s symptoms of anxiety and depression fell over the next two months. The clinician noted that the critical factor in improving Len’s wellbeing was the shift among staff to consider Len’s psychological needs, rather than only focusing on his physical care. Staff recognised the benefit of spending time with a resident to determine their needs, with Jude noting that, “I can’t get this
sort of information in 10 minutes. Having the session is really helpful.” Len also welcomed the opportunity to talk with the clinician, telling the team, “It was very comforting to be able to talk about my feelings, and validating my concerns and challenges. Having someone to talk to who understands how I feel has helped.” PEARL has achieved impressive outcomes during the 12 months it has been running. The research team is gathering evidence on the program’s effectiveness through a randomised controlled trial that is funded by the National Health and Medical Research Council. The team will measure the adjustment, quality of life and mental health of each resident over an eight-month period, compared to residents not receiving the program. ■ Associate Professor Tanya Davison is from the Swinburne University of Technology. The PEARL team is currently accepting expressions of interest from residential aged care facilities in the Melbourne metropolitan area who would like to participate in the trial. For more information, contact the PEARL team at email@example.com, or call Dr Vera Costa on (03) 9214 4668.
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WHEN IT’S GOOD, IT’S VERY, VERY GOOD It is not every day an Australian aged care business has the chance to collaborate internationally, but there is a lot to be gained.
Residents of Gaynes Park Manor.
and where people could feel engaged and live a meaningful life. “At the time, we already believed in the value of smaller, home-like environments, but we felt we should aim for something even more significant with this new home,” Allen said. In the UK, he was inspired by a new approach that grouped residents into the ‘mini-communities’.
rue innovation often requires active collaboration with wisely, and widely, chosen partners. South Australianbased aged and community care provider Life Care took this principle to the extreme when designing Gaynes Park Manor, its new residential living community in Joslin, South Australia. Scouring the globe for inspiration, a visit to the United Kingdom (UK) yielded not only the inspiration for a new model of care, but also a partnership with the Dementia Services Development Centre (DSDC), part of UKbased Stirling University. The effectiveness of the DSDC partnership—augmented by another with international architectural firm Marchese Partners—has gained international accolades. Gaynes Park Manor won the 2018 Eldercare Innovation Award for Best Silver Architecture in Construction, presented in Singapore in April 2018. For Life Care’s Chief Executive Officer (CEO), Allen Candy, the motivation for this worldwide search came from personal experience. “I visited my grandparents at Gaynes’ predecessor Roselin Court as a teenager. Imagine my surprise when I returned as Life Care CEO 30 years later to find that many aspects of Roselin Court hadn’t changed,” he said. “It was a challenging experience. I felt an obligation to create a new environment that anyone would enjoy living in
Discussing this new approach with DSDC, it was clear that collaboration could bring a new level of dementia design excellence. The partnership looked at every aspect of the design, from the size of each mini-community and the distinctive use of objects, colour, texture and finishes for orientation, to enhancing visual access and control of stimuli, lighting and technology. The aim was to provide the best possible space for people living with dementia and other cognitive impairment. While the new model of care seen in the UK-inspired Gaynes Park Manor’s unique layout, partnering with Marchese Partners elevated the project. As with all good architecture, Gaynes Park Manor focuses on the differing needs and desires of its residents. Each of the site’s six ‘minicommunities’ has 16 rooms radiating directly off an openplan communal area including a kitchen, dining space and lounge. Residents can choose complete privacy by closing the door to their ensuite room or, with it open, can feel closer to the ‘goings on’ around them. No one is isolated at the end of a long corridor. Various nooks offer gathering space for small groups, or an individual can sit and enjoy a good book. This sense of being part of the community while still having a choice of multiple levels of privacy reduced loneliness and boredom. Residents are encouraged to maintain their familiar daily rhythms, to take on various community responsibilities, and be part of meaningful social engagement activities. Technology facilitates this sense of freedom. Clinical-looking call bells have been replaced by the southern hemisphere’s first genuinely mobile call system. Each resident receives a wearable device which provides a feeling of security:
Designing Gaynes Park Manor was an international collaboration.
wherever a resident is in Gaynes Park Manor, they can notify staff that they need support simply by pressing a button on their device. Staff are able see the resident’s exact position on a smartphone. As a result, call volumes increase while response times have decreased. Ultimately, such a building can be incredible in theory yet fall short. When it comes to Gaynes Park Manor, the proof is in the pudding.
Gaynes Park Manor in Joselin South Australia is the winner of a prestigious international award. Images courtesy of Life Care.
Residents often comment on how special they feel living in this beautiful space and families spend longer with their loved ones. ■ For more information, visit www.lifecare.org.au/gaynesparkmanor.
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CONNECTING COMMUNITIES ACROSS GENERATIONS Local students regularly visit residents at Melbourne’s Emmy Monash to share traditional cultural activities
s with any good recipe, success depends on the ingredients. Maureen Shulsinger from Melbourne’s Emmy Monash Aged Care has found that to be true, whether it is baking cheesecakes or creating an intergenerational community program. “We were approached by Mount Scopus College wanting their students to volunteer for community work,” Maureen said. “The school originally suggested the students could
perform songs for our residents but I was much more interested in developing meaningful connections through regular engagement between our residents and the students.” Maureen realised there was an opportunity for the students to experience aspects of their Jewish heritage with the residents of Emmy Monash.
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Safta Sula with Brody Hoppe and Tali Golvan. Image courtesy of Emmy Monash.
“Since the first Bridging the Gap program in 2012, the program has grown. We now have 19 Year 9 students from Mt Scopus School joining our residents almost monthly for yoga, cooking, sculpting, walks in parks and having conversations,” she explained. “One of our residents speaks only Hebrew, which is the home language of one of the students and he was able to translate for her. Another girl is studying French at school and comes to converse with our resident who is fluent in the language.”
“Safta Leslie experienced many health issues when she first came to us, but since being around the children her health has markedly improved. During a recent heat wave she was adamant nothing was going to stop her being there for her regular Wednesday 9am class. Both Safta Leslie and Safta Sula come back to Emmy Monash full of stories to share with the other residents. At Passover this year, they even took part in the school’s holiday performance and dressed up as biblical characters.”
At the heart of the approach is the idea of ‘doing with, not doing for’. Following the success of this initial Bridging the Gap program, Emmy Monash has also introduced a weekly Friday program with Bialik College in preparation for the Sabbath. Year 6 students visit, and serve the residents at lunch including traditional Challah bread that is made on site and then wishing everyone the traditional ‘Shabbat Shalom’ (Peaceful Sabbath). Together residents and students then arrange flowers for the tables of the evening Sabbath meal
Their presence has meant children as young as five are part of conversations about ageing, helping overcome stigma. “Many of the students don’t have grandparents, or their grandparents live in other countries. Others have younger grandparents, so this is their first exposure to much older people,” Maureen said.
“We also offer opportunities for students and residents to cook food together as part of celebrating festivals, such as making cheese blintzes, a type of crepe filled with sweet cheese. It’s a practical way to share culture and ensure traditions are passed on,” Maureen said. Two of the residents also visit Mount Scopus Gandel Besen House, a nearby kindergarten, which has provided opportunities to demystify ageing for younger children. “They’ve embraced our residents, calling them Safta Leslie and Safta Sula, (meaning ‘grandmother’) and they can’t wait for hugs and cuddles. Safta Sula is a 96-year-old Holocaust survivor and she takes them for rides on her walking frame.
“We explain everyone is a person first, no matter what their age. We talk to the children about what to expect, about making eye contact and sitting close. They know to put their school bags away so they don’t block wheelchairs.” Maureen has also been able to connect medical students to residents who had medical careers. “It means our residents are still giving, and are able to help students starting out on their chosen pathway.” When asked what makes Emmy Monash’s intergenerational community so strong, Maureen explained it comes down to being contemporary, fun and active. “The ingredients we use are passion and love. We don’t go wrong with those.” ■ For more information, call (03) 8508 9300 or visit www.emmymonash.asn.au.
MONTGOMERY HOUSE AND HALL OPENS DOORS
AFTER MULTI-MILLION DOLLAR RESTORATION
he transformation of the old Swanbourne Hospital precinct from a derelict site is now complete, with the 115-year-old heritage buildings reborn into an exclusive aged care residence and function venue.
For more information go to www.aegiscare.com.au/locations/ aegis-montgomery-house.
Aegis Aged Care Chief Operating Officer, Kevin Brimblecombe, said the company had spent five years and $35 million working to transform the buildings, which have been sitting unused since 1985. “This project has been a labour of love with the highest quality of craftsmanship and restoration techniques used to pay respect to the history of the buildings and the site,” Kevin said. “Craftsmen have used the same techniques used by builders more than 100 years ago and every piece that was missing or damaged has been replicated to the highest possible quality.
“What we have achieved is remarkable and we are truly grateful for the support we have received from the community during this lengthy restoration process.” Montgomery House features 80 deluxe aged care rooms with private ensuites, a café, theatre room, 24-hour nursing care and onsite clinical services, including physiotherapy, occupational therapy and podiatry. Montgomery Hall is an onsite, heritage-listed concert hall with soaring ceilings and crystal chandeliers. It reopens as a grand heritage venue for weddings, corporate events and private functions, with seating for up to 150 people. Aegis was attracted to the old hospital site because it represented the opportunity to create a higher level of aged care services for Perth residents, while also giving back to the community by restoring the grand heritage site. “Montgomery House residents can expect a facility that is uniquely luxurious and homely with most bedrooms boasting high ceilings, polished floorboards, exposed beams and fireplaces,” he explained. “Residents will be cared for to the highest standard. Every day our lifestyle team will set a daily activity schedule, ensuring residents are entertained and engaged. “In addition, our private function areas allow relatives to host special occasions on site for residents and the beautifully landscaped gardens also provide a space for families to enjoy a picnic or cup of tea.” ■
Aegis Chief Operating Officer, Kevin Brimblecombe, outside Montgomery House. Images courtesy of Aegis Aged Care. Aegis Chief Executive Officer, Michael Cross, in a bedroom of the restored Montgomery House.
A PICTURE PAINTS A THOUSAND MEMORIES A successful visual exhibition showcasing residents’ memories morphs into one aged care provider’s powerful and holistic operational tool.
Moran resident Monica Hiss enjoys the vintage memory boards. Images courtesy of the Moran Gallery.
n late 2017 the Moran Gallery at the Moran Sylvania Residential Aged Care home in Southern Sydney, began working with Indigenous artists on the Yarns with Gami Ollie George exhibition, celebrating the life stories of Badimaya elder, Gami Ollie George. The collection tells yarns through artwork and helps to preserve and share the Badimaya language. Recording and sharing memories through art inspired the Moran team to develop a project for residents to also share stories and memories through an exhibition. They called it Making Memories.
What particularly resonated with Moran’s team was the sharing of stories and memories as a way of getting to know someone. The team discussed how an easily accessible medium, such as photography, could generate conversations and recollections with residents, their families and staff. Once the Moran team members started brainstorming and saw how keen residents were to participate in the project, they knew they had started something very special. While the Gami Ollie exhibition tells stories through Indigenous artwork, the Making Memories project was designed to blend Continued on page 70
MEMBER STORIES Continued from page 69
This is Ron & Iris on their wedding day on 6 April 1946.
This photo was taken at Crown Studios Sydney when Iris was 5 or 6 years of age.
Iris wrote on the back of the photo: “Someone had just poured confetti down Ron’s back, you can see him trying to loosen it out of his collar. This isn’t really a good photo, it’s only a street photographer”.
“When I was around 8 years of age I became a Ward of the State. My mother had a stroke and my father was legally blind and they couldn’t look after me. When I was 16, I went back to my family home in Summer Hill. The neighbours had billeted some service men. That is where I met my future husband Ron. Ron was an English sailor and was sent to Australia on a secret mission. Details of that mission are sketchy. The ship that Ron sailed in is currently displayed at the Maritime Museum.
This photo was taken when Ron returned from WWII in 1947. Iris was 18 and Ron 22. This is Iris with her daughter Diane on 20 Jan 1952. Diane was 6 months of age. “I made the dress and the bonnet was to cover Diane’s lack of hair”
Making Memories - Iris Hibberd
Iris Hibberd’s memory board was one of the many on display.
Iris gently touches the photo of her husband.
the tradition of scrapbooking and journaling with digital photography and the desire to share and capture both the past and the present in an interactive way with our residents.
Managing Director Peter Moran, said. “They are soldiers, chefs, home-makers, plumbers and shopkeepers.
Some residents opted to share their personal stories and special moments through treasured and worn photographs. Others wanted to share photographs of themselves in the here and now, enjoying the everyday with friends old and new, and their families. Some residents learned new skills in a photography workshop sponsored by the Moran Arts Foundation, while others sought out old photographs and shared and documented the stories behind the photographs with family members and carers. Staff members were also invited to contribute their favourite photos and to share their special moments. The end result was a heart-warming exhibition which really celebrated the theme and company vision to ‘make each day the best it can be’. The gallery walls were filled with fascinating photographs and stories from yesteryear alongside the current day. The exhibition covered a range of photographic techniques, from film to digital to phone, capturing the formal, the casual and the candid images we now take for granted. A hand-painted wedding photo, hangs next to a colour photo of the 2000 Sydney Mardi Gras and a 1929 black and white family beach photo. All images capture the vitality, excitement and reflect the times. “As our loved ones age, it’s easy to lose sight of the people as they are. By telling stories from their lives, we maintain their importance in our community and celebrate their achievements,” Moran Sylvania Residential Aged Care
“They have brought up families, fought for our nation and seen our community change and develop. Their stories are fascinating and give us a great deal of insight. By presenting this exhibition we can get to know each other better and reminisce over the ‘olden’ days.” The exhibition and the stories learned inspired a project group to work on reviewing how we get to know our residents through their resident profiles. A new type of profile was born, with a focus on creating truly meaningful information that helps residents and staff members engage. This is especially effective when working with residents who are stressed, anxious or confused. The images and information in the resident profiles provide staff with quick conversation starters and opportunities for closer resident and staff engagement. Later this year the profile will be used as part of the induction program for new team members, with new staff completing a profile for themselves and presenting it to their cohort. This will form part of a human resources program aimed at creating better, stronger relationships within teams and also to further develop our culture of diversity and understanding at Moran Aged Care. ■ Nganang Badimaya Wangga – Yarns with Gami Ollie George showcases the artwork of 14 Aboriginal artists from Badimaya and Yamaji country in the mid-west of Western Australia. The exhibition runs until 12 August at Moran Gallery, Moran Sylvania, 29 Sylvania Road, Sylvania, New South Wales. Entry is free. For more information, visit www.morangroup.com.au.
THE PIONEERS LODGE:
BUILDING A SENSE OF HOME AND BELONGING FOR RESIDENTS Body corporate model gives people a say in decisions that impact on their living environment.
hen it comes to creating a home environment for their residents, the Pioneers Lodge in the regional town of Griffith, New South Wales finds the simple things go a long way. What particularly resonated with Moran’s team was the sharing of stories and memories as a way of getting to know someone. The team discussed how an easily accessible medium, such as photography, could generate conversations and recollections with residents, their families and staff. Once the Moran team members started brainstorming and saw how keen residents were to participate in the project, they knew they had started something very special. “A gentle touch, addressing a person by their name, respecting each other, comforting when sick, supporting when grieving
Jane Bonny and Olive Botcher at the Pioneers Lodge, Griffith, NSW.
or just a simple smile makes all the difference,” Jane Bonny, manager of the Pioneers Lodge, explained. The Pioneers Lodge has a long association with Griffith and its surrounding towns. It was rebuilt 10 years ago to take advantage of its natural environment and extensive gardens. The 75-bed facility was expanded further in 2017. Today, 95 residents live across the facility’s four units where monthly meetings are held so residents and their families can give feedback, raise concerns and suggest improvements. “In many ways it’s similar to the way a body corporate operates for an apartment building,” Jane said. “Issues are often small, but important to the residents and mostly easy and quick to fix.
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Having a say has been important, this is their home and we all want to be involved in decisions about our homes.”
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That sense of belonging extends to how residents use the space around them. “Each unit has a large courtyard area for residents and families to enjoy, and it isn’t unusual for a family to use the space over the weekend for a family get together,” Jane said. “It means checking with other residents so no one minds it being occupied by one family group, but rather than anyone objecting they’re often invited to be part of the celebration.”
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Other on-site facilities anticipate all residents’ needs, including a hairdressing salon, foot-spa room, exercise room with gym equipment and a chapel. Regular activities are also part of well-being and each unit has a dedicated lifestyle coordinator. Each week, residents take part in a sing-a-along and outings around the town. A strong network of volunteers is also part of the centre’s community. “Many of our volunteers have had family members here and it becomes such a large part of their own lives that they continue their relationship with us even after their loved one has passed away,” Jane explained. “All staff and volunteers are proud to wear their names badges, we believe that it is important that residents know the names of everyone they have contact with. “It is all about culture, respect and the feeling that someone will take the time to ask you ‘how are you?’ and ‘are you okay?’. “We are blessed at the Pioneers Lodge to have incredible staff and a board of directors who believe the simple things add up to the larger picture, creating a residential aged care facility that is truly a home.” ■ For more information, visit www.pioneerslodge.com.au or call (02) 6960 2500.
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WITH OLDER AUSTRALIANS Identifying underlying causes and finding practical solutions can help this sensitive conversation.
ncontinence rates are high, and rising, in residential aged care, but it is not an inevitable part of ageing. Australians don’t like to talk about incontinence and it is often dealt with quietly, using pads without seeking medical advice as to the cause of the issue. Incontinence can sometimes be challenging to discuss with a resident, however it can lead to improved control and quality of life for those experiencing it. It is crucial that we educate residents, aged care staff and the wider population that incontinence is often a medical condition requiring assessment and treatment from a trained health professional. A pelvic floor physiotherapist can help with this sensitive issue. Pelvic floor physiotherapists are trained to give appropriate assessment and treatment to increase bladder and/or bowel control. A pelvic floor assessment is an important part in managing and treating incontinence for residents. Physiotherapists work in a multidisciplinary team to identify the underlying cause of a resident’s incontinence and decrease symptoms. There are a number of factors that may be contributing to an individual’s incontinence, including:
• neurological conditions
• gastrointestinal conditions
• cognitive decline
• physical decline
• pelvic organ prolapse
• lower back pain.
• prostate conditions Pelvic floor physiotherapists can also determine whether a resident’s incontinence is associated with urge or stress incontinence. If the resident urinates frequently and with short notice before they are wet, then it may be attributed to urge incontinence. A physiotherapist may ask for investigation into their fluid intake and output. This may also involve looking at their intake of coffee, tea, and fizzy drinks as we know that these can often irritate the bladder and bowel, causing urgency. Through altering fluid, diet or
behaviour, changes can be made to reduce the resident’s symptoms. If the resident tends to leak with a cough, sneeze, laugh or positional change then this is likely to be stress urinary incontinence. A physiotherapist can give exercises to strengthen the pelvic floor and reduce leakage. There are practical approaches to improving continence. Encourage residents to void only when they have a full feeling in the bladder. Don’t tell residents to go to the toilet when they don’t need to, for example if they are going out. Give residents time to go to the toilet. Hurrying can encourage people to push down on the pelvic floor muscles, increasing risk of damage. Encourage residents to use a foot stool when they open their bowels. This puts the rectum in a better position, helps with constipation and is beneficial to the pelvic floor. This is particularly important for residents on toilet raisers. Keeping patients mobile is a key component to residents’ continence. This will not only keep the pelvic floor muscles toned to be continent but also allow them to make the toilet in a timely manner. Encouraging greater movement should be a key goal of all physiotherapists, as we know keeping mobile and active will improve older Australians’ health outcomes overall. ■ For more information, go to www.continence.org.au. Elaine Warnecke is a physiotherapist with Portland District Health.
IN AN AGED CARE SETTING Building a respectful, supportive, safe and private environment can help older people fulfil their emotional needs.
he human need for intimacy is present in people throughout their lives, regardless of their age, mobility or living situation. Knowing this, Uniting AgeWell supports its clients so their needs are met in a safe and respectful way. Intimacy comes in many forms, including emotional, physical, experiential, intellectual and spiritual. Aged care providers need to consider them all. Uniting AgeWell General Manager Victoria, Victoria Jacques said clients should be supported to make their own decisions about their intimate, romantic or sexual expression. “We need to build trust with residents and their families during the admissions process and start conversations about intimacy, sexuality and what is important for the client,” she said. “Some couples may be too nervous or embarrassed to bring it up or they may not think intimacy is permitted. “We need to know what each person or couple’s intimacy needs are and how we can support them to meaningfully fulfil their needs. This needs to be respectful and offer a safe, private environment.” Uniting AgeWell works with clients and their families to allow them to fulfil their intimacy needs, whether they are a single person, or someone in an existing, new or samesex relationship.
Uniting AgeWell Kingsville Community residents Russel, 92, and Nancy Treble, 88, have been married for 67 years. Image courtesy of Uniting Agewell.
At some Uniting AgeWell residences, the wives of clients sleep over on weekends on fold-out sofas or additional beds in their partners’ rooms. Uniting AgeWell Residential Services Manager East Amanda Wallace said supporting intimacy in all residents, including those with dementia or complicated health conditions, was important. “We had a resident with advanced dementia who was nonverbal and largely confined to a princess chair,” she said. “Her husband of more than 60 years visited every day. He would spend all day with her, sitting watching television, attending activities, having lunch and always holding her hand. “Having smaller lounges and sitting rooms allowed the couple to replicate what they would have done in their own home. They appeared happy and content, so we believed we fulfilled their emotional needs.” When two residents meet and develop an intimate relationship while living in residential aged care, Amanda
said it was important for staff to initiate conversations about how they can support the relationship. This may include offering a shared room, private space, or private time when they are visiting each other’s room. “It’s really important that staff have a mature and respectful attitude towards the new relationship,” she said. “We also need to be responsive to the emotional needs of the family if the relationship is causing them distress or anxiety. It can be quite a difficult situation to navigate if the family is not supportive.” When adopting person-centred care models, aged care providers need to consider the environment. Some residences are without small lounges or private areas for couples to sit together and hold hands or spend intimate time together. In client rooms, the beds are mostly single and the doors are generally without locks. It means clients and couples are unable to have time together in private. Amanda said providers could support couples by creating private, romantic getaway rooms for a resident and their partner to reserve and use.
Victoria Jacques said Uniting AgeWell’s efforts to support clients’ intimacy needs was written into the organisation’s core values. It is committed to honouring the whole person—body, mind and spirit—values every client’s social and cultural differences and is committed to building strong relationships. “At Uniting AgeWell, we consider how we can support all types of relationships in our residences and provide direction to staff around this area,” Victoria said. “Consideration is given to new relationships that develop between two co-residents, including when the spouse of one or both of the residents is still alive but not in care. “We also consider residents with dementia, taking into account the ethical and legal expectation of consent, family opinion and their role in approval and consent.” Supporting aged care residents to fulfil their basic human need for intimacy is a necessary but sometimes uncomfortable task. Staff education, and encouraging open discussions with residents, their partners and family members, will break down the discomfort associated with geriatric intimacy and help create a more supportive and free environment. ■ For more information, visit unitingagewell.org.
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OUT AND ABOUT
GREAT VIBE AT LASA’S NSW/ACT CONFERENCE
ith more than 350 delegates, 40 speakers, 30 educational sessions and 40 tradeshow exhibitors, spirits were high as the industry came together from 6–8 June 2018 for Leading Age Services Australia’s (LASA) New South Wales and the Australian Capital Territory state conference.
Lowes demonstrated their mobile pop-up shop. Image courtesy of Gerard Delaney.
Themed ‘Disrupt, Innovate and Thrive’, highlights included presentations by: David Martin from Hammond Care on listening and acting on the consumer’s voice through public online feedback; Fiona Kendall from the Village Scalbrini on putting lessons from dementia design into practice; and David Lo Russo from Marketability on regaining public trust and community faith in the aged care industry. Menswear specialist Lowes showed how they are embracing innovation with pop-up mobile stores that go direct to aged care residents, while Junko Takai, President of Hivix Co, travelled from Japan to showcase the company’s revolutionary air support, pressure-relieving mattress. During the evening the winners of the HESTA-sponsored NSW/ ACT LASA Excellence in Age Services Awards were announced from a strong field of 15 nominations. The winners were:
Organisation Award: The Whiddon Group Team Award: Goodwin Health and Wellness Centre Team Individual Award: Claire Abbott, Nurse Practitioner, Peninsula Villages Read more about the LASA award winners from each state and territory on page 84. Congratulations to Brendan Moore and LASA’s NSW team for their hard work. They certainly deserved the celebratory conga line at the conference dinner! ■ The team from Hivix Co attended the conference from Japan. Image courtesy of Gerard Delaney.
OUT AND ABOUT
‘STATE OF THE INDUSTRY’ BREAKFASTS ALLOW REFLECTION ON TRENDS AND ISSUES
eading Age Services (LASA) Chief Executive Officer (CEO) Sean Rooney took to the road in April, hosting breakfast sessions across the country for industry executives and board members to hear the latest from Canberra on the state of the age services industry. Discussions focused on the key trends, drivers and issues facing the industry, including: • the Productivity Commission’s estimate that the aged care workforce would need to grow by around 980,000 by 2050 • impacts of changing technology, innovation and new models of care
• workforce competition with the disability sector. Delivered in partnership with First State Super, the breakfasts were a chance to reflect that in a world where change happens so quickly, the biggest risk is standing still. ■
Goodwin Board Chair, Liesel Wett, and CEO, Sue Levy, with Sean Rooney at the Canberra event. Images courtesy of Gerard Delaney.
A video and presentation slides are available from www.youtube.com/watch?v=eMEkBW_PffQ.
LASA CEO, Sean Rooney, talks to Members and industry executives at the Canberra State of the Industry breakfast, 4 May. Image courtesy of Gerard Delaney.
OUT AND ABOUT
MANAGER OF THE YEAR 2018
he Retirement Village Manager of the Year award was presented at the National Integrated Seniors Housing conference dinner held on the Gold Coast on 14 June.
This award celebrates the passion and achievements of those individuals who continually maintain high standards in customer service, sales and marketing, complaints and dispute resolution and robust operational management processes across their retirement community. The award also highlights the important role that retirement communities play in providing affordable, age appropriate housing and vibrant social and community services for senior Australians. The judging panel confirmed three unique finalists, who were profiled on the night:
Retirement Village Manager of the Year winner Jessica Miles from Queensland’s Renaissance Retirement Living (middle), with Ben Deverson from Hynes Legal (left) and Paul Murphy from Leading Age Services Australia (right).
LASA Strategic Alliance Partner
Incontinence Products and Expert Advice
• Jessica Ann Madden, Manor Operations Manager at De Paul Manor Estate at Southport, Queensland • Genevieve Lee-Carroll, Village Coordinator at Leederville Gardens Estate, Leederville, Western Australia • Jessica Miles, Village Manager at Renaissance Retirement Living, Cleveland, Queensland. While the judging panel commended all applicants for their outstanding contribution to their village and community it was Jessica Miles, Village Manager at Renaissance Retirement Living, who was awarded the Retirement Village Manager of the Year 2018.
Night N Day Global specialises in the supply of leading disposable and reusable incontinence brands at the best prices; saving their Clients time and money. Manufacturing reusable continence products since 1989, Night N Day Global uses their extensive industry knowledge and expertise to offer a One-Stop Shop for quality incontinence products and consumables, as well as expert service, product support and experienced advice.
Contact Night N Day Global for a free quote or price comparison and save yourself time and money. www.nightndayglobal.com I email@example.com I +61 2 9531 2011
Jessica has been with Renaissance for over eight years, starting in administration and promoted to Village Manger in 2016. With a strong focus on resident satisfaction and a demonstrated affinity for the aged, Jessica has led and developed a thriving, harmonious community for senior Australians. Congratulations Jessica. ■
OUT AND ABOUT
LASA Training The LASA Aged Care Training Institute delivers a range of vocational qualifications and skill sets for the age services workforce. Courses are available year round for accredited training and professional development. More than 96 per cent of LASA students secured employment following their graduation, well above the national average of 78 per cent*, showing the LASA Aged Care Training Institute:
Reflects the needs of the aged-care sector
Is a trusted training supplier
Offers value for money
For more information go to lasa.asn.au/training *2017 Student Outcomes Survey from the National Centre for Vocational Education Research
OUT AND ABOUT
EXCELLENCE IN AGE SERVICES
CELEBRATED AROUND AUSTRALIA State and territory winners show their outstanding commitment to helping older Australians.
eading Age Services Australia (LASA) congratulates state and territory winners of the inaugural Excellence in Age Services Awards.
The awards, sponsored by HESTA nationally and in partnership with McCullough Robertson Lawyers in Queensland, showcase the significant contributions being made to improving the quality of life of older Australians. They also promote community involvement in age services.
This means that anyone wishing to seek information, whether for themselves or on behalf of a loved one, can contact the concierge directly to access whatever information they might require. Team Award—Healthy Connections Exercise Clinic, Burnie Brae
Winners from each state and territory are finalists for the national categories of organisation, team and individual awards. Winners of the Western Australian awards will be announced on 3 August. Judging for the national awards commences soon after, with the winners announced at the LASA National Congress, 28—30 October, 2018.
QUEENSLAND Organisation Award—Sundale Ltd Karen Steward Smith of Healthy Connections Exercise Clinic Burnie Brae.
The Healthy Connections exercise clinic team works in a unique setting, providing community access to specialised clinical exercise programs and health management services for older people. Team members work with clients to help them achieve their health, activity and fitness goals. Each individual receives a specialised exercise prescription to be completed in a supportive group setting. Client outcomes and testimonials highlight the strong, positive effect that team members have on the health and wellbeing of clients.
Katie Brown of Sundale Ltd.
Individual Award—Nicole Devlin, Chief Customer Officer, BallyCara
Sundale operates over a wide geographic area, from Cannon Hill in Brisbane through to Boyne Island and west to Kilcoy, and the Sunshine Coast. More than 500 team members are assisted by 300 volunteers, helping more than 2,200 customers.
Realising the opportunity to reframe care and service provision for older Australians, Nicole led the formation and embedding of Sona—a philosophical framework that BallyCara has successfully applied across all areas of service provision. Sona consists of:
In July 2016 Sundale created a Sundale Concierge service in direct response to the implementation of My Aged Care and the changing requirements associated with aged care reform.
• e mbracing each person to genuinely understand their background, skills and passions
OUT AND ABOUT
The rural Victorian town of Benalla has less than 10,000 people but also has a higher-than-average ageing population. There is a strong demand for high care and dementia aged care services in the community. Cooinda has 67 on-site independent living units; 82 beds for high care and dementia care; and employs 115 people from the local area. Cooinda staff are encouraged to participate in mindful leadership, with an emphasis on self-awareness, authenticity, productivity and compassion in all interactions. This has resulted in high satisfaction results from residents and their families, staff, volunteers and partner organisations.
Nicole Devlin of BallyCara.
• e nhancing a person’s independence, wellness and engagement in practical and motivating ways • i nspiring each person to maintain control of their life, discover new opportunities and prosper with real happiness. Through Nicole’s leadership and innovation, BallyCara is now working with other organisations in the age services sector and more broadly in the application of a Sona operational management and workforce development methodology.
Nagambie Healthcare (NHC) is an integrated rural health service with responsibility for delivering services across the spectrum of acute care, sub acute care, aged care and community services. NHC undertook an extensive review of its services, working with community, staff and allied health providers to improve health outcomes for its community. This resulted in new initiatives, including: a social inclusion activities group attended by over 30 members of the community twice a week; community luncheon once a month; day respite opportunities for members of our community with dementia; creation of a community engagement officer position to help navigate the My Aged Care and other health system pathways. Team Award—Carer Health and Wellbeing Coaching Team, Carer Links North, Merri Health
VICTORIA AND TASMANIA Organisation Award—Nagambie HealthCare and Cooinda Aged Care Services (joint winners)
Joint winners Bronwyn Beadle of Nagambie HealthCare and Margaret Aidous of Cooinda.
Christine Ferlazzo and Collette Arnheim of Merri Health. Continued on page 86
OUT AND ABOUT Continued from page 85
As part of the Carer Health and Wellbeing program, Merri Health runs a coaching program for carers of older people. Initially established to run as a one-to-one coaching framework, the program developed a regular ‘walk and talk’ session and goal setting workshop to meet a diverse range of learning styles and accommodate time constraints. Participants keep a health journal that helps them implement and track health goals, creating lasting habits. Individual Award—Kyle Miller, Moments That Matter Coordinator, Australian Unity Rathdowne Place
The Ridleyton Greek Home for the Aged (RGHA) developed a partnership with the Barkuma Disability Service Provider and the EQUALS Registered Training Organisation to support a group of motivated and caring individuals undertake a Certificate III in Individual Support. The program was customised to meet the needs of students living with a disability and provided opportunities to participate in a work-based program. Students were able to undertake a variety of training, both on the job and off, and were supported by staff committed to ongoing support, advocacy and sustainable employment pathways for the students. The program celebrates inclusiveness and equality in the Australian community. Team Award—Reynella Lodge Team, Life Care
Kyle Miller of Rathdowne Place.
Kyle has played a vital role in the success of the Moments That Matter (MTM) program. Overseeing the daily running of the MTM clinic, Kyle has weekly one-to-one checks with residents to assess their required support levels. Where referrals to the Wellbeing Clinic were once generated from a reactive review of progress notes and identifying any resident behavior changes. Kyle has worked to build a strong rapport with staff and family members, encouraging them to share regular updates on residents to enable proactive assistance and interventions.
SOUTH AUSTRALIA AND NORTHERN TERRITORY Organisation Award—Ridleyton Greek Home for the Aged
Staff and residents at Reynella Lodge.
Life Care believes that ageing is a natural part of life that should be respected and celebrated and which provides opportunities for residential customers to embrace and ‘Live Every Day’. Life Care focuses on the individual customer, their lifestyle and normal rhythm of life. As part of adopting the Live Every Day (LED) model, Life Care’s Reynella team managed changes to the site’s physical environment and staff culture and working practices, while ensuring resident and family quality of life was not compromised. Home-like environments were created by dividing the facility into four communities/houses and building kitchenettes, dining and lounge areas within each house. Changing staff culture meant shifting from a clinical focus to working with residents and creating individual ‘Live Every Day’ experiences to improve their quality of life. Individual Award—Simon Chappel, Ubercare Services Simon is the founder of Ubercare, a platform built around a GPSsystem that sends requests to the nearest online care workers. The app sends a user’s request for support to a specific location and allows them to receive offers of care from nearby care workers within minutes. They have a choice
Wendy McCabe and Amanda Birkin of Ridleyton Greek Home for the Aged.
Simon Chappel of Ubercare.
OUT AND ABOUT
of care workers and can review their profile pictures, star-rating and expected time of arrival before accepting them for a job.
NEW SOUTH WALES AND THE AUSTRALIAN CAPITAL TERRITORY Organisation Award—The Whiddon Group
The team at Goodwin Health and Wellness Centre, incorporating Goodwin Health Club, provide seniors with access to a hub of specialists in one location. This ensures that clients’ various health services support each other in the context of the person’s lifestyle, mental and physical health, and care plans. The Health and Wellness Centre promotes active aging with a holistic health focus, including reactive and proactive services. It promotes quality of life for their clients which is consistent with Goodwin’s vision and mission. The age services experience therefore becomes focused on the positives of empowerment, personal gains and goals. The club runs 18 classes each week across three Goodwin villages around Canberra. Individual Award—Claire Abbott, Nurse Practitioner, Peninsula Villages
Josh Keech of the Whiddon Group.
In 2015, Whiddon launched MyLife, a new, wellbeing-focused, model of care. Prior to launch, a review of care planning practices identified a gap around consistent evaluation, goal setting and structures in the wellbeing area. The 15-month trial took place across 2016–17 in partnership with the Adult Social Care Outcomes Toolkit (ASCOT) founders, University of Kent. The main goals were to test the value of using ASCOT to care planning, and the sustainability/ effectiveness of the methodology.
Claire Abbott of Peninsular Village.
The integration of ASCOT in care planning, and the ‘circle of care’ interview methodology that allowed people with dementia to participate, represented an innovative practice in care planning. Registered nurses led conversations with residents, engaged family members and the dedicated MyLife carer.
Claire’s role as nurse practitioner is integral to Peninsula Village as it assists its residents who require ongoing or one-off care, giving them peace of mind that they are receiving high quality care.
Team Award—Goodwin Health and Wellness Centre Team
Claire’s innovative and forward-thinking contributions as Peninsula Village’s nurse practitioner have greatly improved the lives and health of older Australians in their care. Claire’s role supports local general practitioners (GPs) through both formal and informal collaborative agreements with five-out-of-six visiting GPs. As Peninsula Village’s nurse practitioner, Claire reviews around 50 residents per week for chronic, palliative care and gerontological assessment. This has resulted in a 42 per cent reduction in Peninsula Village transfers to hospital over the last three years of her tenure. ■
Kate Fogarty of Goodwin Health.
Meeting. Studying. Sharing.
2019 PROGRAMS NOW OPEN! 5 innovative study tours to learn from the global aged care community
Seniors Living in Canada and US - 2 Programs on offer Timed to align with optional attendance at Global Ageing Network conference 1 - Boston and Toronto 2 - Montreal
England’s Care and Retirement sector – Solutions for 21st Century Get an overview of the English Seniors Living and Care system. London and Bath June 2019
University-Based Retirement Community (UBRC), an innovative model
On the cutting edge of technology: Japan’s approach to Robotics usage in Seniors Living and Care.
Learn more about UBRCs and seniors who choose to head back to school!
Discover first hand new technologies at work.
Register online www.sagetours.com.au Contact Judy Martin for more information or to organise your own bespoke tour firstname.lastname@example.org
Dementia Support Australia Offering nationwide support 24/7 Understanding and addressing the causes of behaviour
Nationally, DSA provides the: • Dementia Behaviour Management Advisory Service • Severe Behaviour Response Teams
Contact us today
Phone 1800 699 799 Refer online www.dementia.com.au
Dementia Support Australia is supported by funding from the Australian Government under the Dementia and Aged Care Services Fund.
OUT AND ABOUT
SIXTH ASIA–PACIFIC ELDERCARE
eading Age Services Australia (LASA) Chief Executive Officer (CEO) Sean Rooney was a member of a prestigious panel of industry experts in health and elderly care from Australia, Hong Kong special administrative region, Japan, New Zealand, Singapore and the United Kingdom (UK), who judged the Sixth Asia—Pacific Eldercare Innovation Awards in Singapore in April. The awards recognised 68 organisations from 12 countries for their innovative approaches in shaping the future of the ageing landscape in the region. South Australian LASA Members, Life Care shone brightly at the awards, winning Best Silver Architecture In-Construction for their new residential living home, Gaynes Park Manor, in Joslin, South Australia. The award celebrates new homes that enable ‘social, health and wellness engagement spaces’, which Gaynes Park Manor achieved through an international collaboration with the Dementia Services Development Centre, part of Stirling University in the UK and architects Marchese Partners from Sydney. Life Care CEO, Allen Candy, who attended the awards, said, “The challenge with Gaynes Park Manor was to create an environment that anyone would enjoy living in and where people could feel engaged and live a meaningful life. To pursue this goal, we initiated a worldwide search for not only the best aged care environments, but also the best model of care and technology to support residents.”
LASA Member, Life Care, won the Best Silver Architecture In-Construction award. Image courtesy of Life Care.
A total of 20 awards, including five major awards: Innovation of the Year—Product Implementation; Innovation of the Year— Service Implementation; Facility of the Year—Ageing-In-Place; Facility of the Year—Independent Seniors Living’ and Facility of the Year—Residential Aged Care, were announced at the event. LASA Members were winners in other award categories, including integratedliving for Best Home Care Operator and Bolton Clarke for Innovation of the Year, Food. Other LASA Members were finalists for many of the categories, including: Seasons Aged Care; Salvation Army Aged Care Plus; Care Connect; Emmy Monash; Scalabrini Village; and Paynter Dixon. Congratulations to all LASA Members for their outstanding work. ■
Winners of the Sixth Asia—Pacific Eldercare Innovation Awards. Image courtesy of Ageing Asia Alliance.
WHAT’S NEW Centred on Wellness Specialised health services provider, integratedliving Australia has developed innovative programs and facilities that focus on wellness to help people throughout rural, regional and remote Australia live, feel and be well. integratedliving’s range of clinically-based Wellness For Independence® programs complement nursing and allied health services to enable early identification and management of chronic illness symptoms. They also provide earlier referral paths and enhanced options for self-management of health conditions in the home without the cost and time burden of having to unnecessarily travel to access services. As part of their focus on wellness, integratedliving have recently opened
100% Australian owned, 100% natural. Supercol is a 100% natural food and liquid thickener that is both gluten free and high in dietary fibre. The Australian owned company has been meeting the needs of aged care and hospitals with their economical thickening product since 1992. In fact, 250mL of liquid can be thickened for under 4cents.
Wellness Centres which feature new Wellness Gyms and a host of wellbeing programs such as chair yoga, remedial massage, restorative art therapy and walking groups. Gym customers use state-of-the art, specialised HUR fitness equipment designed to allow for minimal weight increments which makes it perfect for seniors looking to improve their fitness or who require exercise as part of rehabilitation. Australian Institute of Health and Welfare statistics show three in four older people living in regional areas don’t exercise enough and that the benefits of exercise extend to physical and mental wellbeing. With this in mind, integratedliving chose HUR equipment for the Wellness Gyms on the premise of the positive effects of
With a 5 star health rating and made from 100% guar gum, Supercol contains no preservatives or additives and is both neutral in taste and smell. Recommended by clinicians Australia wide, the powder forms a thick gel when combined with liquid and is suitable for mixing with hot or cold fluids and foods. Supercol is available in 4 convenient sizes 325g, 900g jars, 4.5kg bags and 10kg pails, making it easy for caterers to use in small or commercial kitchens. Supercol works in
Introducing Dermalux Cleansing Wipes Whiteley Corporation have increased their skincare range with the introduction of new Dermalux Cleansing Wipes. Dermalux Cleansing Wipes are a single use wipe designed for everyday use. They are suitable for use in Aged Care, In-home Care, Hospitals and Palliative Care Facilities. Dermalux Cleansing Wipes are gentle on skin, and contain natural emollients leaving skin feeling fresh and invigorated.
strength based resistance training on cognitive performance, maintaining flexibility and balance, prevention or control of chronic conditions. Already many gym customers have seen exceptional results in improving their balance, strength and flexibility with some now having the confidence to walk unaided.
partnership with ISO and HACCP accredited suppliers, to ensure that only the finest quality guar gum is sourced. Ideal to use for people with Dysphagia, Supercol has high viscosity so only a small amount is required to be used. High viscosity combined with affordable cost, you will find Supercol is up to 6 times more economical than solution or gel thickeners.
For more information visit www.supercol.com.au
One wipe should be used for each patient area i.e. face, hands, back and perineal area. A key point of difference is the fact that they are made from sustainable bamboo and are 100% biodegradable.
For more information on Whiteley Corporation’s Dermalux Cleansing Wipes, contact the Product Support Hotline on 1800 833 566 or go to www.whiteley.com.au
South Pacific Laundry specialises in the provision of quality linen and supplies for the aged care industry.
Armidale Coffs Harbour
South Pacific Laundry (SPL) has been a provider of commercial laundry and linen services to the hospitality industry in Melbourne for the last 20 years. Currently, the South Pacific Group is establishing a strong network of modern laundries across Victoria, New South Wales, Queensland, Western Australia and South Australia with plans for several more facilities up the East Coast of Australia. The relocation of our Sydney operations to a new larger facility in Bankstown together with the relocation of our Brunswick plant to Broadmeadows will establish South Pacific Laundry as the single largest privately owned laundry in Australia and in the Southern Hemisphere.
Contact Robert Teoh National PR & Marketing P: (03) 9388 5300 M: 0421 716 888 Coverage Australia wide
Pricing Information Contact supplier direct Delivery Free daily delivery within 25km city metropolitan areas Minimum Order Contact supplier direct
• A 365 day service to all its clientele with a 24 hour turnaround (depending on location). • A leading edge technology in RFID to assist housekeeping and managerial staff in time reduction and efficiency. • Dedicated account managers and experienced support staff who are available 7 days a week. • A dedicated software design package and centralised billing system enables seamless transactions, paperless and customised reports. • Delivery rationalisation systems, providing and streamlining efficient delivery routes which will reduce the company’s carbon footprint. • Building of partnerships and sharing benefits with the customers from savings made through its constant laundry process innovations and group purchasing power of linen products. • Dry cleaning and uniform cleaning services. • Provision and supplying of corporate uniforms/work wears and customised hotel room amenities.
Full Contact Information South Pacific Laundry 9-23 King William St Broadmeadows VIC 3047 P: (03) 9388 5300 F: (03) 9387 2399
*Melbourne, Albury only
E: email@example.com firstname.lastname@example.org