The voice of aged care Winter 2016 | www.lasa.asn.au
UNITED WE STAND Special reports on ACFI, industry reforms and the Federal Election
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CONTENTS The voice of aged care
5 NATIONAL CEO UPDATE
Winter 2016 | www.lasa.asn.au
7 CHAIR UPDATE
FEATURES 10 Where will the Roadmap
Katie McKeown E: firstname.lastname@example.org
15 Dementia in retirement villages
Sean Rooney CEO PO Box 4774, Kingston ACT 2604 E: email@example.com
17 National guidelines for spiritual care
21 Translating wellness into
Loula Koutrodimos Acting CEO PO Box 7, Strawberry Hills NSW 2012 E: Loula.Koutrodimos@nswact.lasa.asn.au
24 Embracing reforms for
27 What ACFI changes mean
quality of life success in the country for you
Barry Ashcroft CEO PO Box 995, Indooroopilly QLD 4068 E: firstname.lastname@example.org
8: Federal election special
Paul Carberry CEO Unit 5, 259 Glen Osmond Road Frewville SA 5063
32 Addressing aggressive behaviour towards staff
36 The balance of supply and demand
39 A strategic approach to
41 Re-writing residents’
Trevor Carr CEO Level 11 600 St Kilda Rd, Melbourne VIC 3004 E: email@example.com
44 Clients’ perspective on quality
48 Differences between med charts and GP records
Beth Cameron CEO Suite 6/11 Richardson Street, South Perth WA 6151 E: firstname.lastname@example.org
ADBOURNE PUBLISHING PO Box 735, Belgrave, VIC 3160
TECHNOLOGY & INNOVATION 51 Virtual reality shaping lifestyle
Melbourne: Neil Muir (03) 9758 1433
Adelaide: Robert Spowart 0488 390 039
Emily Wallis (03) 9758 1436
DESIGN 55 : Dementia care branching out
BUSINESS MANAGEMENT 63 Media skills in the digital age 66 Transforming aged care through consortias
68 How leading wisely impacts
Administration Tarnia Hiosan (03) 9758 1431
71 Putting leadership frameworks into practice
DISCLAIMER Fusion is the regular publication of Leading Age
HEALTH & WELLNESS 75 Native wild foods
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
EVENTS 79 Asia Pacific Eldercare
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.
BUSINESS MANAGEMENT 57: 10 viability checks for home care providers
85 WHAT’S NEW
NATIONAL UPDATE I
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| NATIONAL UPDATE
A TURNING POINT
FOR AGED CARE As the inaugural CEO of LASA as a unified, national organisation, I am acutely aware of the hard work that lies ahead.
ommencing in an executive role, it is always the case that there are hurdles to overcome and a great many opportunities that are clearly visible through fresh eyes.
Sean Rooney Chief Executive Officer Leading Age Services Australia
The task of prioritising LASA’s focus has been made easier by the absolute urgency of overturning the funding cuts announced in the federal Budget. This is the immediate focus of the LASA Board and staff. As caretaker CEO over the last six weeks, Beth Cameron from LASA WA has done an outstanding job coordinating the remaining elements of LASA’s transition to unification, while launching the election campaign and Budget response. Beth has been aptly supported by staff in each LASA office, who have been working tirelessly on behalf of our members and on improving the standing of aged care. Behind the scenes LASA has been letting politicians know they have a fight on their hands through numerous briefings to MPs, Senators and hopeful candidates. These briefings continue to focus on the impact of further funding cuts on providers, consumers, the broader community and local health services. The inevitable outcome of increased pressure on local health services if aged care providers are unable to continue delivering vital services in the community through home care and residential aged care has been conveniently ignored by the Federal Government. Of course, with the bulk of public health funding managed at state level it is not of consequence to the federal health budget but this very real possibility should have every state and local government lining up to support age service providers in their community. Having served as CEO of the Medicare Local Alliance I am very conscious of the linkages between aged care and health, and the impact at a local level of policy changes from people sitting in offices in Canberra, far removed from the coalface. LASA is calling for funding and policy stability in our election campaign, and this is precisely what is needed. Rash policy decisions and debilitating funding cuts with little to no warning or consultation must end now.
I urge each of you to help contribute to the current momentum … No political party can ignore outrage from this number of voters or tax payers. I have noted in recent weeks an increase in media coverage about aged care, with a distinct change in tone from negative sentiment towards service providers to support for those helping Australia’s most elderly. The power of the media in influencing public policy is undeniable and I urge each of you to help contribute to the current momentum in our favour by engaging, sharing and actively participating in the public discussion. Resources have been made available to members in every state and I strongly encourage you to utilise them. The power of persistently writing letters, sharing content on social media, gaining the interest and following of media has led to a number of significant policy decisions being overturned. I am thinking specifically about the mining tax and the current campaign by Australia’s dairy famers that within weeks has impacted consumer behaviour. The number of people touched by aged care as providers, staff, client family members and friends reaches into the millions. No political party can ignore outrage from this number of voters or tax payers. I am extremely proud to have been selected to take on the responsibility of leading LASA at such a pivotal time for our industry, and I look forward to meeting you all at LASA’s National Congress on the Gold Coast in October – if not sooner. ■
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| NATIONAL UPDATE
ONE VOICE FOR ALL
AGE SERVICE PROVIDERS The appointment last month of LASA’s inaugural national Board was a key milestone that nears the completion of our significant and critical journey to unification. The appointments were made under the provisions of LASA’s newly approved Constitution.
Dr Graeme Blackman OAM Chair I LASA
he new Board comprises four state-based directors representing each state that voted to join LASA as a single national organisation, and I have been re-confirmed as the independent Chairman. Three additional skills-based directors will be appointed by the Board later this year, the process for which is now underway with clear parameters for each vacant position.
In addition to committing to overturn the funding cuts, the Board has already passed a motion that allows existing members of each LASA state office that voted to join our unified organisation to automatically become members of the national LASA. This is the most efficient and transparent way in which to transfer members and ensure immediate benefits of the unification.
Robert Orie, CEO of the Sir Moses Montefiore Home, is the Director representing NSW/ACT and has been appointed Deputy Chairman.
I am currently writing to each existing LASA member inviting you to advise us of your individual representative and to confirm your application and acceptance as a Member of LASA as required under the Corporations Act and our Constitution.
Ingrid Williams, Managing Director/CEO of Elm Aged Living and President of LASA Victoria/Tasmania, brings a strong leadership background and longstanding experience with LASA to our Board. Michelle De Ronchi from Western Australia is currently Chief Operating Officer, Care of the St Ives Group, Vice President of LASA WA and a Director on the former LASA Federal Board.
At present our colleagues in South Australia have not committed to joining our unified organisation, though existing LASA members there will have the opportunity to apply for membership from 1 July if they wish to do so. Organisations from any state that are not currently LASA members will also have the opportunity to apply to join our new organisation from this time.
We also welcome Kim Teudt to the Board as the representative for Queensland. Kim is currently General Manager, Acquisitions & Business Growth with Churches of Christ, Queensland and brings a wealth of knowledge and experience in retirement living. She has been a Director of LASA Queensland since 2011.
I have every confidence that LASA, led by the inaugural Board and CEO, Sean Rooney, will successfully serve the interests of our members and advance the standing of aged care in the current political environment.
As an immediate priority the Board is seeking a commitment from all political parties contesting the 2016 Federal Election to reverse funding cuts announced in the recent Budget including the extreme and unnecessary changes to ACFI. It is critical for the future of our country’s age services industry that the next Government prioritises a stable funding and policy environment for the ultimate benefit of consumers.
I would like to take this opportunity to record our thanks for the invaluable contributions and dedication of the outgoing Board Directors who handed over the reins last month. The former Directors Marcus Riley, Glenn Bunney, Felix Pintado, Cynthia Payne, Chris Howe, Robert Dempsey, Neil Pahuja and Tony Smith have represented the interests of their state Boards and members admirably and collectively they have driven LASA to its unification, which has been no small feat.
This message is core to LASA’s election campaign, which is well and truly underway with resources developed for members to actively lobby candidates in their local electorates and a strong public relations campaign that has so far resulted in coverage in Australian’s leading newspapers, television and radio news programs.
We look forward to welcoming you as inaugural members of LASA, as the unified national peak body for all age service providers, from 1 July. ■
LASA DEMANDS: STOP AGED CARE CUTS LASA has called for all parties contesting the upcoming federal election to commit to funding and policy stability in launching its election campaign.
umulative federal policy and funding decisions since 2014-15 have stripped $3.1 billion from Australia’s aged care system. In the past 6 months alone, $1.7 billion has been unnecessarily cut from complex care management and services that enhance people’s wellbeing and quality of life including palliative care. In a manifesto LASA has developed for political candidates that outlines the key issues facing the aged care industry, it calls for commitment to four key areas from the incoming Government: 1. Commit to funding stability and a forecasted funding growth rate based on evidence to ensure ongoing viability and capability to meet demand
2. Accelerated red tape reduction and simplified systems for providers and consumers 3. Co-design policies with industry that support competition, driving innovation and investment 4. Enable industry to remove existing constraints to support a robust, flexible and suitably qualified workforce “While aged care costs have tripled, and continue to grow at a faster rate than indexation, there is an ongoing failure by Government to properly plan for, and fund aged care services to meet the care needs of our seniors,” LASA spokesperson, Beth Cameron said. Labor has shared its plans for aged care if it wins the election, which focus on creating an ‘age friend’ nation by harnessing the economic and social potential of older Australians and addressing current workforce issues. In announcing its aged care promises at the National Aged Care Alliance (NACA) meeting on 26 May, Shadow Minister for Ageing, Shayne Neumann said Labor’s aged care strategy will be developed with in put from all levels of government from local councils to state governments, consumers and providers. It has committed to appointing a Minister for Ageing and developing a National Strategy for an Ageing Australia following an independent review of the Living Longer, Living Better reforms package it launched in 2012 under the Gillard Government. This would include focus on ACFI and with a view to moving to greater flexibility, choice and consumer control by 1 July 2017. There has been bi-partisan support for the 10year Living Longer, Living Better reforms, but Labor says a proper legislative review of the reforms at the half way mark is needed.
Image courtesy of twitter.com & ymgerman/Shutterstock.com
Mr Neumann has committed to addressing ongoing problems with the My Aged Care gateway in the first 100 days of Government,
in consultation with the aged care sector, consumers and medical and allied health providers.
“However, a review will not lessen the blow from $1.7 billion of funding cuts to direct aged care services over the forward estimates.”
He told the meeting an Active Ageing Fund would be developed to support programs to reduce the risk of dementia, LASA is pushing hard for all political parties contesting the prevent falls, improve physical activities and healthy lifestyles 2016 Federal Election commit to reverse funding cuts to – enabling older Australians aged care of $3.1 billion. to age well in their own “We call on Labor to communities, at home and reconsider reversing the cuts There is an ongoing failure by Government to at work. imposed by the Coalition properly plan for, and fund aged care services to Labor would also work Government so that our meet the care needs of our seniors with the aged care sector seniors receive the care and unions to ensure the they need and deserve,” challenges of the increasing Ms Cameron said. need for aged care workers, as well as career progression “The Turnbull Government has already demonstrated that it is and conditions for this low paid and predominantly female clearly out of touch with Australia’s seniors and is shying away workforce, are addressed. from its responsibility to provide the aged care they deserve. However, Mr Neumann said Labor is not in a position “The Prime Minister needs to listen to mounting concerns from to overturn the funding cuts announced by the Turnbull the aged care sector and Australia’s seniors by pledging a Government in the 2016 Federal Budget. reversal of his Government’s budget cuts,” Ms Cameron said. “The ACFI review announced by Mr Neumann is an LASA will continue important first step to fight these in finding a solution funding cuts on for the funding your behalf and shortfalls between support your own Government efforts to fight modelling, and for what is right the true cost of for the aged care providing complex industry, your care services our community and seniors need and your clients. ■ deserve,” Ms Cameron said.
Shayne Neumann, Shadow Minister for Ageing
Join LASA’s campaign Now is the time for age service providers to show political candidates that constant policy change and funding cuts directly impact your ability to provide care to our most elderly and vulnerable. LASA needs your help in getting this message out through letters, meetings and inviting politicians to tour your facility.
Sussan Ley, Minister for Aged Care
• an election manifesto, which outlines the four key areas of concern that we demand the next Government addresses • a template letter to send your local candidates in all political parties • a basic campaign image to use on your website, social media and other communication channels
Make politicians earn your vote! Download the resources from your state LASA website or A range of resources have been developed to support
contact your member services team for more information.
members in actively lobbying in the community, including:
WHERE WILL THE
AGED CARE ROADMAP
Twelve months after the Australian Government tasked the Aged Care Sector Committee to develop a roadmap to set out future Kay Richards National Policy Manager I LASA reform directions for aged care, we have seen the release of a consolidated document designed to lead the industry to a sustainable, consumer-driven and market based system.
he funding cuts announced in the recent federal Budget place in question the current Government’s commitment to the Roadmap actually being achieved. While some contend funding cuts are intended to force market consolidation to occur faster than ‘natural’ progression, ongoing funding and policy instability will not benefit anyone – particularly consumers. The expectation by Government that consumers who can afford to pay for their aged care and services will do so, which is largely supported by the industry, including LASA, thus gives consumers every right to expect – even demand – the services they are paying for are of the highest quality. Therefore, the relevance of the Roadmap should not be understated when reviewing your strategic direction and operational goals for the next one year, three years, five years. The nine domains the Roadmap outlines offer broad goals to strive for but there is a vast amount of work to be done by providers, by the Department, and by Government before we reach the final destination that is a sustainable, consumerdriven and market based system. 1. Consumers, their families and careers are proactive in preparing for their future care needs and are empowered to do so To achieve this, a paradigm shift is needed. Improved communication on the benefits of talking about and planning for aged care is required by everyone – from providers to the peaks, the Department, Government and media – to adjust the negative attitudes in the community about what aged care is and how it is delivered. The Roadmap recognises the need to expand My Aged Care to become a core component of a virtual aged care market. What does that mean for providers? What additional information will be required, and how will that information be displayed?
My Aged Care was initially built to provide information to those seeking advice about aged care and services. Accommodation prices and service information is already published, along with data submitted under the National Quality Indicator Programme. And it is providers who have to explain My Aged Care to consumers. Government needs to dedicate significant attention to how it promotes My Aged Care so consumers know how the system works, how they enter it and what their journey might look like. 2. A single government operated assessment process that is independent and free, and includes assessment of eligibility, care needs and maximum funding level The rollout of a national screening and assessment framework and the implementation of a single assessment process for eligibility, care needs and funding levels for home care remains an unfulfilled short term goal of the Roadmap. The National Screening and Assessment Form (NSAF) has been relatively well designed, however, it is only as useful as the information it holds. More work is required to ensure it is fully utilised and functional to support the assessment process and resulting care and services. This includes a prompt to discuss advance care planning. A well-trained and skilled workforce will be vital to the successful and consistent execution of a national assessment framework through to completing assessments, and will become even more important when the Commonwealth Home Support Programme and Home Care Programmes are integrated in July 2018. 3. Regardless of cultural or linguistic background, sexuality, life circumstance or location, consumers can access the care and support that they need Linked closely to the assessment process, people should be able to access services that suit their individual needs. People
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operating landscape and likely result in market consolidation that could, by default, favour those with existing economies of scale. The removal of allocated home care places could reduce certainty of service volume and income stream, consequently impacting financial sustainability and future workforce requirements. 6. A single provider registration scheme that recognises organisations registered or accredited in similar systems, and that has a staged approach to registration depending on the scope of practice of the providers Approved provider status is and should be difficult to obtain, given the responsibility the provider has to those receiving care and services. However, the proposed change to registered provider has been in part prompted by the need for My Aged Care to list all providers for consumers to have more choice.
have a right to know they can access care and services without compromising their individuality. Consumer directed care (CDC), aims to give people and their carers more power over the design and delivery of their age services. In theory it should especially benefit and empower people with different needs. Will the same approach to CDC be applied across the system, including residential services? Has it already begun? To remain competitive in the marketplace, providers will need to communicate how they meet the different needs of consumers, though investing more in marketing will not suffice long term if your claims do not meet your clients’ experience. 4. The community is dementia aware and dementia care is integrated as core business throughout the aged care system Dementia care and services are core business for age service providers, but community attitudes and fears impact how people consider their future needs. To achieve this long-term goal the industry must work together to ensure care and service delivery is evidence based and that programmes not only provide for the person who has dementia, but also for the family and carers. People will only be able to stay in their homes if the family and carers are supported with integrated services. Providers must be able to link into community support services that are co-ordinated and are manned by a suitably skilled workforce. 5. A single aged care and support system that is market based and consumer driven, with access based on assessed need It is expected that over the next five to seven years we will see seamless movement between home based and residential care with true consumer choice of care and provider. This has commenced with the end of ACAR for home care providers and subsidies be paid to consumers rather than providers from February 2017. Provider feedback to the Increasing Choice in Home Care – Stage 1: Discussion Paper makes it clear the transition to a more competitive environment will change the
Accompanying approved provider status is recognition that the provider meets stringent responsibilities and, in time, will be recognised as a registered provider. The distinction between a registered and private provider must be clear to ensure the consumer can make an informed choice. 7. Sustainable aged care sector financing arrangements where the market determines price, those that can contribute to their care do, and Government acts as the ‘safety net’ and contributes when there is insufficient market response While it is expected that consumers increasingly contribute financially to their aged care cost, this goal fails to acknowledge the importance of continued funding stability. It does provide opportunities for affordable home equity release and other financial products to be developed, however, it also implies that where applicable, providers will be required to set and publish their prices for care and support, accommodation and everyday living costs. For residential providers, there will be implications on the Bond Guarantee Scheme. This – and much else of what is outlined in the Roadmap – will be impacted by the 2016/17 Legislated Review, which at the time of writing had not been announced. It is incumbent on providers to actively participate in the review to ensure their views and concerns are heard. 8. A well-led, well-trained workforce that is adept at adjusting care to meet the needs of older Australians Almost 60% of the current age services workforce will reach retirement age in the next 15 years, and a tripling of the workforce is required over the next decade. The current reliance on the informal workforce may not be available in years to come. The Roadmap states Government will focus on major policy levers, e.g. education, employment, and immigration to address this. However, a whole-of-system approach is required if the pressures are to be relieved on the workforce. This means a review of current constraints to better utilise skill mix, enhance career advancement and enable greater flexibility for
employers and staff. Providers again need funding stability for training and development, while an industrial relations review must consider the changing care needs of consumers and fundamental shifts seen in other industries to services dictated entirely by consumer demand. 9. Greater consumer choice drives quality and innovation, responsive providers and increased competition, supported by an agile and proportionate regulatory framework Work is currently underway to co-design a single set of core aged care standards. This includes how a range of organisations may provide accreditation services and how data may be displayed on My Aged Care relating to quality indicators, measures of consumer experience and quality of life, and accreditation performance. To be useful to consumers, any data presented must be correct, be reliably analysed and be able to demonstrate performance differentiation only where statistically relevant. Specifically, for the three indicators currently collected in residential care, there are concerns that no data cleaning is undertaken on the national dataset. The reporting capability is limited with analysis only on raw data which compares to a mean or average. In the absence of any confidence intervals being displayed, very little can be interpreted from the data set, either at the individual service level or from a national
perspective. For quality improvement to flourish there needs to be confidence that data analysis will enable sound decisions. This is not currently the case. LASAâ€™s response to the Increasing Choices in Home Care Discussion Paper written in October 2015 made it clear that Government and Departmental systems need to be ready for any changes the new legislation would impact. Many providers may find themselves in breach of proposed legislative changes because the Department of Human Services does not have an operational system that ensure accurate payments are made, especially when means testing letters remain consistently inaccurate. How can the Roadmap be achieved if the systems in place to support the industry consistently fail? There is no doubt that to meet increasing costs associated with delivering care and facilitate the changes required to achieve the goals of the Aged Care Roadmap, providers need a stable funding and policy environment. While the Roadmap has been developed in consultation with and by the industry at large, its success will require Government support. It is obvious that there is significant transformation to occur before the industry can say it has arrived at its destination. â–
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CANNOT BE IGNORED Brendan Moore Policy, Research and Information I Alzheimer’s Australia NSW
ementia is an issue that is going to become more prevalent generally, in our communities, and in retirement villages as well. There is currently an estimated 353,800 Australians living with dementia. That number is expected to increase to 400,000 in less than five years1. In addition to this increase, a number of other factors will see operators having to develop organisational responses to residents with dementia in their village portfolio. These include: 1. T he number of Australians living in retirement villages expected to more than double in the next decade. 2. T he average age of retirement village residents is steadily increasing and is now 812
3. The average age on entry to a village is also steadily increasing and is now 743 4. The single biggest risk factor for dementia is age with people aged 80-84 having a 1-in-8 likelihood of having dementia, 1-in-5 for 85-89 and 1-in-3 for 90 and over4. Outside of these dementia and retirement village changes are demographic and policy changes that are seeing: • An increase in the number of single person households, therefore people without co-resident carers • Government support for expanded provision of in-home care and support to delay progression to higher levels of care and accommodation • Changes to residential aged care bed classification, funding mix and resident contributions. An important point to make clear is that a diagnosis of dementia does not mean a person has to automatically live in residential care. You can live a long life with dementia before this is necessary and it is not inevitable for all people with dementia. Research conducted by Alzheimer’s Australia NSW on dementia in retirement villages found considerable variation in the design, management, operation and business models
of retirement villages, which means variation in the types of support and services offered. The research also found vastly mismatched expectations where family members think their loved one with dementia is receiving certain supports and care in the village when they are not. Some of that comes down to a misunderstanding of what a retirement village can and does offer compared with a residential aged care facility. Potential residents and their families need greater clarity around the difference between a retirement village and a residential aged care facility. The unique nature of retirement villages means that any changes need to be supported by the existing residents, with tremendous variability in cultures across the 2,200 villages in Australia. Retirement village operators will need to educate existing residents about dementia, consult with them, and move together on a journey towards becoming dementiafriendly. This includes breaking down the stigma, fear and misconceptions about dementia. Our research found that the village culture and attitudes of residents are critical to creating a dementia-friendly retirement village. There is an opportunity for retirement village operators to make villages ‘healthy ageing places’, which help reduce the incidence of dementia by promoting social interaction and healthy lifestyles, as well as sustaining the independence of residents. Dementia is the most feared health condition in people over the age of 505 and residents are likely to be receptive to messages about how they can reduce their risk. While conducting the research and many times since publication, we have been asked by operators why should they support residents with dementia. Alzheimer’s Australia NSW argues that there are two principle reasons: the human rights perspective – people have the right to choose where and how they live and remain living in their own home for as long as is possible; and the business perspective – there is a growing market for innovative operators to provide retirement village accommodation that is suitable for people with dementia (which will also benefit other residents).
With many operators already altering their business strategy and operating models to incorporate a service-integrated housing approach in response to customer desires for it be the ‘one last move’, the retirement village industry is shifting away from its history of being ‘independent’ living units. There is scope to go further and the market wants this, particularly in relation to people with dementia, as they are invariably ill-disposed to residential aged care. The provision of care and support in villages may include all or a combination of the following elements:
More on this topic will be covered in a digital poster at LASA National Congress 2016.
References 1. Alzheimer’s Australia (2016) Key Facts and Statistics 2016, https://fightdementia.org.au/about-dementia/statistics
• Health and wellbeing staff • In-house home care or relationship with community aged care service providers
2. P WC/Property Council (2015) Retirement Village Census, http://www. retirementliving.org.au/wp-content/uploads/2015/08/127030261_RetirementCensus-Infograph_v7.pdf
• Carer support and respite • Technology for monitoring and community connection
3. P WC/Property Council (2015) Retirement Village Census, http://www. retirementliving.org.au/wp-content/uploads/2015/08/127030261_Retirement-
• Assisted living/serviced apartments As the number of people living with dementia increases, it is essential that retirement villages are equipped to respond to the needs of residents with dementia.
Census-Infograph_v7.pdf 4. A IHW (2012) Dementia in Australia, http://www.aihw.gov.au/WorkArea/ DownloadAsset.aspx?id=10737422943 5. T he Telegraph (2014) ‘Older people are more scared of dementia than cancer,
To view resources developed by Alzheimer’s Australia NSW go to nsw.fightdementia.org.au ■
poll finds’, 4 August, http://www.telegraph.co.uk/news/health/elder/11008905/ Older-people-are-more-scared-of-dementia-than-cancer-poll-finds.html
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A CHANGE FULL OF MEANING
FOR OLDER AUSTRALIANS I started as CEO of PASCOP, now Meaningful Ageing Australia, in March this year. Prior to commencing in my new role, the PASCOP board had already decided that the time was right to implement a name change. This became one of my first tasks, along with listening to the needs of our current members, and preparing the strategic plan for the 2016/17 year. The name change was agreed upon because ‘PASCOP’ did not conjure up the true intent of the organisation.
orking in the area of ‘spirituality’ is typically fraught because for most people in our communities and organisations it is an intensely personal topic. As many people have moved away from traditional religious expressions of spirituality, they have also tended to throw spirituality out with the proverbial religion bathwater. The view we take at Meaningful Ageing Australia, in keeping with current research and practice, is that a person’s spirituality is embedded in webs of relationships. Relationships with self, with others, with nature, with creativity and something beyond ourselves. For some people that is called ‘God’. It is about sources of meaning, hope and purpose – all of which becomes even more important as part of the ageing journey. So changing our name to Meaningful Ageing Australia became a logical step for us. It is part of our agenda to improve understanding of spirituality and spiritual care. Our focus at Meaningful Ageing Australia is to equip providers of services to older people to include some space for spirituality and spiritual expression in their care. By implementing spiritual care across the board, it means a more engaged workforce who understand and connect with the people they are supporting, much more than in the taskfocused approach that has overtaken many places and the disengagement that results. By creating the conditions for attached professionalism, leading organisations re-connect with the fundamentals of the business they are in – not accommodation, cleaning or hotel services, but human care. The outcome of this human care is becoming increasingly important as consumers will look for organisations that spend dollars where they get the greatest effect. Over time, we will be looking at how our tools support results with outcome measures such as the work that is occurring in the SA Innovation Hub where they are using a Personal Wellbeing Index that includes a domain for spirituality, the Australian Community Care Outcomes Measure, and Health Department’s voluntary quality indicators.
Ilsa Hampton CEO I Meaningful Ageing Australia
A key pillar of our strategic plan is the creation of accessible, easy-to-use resources for staff working in a wide range of roles in member organisations. Creating simplicity out of complexity requires a great deal of skill and wisdom – as well as having a talented team, we work from collaborative models that include opportunities for our members to engage in both concept development and real world testing of all our products and services.
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One of our current series that is in development are tools to assist Meaningful Ageing Australia members implement the federally funded National Guidelines for Spiritual Care in Aged Care. Once implemented, the Guidelines will assist organisations in really listening to what their care recipients and future customers actually want and need – which of course is vital for truly consumer directed care. We are creating a suite of resources that fit with all the outcomes expected in the Guidelines as well as offering a consultancy to members. The Guidelines will be completed by the end of June, which sees the end of the federal funding. I am presenting on the National Guidelines at the LASA National Congress this year, along with Cynthia Payne, CEO of Summit Care, who was involved in the pilot.
Membership of Meaningful Ageing Australia is open to all organisations and groups who provide care and support to older people. Members have access to a range of high quality tools and activities developed in collaboration with leading international and Australian experts. We are constantly developing new resources to support high quality pastoral and spiritual care in organisations. One of our most popular resources is an orientation program for staff in any role in aged care, which comes in a pack with a facilitator guide, DVD and access to participant notes, poster to reinforce key messages and staff handover points. A trial using the poster with one of our members showed a huge positive uplift amongst staff as they realised the significance of their daily interactions with residents. ■ For more information visit www.meaningfulageing.org.au
National guidelines for spiritual care in aged care New guidelines for spiritual care in aged care have been developed as part of a project between Meaningful Ageing Australia, Spiritual Health
The project reinforced that view that
offer spiritual care. They focus on
our spiritual dimension is intrinsic to
practical ways that spiritual care can
our humanity. There is evidence that
be incorporated into the care model
unmet spiritual needs may manifest
to complement the organisation’s
in other ways such as increased
philosophy of care.
agitation, depression and complaints.
The guidelines will be available in July
Victoria, the National Ageing Research
Informed by a literature review and
2016 and free workshops will be held
Institute with funding from the federal
extensive consultation process, the
in every capital city throughout June.
Department of Health.
guidelines are designed to provide
Places are limited and registration is
guidance to organisations regarding
essential. For more information go to
how all staff can more effectively
Spiritual care is often aligned with pastoral care and considered by some to be linked with religion.
Monday 20 June 2016
Tuesday 21 June 2016
Wednesday 22 June 2016
All workshops commence at 10am and will end at 12pm
Thursday 23 June 2016
connectedness, so it has relevance
Friday 24 June 2016
for all providers (residential and
Monday 27 June 2016
Tuesday 28 June 2016
Wednesday 29 June 2016
Therefore, traditionally it is associated with the faith-based aged care providers. However, spirituality is more broadly defined to include that which gives meaning, purpose and
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TRANSLATING WELLNESS INTO QUALITY OF LIFE FOR THE ITALIAN COMMUNITY
The Society of Saint Hilarion was founded in 1955 and its origins are owed to the passion of a group of migrants who settled in South Australia after migrating from the town of Caulonia in southern Italy, either side of World War 2. The Society has grown to become a leading multicultural aged care service provider in Adelaide, South Australia. As a not-for-profit organisation, it emphasises family and community values, underpinned by ensuring residents enjoy quality, compassionate support in a loving and caring environment.
aint Hilarion offers its clients a continuum of aged care services, comprising of community and home care, respite services, and residential low and high care services. Its focus extends to the total well-being of residents, incorporating their physical, mental, social and spiritual needs. Concerned that the understanding of wellness within the local Italian and general community and stigma towards mental health issues needed to be clarified and updated, the organisation applied to participate in CommunityWest’s Step Forward – Together program. Education, awareness and resources for the Italian community around all aspects of wellness, particularly mental and emotional health were the highest priority according to Frank Naso, Director of Health, Wellness and Reablement. “We identified many clients were seeking support and solutions to this ever growing issue, therefore we were determined to create a resource which addressed it,” he said. Saint Hilarion is one of 10 pilot projects in the CommunityWest Step Forward –Together initiative that have been trialling co-production with a wellness and enablement focus since October 2015. The Wellness Philosophy is an approach to service delivery promoting social and community connections, independence, autonomy, retaining and regaining skills, and is a way of ‘doing with’, not ‘doing for’. Saint Hilarion saw the Step Forward – Together project as an opportunity to develop a quality of life measuring tool, translated into Italian, which would fit the cultural context of their community. Its aim was to provide a clear understanding and empower people to make positive decisions about their own well-being, break the stigma associated with mental health
Left – Right: Glynn Davies, Lubomira Brown, Amy Curtis, Erin Cusack, Camila Marcon, Sally Kingdon Barbosa, (concealed late Ian Williams) and Kelly Gray.
in the Italian community, provide culturally appropriate wellbeing tools, and support the community to implement the philosophy of ‘Live Happy, Live Longer’. Over eight months the organisation trialled a quality of life framework with the community which resulted in three tools being translated into Italian. “Going through this process of co-production means it’s a more equitable process, and consumers feel involved in decisions being made,” Mr Naso said. “What we’ve also found using this tool is individual needs are being highlighted and addressed and staff have improved their emotional intelligence in relation to consumer needs. By trialling and using these quality of life tools, staff and consumers have gained a better understanding of people’s needs.”
Implementing co-production at Saint Hilarion has led to changes in processes, in particular highlighting the extent to which the current care planning is based on a medical deficit model. “This process has helped us to see the whole person, including their aspirations, and staff and consumers feel more connected as a result. This project has had a profound effect on our organisation in that we are looking at people as if they’re a member of our family now. Their needs are important and we want to know how we can best support that individual,” Mr Naso said. He has also noted changes in the attitudes of people involved in the working group over the last eight months. “Our clients feel now they have a voice to express their opinions. We’ve moved on from a culture of ‘this is how it is’, and I feel we’re operating in a more consumer-centric environment where their needs are being considered and met.”
There have also been benefits to the organisation’s sustainability with new innovative ideas offering potential business growth and a new competitive edge. Saint Hilarion intends to continue the momentum and enthusiasm this project has generated by maintaining its Wellness Together Consumer Advisory Group formed for the project. Their next goal is to look at a future service delivery model, both for community and residential care and how nursing support can be delivered in the home instead of people going into residential facilities. Mr Naso is also advocating for the concept of co-production and the quality of life standards as the new framework for accreditation for service providers, or at the very least, incorporated into the process. ■ For more information contact Kelly Gray, CommunityWest on 08 9309 8135.
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WORKING TOGETHER TO IMPROVE AGED CARE FOR SOCIETY’S MOST VULNERABLE St Bartholomew’s House was established in 1963, its name derived from the St Bartholomew’s Hospital in London which was originally established to care for the needy and homeless. Since then St Bart’s has moved away from being a shelter for men in need to having a more holistic and personalised approach to each resident. They now offer a range of supported and independent living options for people who have experienced homelessness in Western Australia. This includes aged care services, which provide specialised support for vulnerable older people in the community.
t Bart’s applied to be a pilot site as part of CommunityWest’s Step Forward – Together project to develop an outcome statement for their home care service to provide insight and feedback on the service and set the vision for the new era of consumer directed care. Staff worked with their aged care services clients to find out what the organisation represented for them. Manager of St Bart’s Aged Care Services, Sally Kingdon-Barbosa says the project findings have indicated what people really value is independence, friendship, essential support, human contact, security, respect, sense of community and quality of life. “Some of the responses were just so heart-warming. People commented we’re a ‘life saver’ and a ‘lighthouse’ to light the way for people. Another resident told us for him St Bart’s gives hope and love. This has been invaluable in shaping how St Bart’s will provide services in the future,” she said. St Bart’s has seen changes in the staff and residents involved in the project over the last eight months. Residents have become advocates for other residents, and there is a real sense of genuine listening and people feeling like they’re making valuable contributions.
“One of our residents feels he is being genuinely heard and acknowledged now. He was used to being seen by society as an ‘old fuddy duddy’ and being ‘just missed’ because you’re old. A lot of our clients have experienced ageism as well as the stigma which comes with homelessness and mental health issues,” Ms Kingdon-Barbosa said. St Bart’s has committed to providing detailed feedback to those who participated in the project, of which 94 per cent wanted to know the outcome, and will continue to run regular focus groups for residents to be involved in the design and planning of its services. “This demonstrates how involved and invested people feel in the process of co-production,” Ms Kingdon-Barbosa said. “We wish we had more time and the skill development to take it further, but we’ve had a taster and we will continue. Our culture is changing as a result of being involved in this project and implementing co-production.” ■
St Barts’ Steering Group.
EMBRACING THE OPPORTUNITIES
How a regional home care provider grew four-fold in two years The story starts, as so many do, with a move to a new world. In 2008, tired of Sydney, and corporate life, my partner and I “tree-changed”, and moved to live full-time on our cattle property near Armidale, in the New England region of NSW.
had spent the previous decade as an investment banker at Macquarie and Babcock & Brown and in general aged care management at Moran Health Care Group. In between deals, I had become convinced that home care was going to be the most important part of the future aged care landscape. Having worked with Doug Moran and his family from 2003 to 2006, I will never forget his oft-repeated saying: “Don’t predict the future, make it happen”. Taking those words to heart, I put my money where my mouth was, and bought Home Nursing Group in May 2010. It was a small business with one tiny office, about 20 employees and antiquated business systems. One third of revenue was from the DVA (community nursing and home care); one-third came from a local council, for whom we provided the labour force for their community care service; and one-third from a single, very well-funded, disability client receiving 24/7 care. At that time, then Aged Care Minister, Mark Butler, was engaged in his listening tour around the country, and I attended his session in Tamworth in late 2010. Even then, well before the Productivity Report was issued or Living Longer, Living Better released, it was apparent that the future Australian aged care system was to be simpler, fairer, higher-quality, more transparent, consumer-directed and have a more skilled workforce. I knew Home Nursing Group was not even remotely ready to grow and win in Butler’s new world. We needed both more and better-quality revenue, systems to deliver customer service and quality care. We needed to know and demonstrate our
Gorm Kirsch Proprietor and Managing Director Home Nursing Group
value proposition and we needed people up for the thrill of being innovative and competitive. I also knew my investment in the business would be worthless if we didn’t get ready quickly. As Jack Welch, the famous American business leader, once said: “Change before you have to”. One advantage of a small team is you can get everyone in a room and take action. Following several hours of intense discussion with both managers and field staff, we all made a conscious decision to be ambitious, innovative and dynamic. We decided Home Nursing Group would proactively and positively respond to the opportunities of consumer direction and aged care reform. We welcomed the contestability of a competitive market, and launched our transformational journey ramped up in 2012, when we successfully applied for packages in the CDC Pilot. As these were our first directly-held packages; it meant that HNG has never had to transition from the “old way” of packages: all ours have always been delivered on a CDC basis from the beginning and our systems and processes support that. In subsequent ACARs, we have since been allocated a total of 62 HCPs at all four levels, providing us with the skills and experience to compete in the post-February 2017 world. The next key milestone was our success in the 2014 CHSP growth round, when we were allocated over 60,000 hours of CHSP services in both New England and the Mid North Coast. In rolling out these new services; we decided to put the consumer at the heart of everything we did: we conducted extensive research, asked older people (including those not yet receiving services) what they wanted for the future; and consistently oriented ourselves towards finding solutions, not
problems. By embracing change, and the risk of the unknown, we were able to manage the inevitable disruption within the business and across the sector. By committing ourselves to people and culture excellence, we have created more than 150 new jobs and a diverse, skilled workforce providing quality care, great customer service and value for money every time for every customer. We have developed a proprietary customer service training for all staff, implemented innovative recruitment and retention programmes (including bonus payments) and created a staff-centric management model. This is both the sustainable economic moat to grow and defend market share and the foundation for even more expansion after February 2017. Today, the business is turning over four times what it did six years ago. Most of that growth has come in the past two years! We now have four offices in the key population centres of our regions Armidale, Coffs Harbour, Tamworth and Port Macquarie – and we believe that a local, physical presence is a key differentiator for our business and highly valued by both customers and workers. Of our revenue, 80% comes from CHSP and Home Care Packages, with DVA funding now contributing less than 10% of income. As a fully-fledged home care provider, we’re on track to deliver more 100,000 hours of service this year, and will support over 2,000 older people across the New England and Mid North Coast regions to
remain safe and independent in their own homes, surrounded by cherished possessions and memories. Of course, revenue and service hours are interesting, but what really matters for us at Home Nursing Group is whether we are improving the lives of our customers: is their day better because of us? HNG is participating in the KPMG Australian aged care quality indicators pilot project. The results so far show that 71.5% of our customers rate their quality of life as “good” or “very good”, compared with the industry average of 57.4% (see below). We take great pride in these results, because they demonstrate that investing in the right people; listening to your customers and staff; buying the best systems you can afford; and setting ambitious targets pays off – not just in growth, but in quality and service. The past six years have been incredibly exciting for me and for the business. We’ve both been on transformational journeys to new worlds. With the opportunities coming our way from HCP portability after February next year and the integration of CHSP and HCP into one seamless programme, the future promises to be even more exciting. HNG will continue to “make the future happen”, to offer more choice and better service for customers and more opportunities for our workers and their communities. ■
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BUDGET IMPACT ON RESIDENTIAL CARE The aged care sector was landed a blow in the Federal Budget in the beginning of May.
reasurer Scott Morrison’s 2016-17 budget focuses on long term growth, taxation reform and “cutting unnecessary waste” that “keeps us on a sustainable path to bring the budget back into balance”. It appears that aged care is the focus of “unnecessary waste” with Morrison stating that the government is refining aged care funding to address unsustainable spending. Health Minister Sussan Ley says the measures are part of the Government’s ongoing commitment to aged care reform. It’s about “putting consumers, not the aged care provider, in charge of their later years”, she said. There appears little, however, in the budget that will provide more funding or choice for consumers.
Cuts to ACFI The Government says expenditure on the Aged Care Funding Instrument (ACFI) would be expected to blow out by $3.8 billion over the next four years without action. The response is significant with amendments to “certain aspects” of the ACFI funding model aimed to “stabilise higher than expected growth”. The Government hopes that the cuts will bring the ACFI funding back into the budgeted growth trend so that “funding grows at a responsible and sustainable rate”. The budget claw back, announced in Budget 2016-17 of $1.1 billion, is exclusive of funding cuts announced in February 2016 through the MYEFO of $607 million, creating an aggregate reduction of $1.71 billion over the next four years.
David Cox Head of Operational Strategy and Partner I Ansell Strategic Following the Federal Budget, the Department of Health released details of the ACFI clawback. Changes focus on the Complex Health Care (CHC) domain. CHC includes medication assistance, pain treatments and other care interventions for the most frail and unwell residents living in residential care. The changes will be implemented in two stages over the coming six months. On July 1, 2016 changes to the scoring matrix will push a large number of new or reclassified residents who would have previously been classified as requiring high care into the medium care classification. The January 1, 2017 changes are more profound. Significant changes to the scoring of medication assistance will result in most new or reclassified residents moving from a high to a medium classification. Changes to the scoring and eligibility requirements for CHC treatments, including blood pressure measurements, complex pain treatments and the treatment of oedema, will also see large numbers of residents being classified lower than they would have been previously under the current funding arrangements. Based on the announced changes to the CHC Domain, Ansell Strategic estimate that the proposed changes to the ACFI Instrument will deliver funding cuts of almost $350 million more than projected by the Government. Our analysis indicates that funding claw backs to providers will be in excess of $2 billion over the next four years alone. As the proposed changes are permanent, there will be long term ramifications for the most vulnerable residents and the providers that care for them. Funding Cuts (Forward Estimations vs. Ansell Strategic Projections)
2016-17 ($m) 2017-18 ($m) 2018-19 ($m) 2019-20 ($m) Total ($m) MYEFO 2015-16 Funding Cuts (Forward Estimates)1 (92.3)
Budget 2016-17 Funding Cuts (Forward Estimates)2
Total Funding Cuts (Forward Estimates)
Funding Cuts (Ansell Strategic)3
1. Source: MYEFO 2015-16 Appendix A. 2. Source: Department of Health Budget Glance. 3. Source: Internal Modelling Based on Client Databases.
Within an ageing population, adjustments will be required over time to balance the obligation of funding from taxpayers to consumers. However, these changes are one sided and the impacts will be felt by the providers and the people they care for. An average 80-bed home will lose $439,000 in funding each year following the change.
Small additional funding allocations Morrison states that “savings arising from better targeting of the funding that aged care providers receive will provide the ability to introduce new aged care initiatives and help meet the continued growth in aged care funding overall.” The Government will provide $102 million over four years to target the aged care viability supplement more effectively to areas of greatest need by replacing the current outdated remoteness classification system with the more up to date Modified Monash Model. The model is currently used in other health environments and will bring the viability supplement assessment process into line with other health programs. The increases in rural and remote funding appears somewhat tokenistic given the scale of the cuts and the magnitude of the funding shortfall in regional and remote areas.
Impact on care and viability We believe that providers will be less able to address the symptoms of disease within their resident population following
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the funding cuts. The Aged Care Act precludes providers from charging residents for Specified Care and Services. Without appropriate compensation via the ACFI tool, providers will not be able to afford to deliver the same comprehensive complex care services. Providers are already saying that they will no longer be able to afford allied health led pain treatments and will increasingly rely on medications to assist with the treatment of chronic pain. By reducing funding for the care of complex residents with the most costly care needs, providers will be less inclined to admit those who are most in need of residential aged care services. Our experiences of international markets, including New Zealand, has demonstrated the marginalisation or exclusion of residents by providers who are not appropriately compensated for their care. This may result in the displacement of residents into acute care settings. Industry players are stating that the financial impact of the funding cuts on providers will undermine the viability of the sector. The providers who care for those with the most profound care needs will be affected more than those providers who elect to admit residents with lower complex care needs. The cuts come at a time when investment in aged care services is paramount to address the demands of a rapidly ageing population. It also comes at a time when the prevalence of disability amongst the elderly rises. Homes are increasingly caring for residents who have increased complex care needs relating to greater longevity and multiple comorbidities such as heart disease, diabetes, obesity, chronic pain and dementia. ■
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AGED CARE LEADERSHIP CAPABILITY FRAMEWORK INTO PRACTICE A balanced approach to leadership and implementing the Aged Care Leadership Capability Framework can play in driving positive change in your organisation.
People resist change.” This is a common refrain of senior leaders pressing to implement carefully developed strategic plans. One of my favourite Dilbert cartoons has an employee screaming “I chose death!” after the pointy-haired boss announces a new change program. But if people did instinctively oppose change we’d still be in small nomadic tribes roaming the plains rather than living in our technologically sophisticated homes and cities. A quick glance at our forms of transport, our ways of communicating, even the health care we offer to aged care clients, reveals how much we really do embrace change. People will, however, resist change they don’t understand or that’s seen as unfair. The political upheaval currently occurring around the globe is a prime example. Non-traditional candidates are being elected on all continents, supported by populations who see the entrenched ruling elites as outof-touch or self-serving. The consequence is that ideas from established political, academic and community leaders, regardless of their merit, aren’t getting the traction they once did. Senior leaders in our corporates experience a similar struggle, albeit on a smaller scale. Our organisations are not democracies, and employees choose to stay or leave, so the resistance and upheaval that corporate leaders face may be less intense. Nevertheless, the same processes are at play and change initiatives will falter if senior leaders fail to gain the support of their employees. Why does resistance occur? Consider the simplified model in Figure 1. Leaders have to work the gears in their organisations to drive performance. The default gear, over-relied upon by many leaders, is the design and implementation of strategy. Strategy is of course critical for effective leadership – without a carefully developed and implemented strategy, heavy amounts of time and resources can be wasted. But many leaders often forget they must also work the culture gear – they must nurture the values and people practices that support the strategy.
Dr Peter Langford Founder and Director I Voice Project
As a senior leader you can grind the strategy gear as hard as you like, but if your culture gear is sticking, or even pushing in the opposite direction, your performance will suffer. The final component of Figure 1 is the emotional atmosphere that exists in the organisation – the level of employee engagement. Engaged staff are like an oil that keeps the cogs sliding smoothly and eases the implementation of your change initiatives. Having disengaged staff is like pouring sand into the gears – the system is going to crunch and stutter its way to poor performance.
Figure 1. Leadership and performance require strategy AND culture.
So what is needed for effective leadership? Thankfully for leaders in age services, exceptional work has already been done to answer this question and support the development of high performing leaders. The Aged Care Leadership Capability Framework is shown in Figure 2. This framework was developed in partnership by LASA, ACSA and the Community Services and Health Industry Skills Council (CSHISC), with funding from the Department of Industry. An endorsed tool, the Aged Care Leadership Capability Survey, has also been
Figure 2. The Aged Care Leadership Capability Framework.
developed by Voice Project in partnership with LASA, ACSA and CSHISC, to help leaders assess their current performance against the framework and track improvements over time. The survey can be completed as a self-assessment or a 360-degree assessment by managers, peers and reports, and has different versions for executives, middle managers and frontline supervisors. A unique feature of the framework is its broad and balanced content. It describes leader behaviours that are necessary to drive both the strategy and culture gears in your organisation, and to build the employee engagement needed to keep those cogs humming along happily. The Business domain, and much of the Purpose and Change domains, push hardest on the Strategy gear, whereas the Self and Other domains push mostly on the Culture gear and spur employee engagement. The framework is grounded in sound science. Cameron Dougall, Dr Louise Parkes and I recently published an academic paper describing a study in which 193 leaders were rated by 1,186 managers, peers and reports using 360-degree leadership surveys. We also collected performance data about each leader’s team, including employee engagement, employee turnover, absenteeism, employee productivity, safety, customer satisfaction, the effectiveness of change programs, and assessments of overall team performance. We found that the 66 leader behaviours we studied grouped into five broad domains that mirror the framework in Figure 2. There were behaviours associated with creating and communicating the vision and values (equivalent to the Purpose domain). Other behaviours were mainly associated with project management and problem-solving (Business). The third set of behaviours
involved risk-taking and innovation (Change). Many of the behaviours assessed the extent to which leaders involved, recognised and supported other staff (Others). The fifth and final set of behaviours were directed at managing one’s own health and wellbeing (Self). We found that all of these five broad domains impacted team performance, although there were some subtle differences in the types of outcomes achieved. For example, employee turnover was most impacted by the behaviours associated with Purpose, safety outcomes were driven most by behaviours focused on Others, and unsurprisingly the Change behaviours had the biggest impact upon effectiveness of change programs. Employee engagement was slightly more strongly associated with Self and Change behaviours, although all five domains had significant impact. Perhaps the most surprising result was that Business behaviours had the lowest overall impact upon engagement and team performance – a result that highlights the risk of leaders over-relying on grinding the strategy gear. Extensive and high quality support materials are available to help your organisation implement the framework and survey. For a broad range of free support materials to help you use the framework for recruiting, developing and appraising your leaders, visit the Aged Care Leadership Development Centre at www.acldc.com For more information and sample reports for the leadership surveys visit www.voiceproject.com and search for “aged care”. ■ More on this topic will be covered in a digital poster at LASA National Congress 2016.
AGGRESSIVE BEHAVIOURS TOWARDS OUR STAFF: ARE WE DOING ENOUGH? There is a real and growing challenge faced by our staff when dealing with aggressive behaviours. Travis Holland Managing Director I Holland Thomas & Associates
n a recent survey of the aged care sector by the NSW Nurses and Midwives Association, 36 per cent of respondents reported being physically assaulted by a resident or family member in the past five shifts*. In our own survey of over 1000 carers across Australia^, respondents averaged 2.0 incidents of aggression and/or violence in the 30 days prior to completing the survey, yet 50% of those who experienced such incidents chose not to report them. This tells us that the size of the problem is bigger than we think if we use reporting as our benchmark. Carers also believe the problem is growing. In fact, 57 per cent of respondents believe they will face more of these incidents going forward.
Here are seven tips you can implement immediately to help you manage the impact of aggressive behaviours on your staff, the people they support, and your organisation: 1. Know your problem Understand the specific nature and impact of aggressive behaviours for your organisation. Ask staff the right questions and actively seek out the answers. Beware the assumptions we make when we do or do not have safety conversations. 2. Open door policy
Management, including senior management, should be Further to these insights, WorkSafe has sent out letters recently accessible and available to their staff in order to build a culture advising of workplace inspections throughout 2016 with a of open discussion, analysis and resolution of problems key focus on “occupational including the management violence”. The letter from of aggressive behaviours. WorkSafe gets straight to the point about work-related 50% of those who experienced [aggression and/ To paraphrase General Colin violence, stress, bullying and or violence] chose not to report them Powell, “The day staff** stop harassment: bringing you their problems “These are the kind of issues that, left unchecked, could cause serious injuries to your workers. We know the devastation that comes with workplace injuries – to the worker, their family, workmates and employer. And we know no employer wants to face a criminal conviction and significant fines if found guilty of breaching Occupational Health and Safety laws.
Are you prepared for a WorkSafe inspector to pop up at your workplace?” We know all carers will be faced with aggressive behaviours throughout their careers. Are we doing enough to prepare and protect them? Providing a culture that promotes continuous safety improvement and training your staff with the right tools is the most effective combination to managing aggressive behaviours.
is the day you have stopped leading them. They have either lost confidence that you can help them or concluded that you do not care. Either case is a failure of leadership.” 3. Meaningful culture of staff safety Foster a meaningful safety culture where staff safety and the wellbeing of the people you support takes precedence over daily to do lists. 4. Continuous hazard assessment Increase the awareness of your staff of the space they are working in and the ever changing nature of the people they are working with. The earlier identification of potential situations provides more options to achieve safer outcomes.
5. Empower your staff Your staff will be amongst the first responders for incidents involving aggressive behaviours. Empower your staff to make good decisions about their safety and the safety of those around them. Provide your staff with the right tools to manage aggressive behaviours. 6. 60 second incident report form The under reporting of incidents involving aggressive behaviours should not be underestimated. In the absence of reliable incident reporting, how do you know what your staff are enduring (in silence) prior to the submission of their workers compensation claim? Institute a 60 second Incident Report Form to capture the high frequency incidents that are currently not being reported. Routinely analyse the incident data to identify trends across staff and the people they support, then consider setting KPIs around incident reporting. 7. Employee Assistance Program Would you walk around on a broken leg for three months before going to the hospital? Many of us will not seek help
Image courtesy of Pop Paul-Catalin/Shutterstock.com
(or perhaps not know where to start) for a psychological injury. Encourage staff to actually use your Employee Assistance Program early. Getting help earlier will minimise the harm suffered as a result of the injury and start the healing sooner. â– For more information go to www.hollandthomas.com.au ^Home Care, Community Car & Outreach Staff Safety Survey: Understanding the Effect of Aggression & Violence, Holland Thomas.
THE DESIGNER Helen Kelleher graduated as an Occupational Therapist from Sydney in 1965. Her first appointment as an OT was at the Mount Wilga Commonwealth Rehabilitation Centre, Hornsby, in Sydney. Due to family commitments and living overseas, Helen’s career path was put on hold for several years. Upon returning to Canberra, after several years living overseas, Helen joined the Mobile Unit of The Rehabilitation Team at the Canberra Hospital in 1973. In the two years with the unit she made home assessments and arranged the supply of equipment for clients. This gave Helen a more thorough understanding the needs and difficulties faced by clients with the equipment that they had at this time. After eight years running a day care program for the aged and disabled, Helen moved back into the hospital environment working at Queanbeyan Hospital. Her duties included Home Modifications as well as working with patients on the wards and in the Day Care Centre.
THRONE ACCESSORIES It was while working in the Home Modification area that Helen identified a deficit in the design of some of the equipment. She saw that the safety aspects in accessing the toilet for many of her clients were not being adequately met by any of the equipment available. The most obvious challenge Helen identified was that other rails required patients to pull themselves up, a very difficult task for the frail, aged and those with back injuries. The Throne rails are positioned much closer to the body allowing patients to push up more like they do when sitting on a chair. Having exhausted enquiries in her search for suitable equipment, Helen set about developing her own ideas with safety and comfort high on the agenda. She was encouraged to learn that existing porcelain bowls had the strength to hold a rigid fixture that she knew was the answer for people with disabilities and physical restraints. Helen commenced designing a prototype Rail and continued to develop the Rails until the highest safety aspects were met as well as ease of transportation. The initial design was so well received that Helen set about refining the model to accommodate people with a full range of disabilities including sports injuries as well as rails and steps especially for children.
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DYING TO TALK ABOUT
PALLIATIVE CARE New research by Palliative Care Australia (PCA) reinforce the impact early discussions about end-of-life care can have on individuals and family members, particularly at stressful times when they are no longer able to make medical decisions for themselves.
eleased at the start of National Palliative Care Week (22-28 May), a survey conducted by PCA found only 51% of the general population are comfortable talking about death with anyone.
Despite 82% of Australians believing it is important to talk with their family about how they want to be cared for at the end of their life, only 28% have actually done so. One in five respondents had experienced the death of a family member in the past 12 months, and one third of these people had been required to influence or make health care decisions for this relative. Discussing what their family member wanted in terms of care directives helped 86% of them make decisions.
Labor has committed to $35 million towards new models of palliative care should it form Government in the next election. This would including funding for increased palliative care in the home delivered through the primary health networks, and will include training and support for carers; funding for a proactive palliative care model to improve palliative care delivery in residential aged care, following successful trials of this model at Claire Holland House, a hospice in the ACT; and working through the Council of Australian Governments (COAG) to nationalise advance care directives. ■ PCA had developed a Discussion Starter, which provides a step-by-step guide with activities to help people talk about their end-of-life care wishes with their loved ones
Only 51% of people are comfortable talking about death with anyone, yet 33% have had to influence or make [end-of-life] health care decisions for a relative
and health professionals. The Discussion Starter is available from www.dyingtotalk.org.au
PalliAGED nurse app A new app has been launched to help nurses provide
Of particulate note is that 70% of Australians would like to die at home, while the national average is currently around 14%.
high quality palliative care for older people in all care
“Ensuring the quality of life right to the end of life is important no matter what age you are,” PCA CEO, Liz Callaghan said.
The palliAGEDnurse app was developed by the Decision
In an election statement PCA has called for increased support for paediatric palliative care, recognising the burden associated with caring for a child with a life-shortening illness. It also calls for a study to better understand the quality of death in aged care services.
to support nurses with advanced care planning,
“You only die once and as a society we only have one chance to get that right,” Ms Callaghan said. Changes to the complex health domain of ACFI are likely to impact palliative care and PCA has reaffirmed its calls for quality of death audits. “Half of all people who die in Australia access an aged care service during the 12 months before they die. Monitoring quality of death in aged care would provide evidence to inform future funding and policy,” Ms Callaghan said.
Assist team at Flinders University, provides information palliative care cases conferences and terminal care planning. Its content is based on materials developed for the Decision Assist Aged Care Workshops and learning modules. The online-offline capacity means nurses can use the app anywhere in Australia and automatically updates as new evidence and resources are released. It is free to download and can be accessed through the Apple iTunes and Play online app stores. More information is available at www.decisionassist.org.au.
THE BALANCE BETWEEN SUPPLY AND DEMAND
FOR RESIDENTIAL PLACES Bruce Bailey
In last edition of Fusion we suggested that CDC in home care will result in the Government managing demand via prioritisation of eligible care recipients compared to the former practice of managing supply.
he release of the ACAR for 2015 and recent research undertaken by RSM for our Aged Care Sustainability Review 2016 provides an opportunity to consider how the supply management regime is working in residential aged care. The below table from the RSM Aged Care Sustainability Review shows the degree of interest in recent Aged Care Approval Rounds: 2009
ACAR places sought
Places sought relative to places offered
ACAR places offered/ allocated
is to cease the process of allocation of places. As it takes on average 4.2 years to bring places on board this begs the question of why is there such a large increase in winning places in the ACAR? Delving deeper into the data around places and investment in new building provides a clearer picture of what is happening to the stock of places. Table 2 shows the percentage of allocated places that are actually operational: 2011
Stocktake Operational places
Stocktake Allocated places
Table 2 – Stocktake of operational vs active places.
Table 1 – Aged Care Approvals Round results 2009-2015.
Notwithstanding an increasing appetite to win places in the ACAR, a relatively small number of these places (3,000 in 2015) are being brought on line. As of 2015 the percentage of on line places was at an historic low of 85%.
While it is arguable that the dip in interest in 2013 related to the uncertainty surrounding the reforms flowing from Living Longer, Living Better policy, 2015 clearly demonstrates provider support for the new accommodation charge regime and the increase in the accommodation supplement for supported residents. At this level the policy direction appears to have been a resounding success.
The current official forecast of the investment required to meet the demand for new places as shown in table 3 and the level of building activity in table 4. These tables suggest that in financial terms there is a significant lag in construction that has to be addressed if the required additional places are to be brought on line to meet forecast demand. Practically this will require an increase of 300% to 400% in historical level of activity.
At the time of writing the Aged Care Roadmap has been released and in the section “What care is available” the plan
The table at the top of the next page shows the recent new construction building activity:
Investment required (billion)
Table 3 – Investment required for new places 2015-2024.
2. There is a more limited scope for having extension approved. We see both of these as positive in terms of turning potential supply into active places.
New building work ($ million).
Considering the rate at which places are coming on line and the level of building activity it may not be inappropriate to suggest that the interest in ACAR is more about developing investment pipelines and taking out insurance against the time to bring facilities on line than reflecting a current intent to expand capacity. The Aged Care Amendment (Red Tape Reduction in Places Management) Act 2016 which came into force in February seeks to address the rate at which places are brought on line. There are two key measures: 1. T he initial approval has been increased from two to four years and
There is a significant lag in construction that has to be addressed if the required additional places are to be brought on line to meet forecast demand. Based on the above and other research undertaken by RSM we are firmly of the view that now is the right time to be actively expanding supply in appropriate regions. Those who act will either create first mover advantage in the event that supply is deregulated, even if deregulation of supply is delayed there is sufficient underlying demand to fill any expanded supply that can be created in the short term. ■ View our Aged Care Sustainability Review 2016 at www.rsm.global/australia/industry/aged-care
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palliAGEDnurse is a free smartphone app which provides current clinical advice to help nurses care for their older patients approaching the end of life. The app covers advance care planning, case conferencing, and terminal care management. Designed by Decision Assist, it even works when you are not online. To download this easy to use app go to Google Play or the App Store.
Are you caring for older people near the end of life? Do you need more clinical advice at your ďŹ ngertips?
To ďŹ nd out more visit decisionassist.org.au Decision Assist is funded by the Australian Government
A STRATEGIC VIEW
ON AGED CARE MEDICATION MANAGEMENT Medication management in residential aged care is rapidly changing and sometimes high risk. It requires robust clinical governance and an increasingly strategic collaborative approach in its delivery.
esidents are entering aged care much older and frailer, often with complex care needs and requiring multiple medications. With Government policies and best practice guidelines driving the change to consumerfocused care, it is essential that aged care staff are supported by safe, appropriate, effective and efficient medication management systems.
Changes and cutbacks to Commonwealth funding of residential aged care facilities (RACFs) in the recent Federal Budget, combined with the recent cutbacks to pharmacy funding for dispensing, sometimes referred to by economists as ‘clawbacks’, offer a useful reminder of the importance of adopting a strategic, end-to-end approach in medication management. In order to ensure the safest, most effective and efficient aged care environment there needs to be effective communication between the RACF staff, doctors and your pharmacist provider while adopting the most efficient systems available.
Consumer-directed care The paradigm shift to consumer-directed care in aged care makes the resident central to all activities and reinforces the value and the importance an effective, complete, and current medication profile. The medication profile is the key to ensuring there is no health and safety issues related to medication usage. Even though the medication profile has been fundamental to knowing what medication should be packed (e.g., into a Webster-pak), this will, over time, fundamentally change the way aged care is delivered in Australia as electronic signing systems rely on accurate and up-to-date medication profiles. Coupled with the National Medicines Policy and the National Quality Use of Medicines Initiative, the focus on consumerdirected care highlights the importance of an efficient endto-end medication supply, along with effective management of resident profiles, to bring together all the partners in the medication use pathway with common purpose.
Gerard Stevens Managing Director and founder I Webstercare
Consumer-directed care is a reality in the community care sector. The last two Australian Federal Governments foreshadowed its implementation throughout the residential aged care sector. Exactly how this might be realised, and its impact across the sector, is unknown. What is clear is that aged care policy has shifted significantly towards individuals having a greater say in their care and being financially responsible for it where they have the means, along with a safety net for those who do not. Where people individually pay for services, it is only logical that they will seek to exercise choice in accessing the service that best meets their needs. I believe the value of supporting the local pharmacy service provider is that the resident can maintain ties within their community while transitioning to residential aged care. Local pharmacies that retain some measure of control over service delivery, that have the right systems and processes to effectively manage resident medication profiles, and have the right ‘culture fit’ with the facility, make a good choice for ensuring your medication management services are fit for purpose in this increasingly complex and challenged sector. So when working with pharmacy service providers, I believe RACFs should consider developing a project strategy and implementation plan that takes into account the facility’s existing culture and what may need to change. In order for a pharmacy service provider to maintain a safe and effective system, timely and accurate information, including dose changes and new medication, must be communicated. Incomplete information increases the risk of misadventure. To this end we have identified that less than one-third of the pharmacist’s time is devoted to preparing the medication into, for example, the Webster-pak. More than half the time spent is in medication profile management.
This includes drug interaction checks. We have a policy of zero tolerance for error. If the communication and co-operation reflects the needs of the resident, this is achievable. Effective, efficient and resident-focused medication management requires a collaborative approach that includes all the partners in the process – local pharmacies, RACF staff and prescribers. The smart use of information technology such as the electronic version of the National Residential Medication Chart (ie. the RxMedChart), which is virtually eliminating prescription writing for doctors, helps in managing the resident medication profile and all the associated factors that are integral to safe and effective use of medications. Such a system is key to adapting and transitioning to the changed funding environment over the next four years.
Budget pressures The Mid Year Economic Forecast and Outlook, coupled with the 2016-2017 budget measures recently announced, provide context to the importance of strategically thinking about the entire process of delivering medications into the hands of consumers. Aged care medication management in particular is caught in the pincers of government cost-cutting measures, realigned budget allocations and ever-increasing public expectations. Some of this budget realignment is being allocated to increasing accountability measures that place even more pressure on residential aged care facilities. The Federal Budget changes to the classification of aged care residents with medication and complex health care needs have been highlighted by some analysts and point to increasing pressures on funding medication management needs. This, in return, will require closer co-operation to ensure standards remain high.
In this environment, RACFs will find it increasingly useful to develop a strategic partnership with their pharmacy service providers who adopt efficient safe systems. Cost in this environment is clearly an issue, but the focus should be on long-term cost-effectiveness, not just cost in isolation.
The medication profile is key In my experience, the cost of simply supplying medications is the less complicated component of the medication management equation. Far more complex is the effective ongoing management of the medication profile because it requires the right systems, processes and culture from not only the pharmacy provider, but also general practitioners and aged care staff all working in harmony. RACFs now rely more on the medication profile being electronically maintained than ever before. Poor management of the medication profile is where the big potential costs can accrue, such as the time spent in finding lost or missing prescriptions, incompatibilities or contraindications leading to adverse outcomes, accreditation failures and medication mishaps that can potentially lead to lawsuits. The complexity is increased when numerous variables, or ‘dependables’, come into play. This is usually a consequence of service agreements that don’t take into account the many variables that can unnecessarily and unexpectedly increase the time required to serve the medication management needs of RACFs and, therefore, the costs borne by the provider. In this environment RACFs will find it increasingly useful to develop a strategic partnership with their pharmacy service providers. ■
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THE NEW NORMAL: RE-WRITING YOUR
RESIDENTS’ EXPERIENCE Across multiple sectors, the service delivery model is being overtaken and replaced with experience delivery.
Colin King Global Head of Business Development I Sodexo Seniors
he resident experience is being transformed by many forces, including shifting demographics, increased diversity among residents, changes in resident preferences, and evolving stakeholder policies and positions. This will mean adjustments and new risks for providers in this market, and, for those industry leaders who can understand and get ahead of the curve, new opportunities. One major trend shaping changes in the resident experience is the rise of the “experience economy,” a development that has significant implications beyond the senior living industry, to include hospitality, retail, consumer products, and more. The bar is being raised above and beyond simply servicing customers to provide them with a distinct economic offering: memorable experiences. This shift is forcing industry players to re-evaluate their existing services and focus greater attention on experience design. In order to succeed in this arena, players must have a good understanding of who their customers are, and in the case of the senior living industry, who they will be. Across multiple sectors, the service delivery model is being overtaken and replaced with experience delivery. As customer expectations rise, it is imperative that senior living providers understand more than the basic needs of their customers; they will need to understand what customer expectations are, how companies across all industries are improving and innovating experience offerings, and what will be considered the new normal in senior living. The new face of ageing The commonly held perception of a “typical” senior is changing. This will significantly impact the experiences residents expect from their senior living communities – particularly as it relates to amenities and social offerings. Not only are seniors living longer, but they are also becoming increasingly diverse with respect to their backgrounds and beliefs. As life expectancy continues to rise, senior living will need to transform in order to accommodate not just the needs of older residents, but also the needs of a wider range of residents: the
younger seniors and the older seniors, whose preferences can differ significantly. These differences can make it challenging for the industry to effectively create tailored experiences for diverse groups. The new way of ageing Not only will there be changes to the demographics among residents of senior living communities, the common perception of what “being a senior” means will change as the baby boomer generation enters the senior living equation. This generation stands to turn the idea of “being a senior” on its head, requiring new experiences through health and wellness initiatives and technological advances to facilities.
Promoting the idea of independence and dignity at all levels of living is essential to changing this consumer perception With this new way of aging in mind, it is essential that the perception of senior living communities change so that they are seen as the next step in life rather than “a place to die.” Promoting the idea of independence and dignity at all levels of living is essential to changing this consumer perception within the industry. Changing expectations The senior living industry will need to adjust not only the services it provides to elevate its residents’ experiences, but it will also need to make changes to its facilities in order to accommodate an entirely different “senior” and their new needs, preferences, and expectations. Looking beyond just a gym facility, senior living communities will need to offer more encompassing fitness programs. Beyond just a healthy menu, communities will need to accommodate dietary preferences like gluten-free foods or menus which accommodate religious requirements. Lastly, resident social inclusion will become not just an add-on, but the status quo.
At Webstercare, we understand that residential aged care facilities need end-to-end visibility and accountability with medication management.
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INFORMATION TECHNOLOGY IN AGED CARE
Health and wellness Staying active and healthy is a new priority for senior living residents. As this trend continues to evolve, new communities will need to create diversified programs for seniors that provide them with a variety of opportunities to remain physically fit and socially engaged. Exercise classes tailored to specific health problems are rising in demand. Group classes such as yoga, Pilates, Tai Chi, strength training, and water aerobics classes are especially popular among this demographic. Some seniors seek out opportunities to be active outside of fitness-related endeavours. For example, many find gardening to be a purposeful hobby throughout their lives, and do not want to give it up when entering a senior living community. With respect to nutrition, foods that promote health and wellness have become a high priority. Today’s seniors expect a greater variety of menu options and dining accommodations, and may also enjoy the social aspect of the dining experience. Residents are looking to have their health, social, and religious needs meet, and dining facilities must accommodate a variety of preferences, with respect to the food itself as well as the ambiance of the dining spaces. Social interaction Research indicates that loneliness is prevalent among older populations and has negative repercussions on seniors’ health and well-being. Most communities offer comprehensive programs that support social engagement, and can include activities such as arts and crafts, cooking classes, music lessons, book clubs, and holiday celebrations. Overall satisfaction and a boost in underlying health benefits are likely to result when seniors interact with others and have an opportunity to cultivate close relationships. Technology needs When it comes to technology, there are generally two types of seniors – the younger senior who is comfortable with technology and online platforms, and the older senior, who may be less affluent and largely disconnected from the world of digital tools and services, both physically and psychologically. The internet is playing an increasing role in connecting people to news, information, government services, health resources, and opportunities for social support. Senior living communities will need to assess the needs of their residents and adjust accordingly – whether it be accommodating the needs of technologically-advanced seniors (e.g., wi-fi, access to tablets, smart TVs) or providing support services to help those residents become more familiar with technology applications.
As the resident experience undergoes transformation from all angles, providers must re-evaluate existing frameworks and services. The holistic quality of the resident experience – beyond the quality of individual services – is the new normal for how providers will be judged. That new normal is a reflection of the increasing importance consumers place on quality of life. Shifting demographics and psychographic characteristics among seniors – longer life expectancy, increased diversity, and a new generation that is healthier and more tech-savvy – will reshape the industry and ultimately the desired experiences of its customers. These shifts will have greater implications than the simple sum of a broader customer base; rather, they are likely to drive broader government spending decisions, policies, and oversight priorities. Understanding the consumer trends, challenges and opportunities facing the industry is essential – and a lack of research in this area is a challenge. Many of the emerging trends introduced warrant further consideration to bring about the innovation required to impact quality of life and to provide a conceptual framework for experience measurement and design. For more information go to www.sodexo.com ■ More on this topic will be covered in a digital poster at LASA National Congress 2016.
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Conclusions Across the globe, and within each service industry sector, providers clinging to the status quo of the service delivery model risk ceding ground in market share and pricing power. An understanding and incorporation of experience delivery, on the other hand, can create opportunities for new growth.
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REVISITING REPUTATION –
A CLIENT PERSPECTIVE ON QUALITY Trish Carroll Principal I Elder Matters
The burgeoning business opportunities and imperatives within the current aged care industry present increasing challenges and complexities for leaders in aged care, be they board members, executives, managers, directors of care, clinical staff, allied health and care staff in all capacities.
hese challenges and complexities include: how best to meet governance obligations, provide person-centred care, promote access and choice for residents, create safe and enabling environments, recruit and retain skilled staff, prepare for accreditation, ensure clinical excellence, maintain funding, and plan for the future. These and other priorities can distract executives from the essence of the business, namely: clients/residents and their families, each with unique life stories and circumstances, and all experiencing profound life transitions. Clients and prospective clients of aged care all have different priorities, subject to their wellness and circumstances. Many are seeking quality and compassionate care, comfort, ongoing independence and enablement, positive relationships with care staff, confidence in the organisation, and an environment where they can expect and experience dignity and respect. The search for an aged care provider that can meet these expectations and live up to its promises, mission or marketing claims, is a source of anguish for many individuals. Any organisation can articulate a vision, mission or philosophy of care. The extent to which these translate into reality informs first impressions, creates lasting memories and determines reputation. Reputation, in turn, influences occupancy and income, accreditation outcomes, resident feedback, quality of care, staff turnover and survival of an organisation.
Reputation is everything In discussing reputation, it is critical to consider the voice of the recipients of care and those who can influence the extent to which an organisation is held in repute (or otherwise). The clients/residents, families, loved ones, staff, volunteers, chaplains, visitors, allied health and providers of all products and services will all form opinions based on their experiences
of care provided by an organisation, and they will share those opinions with their many family, social and professional connections. The expanse of these connections cannot be underestimated. Service providers cannot ignore the impacts of increasing social connectedness of people within and across Australia on reputations of aged care services, especially through the influence of social media. The population of baby boomers affected by the experience of aged care will continue to share their experiences (good and bad) with friends and colleagues, particularly as they become more informed about the aged care industry and the focus on consumer choice.
How is reputation gained or lost Each individual’s experience of aged care is influenced by spoken and unspoken expectations, which represent for them clear measures of quality. Table 1 includes a sample of ‘client measures of quality’ sourced from consumers of aged care services. The extent to which these measures are met will directly influence the reputation of an aged care organisation. So many of these measures of quality can be (and so often are) met through a culture of person-centred care, defined by Kitwood (1997) and Brooker (2004). The onus for successfully creating a person-centred and relationship-centred culture rests squarely with executive leaders, insofar as putting this philosophy/theory into practice. This requires an ongoing financial investment in staff education, and integration of the philosophy into induction, recruitment, performance management and language of care. A person-centred culture is not sustainable if not understood and modelled at the highest levels of the organisation. Reputation is therefore reliant on the critical decisions of leaders and the culture they create, fund and model.
Did you know? You can reduce medication errors by up to 66%1 with an electronic medication management system. AutumnCare Medicateâ„˘ is the leading medication management software for aged care. Find out how you can improve quality of life for your residents and reduce accreditation risks today. Visit www.autumn.care/events/medicate to read more or register for an in depth discussion. Tel: 1800 422 472 1 Ref: Australian Commission on Safety and Quality in Health Care, Literature Review: Medication Safety in Australia 2013
Making Lives Better
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Swift Electrical • Uses Licensed Electricians and testing is performed to Australian Standards • Provides detailed reports to meet legislative requirements • Cares about the residents’ health and respond quickly • Provides organisations with comfort and security Servicing: • Aged Care residences • Community Service organisations • Health service providers • Schools and pre-schools
Specialising in: • Electrical compliance services • Electrical safety gap analysis • Lighting recommendations and installations • General electrical works with rapid response • Falls prevention systems (Bedside Guardian)
Table 1 – A sample of client measures of quality in aged care • Values/mission/philosophy is visible at all levels, and in all processes of the organisation. • Safe, clean, hygienic, enabling and comfortable environment in pleasant surroundings. • Each person is treated as a valued and respected individual, with their unique and complex health circumstances and cultural diversity. • 24/7 access to clinical and care staff qualified to deliver expert and holistic aged care services from admission to end of life - anticipating and responding to all care needs. • Focus on family and loved ones, keep them informed and providing support as needed. • Language of care – staff communicate professionally with residents, family and other staff, demonstrating kindness, listening skills, dignity, empathy, a focus on relationships and respect. • Aged care services are provided as advertised and contractual obligations are met. • Activities and outings provided are plentiful and tailored to individual client preferences. • Specialist care, support and advice are readily available for all health and capacity challenges. • Low staff turnover and happy staff who interact positively with residents and each other. • Organisation has consistently met all accreditation standards and governance requirements. • Focus on the individual and their needs vs a focus on money and business. • Effective and transparent process for complaints and feedback.
Framework for Quality Assessment The McKinsey 7S Framework (see Figure 1) can assist leaders at all levels to incorporate client measures of quality into organisational processes and conduct their own review of quality care. This tried and true framework identifies seven internal and interdependent elements of an organisation, which need to align for an organisation to be deemed effective. Importantly, the shared values at the centre are a reminder of the centrality of the resident in aged care, as articulated by clients in the table above, embedded in legislation and best practice in aged care. Figure 1 McKinsey 7S framework
The framework provides an opportunity to review the extent to which a client/person-centred focus is realised and reinforced through: strategy, organisational structure, systems and processes, employees and providers, training strategy and – very importantly – leadership style. This framework encourages leaders to look beyond the systems and processes which are the focus of so many audits and explore/review the broader care landscape, accreditation requirements and client expectations as a part of that review process. It also enables aged care professionals at all levels to visualise the resident as their focus, and appreciate the interdependencies between the resident experience and all that a team of aged care professionals do to create that experience.
Baby boomers will continue to share their experiences (good and bad) with friends and colleagues, particularly as they become more informed about the aged care industry and the focus on consumer choice.
A limitation of the McKinsey framework is that it does not specifically mention the importance of `environment’. However, that can be included and reviewed as part of the ‘strategy’ element. The external drivers and influences (legislation, reform etc.) are not specifically mentioned in the model either but can be articulated as a part of the review of each element. Indeed, the impacts of external influences are a reason to apply this framework to continually review quality and reputation. The centrality of the client/resident experience in aged care and the influential role of clients in determining reputation is fundamental to the success of any aged care provider. The clients’ measures of quality extend far beyond those listed, and social connectedness ensures that resident/client expectations will continue to be articulated. The McKinsey model will hopefully prompt leaders in aged care to revisit the essence of aged care and consider reputation in a new light. ■ More on this topic will be covered in a digital poster at LASA National Congress 2016.
References Kitwood, T. (1997) Dementia Reconsidered: The Person Comes First. Buckingham. Open University Press. Brooker, D. (2004) What is person-centred care in dementia? Reviews in Clinical Gerontology. 13, 215-222
MEDICATION CHARTS AND GP RECORDS
PUTTING PEOPLE’S SAFETY AT RISK Getting a resident’s medication orders correct is critically important from a patient safety perspective, and many aged care facilities are now using medication management modules in their clinical information systems. These modules generally A/Prof Meredith Makeham focus on electronically sharing medication GP & academic I The Australian Institute for Health Innovation charts with pharmacies, and recording the administration of medicines.
ut what happens when a visiting clinician – often the resident’s GP – wishes to add a new medicine at the facility? They usually add it on by hand to a medication chart that has been printed out from the electronic system at the facility. That’s with a pen – and not with the clinical decision support software that they are used to using back at their practice, which alerts them to a possible serious drug interaction with the resident’s other medicines. And not always very legibly for the pharmacy who then often receives this updated chart by facsimile.
interoperability functions between the standard clinical software used in GP and RACF settings has resulted in a very serious potential safety risk for RACF residents – and nobody knows quite how big or how risky that situation really is. So how big a difference are we talking about? And how likely is it that those differences are for ‘important’ medications that could pose a real safety risk to these residents?
The General Practice and Residential Aged Care Concordance of Medications study (GRACE-Med) is underway at the Australian Institute of Health Pens and faxes are still the Innovation at Macquarie standard for medication chart University, asking these Our comparison of 5,000 people’s medication alterations in many aged care and related questions. facilities. To add to this, the charts in aged care facilities and the medicines We are analysing over 5000 GP also needs to remember listed on their GP’s records has found more than medication orders, comparing to make those same changes the medicines listed on the half have substantial differences back at the practice’s same day for a resident at electronic record system their GP’s surgery and in when they return if they want their medication chart at the to keep these resident’s medication lists up to date there, and facility. When those orders are different, we are also looking these practice records are regularly used to generate repeat at how serious a safety risk this poses for these residents, prescriptions and referrals. whether they were intended, and why the GP thinks More than 97% of GPs in Australia are now fully computerised they occurred. for prescribing at their practices, and electronic decision So far the GRACE-Med study has found that the vast majority support is standard practice for new medicine orders made in of people have a substantial difference in these medicine lists, these systems. That’s OK you may say, because when they get with more than half of all medication orders being different, back to the practice and update that resident’s medication list, and that after expert review, around 20% of these differences the computer will alert them to a serious drug interaction they pose a high patient safety risk. missed when they altered the chart by hand. But what if the This situation presents a serious potential safety risk medication list back at the practice is different? associated with medication record inaccuracies. The problem is that we don’t actually know how often GPs Misinformation in our GP record systems can lead to problems remember to update their practice medication lists for their like missing drug interactions, but consider also how it might patients residing in aged care facilities, and whether those affect our transforming digital health landscape in Australia. lists reflect the reality of what that resident is actually taking at the facility. Relying on memory, and having no sophisticated
My Health Record is our national online health record, and is now being trialled in two regions in Australia as an opt-out system. The information in My Health Record that contains a person’s medication list is generated in the main by their GP, who uses their general practice software to create a document called a ‘Shared Health Summary’. This summary uses the list of medicines held electronically in that system, located at the GP’s surgery. While clinical information systems are being increasingly used in aged care facilities, and GPs are provided with log-ins to add clinical notes, these systems don’t support the type of medication prescribing tasks that a visiting GP needs to perform. For example, there’s no ability to electronically add a medicine to a chart with access to electronic drug interaction warnings. A number have (or are developing a process for) the capacity to perform ‘Shared Health Summary’ uploads that would potentially contain medicine lists, but to our knowledge nobody is using it in the aged care facilities setting. So if a resident gets a Shared Health Summary generated by their GP, from where will the medicines information in this summary originate? At present you can assume it is from their
GP’s surgery, because that’s where the GP can do it using the clinical information software that they know how to use. We are in a new age of health information technology that should be designed to be patient-centred and accessible, supporting clinicians to minimise safety risks, and facilitating the sharing of health information across those traditional siloed boundaries that have long existed between different health care settings. But before we can share medication information for residents with confidence, we need to close the safety gap that is evident from the GRACE-Med study results. New solutions are needed that offer a way to accurately update a resident’s medications in real time at their facility and at their GP’s surgery, and provide GPs and other clinicians at aged care facilities with prescribing software that contains electronic decision support. We need to stop depending on busy, stretched clinicians trying to remember to duplicate their work, and to help them to replace their pens and fax machines with sophisticated interoperable clinical information systems in our GP surgeries and aged care facilities. ■
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For Information and to book your discounted rates for LASA Fusion readers please contact our team! Call 02 8624 3300 OR email firstname.lastname@example.org Your Partner in Aged Care and Community Services Sydney Office
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LET’S TALK ABOUT QUALITY – TURNING INSIGHTS INTO ACTION Last year we joined with key industry stakeholders on a rewarding project – The Quality Dialogue – exploring the best possible ways to describe, encourage, measure and monitor quality in aged care services.
e are grateful for the insights and input of this authentic conversation about quality in aged care. The full report Let’s Talk About Quality was released early January 2015. The findings are already informing our work and the work of the Australian Government including continued engagement with the aged care community, on driving quality in aged care. We heard that consumers and their families are looking for information that they can understand and use. The Quality Agency has a key role in providing reliable information on the performance of aged care services. The Quality Agency conducts consumer interviews with a minimum of 10% of care recipients or their representatives when we undertake reaccreditation audits and assessment contacts. That’s about 55,000 interviews each year. It also forms part of our quality review of home care services. The evidence from these interviews is used alongside observations and documentation, to assess a services’ performance against the accreditation standards. However, what consumers tell us about standards of care during re-accreditation audits is not reported in a structured way. We will be introducing a validated interview tool to provide the auditors with a better way to capture and reflect the consumer experience against the standards. This will give greater consistency in how consumer perspectives are captured in the audit and publicly reported. We want our audit reports to better inform consumers about the care and services experienced.
Nick Ryan CEO I Australian Aged Care Quality Agency
We are exploring ways in which we can use our expertise in accreditation issues and performance trends to support sector improvement. We are developing an innovative new information and communications technology-based program, to generate new auditing, reporting and communication tools in order to improve quality assessment and compliance, and deliver better consumer outcomes in aged care. This system will support improved data collection, reporting capabilities and outcomes, including interface with our education programs. Better Practice Conference Programme 2016 is underway. This conference promotes quality of care beyond compliance with minimum standards, to broader notions of innovative, high quality care that meet the needs and expectations of consumers and their families. Our annual Better Practice Awards scheme celebrates aged care providers that demonstrate excellence in service through innovation. And we are working with the Department of Health to identify improvements in the quality assurance framework to hold industry to account for core standards of care, and to raise public awareness and confidence in the quality assurance process and regulatory framework for quality in aged care. This is just the start of our conversations about quality. We welcome LASA’s new CEO Sean Rooney to his role at the head of a nationally integrated LASA organisation – we want to continue to engage with LASA and other key stakeholders to be a strong voice on quality in aged care, and be a driver for changes for the benefit of older Australians and their families. ■ To view the full Let’s Talk About Quality report go to www.aacqa.gov.au
TECHNOLOGY & INNOVATION
ENHANCING LIFESTYLE SERVICES WITH VIRTUAL REALITY TECHNOLOGY
Sonja Bernhardt OAM Technology is changing at such a pace these days that most CEO I ThoughtWare people find it difficult to keep up. To make it easy for you, Sonja Bernhardt offers an overview of new realities and how they can change your world.
re you so busy that there is no time left to explore the new technologies that pop up all the time? If so it’s time to reconsider, as rapidly moving developments in Artificial Intelligence (AI), Augmented Reality (AR), Virtual Reality (VR) and Holograms can provide direct benefits to your business, clients and staff.
Holograms first appeared in the early 60’s as 3D laser images, augmented reality in the late 60’s, and virtual reality was introduced in the late 80’s early 90’s. However, with rapidly advancing technology, we are now experiencing a renaissance period of these technologies, and activity is progressing at an increasing rate with a lot of competition hotting up.
Moreover, the companies working on this technology need your knowledge and experience to further improve and advance their products for consumers and business owners.
Forget the futuristic images these words conjure, where people are slaves and subject to wearing headsets and being tapped into a digital machine. While science fiction books and movies tend to paint a dystopian future where the machines take over and the outlook is bleak; where technologies run rampant and nothing good comes of it, the fact is most of these technologies have been around for decades.
ITAC 2015 saw the emergence of an organisation called “Virtual Reality for Aged Care”. This firm introduced a headset where people are taken on virtual reality ‘holidays’ and tours of global locations and experiences, including helicopter rides, safari outings, hot air ballooning, boat trips and more. Imagine what this could mean for people who are unable to travel due to cost, frailty or disability?
Technology What it is
An artificial, computer-generated simulation or recreation of an environment or situation that seems “real” to the audience.
It immerses the user by making them feel like they are experiencing the simulated reality firsthand, primarily through vision and hearing: e.g. you feel you are a passenger of a helicopter, you hear the noise, you see the aerial views, yet you are sitting in your lounge chair.
The blending of virtual reality and real life. The user sees the real world but with the addition of computer generated images which are overlaid on various objects within the real world.
You may be looking at something in real life and augmented reality displays information for you about what you are looking at. E.g. you see an overlaid display on how to access the dining room; then when you walk into the dining room, digital material about the day’s menu and your personal preferences is displayed as an overlaid display “floating in the air”.
A three-dimensional image, created with photographic projection. The term is taken from the Greek words holos (whole) and gramma (message).
Microsoft’s ‘HoloLens’ is essentially a holographic computer built into a headset that lets you see, hear, and interact with 3D simulated objects within an environment such as a living room or an office space.
Computer systems able to perform tasks normally requiring human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages.
An artificial pet that is used as a companion, has embedded artificial intelligence and responds to you when called, when doing tasks etc.
TECHNOLOGY & INNOVATION
Image courtesy of Anchiy/Shutterstock.com
Scan the VR QR code for a 2 minute news story to learn about VR in an aged care facility and how it is assisting those with dementia.
Lifelong learning In April this year a combined AR and VR tour bus was launched that lets school children go on an excursion on a real bus across the surface of Mars. There are no limits to lifelong learning these days. Experience Augmented reality; scan the QR code to experience a 45 second bus trip on the surface of Mars.
Virtual Reality theme parks Opening in mid 2016 on the Gold Coast is VR/Holographic Theme Park.
Rise of Artificial Intelligence Back in 2010 Liesl Capper presented at ITAC on Artificial Intelligence pet helpers and avatars for aged care. Since then there have been major advances in AI including “deep learning” neural networks, which teach themselves by ingesting large amounts of data. AIs are now commonplace, from the clever but not yet perfect (and sometimes infuriating) Apple guide Siri, to IBM’s Watson. Watson has been taught cooking, finance, medicine and is reported to be able to diagnose certain cancers better than human doctors can. Over the next period of time we can expect to see a wide variety of superior AI applications emerging.
Experience VR/Holograms: Scan the AR code to view the news story and sample 3 minutes
Watch this SBS Insight program from April
of the theme park holograms
2015 on robots and aged care by scanning the QR code.
Shared experiences Bringing AR and 3D virtual objects into the living room and office is Microsoft’s new HoloLens, not only enabling you to see computer-generated objects within a room interacting with (and even hiding behind) real objects, but allowing multiple people to share the same augmented reality. Experience Holograms: scan the QR code for a 6 minutes video showing how HoloLens works.
We can expect to see an increase in AI for aged care, as technology combines artificial intelligence and natural speech and can interface with patients to provide education, guidance and supervision. We are seeing exponential advances in technologies such as sensors, networks, artificial intelligence, and robotics. The convergence of these technologies is making amazing things possible. Taking the time to learn about and explore these fascinating and valuable options will enhance your clients’ experiences and the overall quality of care. As we see increased focus on competition and consumer choice, imagine offering these ‘experiences’ as part of your lifestyle program: • Exploring nature parks • Hot air balloon ride • Helicopter flight over New York • Gondola ride in Venice
TECHNOLOGY & INNOVATION
While most are still driven by headsets, one-off investments may be needed but could undoubtedly be drawn from home care packages as i-Pads can be. Some virtual reality products run off smartphones, and we expect to see this trend increase.
• Being immersed playing a tennis match • Rock Climbing • Hiking • Sailing • Flying • Going on safari in Africa • Playing a board game with family members from around the world • ‘Bus excursions’ to destinations that have personal meaning to the viewer These technologies will change how we learn and remember and how we entertain ourselves. Activities will become experiential, because people can ‘visit’ and explore the world and the universe. We can tour far-off destinations and spend evenings with relatives and friends who are thousands of miles away. Rather than watching movies we will be able to be part of the action, virtually in the back seat of the car chase, flying the plane, exploring hidden worlds etc. That is all possible using AI, AR, VR and Holograms.
The other critical factor is this content is best driven by the end user. This means you, your staff and your clients need to be able to use it. Taking the time now to learn about it will pay off greatly in the long run. And as the next generations who are more tech savvy that previous ones move into aged care both as staff and as clients, it will be increasingly easier – and expected – to offer this technology as part of your lifestyle package.
Find out more If you come across firms demonstrating these capabilities at conferences and trade shows, make the time to explore and engage in trials.
If you have ideas for content, reach out to the content creators. Developers often attend events like ITAC, which showcase their products. Talk to your association, local universities, your peers and your kids – there is so much out there already. Don’t get left behind. ■
The prohibitive cost of the equipment to use these technologies has come down significantly in recent years.
More on this topic will be covered in a digital poster at LASA National Congress 2016.
AMH IS ON THE MOVE Australian Medicines Handbook
Aged Care Companion
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DEMENTIA CARE BRANCHING OUT The Flametree Dementia Care Project at IRT Woonona is transforming a secure dementia care unit into a more welcoming space and is achieving better care outcomes for aged care residents and increasing employee engagement.
RT Woonona’s dementia care unit combines evidencebased design with innovative new ideas around environmental design for dementia and resident grouping.
Home to 34 mobile residents living in two separate wings connected by a communal garden, it is one of the first projects in Australia where changes to care components have been researched in tandem; studies usually focus on one care component at a time.
and living spaces. Room doors have been individualised; a memory box for each resident is located adjacent to their door; and unique door handles enable residents to confirm they’re in the right place through touch.
“After undertaking a Strategic Asset Management review that included using an Environmental Audit Tool developed by Professor Richard Fleming from the University of Wollongong’s NSW/ACT Dementia Training Study Centre, we recognised we could do better in care design,” Matt Hough, Area Manager Northern Illawarra, IRT Group, said. “With the number of Australians living with dementia expected to nearly triple to 900,000 by 2050, it’s critical that the importance of environmental design to quality of life is recognised and embraced by care providers. One thing we’re really passionate about is making our dementia unit a more inviting, engaging and fun place to be,” he said. The unit was designed under guiding advice from Professor Fleming and with input from staff and the residents’ families. Prof Fleming and his team are researching how the changes are impacting residents’ lives, with funding support from the IRT Foundation’s Research Grants Program. “When visiting the dementia care unit, creative thinking is evident in the interior design and outdoor area,” Mr Hough said. “One of the first changes we made was to improve sight lines for both residents and staff. The nurses’ stations were reduced in height, walls that once blocked views now incorporate windows, and entrances to areas where residents don’t require access have been camouflaged into surrounding walls.” Colour, contrast and texture have been used extensively. Each corridor – or street as they’re now called – utilises a different colour scheme. Internal murals in each street act as unique way finders. Contrasting colours differentiate walls and floors,
“We’ve made it much easier for residents to navigate around their environment on their own, which has the added benefit of freeing up staff to spend more quality time with them. Along with resident independence, safety has improved with a reduction in falls, agitation and frustration. Even a long-term member of the cleaning staff has noticed far fewer scuff marks on the walls as residents are not bumping into them with their walkers,” Mr Hough said. Simply relocating the television from the main wall in the lounge area has changed the focal point of the area, leading to more time spent enjoying music and resident involvement in social activities. Significant changes have been made to outdoor areas with a large digitally produced mural along the back fence. The realistic scenes include a lake, forest, picnic area and playground. The mural is brought alive by placement of props throughout the garden: a parked car; a garden shed with a lawn mower and wheelbarrow; picnic tables; and a children’s
“We hope to move beyond visual cues in the next stage of improvements. Ideas include incorporating sound into the mural and a video monitor into the car’s windscreen to provide the illusion that the car is moving,” Mr Hough said.
playground designed to also engage residents with tactile play equipment including life-sized noughts and crosses. A street scene – Penny Lane – has been created on the exterior walls (pictured right). A general store, butcher shop and cafe share the laneway with a barber shop that is also home to the community’s visiting hairdresser.
The changes to the outdoor areas were designed to achieve certain outcomes, however expectations have been far exceeded. Residents interact with the mural and garden props, rather than seeing the fence as a barrier to the outside world, reducing anxiety and behaviours of concern. Visiting families are utilising the outdoor space; even staying for picnics. Children are visiting more often with their families, enjoying the garden area and playground. The Flametree Project is also developing new models of care, and design improvements have enabled a change to the physical and social dynamic of the resident mix. “Residents are able to engage with their environment and benefit from those changes. Staff are able to develop specialised skills required for the physical care of residents with particular needs, management of behavioural problems and activities of daily living. Criteria for acceptance to reside in the unit have also been broadened as a result. Families have told us this has provided them with more confidence in their loved ones’ care and safety, and that’s a great outcome,” he said. ■ For further information contact IRT on 1800 024 915 or firstname.lastname@example.org.
Designing the future of Aged Care
Calder Flower Architects Level 2, 140 Myrtle Street, Chippendale NSW 2008 | T: 02 9698 9822 | E: email@example.com | www.calderflower.com.au
HOME CARE VIABILITY IN 2017
Ahead of the next stage of changes to the way Home Care packages are made available to consumers from February 2017 it’s time to check how competitive your business is against this check list by Ross McDonald, founder of Capital Guardians. Claim quickly
Ross McDonald Founder Capital Guardians
Paper invoices are a thing of the past. Anything not in electronic format increases the administrative burden of transparency and also increases the possibility of mistakes with rekeying invoices.
ll homecare operators have a Medicare subsidy claim process in place, however, a significant number do not have Medicare funds coming in at the start of the month and are not completing full reconciliations Brokered suppliers not charging GST on receipt of remittance. This is more prevalent in smaller The supply of home care services by a service provider is GSTorganisations where the responsibility sits with an overworked free under the Aged Care Act. Private tax rulings have been case manager, whole client issued by the ATO in respect facing responsibilities of no GST payable under a have been correctly taking CDC homecare package. precedence. Except for isolated regional areas, travel
costs cannot be passed Without the prepayment of Medicare, organisations are using their own money to finance their homecare business, at a cost to significant organisational cash flow that is difficult to spot within monthly finance statements. Claiming is too important to “add on” as an additional job for an already overworked staff member. The role of claims should be formalised, to a staff member, ideally with a finance background. The timing of cash collections and claim reconciliations need to be reported as part of their key performance indicators. Do not accept slow invoicing Suppliers taking over a month to invoice a client cannot happen. Slow invoices burden an approved provider with needing to administratively manage “accruals” or not have individual statements up-to-date. Additional costs site with the supplier who misses out on cash flow and require a lengthy process for any disputed invoices that could have been dealt with quicker closer to the date of the service. Further, with new legislation coming in regarding the return of monies to the government and consumer, approved providers will need to quickly sort out all accounts prior to the return deadline. If any are missed, approved providers will be liable.
on to clients.
Most Approved Providers are still accepting GST on brokered service invoices, and as such they are spending administrative resources capturing GST, paying it out of their own funds and claiming it back a month later. This costs their cash flow and administrative resources. Case Managers do individual budgets, not finance Under CDC, Case Managers have a core role of maximising their client’s wellbeing within the given resources. Budgeting for an individual cannot therefore be outsourced to the finance department, as it must be central to Case Management accountability to not “under” service, with clients missing out or “over” service, with an approved provider footing the bill. Treat Case Management as a separate business unit Care recipients will choose case managers who represent their interests. Where case managers also represent services from their organisation, or feel pressure to push their organisations services, care recipients may form perceptions that their goals are not aligned to organisational objectives. For a Case Manager to truly optimise services and the budget for a care recipient, they need to consider all supplier options and manage them at arm’s length, regardless of the owner of these services.
Utilise volunteers first in planning With the goal of maximising an individual’s welfare, it’s important to get the free stuff first, then use the budget for the rest.
a client want to pay $50 per hour or would they rather pay $35 per hour to someone else without the bullet proof gardening quality checklist? Further, is a client willing to pay a premium for an overqualified carer, or will the carer’s organisation pay the difference?
Care planning needs to actively challenge the Case Managers No organisation can be good to actively build in activities at everything. Being good and support that do not means not only having the necessarily cost money. Organisations that fight the desires of consumers best staff, it’s having the Organisations might have their with restrictive work practices will lose customers. best price, or mixing the own volunteer networks or two, “best value for money”. ability to tap into others. There Approved providers and are also family service organisations will need and friends. to network and work together, including organisations paying Case managers can make willing family and friends their competition to service their clients. Local networks to accountable for certain activities, in the interest of maximising local senior citizens clubs, councils and general community a budget. A good plan will have all relatives knowing what is happenings will also be increasingly important. expected of them and when. There are even the opportunities for family and friends to take on case management duties for a Keep it local lower fee. Approved providers of tomorrow will need to source carers Complete a real care plan A real care plan is not just a summary of services and cost. It should be more like a formal business plan that requires a qualitative and quantitative document that outlines: where an individual is at; where they want to be; and how they are going to get there. A plan is a document that stands on its own with such strength, it doesn’t even need to be linked to a home care package to be of value to the individual. In fact it might recommend other options, such as private care arrangements, house sharing, village environments, or the Commonwealth Home Support Program in the initial instance. Like the travel agent industry had to justify directly charging for their services when commissions were significantly cut and direct internet bookings appeared, approved providers will be judged on their care plan and be assessed on what it costs. Encourage “coopetition” and networking Quality at any cost will not keep an organisation in business. An organisations’ gardeners might be very good, however does
Image courtesy of iofoto/Shutterstock.com
locally to minimise travel. Except for isolated regional areas, travel costs cannot be passed on to clients. It’s nice to send your own care staff to a client, however, not when they have to drive 20Km. Travel is dead money and there is the cost to the staff member and the cost for the transport itself. Where tight scheduling with route optimisation is not possible, the use of other home care organisations (ie coopetition) and innovations with semi-formal carers will become necessary. Put the client first Consumer Directed Care is consumer directed. Organisations that fight the desires of consumers with restrictive work practices will lose customers. Minimum shifts, demarcations of types of work and traditional rostering doesn’t necessarily meet care recipient needs and is administratively costly. Further, work place award structures and on-cost demands are not necessarily valued by carers. Only the largest care providers with a willing full-time locally based workforce on very tight scheduling and a large numbers of clients could possibly meet CDC client needs. Even then they would still be at a cost disadvantage to nimble new operators emerging giving carers access independently to clients in a similar way to what “Uber” has done with the highly regulated taxi industry. Bottom line, clients will not pay for inefficient work practices that they don’t want. Most organisations will need to embrace innovative methods to legally use contractors, casuals and even neighbours and family who have passed provider standards. ■ Capital Guardians is an aged care equivalent ‘paypal’ for homecare funds. For more information email firstname.lastname@example.org
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THE RIGHT BUSINESS TECHNOLOGY FOR YOUR NEEDS
Today’s aged care organisations have a broad choice of technology solutions, ranging from administrative and finance platforms to integrated home care systems with video download capabilities.
electing and implementing business technology, whether software applications or IT infrastructure, often leads to unexpected complications ranging from budget blow-outs to a failure to meet business needs.
For the best chance of project success, aged care business leaders need a structured approach to purchasing in order to assess business requirements and agree on a plan before presenting it to senior decision-makers. However, many aged care organisations launch their IT procurement process without first considering the overall business strategy or their needs in sufficient detail.
Start with strategy The fact is that technology alone doesn’t drive profitable outcomes – business strategy does. To make the best choice for your business, you must align your technology strategy with your business strategy. By planning up front and considering their overall strategy, businesses will be better placed to make informed purchases.
Robert Samuel Partner – Technology Advisory and Solutions Grant Thornton Australia
Technology procurement process Step one: Define and assess requirements Having considered their long-term strategy, decision-makers are ready to list, prioritise and agree on business requirements, including any specific technology needs. The best way to do this is to work out where the business is now (the current state or status quo), where it wants to be (the future state), and create a roadmap to guide the business through this process. Aged care providers should subsequently engage in the definition and prioritisation of requirements – these will later form the basis of the project plan. Once the future state of business technology is defined, the focus will shift to selecting an adequate solution and vendor. Step two: Select the right product and vendor When it comes to product selection, businesses that are unsure of their exact requirements are at a distinct disadvantage and may be swayed by charismatic sales people and dazzling presentations. In stark contrast, businesses that have defined and prioritised their requirements are in a much stronger position to select a product that meets their short and medium-term goals. Use a blend of technical, commercial and legal criteria to assess product and vendor capabilities. While flexibility, scalability and cost-efficiency are critical to a good IT investment, so is compliance and cyber security. It is particularly important that requirements are presented in a clear and unambiguous way, obliging vendors to address them directly, and that attention is focused on the binding nature of all statements made by vendors during the procurement process.
Step three: Establish the project scope The goal of the scoping phase is to take the outcomes of the previous two steps and include them in a high-level project plan that includes three key components: solution scope, resources and timeline. The scoping phase allows you to eliminate any ambiguity around the solution and the implementation timeline. This dramatically reduces the chances of any unpleasant surprises later on. Step four: Justify the project The justification phase is the most important in the process. It involves producing a formal business case outlining the costs and benefits of the proposed solution which demonstrates how it will support the business’ strategic goals. The business case should identify the following key items: • The recommended solution and vendor • Implementation steps and timeline • Stakeholder mapping • Benefits analysis of the selected option At the core of the business case is a benefits analysis that should demonstrate exactly why the proposed solution will help
the business. This section serves to summarise the tangible and intangible benefits and can also emphasise the advantages of selecting newer, more cost-effective technologies such as cloud capability. It is recommended that business cases are shared with your full management team and Board to give them an opportunity to assess the project benefits, and allow them to ask any relevant questions before progressing with the project.
Measure twice, cut once With the market saturated with software options for businesses of all sizes, you can’t be too careful when investing in new technology. It is important for aged care providers to go beyond the technical specifics and discount offers and focus on aligning their chosen IT solutions to business objectives. Aged care providers face evolving demands and a broad range of constantly changing technology options. So whether you’re choosing new software for the whole business or solving a specific issue, it’s important you ask the right questions, get the right answers, and ultimately make a great technology choice, not only for today’s needs, but for tomorrow’s requirements. ■
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NEWS MEDIA SKILLS IN THE DIGITAL AGE Many aged care industry leaders have been the subject of unfavourable news coverage over recent years, largely because they have been unaware of the changing needs of the news media in the digital age. Pete Burdon Author I Media Training for Modern Leaders
ost leaders in the industry steer clear of the media like the plague for fear of being misquoted, quoted out of context, or humiliated at the hands of an aggressive interviewer. This fear is nothing new, but many are unaware of the changes they have needed to make when dealing with reporters since the advent of social media and the growth of other technology.
Speed of response An important change is the speed with which you must respond to media requests, particularly when it’s an issue that could damage your reputation or that of your business. This could be an allegation about staff that are likely to be false, or something more serious like a minivan crash causing death or serious injury to residents. I often hear clients say the media is not a priority and journalists can wait. I agree that in an emergency or crisis, other stakeholders are the priority. However, the media must be a close second for good reason. Firstly, the media will produce stories about your issue whether you are in them or not. If you are not available, the story will probably be onesided against you and be full of misinformation or speculation. Your contribution is likely to read something like, “The CEO refused to comment.” You’ll agree that is not a great look, even if you are busy doing more important things. The story will then spread through social media like wildfire where you will be accused of either not knowing what is happening, or not caring. This will damage your reputation and bottom line. Before the advent of social media and online news, you only had to worry about tonight’s television news bulletin or tomorrow’s daily newspaper. Today a story will be up on news websites within minutes and scattered through social media channels. You need to be in it, even if it’s just showing empathy for a victim or explaining how you are resolving the situation. It’s a different ballgame. Many aged care businesses have been burnt by this speed of news distribution.
The answer is to know how to prepare a message quickly and have messages ready go at a moment’s notice on issues that could blow up.
Short messages All aged care owners and managers should have received formal media interview training. There will be times when you need to front up to media interviews – you can’t always hide
Do you or your staff care for people who are at end-of-life? “I have become a lot more confident, my communication skills are better when talking about death and dying. I learned a lot about symptom management.” – Nurse “I feel more comfortable talking and working with patients that are terminal” – AIN
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Funding support PEPA is funded by the Australian Government Department of Health. There is no fee for placement or workshop attendance. Financial assistance for travel and accommodation may be provided. Reimbursement towards backfill is available to facilitate placement attendance.
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behind prepared statements. Those who have been trained understand how to prepare for a media interview and how to get their points through media gatekeepers and into stories. The best spokespeople usually do annual refresher courses.
Your message must still be of interest to the reporter and you must still answer their questions. However, it’s important to have your own messages and know how to get them across in a way that satisfies the reporter.
However, people who have completed a media training workshop did so some years ago before these rules changed. If this is you, the trainer may have told you to come up with a few messages you want to get across in the interview. This is good advice, but over recent years the length of those messages have needed to drop dramatically. Some media trainers told clients to come up with three key messages that lasted no longer than 60 seconds between them.
Media skills for day-to-day business
If your messages are that long these days, you could get into trouble. The average sound bite on television and radio news is now around seven or eight seconds. That means your three messages should each be about this length. You need to break them down to their absolute core.
Media skills are the best way to win this battle in all business environments. The key is to break a message down to its core and communicate it in an attractive way. This can be done in the form of analogies, stories, the use of emotion and other ways. This is something that great communicators do, but it’s rare. Think of the last presentation you sat through at a conference. What can you remember about it? I bet it’s very little.
Media relations is not the only area where messages are more difficult to get across in the digital age. We are now bombarded with thousands of messages a day. The question is, which ones will be retained by our stakeholders? This is relevant for board meetings, presentations and the growing popularity of video as a business communication tool.
If you can’t do this, often the reporter or editor will do it for you. They may only use half of your point. That could change the context or make you look incompetent. The other possibility is that the reporter tries to paraphrase what you said. This is usually when spokespeople get misquoted. The answer is to be as brief as possible. Then there is less for the reporter to choose from.
In a nutshell, aged care leaders need to know the new rules of media relations in the digital age as an insurance policy against reputation damage, while these same skills can help them communicate better with other stakeholders. ■ For more information go to www.PeteBurdon.com
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A FRAMEWORK FOR SUCCESS:
HOW PHN-LED CONSORTIA CAN TRANSFORM THE AGED CARE LANDSCAPE
An independent evaluation of a consortium set up to manage Commonwealth Home Support Program (CHSP) service delivery in Brisbane North shows it achieved efficiency gains of close to 30 per cent, following a transition from an earlier Michele Smith governance structure. Manager I Community Care at Brisbane North PHN
risbane North PHN established its CHSP consortium in April 2013, prior to the programâ€™s name change, when it was known as the Home and Community Care (HACC) program.
The consortium then oversaw the transition of around 3,500 HACC clients from MNHHS to the consortium over a period of six weeks.
The Metro North Hospital and Health Service (MNHHS) had previously delivered HACC services in the Brisbane North region, but had made a decision to relinquish its Commonwealth contract.
The Australian Centre for Health Services Innovation (AusHSI) at the Queensland University of Technology was tasked with evaluating the consortium over two years (2013-15), and an initial progress report was completed in October 2014.
Brisbane North PHN, which itself has undergone a name change since these events transpired, initially established a consortium of 12 organisations to manage its HACC contract.
This report found that the providers involved in the consortium worked together collaboratively, openly and supportively in a traditionally competitive sector.
A management committee, comprising each of the provider and peak organisation members, the MNHHS, and carer and consumer representatives, was also created to oversee all consortium activities.
A final report (November 2015) found evidence of considerable improvements to HACC services and that the transition to the consortium model had dramatically reduced costs to the Commonwealth Government, delivering efficiency gains of close to 30 percent.
Image courtesy of Ocskay Bence/Shutterstock.com
AusHSI also found that clients remained satisfied with their services throughout the transition, proving that consortia could deliver efficiency gains while continuing to meet client service expectations. The providers reported numerous other benefits from joining the consortium, which is now operating under the name: Healthy@Home. High among these benefits were networking and professional development opportunities with other providers (facilitated by the consortium), client base expansion, greater service
flexibility, and enhancement of individual business models through collaboration.
platform to support our consortia partners, but within a collaborative framework.
CHSP service utilisation has been another key indicator used to measure the consortium’s effectiveness. In both the 2013/14 and the 2014/15 financial years the consortium easily exceeded Australian Government targets across all of the four main service groups.
The backbone organisation provides a consortium with dedicated staff whose function it is to help member organisations shift from acting alone to acting in concert, and this generates efficiencies.
The graph below illustrates CHSP service utilisation in the Brisbane North PHN region in both the 2013/14 and the 2014/15 financial years, and compares usage to the Australian Government targets. There are now 19 organisations involved in the Healthy@Home consortium, which is providing high quality community aged care services to around 6,000 clients per year. Moreover, Brisbane North PHN has successfully implemented two other consortia, one of which is contracted to deliver a Regional Assessment Service across all of Brisbane and the Moreton Bay region and another which coordinates mental health services (North Brisbane Partners in Recovery).
Collaborative framework As a Primary Health Network, we know we are uniquely positioned to lead the coordination of health and aged care services in our community. We are also eager to share our experiences with other like-minded organisations interested in implementing consortia in their own regions. We have adopted a Lead Partner/Supply Chain model to manage our aged care consortia. This model involves more than just the sub-contracting of services and instead has a strong focus on collaboration to achieve service and system improvement. From a collective impact perspective, we have taken on the role of a ‘backbone’ organisation. This gives us an effective
It can also alleviate pressure on service delivery organisations in areas such as tendering, performance monitoring, management, and reporting. The backbone organisation is primarily focused on quality services, contract management and policy advocacy. Funding bodies may also perceive this model to be less risky if the backbone organisation has established itself a good reputation. We believe that consortia can advantage small to medium organisations in particular, because they have the support and backing of larger members, which can translate into increased influence and voice to help all partners achieve shared goals. Consortia structures can offer better value for money, reduce duplication of services and can improve or encourage innovation in service standards. They can also provide an infrastructure for mutual support and development and, in this way, can increase opportunities to share expertise, skills, knowledge, resources and training, or to pursue opportunities for business development and expansion. One of the key ways Brisbane North PHN supports sector development is through our annual and quarterly aged care forums. These events regularly attract large turnouts, with more than 200 aged care and community care workers attending last year’s annual forum. But despite the benefits of consortia, we recognise that achieving consistency in an unstable environment will remain a major challenge as Australia’s aged care reforms are progressively implemented. Systems like the My Aged Care Gateway are not necessarily designed to support use by consortia and can impede their ability to refer clients to more appropriate services. Maintaining a positive consumer experience as clients access services will be a further challenge. Learn more about Brisbane North PHN’s aged care consortia at www.brisbanenorthphn.org.au ■ More on this topic will be covered in a digital poster at LASA National Congress 2016
BECOMING A WISER LEADER In this article about leadership and corporate culture, Sue Jauncey, Founder of Pulse Australasia, challenges the belief that simply thinking you have a happy and engaged workforce will automatically increase productivity results.
ften leaders are told to measure staff engagement to improve productivity, the premise of which assumes that increased discretionary effort by individual employees will increase their engagement and subsequent productivity. But do we really understand what this may be unintentionally reinforcing? In my column in the Autumn issue of Fusion I discussed how staff engagement surveys could be harming your business by reinforcing a culture of entitlement. But without using surveys to measure and track improvements, how do we, as leaders, identify and ensure that we are driving our organisation towards achieving the collective interests of the organisation? The plethora of programs designed to develop and improve leadership performance often imply that through improved leadership all of our people issues will disappear so we can work happily together to successfully achieve our organisational objectives. Armed with engagement survey results our leaders are turning themselves inside out to attempt to satisfy the needs of their workforce rather than focusing on achieving the business outcomes. Yet studies show if individuals are focused on having their needs met through self-gratification, it is highly unlikely they will ever feel satisfied, regardless of efforts taken to establish a happy workforce. Ironically, if individuals are focused on collective achieving goals and sharing collective successes as a team, they are more likely to feel a deeper sense of satisfaction. Have any engagement surveys or leadership programs ever resulted in bringing about the required change that is needed for your organisation to deliver its strategy? More likely, you will have spent more time ‘reacting’ to these programs and results than ‘responding’ by considering them in the context of the organisations strategic direction and purpose.
Wise leadership As custodians of the organisations we lead, it is important to understand how we are unintentionally reinforcing the entitlement syndrome and what we need to do to become
wiser leaders. Consider what is occurring in your organisation – are leaders working together to collectively come up with solutions or are they more likely blaming and/or working against one another to have their own agendas realised? When staff witness leaders focusing more on their own individuals needs rather than making decisions in the best interests of the business, trust and confidence begin to decline. Staff will also begin to model these same self-interested behaviours, which is where silo mentalities form with teams interested in their own success over and above other teams in the organisation. By prioritising their own self interest, leaders are unintentionally promoting a culture of entitlement where dissatisfaction and blame are central to most organisational outcomes. Often leaders operating out of self-interest are responding to their own personal automatic response/ego defence mechanisms. These defence mechanisms are created as an outcome of all the messages we have received from our life situations and circumstances. Generally speaking, we respond automatically to all current and future events based on our fears of what we think may or may not happen, or what we think we need to have happen to make us feel better, more valued and worthy. When we are responding automatically to our ego-based defence mechanisms we personally absorb what is going on around us and judge every conversation through the lens of what we think it is we need, or to the degree to which we feel we are under threat. When in this zone, we are personalising every situation we are a part of and are unable to make decisions in the best interests of our staff or the business. By absorbing everything personally, leads us to a lower sense of self-worth, a focus on blame, attempts to overly control situations and overall dissatisfaction. It is this style of leadership that leads to bad decisions being made.
Observing with an open mind A wise leader does not absorb what is going on around them, they observe what is happening without taking it personally.
They can walk into a meeting or gather information with an open mind and then look for insights when sorting through all the information presented. They are able to walk in the shoes of others and are curious and interested in the views held by staff and how they come to see a situation as they do. Wise leaders ask questions followed by more questions and rarely make statements. Staff feel confident that when their wise leaders make decisions even if it is not what they wanted, they have put the interests of the whole business first and they therefore trust in the decision leaders have made. In turn, staff stop thinking about what they want and instead are focussed on the heightened sense of achievement experienced when shared goals are realised as a collective.
Knowing what space you’re in Our ‘Wisdom in the Workplace’ model was developed to help leaders identify what wisdom looks like and reflect on their own behaviours and how this contributes to their own company culture. We describe the difference between leaders unintentionally and automatically operating from a self-interested position, which is motivated by protecting and having their own personal needs met. In a position of self-interest leaders are more likely to absorb everything around them from a personalised position, which we call the ‘orange space’. When a leader observes what is going on around them in a de-personalised manner and is not motivated by having their own personal needs met they are able to respond to situations more effectively. We call this the ‘green space’ Simply put, wise leadership is all about asking the right questions, starting with the intervention question “which space am I in right now - orange or green?” Identifying this by simply asking the question prevents leaders from responding automatically to situations and instead provides them with the choice of which space they would like to operate from. Our results show that when leaders ask this intervention question they have a higher likelihood of demonstrating better decision making than automatically responding from a selfinterested, ‘orange’ perspective. When leaders consciously make the choice to operate from the ‘green space’ the outcomes will more likely result in a win-win situation for staff and the business as a whole. Developing our intrinsic leadership attributes through a cognitive reflection process stops us from making fear-based responses related to past experience and gives us the freedom to make better quality decisions that will inspire cooperation and cohesiveness across the organisation. ■ Sue Jauncey will be facilitating a leadership workshop at LASA National Congress on Monday 10 October. For more information go to www.lasacongress.asn.au
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GAINING A COMPETITIVE EDGE
THROUGH COLLABORATION Catherine Brooks and Hugh Watson Principals I Moores
Age service providers must think creatively to stay competitive. As an alternative to mergers and acquisitions, many aged care providers are looking at collaborative arrangements to obtain a competitive edge.
ollaborative arrangements involve the sharing of resources and the allocation of responsibilities between two independent organisations. This can include joint ventures, co-location arrangements and shared service models. Collaborative arrangements can be implemented through simple, informal networks or as legally binding and well-documented deals.
Benefits of collaboration • Maintaining independence • Greater efficiency and less duplicated effort • Access to additional resources, or lower costs, through sharing resources • Improved service coordination • A holistic approach to meeting client needs • Increased capacity to deliver projects However, there can be disadvantages. For example, organisations who are too busy may struggle to commit the time needed to successfully collaborate with another organisation. Collaboration may also inhibit an organisation’s flexibility. Consideration should also be given to the risk of sharing confidential and commercially sensitive information.
Achieving a successful collaboration A successful collaboration occurs when all organisations involved achieve more for less cost and effort than if they had acted on their own. Like everything, however, a successful collaboration takes careful planning and implementation, and is dependent on factors including:
• Do the collaborators share the same vision, values and commitment? For effective relationships to be developed there needs to be alignment of goals and values. • Are the collaborators individually and collectively clear as to purpose and desired outcome of the collaboration? This includes: - Each party being certain as to the need to collaborate. - Having a business plan, which details the organisation’s purpose, resources, key assets and time frames for achieving outcomes. - Certainty around including key deliverables, timelines and budget allocations. - Thoroughly documenting the formal arrangement between organisations. The type, extent and complexity of documentation will depend on the type of relationship being formed and the purpose of collaboration. • Has each organisation done its research? This will include: - Drilling down into the specific details of a proposed collaborative structure to enable the organisation to decide whether collaboration is viable. - Considering the potential risks, as well as the benefits. For example, the impacts on service users and staff, and suitability of collaboration in meeting organisational objectives? ■ For more information go to www.moores.com.au
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THE REAL COST TO PROVIDERS
OF WRONGFUL ACFI CLAIMS
In the face of recent allegations by the Department and Minister for Aged Care that providers are over-claiming on ACFI, our client data shows that 85% of facilities are not receiving all the funding for which they are eligible.
hat’s right, under claiming. Working with clients in care services including disability and aged care, we see that people generally work in these industries because they care about others.
Having interviewed hundreds of health and care workers around Australia, it is no surprise we see some general recurring themes. Workforce themes range in the extremes from “super passionate carers” to “transitional income”. From 90% female frontline staff to mostly male management. From “community service” to “corporate shareholder responsibility”. Despite the changes occurring in aged care, one consistent theme we hear – and see – is that people and providers who remain in this industry long term are there because they care. They care about their clients, about the community and about the welfare of those around them. But sadly, caring alone isn’t enough. It does not translate to an understanding of someone’s individual importance in the care funding model their organisation relies on to remain a viable business. Nor will caring alone solve the workforce and skills shortage crisis slowly unfolding in many aspects of aged care delivery. Our research has found that the average training spend in aged care is less than 0.3% of payroll. Historically, the average training spend figure for Australian companies is 2% of payroll How is that an industry so committed to caring for others fails to invest in the very people delivering the care? While there are obvious issues around workforce pay and conditions, there are strong correlations between learning and staff engagement. For a services-based business 2% including EBA costs around payroll should be the minimum allocation for staff training and development.
Marc Niemes Founder I healthxn.com
Nearly 70% of the approximately 2700 residential aged care homes here in Australia are single-site operators but there is no avoiding the fact that Government wants to see increased corporatisation of the industry, with standardised care and economies of scale. If you read through the IPO documents of these emerging organisations you will see a good growth in customer demand but not much discussion about the ability to streamline supply of capable staff. Conservatively, Australia’s aged care workforce needs to double from 300,000 to 600,000 in the next two decades to meet the growing demand and fill shortages from nearly 50% of the existing workforce due to retire during this period. By comparison, China’s shortfall of aged care workers will be about 10 million during this same period.. This is not just a local or national problem; it is going to be a global problem very soon. Where are these qualified and capable people going to come from to really help deliver on care into the future? Who is going to not only fund this shortfall but find these people? Most organisations cannot afford to wait for legislative changes, additional workforce funding or changed immigration laws that are some of the proposed solutions to our current workforce problem. The best solution to retaining good staff, and attracting others to your team is by demonstrating to staff that you care about them, about their own personal/professional development. And you do this by investing in training and ongoing education. If your staff are not submitting ACFI claims properly, your business or organisation could be missing out on funding that you and your clients rightfully deserve. Don’t let the Government take any more from your organisation than it already has. ■ For more information email firstname.lastname@example.org
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2016 PROGRAM Netherlands/ France September Industry Study Tours for Executives
2017 Study Program
NOW TAKING EXPRESSIONS OF INTEREST! To register or for more information visit sagetours.com.au or contact Program Manager Judy Martin email@example.com mobile 0437 649 672
A highlight of this tour will be SAGE delegation participation in the IAHSA Leadership retreat. The tour is also timed to align, and will include, attendance at the European Association Homes and Services for the Aged (EAHSA) conference in Lyon. A post tour to the wineries of the Lyon region will be a wind down from the intensive educational program.
BOOK NOW! Only 2 places remaining Registrations close 1 July
HEALTH & WELLBEING
NATIVE WILD FOODS –
INGREDIENTS TO GOOD HEALTH IN AGED CARE Taking a local approach to its community meals program has won the Clinical Service team at Integratedliving in Muswellbrook, NSW the national Team Excellence Award at the 2016 HESTA Australian Nursing Awards.
ith a significant number of indigenous clients using Integratedliving’s in-home support services, the team saw an opportunity to fulfil a community need with culturally appropriate dishes, using native ‘wild food’ ingredients that promote improved diet and health outcomes.
Bron McCrae, Integratedliving’s Clinical Governance Manager, with HESTA CEO, Debby Blakey at the awards ceremony
The innovative approach to meals provision aims to improve diet and nutrition in the community, with a growing body of research pointing to the nutritional value of native ‘wild’ foods and ingredients, Integratedliving’s Clinical Governance Manager, Bron McCrae said. “All Australians through us have the opportunity to have meals delivered to their homes that contain Indigenous foods and we’re seeing the research now that shows the nutritional value of native foods is just amazing,” Ms McCrae said. Ms McCrae said that Australians only use about 5% of their native flora and fauna for food, much less than other countries. The provision of nutritious indigenous meal varieties provides not only great meals like roo rendang with cinnamon myrtle and bush tomato risotto with zucchini, but is accompanied with an innovative ‘cook and yarn’ community education program. HESTA CEO, Debby Blakey said the team at Integratedliving showed leadership and initiative in identifying and fulfilling a community need in the provision of meals that has also improved the nutrition and health of clients. Ms McCrae said the $10,000 development grant prize would be used to expand the program to raise awareness of the nutritional value of our native foods. “We are looking to partner with researchers as the potential for these Indigenous ingredients is just astounding, they are truly super foods and could one day assist with treatment,” she said. ■
Lyndoch as a Leader within the Health Industry with landmark Conference:
Healthy Change and Innovation Beyond 2016 Lyndoch Living is proud to announce it will host a conference titled ‘Healthy Change and Innovation Beyond 2016’ in August which will feature the themes of ‘Change and Innovation’ and will provide the opportunity for clinicians to gain valuable insight into the changing face of the health industry and the innovations that are emerging to help shape the destiny of the health industry and support best practice for organisations.
Kate Swaffer is a leader in the field of dementia. Kate is paving the way in changing the language and approach that was once taken with people living with dementia.
Holly Ransom, CEO of Emergent Solutions, a company specialising in the development of high performing intergenerational workforces, leadership and social outcomes.
The conference will be held at the Quality Suites, Deep Blue Hotel & Spa, Warrnambool ‘The Regatta Room’ on Friday 26 August 2016 and will feature a range of topics that are relevant to a broad range of health specialties that ensures we can reach a large audience and sets the bar for Lyndoch as a leader for education within the region.
Neil Petrie is a consultant pharmacist who was the 2014 recipient of the Victorian Pharmacist Medal.
We can confirm the following international and nationally recognised speakers for the event: •
MC for the conference Dr Sally Cockburn is a GP and health advocate.
Claire Madden is a social researcher and Director of Research at the internationally recognised McCrindle.
Target audience • CEOs • Directors of Nursing • Facility Managers • Education Managers • Nurse Unit Managers • Continuous Quality Managers • Associate Nurse Unit Managers • Registered Nurses • Managers of Strategy and Innovation For more information contact Roselie Morey firstname.lastname@example.org or phone 03 5559 3460 or go to the event webpage http://www.cvent.com/d/bfq18r
AUSTRALIAN PROVIDERS LEAD THE WAY AT 2016 ASIA PACIFIC ELDERCARE INNOVATION AWARDS
Australian’s reputation of delivering cutting edge service and innovation in age service has been reaffirmed with local companies winning five categories and being name finalists in nearly all categories of the 2016 Asia Pacific Eldercare Innovation Awards.
he regional awards program, held in conjunction with the 7th Ageing Asia Innovation Forum in Singapore in April 2016, recognises the best in the industry for innovation and delivery to change the way seniors age.
More than 150 award entries were received from 15 countries for the 17 award categories, highlighting the diversity of innovative programs and services in our region and beyond.
• Ms Madeline Gall, Chief Executive Officer, Lifeview Residential Care, Australia • Mr Peter Bewert, Executive Manager - Care Services, The Salvation Army Aged Care Plus, Australia • Mr Tan Choe Lam, Founder & Managing Director, Jeta Gardens (Qld) and Jeta Global, Australia & Malaysia
LASA congratulates all winners and finalists.
FACILITY OF THE YEAR – INDEPENDENT SENIORS LIVING
PEOPLE’S CHOICE: CHANGEMAKER OF THE YEAR 2016
The Tanner Hill by Hong Kong Housing Society, Hong Kong SAR
Ms Evette Moran, Vice President, Mark Moran Group, Australia
A first-of-its-kind quality housing project for citizens aged 60 or above in Hong Kong providing 588 independent living units, a residential care home with 117 beds, a day care centre with 100 places, an elderly hub comprising recreational, catering and medical facilities as well as a wellness centre.
FACILITY OF THE YEAR – RESIDENTIAL AGED CARE Good Time Living Nakamozu by Orix Living Corporation, Japan A nursing home that features a university student dormitory and houses 1200 condominium units to build a multigenerational community together. Two Australian providers were recognised as finalists: • Wynyard Care Centre by Synovum Care Group Winner Evette Moran, with founder, Janice Chia and the Peoples Choice finalists
Three other Australians were recognised as finalists in this category:
• Montrose Aged Care Plus Centre by The Salvation Army Aged Care Plus
BEST ACTIVE AGEING PROGRAMME Exciting the senses by Mark Moran Group, Australia
BEST APPROACH TO SUPPORT AGEINGIN-PLACE SilverCOVE by NTUC Health Co-operative Ltd, Singapore A holistic approach to helping seniors age healthily and happily within the community through emphasis on physical, intellectual, social, emotional, spiritual, vocational and financial, and fitness activities.
BEST DEMENTIA CARE PRODUCT Memoriana by wissner-bosserhoff GmbH, Germany
The integration of Mark Moran Group’s award-winning activities to stimulate the mind and engage the spirit and body to enable residents to ‘live younger longer’. From innovative arm-chair Tai Chi, to the Paddock to Plate program and specially prepared “My house my kitchen” meals to reactivate positive memories. Aged Care, Australia was recognised as a finalist for its “Bridging the Gap inter-generational program” with Mount Scopus Memorial College.
BEST ACTIVE AGEING SPECIAL PROJECT Positive Ageing Celebration by Lifeview Residential Care, Australia
A concept for the support of residents and nursing staff, developed in partnership with Sterling University, Scotland, which takes into account the special needs of dementia afflicted persons and nursing staff. It ensures an optimised living and nursing environment and is based on orientation, safety and independence. Lifeview Residential Care, Australia was recognised as a finalist for its Virtual Forest product.
BEST DEMENTIA CARE PROGRAMME Green Fiesta by Li Ka Shing Care & Attention Home for the Elderly, Hong Kong SAR A tailor-made rehabilitation program for dementia elders to enjoy activities in natural green environment within the elderly home. Four Australian providers were recognised as finalists for their dementia care programs: • Memory Wellness Program by integratedliving Australia • Intergenerational care and activities program by Mark Moran Group • Music – Bringing life to this place by The Salvation Army Aged Care Plus • Spark of Life by Thomas Holt
BEST HOME CARE OPERATOR Winner – Yushoukai Medical Corporation, Japan Home Nursing Group, Australia was recognised as a finalist.
Each year residents from all Lifeview homes get together to demonstrate their creativity and skills in a program designed specifically for them, where there are no barriers in relation to age and ability. Blisscare Australia was recognised as a finalist for its festive “dance party” rejuvenation project.
BEST PRODUCT TO SUPPORT AGEINGIN-PLACE Wrappon Everi Portable Toilet by Healthcare Matters, Singapore
Difficulty navigating the Aged Care minefield? Our fully integrated suite of software is compliant with the latest legislation and can help you plot your way through.
✓ Stable, reliable and cost effective ✓ Fully backed up with support desk and training ✓ AIM is ‘hands on’ using its own software daily, providing payroll bureau and fully outsourced financial Management Services ✓ Community Care module is CDC compliant ✓ Our clients benefit from our knowledge of the industry and the commitment to develop ongoing practical solutions
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Silver Memories is a twenty-four hour a day nostalgia radio service
❖ plays cheerful music from the 1920s to the 1950s ❖ cheerio calls, birthday calls, old radio serials, comedies ❖ based on Reminiscence Therapy & ideal for aged care homes ❖ relieves depression, triggers happy memories & assists relaxation
Silver Memories CD series now available at all good record stores including ‘Our Vera’ – celebrating Dame Vera Lynn’s 99th birthday.
Have Silver Memories installed in your Aged Care Home 4mbs.com.au/silver Debbie Price 07 3847 1717 I firstname.lastname@example.org 81
BEST PRODUCTIVITY INNOVATION IMPLEMENTATION NEXT-PLATFORM by Yushoukai Medical Corporation, Japan
Three Australian companies were recognised as finalists: • The Brighton Retirement Community by Campbell Luscombe Architects • Bethanie Peel Stage 2 by KPA Architects
A computerized medical record sharing system.
• St Paul’s Residential Aged Care by ThomsonAdsett
Two Australian providers were recognised as finalists in this category:
BEST TECHNOLOGY FOR OPERATIONAL EFFICIENCY
• Spirit of Life (SOL) at Work programme by Mark Moran Group, Australia • Organisational Leadership and Retention through Staff Wellness - I like to move it move it by The Salvation Army Aged Care Plus
BEST REHABILITATION OPERATOR Apple Wood Saidaiji, Japan A specialised functional recovery rehabilitation program that offers medical care to clients who have been discharged from acute care at hospitals and those in the highest category of care. Blisscare and Mark Moran Little Bay were both recognised as finalists.
BEST SILVER ARCHITECTURE – COMMUNITY SPACES SilverCOVE Senior Activity Centre (Singapore) by NTUC Health Co-operative, Singapore An eldercare hub offering a wide range of fitness, healthcare services and social activities.
BEST SILVER ARCHITECTURE – RESIDENTIAL Synovum Care Bellmere (Australia) by Paynter Dixon Queensland (Australia), Australia A 120-bed residential aged care development, built as a small scale community. The design allows residents, no matter their diagnosis, freedom of movement in and out of their own homes and into an ‘active’ community.
Carefort Automatic Waste Packing Machine by Healthcare Matters, Singapore A product that seals non-sharp waste material into a compact, flat pack.
BEST WELLNESS PROGRAMME – COMMUNITY The Brain Trainer Exercise with Pepper by Sendai Television Incorporated, Japan A humanoid robot named Pepper, that visits nursing home facilities, providing brain training exercises for everyone based on scientifically backed program supervised by renowned brain scientist, Dr. Ryuta Kawashima. RDNS HomeCare, Australia was recognised as a finalist for its Positive Ageing, Health and Wellness Program.
BEST WELLNESS PROGRAMME – RESIDENTIAL AGED CARE Team Ride around Australia by St Hedwig Village, Australia A program designed to get residents up and moving, using a Motomed bike that allows participation from residents with different physical ability levels. It helps with passive, active assisted and active resisted training through virtual bike tours. Residents have a team of completing a tour of Australia together. Mark Moran Group was recognised as a finalist for its Paddock to Plate program. ■
ASSA ABLOY Hospitality ASSA ABLOY Hospitality has served as the leading global technology provider of access control and Energy Management Systems for over 35 years. As a provider of modern technology, knowledge and application to the senior care sector, we know what it takes to unlock a true feeling of security for residents and their carers. Our electronic locks ensure secure and convenient access, while guaranteeing that staff members are able to maintain a high level of security throughout a facility via the use of audit trails. Maximizing security, operational efficiency and convenience, our technology has been designed to ensure that resident safety is always paramount. Residents and staff can also expect a seamless access experience that saves time and enhances the value of your facility. For more information on ASSA ABLOY Hospitality solutions and how they can benefit your operation, please contact our office at 1 300 796 233 or visit www.assaabloyhospitality.com.
The global leader in door opening solutions
smarter laundry solutions
Laundry isn’t your core business… but it is ours. Washer Extractors
Aqualogic Laundry Systems is your single destination for all laundry needs. We offer total solutions making operating your own in-house laundry easy.
Specialising in both new laundry design and updating existing laundries – we assist with ongoing support, training, maintenance and customer care. We are
Ironers Finishing Equipment
with you every step of the way. Not just an equipment supplier, we partner you and your in-house laundry to ensure a successful, efficient and economical solution to your laundry needs, now and in the future. Renowned as the supplier of choice in Aged Care, our customers include the
Trolleys & Accessories
leaders in the care sector. Nursing homes, hostels, retirement and independent living facilities need the assurance of guaranteed service, parts and support. Quality equipment, industry leading warranties, outstanding service and value for money are the cornerstones of our partnerships. Talk to us about our Total Care Rental packages; no initial investment , fixed monthly fees and guaranteed service response for Aged Care facilities.
www.aqualogic.com.au NSW: U H/ 2 Hudson Ave Castle Hill NSW 2154 T: (02) 8850 1300 | F: (02) 8850 2255
QLD: 2/123 Muriel Ave Moorooka QLD 4105 T: (07) 3392 9299 | F: (07) 3392 9211
WHAT’S NEW ASSA ABLOY
ASSA ABLOY Hospitality has served as the leading global technology provider of access control and Energy Management Systems (EMS) for over 35 years.
Do you want to eliminate missed medications from your clinical records? Are you aiming to bring your missed signature rate to zero?
As a provider of modern technology, knowledge and appliances for the senior care sector, we know what it takes to unlock a true feeling of security for residents and their caretakers. Our electronic locks ensure secure and convenient access, while also guaranteeing that staff members are able to maintain a high level of security throughout a facility via the use of audit trails. Our technology has been designed to put safety first, while increasing operational efficiency and convenience. Residents and staff can also expect a seamless access experience that saves time and enhances the value of your facility.
For more information on ASSA ABLOY Hospitality solutions and how they can benefit your operations, please contact our office at 1 300 796 233 or visit www.assaabloyhospitality.com
Minimising medication errors is vital to providing safe, high quality care to your residents. The most effective means of reducing medication errors is by integrating your clinical management and medication management into a single electronic system (as outlined by The Australian Commission on Safety and Quality in Healthcare). When you implement an electronic medication management system that incorporates alerts and enforces best practice workflow, you eliminate the risk created when tasks are able to slip through the cracks. AutumnCare have been on the road the past few months delivering interactive seminars on medication management Australia wide. If you missed out, it’s not too late to find out more about how you can minimise medication errors at your facility. You can say goodbye to missed meds with AutumnCare’s Medicate. Medicate enforces a reason being provided for non-administration. It empowers staff to feel confident when performing medication rounds because they know everything due in this round will be displayed.
Contact AutumnCare today to arrange an information session or a demonstration of the enhanced Medicate 4.5.2.
Livi® Our globally recognised Livi® brand cares for delicate skin and provides unsurpassed hygiene quality through gentle facial tissues, toilet paper and associated products*.
Flu season is alive and kicking
Three lines to suit all needs We are purposefully positioned to satisfy all budgets and serviceability needs through our three lines: Impressa, Essentials and Basics. • Livi Impressa – A deluxe range of stylish, cubed facial tissue and soft embossed toilet paper that deliver optimum comfort for fragile skin and mitigate irritation so patient’s condition improves sooner.
The flu shot doesn’t necessarily prevent the illness. Comfort and reassurance go a long way to reducing recovery time and alleviating the misery that patients experience. Livi’s hypo-allergenic facial tissues are the softest around, minimising harm to fragile skin and delivering comfort with every touch. By preventing further irritation, the risk of bacterial infection is greatly reduced.
• Livi Essentials – Premium products for all daily requirements, from high volume jumbo rolls of toilet paper and towel to individually wrapped toilet rolls and facial tissues.
Quality you can genuinely trust
National distributor network
As a conscientious APP affiliate, Livi has maintained a consistent standard of excellence that places us at the leading edge of the industry. Measuring by Olympic Standards (MBOS) and complying with the quality standards of ISO 9001 Livi’s tissue paper is sourced from our own integrated supply chain, meaning all products are of a controlled and consistently high quality and perform to the highest standards.
Livi Tissue Papers can provide state-based sales support through our efficient national Distributor network.
• Livi Basics – A practical range of toilet paper and towel for high volume facilities.
Get in touch today for further information – 1300 832 883 – email@example.com *Livi®’s full range of high quality B2B tissue products includes toilet paper, paper towel, facial tissue, napkins and dispensers.
WHAT’S NEW SPEED QUEEN BARRIER WASHER-EXTRACTORS Getting behind the ‘barrier’ concept The ‘barrier’ concept is proving more and more popular in the Healthcare sector and we can guide you on either creating the optimum laundry layout from the beginning or help you upgrade your existing laundry. The process us focused on preventing contact between clean, disinfected laundry and soiled, contaminated laundry. Determining factors in planning include the proposed number of beds or patients, the necessary area, space, equipment, utilities, accessories and auxiliary equipment, and the number of operators you will need. As you know, Hospitals and other Healthcare environments need to take preventive measures in order to avoid microbiological contamination, also referred to as ‘hospital acquired infections’ (HAI), in the laundry process. The contamination/recontamination risks that apply to linen can be eliminated using the hygienic ‘barrier’ concept in accordance with EN14065 (ISO Norm) that focuses specifically on laundry-processed textiles and the bio contamination control system.
Invacare Softform Mattresses are hard at work, clinically shown to better support patients and your bottom line Using the Maxi Glide mattress Canberra Hospital demonstrated 14% reduction in pressure injuries. Fewer pressure injuries mean fewer days stay in hospital, less cost. The Softform Maxi-Glide mattress features our patented ‘gliding’ system which allows the top foam layer to slide over the bottom foam layer - reducing shear forces that lead to or increase the prevalence of pressure sores. Patient treatment is estimated at costing around 2.5 more times than preventative treatment and the length of stay of a patient with a pressure ulcer is about 3.5 times that of a patient without a pressure ulcer. The Softform Maxi-Glide significantly eases the burden of pressure ulcers on patients and carers as well as providing significant cost savings. With your professional care and Invacare’s exceptional care surfaces pressure ulcers can be prevented and damaged skin nursed back to good health. Source: Canberra Hospital and Health Services, Research Report – A comparative study on the effectiveness of two pressure relieving
A specially developed range The Speed Queen SH-range and SB-range of soft-mount barrier washer-extractors offers a solution to the threat of HAI as it considerably reduces the risk of recontamination or cross contamination thanks to its ‘dual door’ design. The barrier washerextractors are built ‘into’ a physical wall separating the loading and unloading side. This set-up promotes greater hygiene as it ensures there is no contact between clean, disinfected laundry and soiled, contaminated linen. Sensors ensure that the door on the contaminated side remains locked while the door on the cleanroom side is open, and vice versa. The aim being to help you eradicate bacteria, viruses and superbugs including MRSA and C. difficile to better safeguard patient and resident health. Our team would be happy to advise you on tailoring the ideal layout and Speed Queen equipment.
We enable ultimate tracking and traceability for you, end-to-end, to help you manage inventory, hygiene and costs. For more information please contact firstname.lastname@example.org (VIC, TAS, SA & NT) email@example.com (NSW & WA)
mattresses in prevention of pressure injury on medical and surgical inpatients at Canberra hospital. A.M Dunk & J. Parke, June 2012.
For More information contact Invacare – Phone: 1800 460 460, Email: Orders@invacare.com.au
COMPUTER SOFTWARE OPTIMISE YOUR LAUNDRY EFFICIENCY | TECHNOLOGY
The Solution is Speed Queen On-Premise Laundry Equipment • Specialising in the AGED CARE and HEALTH CARE industries
• Nationwide SPARE PARTS and FACTORY TRAINED Installers & Service Technicians • Full tailor-made PREVENTATIVE MAINTENANCE PROGRAMS
• OTEK OZONE technology for the ultimate in laundry disinfection, increasing productivity, extending the life of your linen and reducing operating costs • Professional laundry APPRAISAL, planning and CAD design service
• Flexible FINANCE packages available via Macquarie Equipment Finance
Manufactured by the world’s number 1 Commercial Laundry Company, every Speed Queen model is tested to its limits and beyond, and benchmarked against the competition to ensure it out-performs and out-lasts the rest.
P: 03 9495 1300 I W: www.speedqueensales.com.au E: firstname.lastname@example.org (Vic, Tas, SA & NT) P: 02 9748 2155 I W: www.speedqueenlaundry.com.au E: email@example.com (NSW & WA)
Hands love Jasol.
From liquid to foam hand soaps with the latest dispensers weâ€™ve got all your hand hygiene needs covered. NEW TOUCH FREE & MANUAL LIQUID OR FOAM SOAP DISPENSERS Jasolâ€™s new wall mounted soap dispensers have a 100% disposable inner mechanism to ensure full hygiene integrity. Both units have interchangeable pumps and soap pods that can be easily switched between each. Once the soap pods are placed in the unit they only need replacing when the container is empty. The chemical is never in contact with air or germs.
NEW SAFE T GUARD Why not combine your Jasol Dispenser with our new, non alcohol, foam hand sanitiser. Also sold in 50ml and 500ml packs. Contains unique ingredients that reduce the spread of germs. Placed directly onto the skin it quickly evaporates when hands are rubbed together.
Speak to your Jasol Account Manager or contact our customer service team on 1 800 334 679 or visit jasol.com.au
Providing hygiene service solutions since 1934