February â€“ March 2012 | Vol. 6 Issue 3
AGED-care & retirement
Weâ€™ve got your industry covered I www.insitemagazine.co.nz
16 i INTERVIEW
On the soap-box...
Todd Jenkins and the DHB 4 I Focus on:
Retirement Villages as a business
2 i NEWS
Pensioners benefit as Kiwisaver turns FIVE
AGED-care & retirement
4 INsite Magazine Vol. 6 Issue3 Editor:
E: email@example.com ADVERTISING: Belle Hanrahan T: 04 915 9783
Retirement Commissioner DIANA CROSSAN talks to INsite about how retirement villages are raising their game following some damning revelations from last year’s review of the Retirement Villages Act.
GRAHAM WILKINSON gives his opinions on the similarities of the hotel and retirement village industries.
In our education & training special feature, we ask Careerforce what’s being done about career progression for caregivers, page 8; John Collyns and Margaret Owens outline the RVA’s plans for a core training programme for retirement village managers, page 10; and Julie Haggie discusses the goals to upskill the home health workforce, page 13.
Meet the caregivers who were nominated for the INsite/NZACA Christmas Cracker Caregiver Competition.
E: firstname.lastname@example.org PRODUCTION ManAger: Barbara la Grange EDITOR-IN-CHIEF Shane Cummings T: 04 915 9795
Why did Metlifecare, Ryman and Summerset all made headlines last year and what is in store for these three rapidly growing corporations in 2012?
Jude Barback T: 07 575 8493
In this issue... 7
Retirement villages: Long-stay hotels or aged-care facilities?
GENERAL MANAGER/ PUBLISHER: Bronwen Wilkins SUBSCRIPTIONS: T: 04 471 1600 F: 04 471 1080 E: email@example.com PUBLISHER’S NOTE: © Copyright 2012. No part of this publication can be used or reproduced in any format without express permission in writing from APN Educational Media (NZ) Ltd.
EDITORIAL & BUSINESS ADDRESS Level 1, Saatchi & Saatchi Building, 101-103 Courtenay Place, PO Box 200, Wellington 6140, New Zealand Ph (04) 471 1600 Fax (04) 471 1080 ISSN 1177-9268
New year, new INsite This edition marks the beginning of some exciting new changes for INsite. In an effort to do justice to the many and varied topics confronting the aged care and retirement sectors, we will be honing in on a different topic in each edition. The focus for this issue is ‘retirement villages as a business’ and accordingly we look closely at some of the retirement village corporations that made media headlines late last year, as well as considering the similarities (or differences!) between the retirement village and hotel industries. We also feature a bumper education and training special, headed by the RVA’s plans for their new core training programme for village managers. Fear not, a ‘focus’ does not mean we intend to neglect other aspects of aged care. Our news section and new columns are testament to this, bringing you all the information you need regarding your sector. As INsite’s new editor, I will strive to give readers an insight into the lives and expectations of the residents, caregivers and leaders comprising New Zealand’s aged-care and retirement sector. But I need your help. In order to fully engage with the sector, we encourage readers to express their views online, so check out our online version at www.insitemagazine.co.nz. INsite will also be accepting letters to the editor this year. The next issue will look in depth at concerns around the topic of long-term care – we welcome your ideas and input. Jude Barback firstname.lastname@example.org
Caregiver Competition winners
NEWS Snippets and updates from the industry
On the soap box... Todd Jenkins
Spotlight on... Gardens
Up close and Personal WITH... Rosemary Westley
Let’s snoop around... Ocean Shores Retirement Village
A TYPICAL day in the life OF... Liz Black
The last word... Minister of Health, Tony Ryall
Spotlight on... Gardens
www.insitemagazine.co.nz | February/March 2012 1
news News IN BRIEF
»» The Selwyn Foundation appoints Garry Smith of Auckland District Health Board as its new chief executive officer. »» First eligible KiwiSaver investors will be able to take their money out from July this year. »» Bupa Personal Medical Alarms has launched new technology aimed at helping people stay in their homes for longer. »» Minister of Health Tony Ryall opens newlyrefurbished buildings of the Hospice Eastern Bay of Plenty. »» NZACA will be visiting branches throughout New Zealand over the next month. »» Construction has begun for much needed hospital and dementia beds at Merrivale Care Home in Kamo. »» The formation of a new association, Care Association New Zealand (CANZ), was announced at the end of 2011. »» Lois Cossey of Selwyn Oaks wins the INsite/NZACA Christmas Cracker Caregiver Competition. See more on page 14.
New association marks new phase in aged care
The formation of Care Association New Zealand (CANZ) was announced at the end of last year and marks “a new phase in aged care”, says Victoria Brown, on behalf of the CANZ executive. The new association aims to support aged-care providers to achieve excellent standards of care for elderly residents. The creation of CANZ came in response to concerns by primarily hands-on providers that the formation of a single aged-care association has left a gap in the knowledge and support base for aged-care providers, says Brown. Brown says this group of aged-care providers expect CANZ to participate fully in every area where sector issues are discussed and whenever decisions affecting aged-care providers are being made.
NZACA branch visits
For the next three months, NZACA will be holding branch visits throughout New Zealand. Among the items on the agenda are the association’s internal and external strategic direction in relation to the new government, the A21 review and many other specific topics, including the interRAI roll-out, ARC Service Review and Careerforce. Also to be discussed are issues relating to NZACA’s future in terms of fees, services and coverage, as well as local DHB issues. Martin Taylor, chief executive of the NZACA, stresses that it is very important for members to attend the meetings to give the NZACA a good idea of what they are willing to support. “We will also be asking for a vote on many topics, and we will collate the vote and report the result to the board.” 2
February/March 2012 | www.insitemagazine.co.nz
KiwiSaver makes it through KiwiSaver turns five in July 2012, having weathered a global financial crisis and tinkering by successive governments. This milestone means the first savers will begin to benefit. Around 75,000 people – those who are aged over 65 and have been in the retirement scheme for five years – will be eligible to take their money out.
It is up to the individual to decide whether to leave the money in the KiwiSaver scheme, or take it out in one lump sum or in regular withdrawals – although if all the money is withdrawn, the account is closed and the individual will not be able to rejoin KiwiSaver. Experts expect people to use their KiwiSaver funds rationally. “We don’t expect hordes of 65-year-olds to cash up and party until it’s all gone,” says Andrew Gawith, a director of Gareth Morgan Investments. Many people decide to cash up all their investments at 65 and put the money in the bank, but, according to Jeff Matthews of Spicers Wealth Management, the low interest rates for bank savings accounts mean the investments don’t keep up with the rising costs of living. KiwiSaver is a low-cost way to invest in higher-growth investments such as shares and property, and Matthews says that if people can keep contributing after age 65, that’s even better. That said, the benefits of staying in KiwiSaver will be reduced. The Government and often employers cease contributions once an individual turns 65. David Boyle, general manager of funds management for ANZ Wealth and OnePath, says that when KiwiSaver was launched, the biggest uptake for active investors (those who chose to join the scheme rather than being auto-enrolled) was from people nearing retirement. “Consequently, large providers like us will have a greater bubble in that age group,” says Boyle. OnePath alone has 3000 members who will be able to pull their money out in July. With an average balance of $15,000, that is $45 million that could go back to investors.
Numbers at a glance »» 1,970,000. The number of people expected to be in KiwiSaver by July 2012. »» 75,000. The number of people who will turn 65 between 1 July 2012 and 30 June 2013 and be eligible to take their money out of KiwiSaver. »» 17,500. The number of people who will be eligible to withdraw their money in July 2012.
Source: Pre-Election Economic & Fiscal Update 2011
Ryall visits newly refurbished hospice
Minister of Health Tony Ryall recently opened the newly refurbished buildings of the Hospice Eastern Bay of Plenty. The refurbishments will enable the hospice to offer even better services to patients and their families across the district, along with more day services on site. Hospice Eastern Bay of Plenty has a contract with Bay of Plenty District Health Board to provide specialist palliative care, which Ryall says has been boosted under the current government. “We increased funding for hospices by $15 million a year to $75 million in 2011, to expand care and services and meet current financial challenges.” Ryall says that while this investment provided equitable funding across hospices so that we can have this vital service in our communities, he knows it doesn’t cover the whole bill. “We must all rely on the generosity of communities – who reached into their pockets to the tune of around $30 million dollars in 2011 to enable patients and their families to make the most of the time they have left together.” The health minister thanked the 50 or so volunteers who contribute their time and talents to running Hospice Eastern Bay of Plenty – calculated at about 3500 hours a year between them. “That is the sort of dedication, generosity and hard work that has grown hospice services here from a volunteer-led organisation 27 years ago to one of the core health providers in this region.” “While medical progress finds new cures at an accelerating pace every day, there will always be the need for end-of-life care,” says Ryall. Dame Cicely Saunders – the modern founder of hospice – described the end of life as often the most important part. Hospice care makes a huge difference to people’s lives by ensuring that terminally ill people are as free from pain and suffering as possible and that they can die with dignity.
New CEO for Selwyn Foundation GARRY SMITH has been appointed by The Selwyn Foundation as its new chief executive officer and will begin his new role on 2 April 2012. Smith, who is the current CEO of Auckland District Health Board, will succeed Reverend Duncan Macdonald, who is retiring as head of the foundation, one of New Zealand’s leading not-for-profit providers of aged care services. “I am honoured to have been appointed to The Selwyn Foundation role. I look forward to preserving the strong heritage of the foundation and ensuring that the delivery of care is innovative and at the forefront of the agedcare sector,” says Smith, who has 20 years’ experience in the health sector. Smith has held a number of senior management positions with public and private healthcare organisations throughout New Zealand. A qualified accountant, he also has expertise in management, planning, accounting and finance. Chair of The Selwyn Foundation Board, Dr Kay Hawk, says, “We are extremely fortunate to have a CEO of the calibre and with the qualities and experience of Garry Smith. He is the ideal person to continue the strong growth path and Selwyn culture established by Reverend Duncan Macdonald, and to lead the foundation into a new era in which we meet the needs of the next generations of ageing New Zealanders.” The Selwyn Foundation provides residential care, independent retirement living and community services for the elderly, and owns or manages a total of nine retirement sites across the upper North Island.
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New technology helps older people stay independent Bupa Personal Medical Alarms has launched new technology aimed at helping older people with dementia or other medical conditions stay in their homes for longer. As new medical alarm technologies continue to grow in popularity and peoples’ desire to stay at home longer increases, health and care company, Bupa, has invested in sourcing compatible technology to make staying at home easier. The latest range of sensors help detect both activity and inactivity; that is, when the person is moving about or not moving. These sensors either link to a personal pager used by the carer (in the same house), or link to the Bupa monitoring centre, 24 hours a day, seven days a week. This is the first time this technology has been linked in this way in New Zealand. It allows the person whose activity needs to be continually monitored more freedom in the home. Their carer can be more relaxed, secure in the knowledge that they will be alerted immediately, if needed. There are three products available for supporting carers and people living with dementia or other medical conditions. A pressure mat sensor that can be placed in a range of locations and will trigger a pager or send a call to the monitoring centre when the person with dementia crosses the path of the mat, indicating that they are on the move. The bed-occupancy sensor works in a similar way and is activated when the person with dementia gets out of bed, which in turn alerts the pager of the person in the home caring for them. This sensor can be set at various levels depending on the normal movement of the person. For example, it can be set to trigger after the person has been absent from the bed longer than a set amount of time. This sensor can also be used for inactivity, so if the person does
not get out of bed at the pre-determined time, an alert will also be sent. The third product is the property-exit sensor that is triggered by the door opening. It is generally used on a front or back external door, to indicate that the person is leaving the house. Margaret Owens, general manager of Bupa Independent Living, says, “We want to help people stay safe, secure and independent in and around their homes. Caring for someone at home with a medical condition or disability can be a stressful role, and these sensors can reduce some of this stress. These solutions are designed to offer peace of mind to friends and family, and provide support for living with the condition stay in their own home.”
Much-needed hospital and dementia beds under way for Kamo
Construction has begun on the development at Merrivale Care Home. Located in Kamo on Winger Cresent, the development includes 15 new serviced apartments for more independent living plus 34 new hospital beds, which include nine dementia beds. Currently Merrivale Care Home offers resthome, respite care and day care for older people. The expansion of the care home will see the addition of much-needed dementia beds for the area plus additional hospital-level care beds. “Bupa are delighted at the opportunity to expand care services in the North. We are particularly excited about the addition of dementia beds plus the retirement living apartments,” said Beth Kelly, care home manager of Merrivale. The development of the new facilities is due for completion in stages, with the apartments and dementia beds due in the first half of 2012.
www.insitemagazine.co.nz | February/March 2012 3
Tale of three villages Retirement village corporations dominated business news at the end of 2011. What deals were done? What forecasts have been made for 2012? And what do the experts think?
first time trading In the news
structural shake-up In the news
Metlifecare made headlines in November last year when the company announced the completion of the strategic review of its capital and ownership structure. The review followed reports earlier in the year that the company had suffered a net profit drop of almost 70 per cent resulting largely from a shift in fair value of assets following the sale of its Merivale retirement village in Christchurch. The initiatives resulting from the review were aimed at providing a platform for growth and unlocking value for all shareholders. One major initiative was the placement of new and existing shares to institutions and other eligible investors. Capital was raised accordingly by the primary offer of new shares of $40 million at a 7.1 per cent discount to institutional investors. Additionally, shareholders were given the opportunity to subscribe for up to $5.5 million of new capital through a share-purchase plan. The offer, which closed on 6 December 2011, received applications totalling $3.85 million by 312 shareholders, representing 58 per cent of eligible shareholders. Capital was also raised through a secondary offer of existing shares of $59.2 million at $2.10 per share (discounted from $2.26), thereby reducing Retirement Villages NZ’s 82 per cent holding to 51 per cent. The other major initiative resulting from the strategic review is the appointment of three independent directors to the board, including possibly the appointment of an independent chair. In December, Gregory Flood tendered his resignation as chairman of the Metlifecare board of directors, following his resignation as CEO from Retirement Villages Group. Peter Brown, who has been a director for six years, has been appointed interim chairman.
What’s in store for 2012?
According to shareholder information, the capital raised will initially be applied to reduce bank debt. Beyond that, the new capital is expected to provide Metlifecare with a prudent level of financial flexibility which, together with ongoing sales, will provide a strong capital base for future growth. 4
February/March 2012 | www.insitemagazine.co.nz
Plans for future growth reportedly lie in the further development of four North Island sites, including sites in Takapuna, Paraparaumu, Tauranga and West Auckland. Plans are also afoot to return to dividend policy initially targeting between two and four cents per share, with the first dividend payment expected to be made following the completion of the 2012 financial year. The changes in governance are likely to take place in 2012 as well. Peter Brown, as interim chairman, will oversee the transition of the board to comprise the three independent director, three Retirement Villages NZ representatives and the managing director.
The experts say...
Metlifecare’s board of directors is pleased with where things stand following the review. “Through the recent successful capital raising, Metlifecare is in a strong financial position to execute its growth strategy in the new year and beyond,” says Brown in a shareholder statement. Flood, chairman at the time, expressed his satisfaction at the participation in the sharepurchase plan, believing it to be a further strong endorsement of the company. Investors are largely positive about the shake-up too. According to the NZ Herald, Craig Tyson, equity investment manager of OnePath, which has an existing stake of 3.4 per cent on Metlifecare, welcomed the sell-down by Retirement Villages NZ, as it creates more liquidity in the stock. Tyson said Metlifecare has performed badly in recent years due to overpaying for assets and taking on too much debt.
Metlifecare was established in 1986 and is a publicly listed retirement lifestyle company. The company has 16 retirement villages throughout New Zealand – all accredited members of the Retirement Village Association. Most villages provide a full continuum of care, from independent villas and apartments through to serviced apartments, resthomes and hospitals. Alan Edwards is the managing director and CEO of Metlifecare and has spent over 12 years leading companies in the retirement village industry.
Summerset Group Holdings recently began trading in ordinary shares on the New Zealand Stock Exchange. Summerset chairman Rob Campbell described the launch of trading on the NZX as a further milestone in the growth of the group from a local family business to a nationwide publicly traded company. Summerset debuted at $1.45 a share – a five cent (3.6 per cent) premium to their $1.40 a share issue price. Pricing of the company’s share issue was set through an auction-style bookbuild. The initial public offer (IPO) undertaken by Summerset’s majority owner, Quadrant Private Equity, raised $123.6 million – $50 million of which has been fed back into Summerset to fund and support its growth plans. Quadrant Private Equity will remain Summerset’s cornerstone shareholder holding 56 per cent of the shares. The balance of the shares is held in approximately equal proportions by institutional shareholders and retail investors, including senior management, staff and residents. At about the same time as listing on the New Zealand Stock Exchange, Summerset was named best retirement village operator in Australasia for the second year running.
What’s in store for 2012?
According to Summerset, the plan for 2012 is to maintain momentum and go for a trifecta on the best retirement village operator. This year will see a number of announcements around growth in existing villages. There are plans to begin building a second village in the South Island. Summerset continues to look for new land and new opportunities across the country, with a particular focus on the underserviced Auckland region. This year Summerset will be announcing its first set of annual results and releasing an annual report to new shareholders, many of whom are also residents at one of Summerset’s 14 villages. Development at Summerset’s largest village, Summerset by the Park in Manukau, has now been completed, a significant milestone for the company. There is also a focus on extending the continuum of care model across the country and investigating new and innovative ways to continue increasing quality of life for all residents. The start of 2012 saw the establishment of Summerset’s own in-house design team. This is a continuation of an ongoing project that focuses on Summerset executing full internal control over all stages of village development through to implementation and execution from capabilities held within the company. “The aim is to ensure quality and consistency at all Summerset villages
FEATURE and guarantee residents they are choosing the best in retirement living,” says Summerset’s Harriet Palmer. Summerset also expects to welcome its 2000th resident this year, which will be the cause of much celebration.
The experts say…
Investment banking sources say Summerset is being seen as an important test of investor confidence as other companies, including fellow retirement village operator Vision Senior Living, follow suit and begin trading on the NZX.
Summerset was founded by John O’Sullivan in 1994 in the Kapiti and Horowhenua regions. It opened its first village in Wanganui in 1997 with 14 retirement units and an aged-care hospital; in doing so Summerset implemented its strategy of providing a full range of aged-care services and living options for residents. With this strategy Summerset has since grown to become the third largest retirement village operator in New Zealand and the second largest developer. It currently has 13 villages in operation. Norah Barlow has been the chief executive officer leading Summerset since 2001, having joined Summerset in 1999.
Ryman Healthcare: market darling In the news
Ryman Healthcare was named one of the top stocks for 2012 by brokers. With reported shareprice returns of 16.95 per cent, Ryman has been described as one of the “market darlings”. In November, Ryman Healthcare announced its purchase of a site in Wheelers Hill, Melbourne, paving the way for its move into the Australian market.
What’s in store for 2012?
Ryman is expected to start construction of the Wheelers Hill project towards the end of 2012, with stage one including 150 units. According to the NZ Herald, David Kerr, Ryman chairman, said the company would apply its standard formula in Australia. “Ryman plans to develop a medium-density village along similar lines to the villages it has successfully developed in Auckland and Wellington, and plans to offer the full continuum of care, including independent apartments, serviced apartments, a village centre and an aged-care centre. “Our focus will be on successfully establishing this first village in Melbourne, and learning how to adapt our model to the Australian market, while maintaining our expansion in New Zealand,” said Kerr. Meanwhile on this side of the Tasman, Ryman will continue with its growth target of 550 new units each year.
The experts say...
The plan for 2012 is to maintain momentum and go for a trifecta on the best retirement village operator.
Few would dispute that Ryman Healthcare is a business success story. Craigs Investment Partners say that since listing in June 1999, Ryman Healthcare has delivered its shareholders a total return of over 1000 per cent; by returning 10 times the original investment, brokers will refer to Ryman as a “ten-bagger”. Craig Tyson, OnePath equity investment manager, agrees that Ryman has performed well in a tough market. “Ryman is now the seventh biggest company in the NZX 50, bigger than Fisher & Paykel Healthcare. The company has not raised equity since listing in 1999 and now has a value of $1.3 billion. If you had invested $1000 in 1999, then that would have returned dividends and capital of over $14,000,” Tyson said. Experts tend to agree that Ryman, and
indeed other aged care providers, have the demographics of an ageing population on their side. Mark Lister at Craigs Investment Partners is one who sees potential in the positive demographic trend, believing there to be capacity for growth in existing sites and opportunity for ongoing growth in new sites. Jeremy Simpson, director of Forsyth Barr’s research, notes that while Ryman has been a high-performing stock currently trading at a premium, it was never an overnight success. The share price picked up in mid-2006 after a relatively flat period of about four years since it was first listed, and then responded well after the global financial crisis as the market realised how strong its business case was, even in a slow period of economic activity. With regard to the move into Australia, William Curtayne, of institutional investor Milford Asset Management, said New Zealand companies had a poor record in Australia, but Ryman was more likely to be successful because of its low-risk approach. Curtayne says the Melbourne project will represent around 20 per cent of the company’s new units in year one and about four per cent of Ryman’s total portfolio when completed, hence Ryman is taking a measured approach to its Australian expansion. “There are a number of plus factors across the Tasman, including a much higher population, superior unit prices, and care beds are more lucrative in Australia than New Zealand.”
Founded in 1984 by John Ryder and Kevin Hickman, Ryman Healthcare opened its first village offering the full continuum of care – Rowena Jackson Retirement Village in Invercargill in 1996. Three years later, it opened Malvina Major Retirement Village, its first village in the North Island. In the same year it was listed on the New Zealand Stock Exchange, raising $25 million, attracting 1600 shareholders and market capitalisation of $135 million. 2003 saw Ryman’s entry into NZX 50 and 2009 into NZX 10. Today Ryman Healthcare has over 12,000 shareholders, market capitalisation of $1.3 billion and has paid $200 million of dividends since listing. With 24 retirement villages throughout New Zealand, it has over 2600 staff and 5400 residents. David Kerr, a general practitioner who operates a private practice in Christchurch, joined the Ryman Board in 1994 and has held the role of chairman since 1999. www.insitemagazine.co.nz | February/March 2012 5
Complying with the Act Last year the Retirement Commissioner released a report revealing that many residents were left concerned and confused following poor communication from their retirement villages. Seven months on, JUDE BARBACK looks to see whether things are any clearer in the retirement village industry.
n July last year the retirement village industry was in the media spotlight for all the wrong reasons. Retirement Commissioner Diana Crossan released a report (the Retirement Villages Act 2003 Monitoring Project: Residents’ Perspective report) that revealed a number of concerns held by residents of retirement villages. The research involved 23 focus groups held in five regions throughout New Zealand, with 293 participants. Some residents felt they were not consulted properly about fee increases, reductions in services or changes in the operation or ownership of their village. Others were unhappy about the failure to maintain or provide amenities as agreed. Residents repeatedly noted that problems arose because they had not appreciated the meaning and implications of their contracts. While residents were generally happy with their decision to live within a retirement village, as the report states, it is clear their “confidence and comfort can be compromised by deficiencies around the processes by which they came into a village”. It is important, at this point, to make clear that the report was not implicating the New Zealand retirement village industry in its entirety, rather the minority of village operators that failed to implement the 2003 Retirement Villages Act properly. Without wanting to condone these operators for what is fundamentally poor communication, the report does beg the question of whether the industry is unnecessarily cluttered with complicated jargon and ambiguous terminology, making it difficult to easily comprehend the issues at hand. Indeed, top of the list of residents’ suggestions for improvement was for ‘easily understood information presented in a large font’. One resident included in the research said, “I didn’t question the information I was given. I wasn’t aware of the architectural shortcomings of the building.” Others found that the cost of some ‘extras’ were not always made explicit, with one resident confronted with an additional $20,000 for a car park, which he was only made aware of on the day that the occupancy was to be taken up. This isn’t the only example. Another resident claimed, “I only recently realised that I have to pay the fee until the unit is sold. I didn’t realise this when I signed the agreement.” As one resident put it, “Not everyone understands things like that [contracts]. You look at it and your mind goes blank.” While retirement and aged care may present complex issues, perhaps the sector needs to simplify its outward appearance for the benefit of everyone, and especially the end user. It seems Crossan agreed with this premise; in the report a number of suggestions for the industry were given, including making documents comparable between villages and keeping them in plain English so they are more easily understood. The report
February/March 2012 | www.insitemagazine.co.nz
also recommended clarification of the Statutory Supervisor role and implementation of consultation guidelines for operators and residents. Villages should be independently rated on their financial, service, amenity and procedural performance. It also stated there should be an independent advice service for people entering retirement villages as well as a dispute resolution service for complaints. Essentially these suggestions were to address three main perceived problems with the system: problems with the Act itself, including a lack of clarity about the role of the Statutory Supervisor and requirements around disputes procedures; problems with the implementation of the Act, mainly concerning a failure to equip residents with the necessary information and detail concerning fees, maintenance plans, complaints processes and other factors; and, problems with consumer support, which pertained to a lack of awareness and confusion around the key areas of occupancy. Seven months on and I’m curious to know if the report has prompted retirement villages – or at least the main offenders – to rectify themselves. Or are we still faced with an industry plagued with convolution? Does it warrant an overhaul of the Retirement Villages Act and the Code of Practice? Crossan says the review has been helpful in addressing a number of areas. She says since the report they have implemented a disputes process for retirement villages. They are also encouraging the use of mediation for the rare incidents when this is needed. Crossan also supports regional residents’ associations as a means of feeding back residents’ concerns. She says there was some push to set up a residents’ association at a national level, but the practicalities of this proved to be too much of a barrier. “Residents don’t want to spend all their time serving on committees; they have spent their whole lives on committees,” says Crossan. Incidentally, Crossan says she plans to attend a regional meeting in Hamilton shortly where she will speak to the residents, and also listen to their concerns. Such an opportunity is rare for Crossan. In fact, she says one of the main difficulties is that she is not alerted to any concerns, so unless feedback is actively sought through a formal process, such as the review, she remains unaware of any problems in the sector. As a result, it tends to be a self-regulating system. There are ongoing meetings to address housing, residential and other sector concerns. Crossan gave me the example of a resident who spoke up publicly at one of these meetings, saying that as an intending resident she had been treated with the utmost respect by the village operator in question, but once she had signed on the dotted line, the respect vanished and she claims to have been treated appallingly. Her words would have certainly been damaging for the reputation of the village in question. Crossan says she doubts the operator will
Residents don’t want to spend all their time serving on committees; they have spent their whole lives on committees... – Diana Crossan, Retirement Commissioner.
behave in that manner again. “It is a process of evolution, really,” she said. Last year’s review was the third of five reviews intended to assist with the ongoing monitoring of compliance with the Retirement Villages Act. The first looked at the role of the Statutory Supervisor, and the second at village operators. This year’s review was supposed to look at intending residents; however, with the variation to the Code of Practice – which mainly concerns insurance issues resulting from the Christchurch earthquakes – currently underway, Crossan thinks it is likely this particular review will be put on hold. She hopes to make the recommendation to Government very shortly. The final review of the series will hone in on the disputes process. All of these should go some way in helping to monitor compliance with the Act, but for the most part, it is down to the selfregulating nature of the market to keep operators doing things right by their residents.
Long-stay hotels or aged-care facilities? With increasing emphasis on the five-star facilities retirement villages have to offer, INsite considers the similarities between villages and hotels.
ith all the luxuries of a five-star hotel, and a warm and friendly atmosphere, it’s no wonder our residents exclaim, “It’s the only place to be!”’ This is what potential residents will read when considering Ryman Healthcare’s Grace Joel Retirement Village. And they are unlikely to be disappointed. Among the facilities on offer are bars, lounges, an internet cafe, swimming pool, spa pool, hair and beauty salon, gym, library, bowling green... the list goes on. The little martini-glass icon used to denote the presence of a bar, the stick figure on the tread mill to indicate a gym and the other icons all seem vaguely reminiscent of a hotel brochure or website boasting what it has to offer its guests. Indeed, you could be forgiven for thinking you had entered a hotel or resort the first time you set foot in a modern retirement village. Like Grace Joel, many villages have a vast range of enticing facilities, immaculate grounds and carefully selected décor. Many village residents agree. “It’s like living in a resort,” says a resident of Ocean Shores when asked about her experience of village life. However, Graham Wilkinson, director of Retirement Assets Limited and the longest serving member of the Retirement Villages Association (RVA), dispels some of the myths about the similarities between the hotel and retirement village industries. Wilkinson believes residents liken their retirement village home to a hotel because they feel like they are on holiday with relatively few concerns and all manner of activities and facilities available to them. “Practically speaking, however, most people choose to live in a retirement village for the security it offers.” Surveys conducted by the RVA confirm Wilkinson’s thinking: safety and security are consistently ranked as the main reasons people opt for a retirement village lifestyle, over and above the facilities on offer. Wilkinson is well qualified to comment; he has a raft of experience acquiring and developing hotels, subdivisions, apartments and retirement villages. From site selection and development through to management and end-user experience, Wilkinson says there are virtually no similarities between hotels and retirement villages. When selecting a location for a retirement village, the purchaser is likely to be looking for large, suburban sites; meanwhile, hotels generally
Safety and security are consistently ranked as the main reasons people opt for a retirement village lifestyle, over and above the facilities on offer.
need to be in city centres or in easy reach of airports. “You’re catering for two very different markets,” says Wilkinson. With retirement villages the emphasis is on long-term relationships, with residents investing a lot of money, time and energy in choosing to live there. With hotels, on the other hand, the focus is more on the short-term, with a constant turnover of customers. Consideration of the brand is another key difference between the two, in Wilkinson’s eyes. While a retirement village might rely on branding to a certain degree to attract residents, people are unlikely to move too far away from their friends and family and their previous home. Although brand and reputation are important for a village, other factors - like location - will play a significant part in people’s decision to move there. For a hotel chain, it is critical to get the branding right as they are trying to target potential customers from all over the world. That said, we are all aware that the baby boomers, with their accustomed tastes for the finer things in life, are looming over retirement villages. This is a generation familiar with hotels, a generation that expects five-star quality and service. It is not difficult to understand why retirement village operators try and deliver on this front. Richard Dalman of Dalman Architecture in Christchurch, which has designed a number of retirement villages over the last three years, has noticed an increased demand for five-star hotelstandard village complexes. He believes baby boomers and subsequent generations will want the best of whatever defines a quality lifestyle at the time and this will need to be reflected in retirement villages. It appears the increased expectations of the next wave of residents have led people to draw
comparisons between hotels and retirement villages. So it comes as no surprise that a common assumption is that managing a hotel is on a par with managing a village. Certainly many recruitment advertisements for retirement village managers suggest that hotel management experience would be desirable. Advertisements often suggest, as this example does, that applicants should ideally have ‘a background in any of the following: managing serviced apartments; retirement village management; concierge; facilities’ management, including, managing hotels/motels or similar at a management level’. While Wilkinson concedes there are some similarities in terms of skills, he believes managing a hotel is more challenging than managing a retirement village. A hotel manager is likely to have more departments to oversee and with a quick turnaround of clientele, and the importance of repeat custom, there is little margin for error. Wilkinson’s opinion is clear: a retirement village is not simply a long-stay hotel. People do not stay at one for the same reasons they live at another. The respective sites for hotels and villages are developed in different ways and marketed to different audiences. The branding is different. They are not managed in the same way. And that is not to forget the most significant difference of all – the aged healthcare offered by many retirement villages is perhaps a stark reminder that you are not in a hotel. Martin Taylor of NZACA says aged-care facilities are such an integral part of retirement villages that villages can be classified by the care they offer. What retirement villages do have in common with hotels, however, is a desire to deliver top quality service and facilities to discerning customers. www.insitemagazine.co.nz | February/March 2012 7
FOCUS Education & Training
Climbing the staircase What is being done to address concerns about career progression in aged care? JUDE BARBACK reports.
areer progression or ‘staircasing’ has been identified as a major concern for employees of the aged care sector. What training is out there to help progress the careers of the talented carer or the ambitious registered nurse? Is it clear what the next steps are for the activities’ coordinator or the chef keen to continue climbing the ladder? The level 2 and 3 qualifications provide some clear goals for caregivers and community support workers. Careerforce, the sector’s main industry training organisation, constantly adapts the certificates in order to address skills gaps as they arise. Providers are seemingly keen for their staff to achieve the qualifications, with many aspiring to make the qualifications mandatory. The level 3 qualification provides sufficient training for many, but what options are there for those who wish to progress further still? Fortunately new level 4 and 5 qualifications are currently being developed to satisfy a need for more tangible career pathways in the sector. The level 4 National Certificate in Health, Disability and Aged Support (Senior Support) and level 5 National Certificate in Health, Disability and Aged Support (Team Management) have now been registered with NZQA. Sector panels, originally from the aged care, disability and home and community sectors, worked with Careerforce to develop the core competencies required of supervisors and team, which in turn have been converted into draft unit standards. Careerforce is currently finalising the delivery arrangements for these qualifications and is committed to having these qualifications available to the sector this year. Further qualifications for registered nurses are there for the taking as well. Gina Langlands, Bupa’s general manager of quality and risk, points to a variety of postgraduate papers provided at many tertiary institutions that registered nurses working in gerontology can complete. Perhaps these options for further study need to be better promoted. Ginni Cashell, general manager of Althorp Provate Hospital in Tauranga, is among several managers and nurse educators who feel aged care nursing is not sufficiently recognised as a complex speciality area of nursing. “More adequate postgraduate and in-house training opportunities are required,” says Cashell. Outside of further study, Langlands says, nurses working in the aged-care sector can
February/March 2012 | www.insitemagazine.co.nz
decide to stay clinically focused and pursue unit coordinator or clinical manager roles. These are essentially lead nurse positions, leading at a unit or care home level, although smaller care homes may not have many of these positions available. Conversely, larger care homes also require some ‘specialist functions’, such as infection control officers or restraint coordinators. Registered nurses can advance their knowledge in these areas. Other nurses may prefer to take the management route and run a resthome. “Many senior nurses have ended up as care-home managers,” says Langlands. Others still may be happy with the status quo. “I think we have to consider the fact that not all nurses want to progress – they enjoy the work they do and want to continue the close connection to their residents and their families,” says Langlands. Aged care provides a unique area of nursing, which calls for different skills to be developed. Often working in small nursing teams without doctors on hand, nurses in aged care develop acute assessment skills and find themselves managing changing health status in increasingly clinically complex residents. “The majority of
Often working in small nursing teams without doctors on hand, nurses in aged care develop acute assessment skills and find themselves managing changing health status in increasingly clinically complex residents.
care is provided by non-regulated carers – often highly skilled – but unregulated all the same. Registered nurses have to be eagle-eyed and ensure they keep connected to the care that is being provided by these teams,” says Langlands. There seems to be a great divide between registered nurses and carers, yet for the proficient carer who has achieved all qualifications available to them, becoming a registered nurse often appeals as the obvious next step. But it is not a straightforward jump. Tamara Dalrymple, a carer at Rawhiti Lodge in Matamata (see profile opposite), has completed all the ACE programmes available to her and is now working on becoming an assessor. But what next? Dalrymple said she had considered becoming a registered nurse, but the study required, even on a part-time basis, would demand too many compromises to her work, family and personal finances. It seems strange that a very experienced and qualified caregiver like Dalrymple must start almost from scratch with a nursing degree. By contrast, Jo Wallace, a registered nurse also from Rawhiti Lodge, says she felt lacking in practical nursing skills as a new graduate, an admission made by other nurses as well. Similar comments have come from nurse educators at various rest homes and hospitals. Gail Hosking, nurse educator for Althorp Private Hospital, believed the gaps in Registered Nurse education and training mainly related to clinical skills including wound assessment and knowledge of dressings, neurological assessment, pain management and medication knowledge. It appears there are demands for more practical training for nurses. Perhaps a stepping-stone position or specific training programme that allows experienced and
FOCUS qualified carers to progress to a nursing role is needed. Langlands recognises that there is a lot of competition for registered nurse training placement and thinks a caregiver should fare well in applying for placement. “I think an applicant who has worked as a caregiver for a period would potentially have an advantage over others if applying to do their training.” Bupa is currently assisting a number of their caregivers to complete their registered nurse training. However, it is important not to lose sight of the fact that a nursing degree involves tertiary study and is not going to be attainable by everyone; it may be beyond the grasp of even the most experienced caregiver. Langlands points to other options for caregivers. “They might consider enrolled nurse training and becoming a second tier nurse, but this too will require 18 months full-time study.” The role of enrolled nurse appears to be the ideal stepping stone, and some caregivers have indeed gone on to pursue this position. Raewyn Fletcher worked as a caregiver at Fergusson Rest Home and Hospital for two years and was motivated to train as an enrolled nurse. Langlands says many enrolled nurses work in the aged care sector; Bupa has 90. “Up until the recent review of their scope, aged care was really the only area [enrolled nurses] could work.” Martin Taylor of the NZACA agrees there is potential with the position. However, he says there have been some reservations about the job title and supervisory aspects of the role. Bupa progresses employees and improves
service with a programme, Progress Steps, which came to fruition after consultation with the New Zealand Nurses Organisation and the Service and Food Workers Union. Together the parties developed a voluntary training and development programme that helps employees build skills applicable to their role through feedback and financial reward as well as providing opportunities for career progression. Progress Steps works like this: managers look at the skills and competencies needed to perform a job and break these into five steps, with Step One as the entry-level step and each upward step reflecting the employee’s increasing abilities and responsibility. With so many occupational groups to consider, including registered nurses, enrolled nurses, carers, activities’ officers and chefs, it was clear a one-size-fitsall programme would not be effective; therefore, Progress Steps was designed to respond to the unique characteristics of each role. Specific training courses, managerial support and coaching help guide employees through the five steps. Bupa provides a learning and development fund to support staff in their efforts to up-skill. All training time is also completed as paid hours. Their investment in the programme appears to be paying off. Since Progress Steps was implemented in February 2008, they have reported a significant reduction in staff turnover and an increase in customer satisfaction.
With so many occupational groups to consider, including registered nurses, enrolled nurses, carers, activities’ officers and chefs, it was clear a one-size-fits-all programme would not be effective; therefore, Progress Steps was designed to respond to the unique characteristics of each role.
Tamara Dalrymple, caregiver When Tamara Dalrymple started working as a dishwasher at a rest home in Whitianga many years ago, she didn’t think she would one day be a qualified assessor for trainees undergoing their ACE programmes. Dalrymple has always aspired to become a qualified embalmer, but family commitments prevented her from embarking on the work and study required for this career. However, Dalrymple’s ambition and natural affinity for elderly people soon saw her progress from washing dishes to a caregiver’s position at the rest home. She eventually moved south to Matamata, where she was offered a caregiver’s position at the dementia unit, Malio House. It was here she decided to work towards becoming qualified as a caregiver. Over the course of four years she completed the national certificates via the ACE programmes that were on offer. This was no small achievement, and Dalrymple received recognition from the town mayor. Now working as a caregiver at Rawhiti Lodge in Matamata, she is working towards becoming a qualified assessor, which will allow her to mark modules completed by caregivers following her path up the qualification ladder. So what’s next for a clearly competent and ambitious caregiver like Dalrymple? Does the system offer enough career progression? Dalrymple is uncertain where she would ultimately like to end up. She still entertains hopes of becoming an embalmer and has even considered training as a registered nurse. With her children now older, both are fast becoming more feasible options. However, to pursue nursing training, even on a part-time basis, would require compromises to her job and family commitments.
www.insitemagazine.co.nz | February/March 2012 9
FOCUS Education & Training
Training village managers The Retirement Villages Association (RVA) recently conducted a major formal review of training for retirement village staff. JUDE BARBACK considers what the findings mean for retirement village managers.
etirement village managers wear many hats. With customer service and staff management essential components for the job, it comes as no surprise that recruitment advertisements for village managers typically call for excellent inter-personal skills. Ideally managers should also have administrative nous, technological know-how and good organisational skills. The swift growth of retirement villages and the fast-evolving nature of the industry itself require managers to be adaptable and able to lead villages through times of change. As there is no prerequisite training or mandatory qualification needed to become the manager of a retirement village, it stands to reason managers come from a wide variety of backgrounds. Mike Flattery, manager of Pacific Coast retirement village in Papamoa, was previously an officer in the New Zealand Army before holding several management appointments including at Massey University and Orewa College. Flattery says these managerial positions provided him with the right mix of skills needed to run a retirement village. But how can we be sure previous experience in other fields is going to be sufficient preparation for managing dozens of staff and hundreds of
residents. To an extent we are reliant on the system sustaining itself – after all, it is unlikely village operators are going to employ a manager who is unfit for, or even incapable of doing, the job. For this reason, there are so many shining examples of excellent village managers to be found. Furthermore, the operators tend to roll out their own managerial training and professional development courses to their villages. While this
question. “Our challenge with industry training is that the sector is very diverse and this makes centralised training programmes hard, as they are not necessarily relevant to everybody. Villages are large and small, corporate or private, profit or not for profit – all require different settings for their managers’ skills.” This was one of the main issues driving the recent major formal review of education and training for staff in retirement villages. The
Meanwhile, managers of smaller organisations and independent villages tend to focus on specific training needs. These managers appear to have more freedom in their choice of training, as long as they complete the necessary amount of training to satisfy audit requirements. seems to be beneficial for those managers under the umbrellas of the ‘giants’ of the industry – the Metlifecares, the Ryman Healthcares and the like – what about those managers employed by smaller organisations, which may perhaps lack the funding for such training opportunities? Margaret Owens, convenor of the RVA education committee and Bupa’s general manager for independent living, agrees this is a valid
review, which took place late last year, was administered by the RVA, with Duncan Macdonald of Selwyn Care and Ed Thomas, Association Manager of RVA, working alongside Careerforce to compile and roll out the survey to villages throughout New Zealand. It was the first survey of its kind in the four years John Collyns has been at the helm of the
The many different faces of village management Bruce Cullington, Acacia Cove Village, Manakau “I hold a NZIM diploma, am a chartered secretary and a qualified real estate branch manager. Most would describe my leadership style as a cross between charismatic and participative. I have a fairly strong personality, am naturally gregarious and life to the fullest. I am also passionate about everything I do and this tends to rub off on people around me. My biggest strength would be my ability to communicate with people at all levels and to make them feel special. I place a lot of emphasis on working with our residents’ and social committees to ensure that we have a wide range of activities, and this makes our village extremely vibrant and a positive place to be. I consult as and when necessary, but do not over-consult as I have found that most people have more confidence in a manager capable of making a decision. With staff I seek their opinions and consult before making decisions affecting them. I am also keen to see staff develop and have engaged a life coach for two employees and a
February/March 2012 | www.insitemagazine.co.nz
motivational speaker for others. I continually up-skill by attending external courses and industry forums, as management techniques are continually changing.”
Denise Te Tai Was there a beginning?? When I was approached to write an article regarding my journey from nursing to village management I really had to sit down and think, as I don’t believe it was a calculated or planned career pathway that I consciously took. In the days prior to the Act or the Code if you were in a village that had some licence to occupy units, you managed them – in much the same way as you managed the care facility – it was not rocket science and the residents were content as being treated as one – how times have changed! I suppose during the journey I have grown into the role and in many ways developed the position as I believe it should be. Obviously you must have business acumen and an understanding of budgets; however, your greatest strengths lie with an understanding of the older person, patience and, most of all,
time management. I was showing people around the village recently (sales is yet another skill that is required) and was asked what is like to manage a village. My reply was, “Do you have grandparents?” “Yes” was the answer. “Do you have a bank manager that is constantly watching you?” “Yes” was the answer. “Then times your grandparents by 300, and then throw in your bank manager in the mix, and that nearly explains what is like to manage a village.” Ensuring you have the right staff is very important as it is with any management role. Henry Ford had the right idea when he wrote “I am looking for a lot of wo/men who have an infinite capacity to not know what can’t be done.” For me leadership is simple: »» Walk beside people, not ahead of them, to gain loyalty and understanding from them. »» There is no such thing as ‘can’t’, just ‘how’. Flexibility is a must and caring attitude essential. »» Communication is very important. Residents need to know what is happening in their home, good or bad; ensuring they feel as if they are heard and are included in decision making where appropriate is vital.
FOCUS RVA. Collyns, a “keen advocate of training”, claims to have been particularly inspired by a one-day seminar in Hamilton in May 2011 that dealt with recognising and dealing with the onset of dementia. The strong uptake of this seminar prompted Collyns to consider what other areas might be in need of more attention from a training perspective. Prior to the RVA’s training review, Collyns said he will be interested to see if it revealed
a need for a more standardised approach to managerial training. Apparently a remote learning qualification offered to retirement village managers that drew on their ‘on-the-job’ training was not widely embraced; Collyns believed this to be largely because corporate villages, which comprise approximately two-thirds of retirement villages in New Zealand, tend to offer internal training programmes for their managers. Ocean Shores in Mount Maunganui, owned by
»» Support and empower your residents to believe in their own ability, regardless of how little or great, to enable them to enjoy the quality of life that they have earned. Village management is a great job; never are two days the same and it is great to have the feeling that you have made a difference at the end of the day. Woodrow Wilson had it right when he said, “You are not here merely to make a living. You are here in order to enable the world to live more amply, with greater vision, with a finer spirit of hope and achievement. You are here to enrich the world, and you impoverish yourself if you forget the errand.”
that are important in most managerial roles. This experience also provided the necessary skills to react to a raft of different situations, urgent or otherwise, that arise on a daily basis within most communities. The most effective staff groups tend to be those that act as a team. It is therefore important to gel the staff into supporting one another to form that valuable team base. In regard to residents, I tend to put myself in their position and ask the question ‘what would I want out of living in this village?’ and I treat everyone with the respect that I would expect after all there is not too much age difference between the residents and myself.”
Mike Flattery: Pacific Coast Village, Papamoa
Donna Prince, Selwyn Heights Village, Hillsborough
Mike retired as an officer in the New Zealand Army in 1989. Since leaving the army, Mike has held management appointments at Massey University, Manawatu Rugby and Orewa College before joining the retirement industry in 1999. “My previous managerial experience provided me with the people skills to manage a retirement village. Being an army officer in particular provided the necessary skills of leadership, logistics and accounting processes
“All managers have their own techniques, as not all training can be obtained from text books – especially in our industry. You need to really understand and work with your residents to find out what makes a successful, happy village that everyone wants to be a part of. In my opinion, working in a village with (and on behalf of) older people who have a lifetime of experience is a great honour. My management style is to be caring and supportive, fair but firm when the occasion requires. I endorse the open-door policy, which conveys a more friendly, welcoming approach.
Lend Lease, is one such village. Manager Sandy Quigley thinks working for a large corporation has allowed her more opportunities for training and professional development. Last year Quigley attended a two-day sales and marketing seminar in Australia, the RVA conference and a village manager conference. Summerset’s village managers and nurse managers currently attend managerial training conferences twice a year and additionally as required. Summerset had previously taken a more ‘village-by-village’ approach to managerial training. However the organisation is experiencing such rapid growth it is essentially starting again with training operations and rolling out more centralised processes. Harriet Palmer of Summerset says they have now embraced the three-month induction training for all caregivers, meaning everyone will have the desirable Level 2 qualifications, and a fresh look at its managerial training programmes is bound to follow suit. Many village managers think a standardised approach to managerial training would not be appropriate because every manager has a different style and has different needs. “All managers have their own techniques, as not all training can be >> Of course, time is precious, but when someone has a concern or needs assistance, it’s important to make the time to help resolve their particular issue. I show respect, not just to my residents, but also to my team. We are a group of multiskilled people who all share reception duties, sales, activities, outings, welfare checks and even lesser handyman tasks! I acknowledge everyone who goes that extra mile. Being customer-focused, having a listening ear and wanting to be a part of our unique environment are all essential attributes in this business. Selwyn Heights Village is characterised by its friendliness and down-to-earth approach, but it also offers the style and elegance that today’s retirees are looking for. Within an ever-changing legislative and consumer landscape, I strive to keep my team up-to-date with current developments and to provide regular training to ensure that all regulatory compliance is met and customer satisfaction maintained. To manage a retirement village, I believe you should share your experiences, attend manager forums, learn from others and endeavour to implement a programme of continuous improvement in all areas of your work, as well as in your own professional and personal development.”
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FOCUS Education & Training
CAREERFORCE QUALIFICATION DELIVERY 2012 THE LEVEL 2 FOUNDATION SKILLS NATIONAL CERTIFICATE An employer-led qualification made up of 43 credits, with an average duration of 8 months to complete. This qualification attracts literacy funding in 2012. The cost is $200* Enrolments are open. THE iLEARN-BASED CONTINENCE LEVEL 2 UNIT STANDARD Available on the ilearn site http://ilearn.careerforce.org.nz in February 2012. Anyone can access the learning from this site. For trainees who have these units in their national certificate programmes, see * below. You do not need to be enrolled in a national certificate to complete your assessment and have it recorded on the NZQA framework, but you do need to be enrolled as a trainee. THE LEVEL 3 CORE COMPETENCIES NATIONAL CERTIFICATE An employer-led qualification made up of 57 credits, with an average duration of 12 months to complete. This qualification attracts literacy funding in 2012. The cost is $230* (This support will be reviewed in 2012.) $8 per credit payment to employers when new level 3 credits are reported Enrolments are open. THE NEW LEVEL 3 HEALTH ASSISTANTS NATIONAL CERTIFICATE Strands in Dietitian Assistance, Dental Assistance, Healthcare Assistance and Rehabilitation Assistance will be available to DHBs from January 2012. Careerforce is launching this certificate as an employer-led qualification which can be completed in the workplace. This certificate has 72 credits and a completion timeframe of 13 months. There are a number of steps that employers need to take to prepare for delivery of this programme at their workplace. When employers are ready to start their planning or for further information, please contact: The cost is $270* Daria Martin, account leader There will be a credit payment of $8 per new level 3 credit for 2012 email@example.com THE LEVEL 3 RESIDENTIAL (AGED CARE) STRAND An employer-led qualification with 12 month average duration timeframes. Trainees can continue to use the ACE programme to complete this qualification. Level 3 Core Competencies national certificate is a The cost is $230* prerequisite for this qualification. Attracts $8 per credit when new level 3 credits are reported Enrolments are open. THE iLEARN-BASED DEMENTIA LEVEL 3 UNIT STANDARD Available on the ilearn site http://ilearn.careerforce.org.nz in February 2012. Anyone can access the learning from this site. For trainees who have these units in their national certificate programmes, see * below. You do not need to be enrolled in a national certificate to complete your assessment and have it recorded on the NZQA framework, but you do The cost is $155* need to be enrolled as a trainee. THE LEVEL 4 DEMENTIA LIMITED CREDIT PROGRAMME An employer-led programme made up of 20 credits. Results can be posted using the iportal. The level 4 Senior Support and level 5 Team Management qualifications have been registered with NZQA. Further information will be available by the end of March regarding the pilots for these two qualifications. Enrolments are open.
* Assessment can be done by the workplace assessor, with trainee assessments downloaded from the Careerforce website or purchased from the Careerforce shop.
<< continued from page 11 obtained from text books – especially in our industry. You need to really understand and work with your residents to find out what makes a successful, happy village that everyone wants to be a part of,” says Donna Prince, manager of Selwyn Heights Village in Hillsborough. Meanwhile, managers of smaller organisations and independent villages tend to focus on specific training needs. These managers appear to have more freedom in their choice of training, as long as they complete the necessary amount of training to satisfy audit requirements. Most managers seem comfortable with this arrangement; as one remarked, who is better placed to identify their training needs than they themselves? However, common training needs emerge, such as managing staff and keeping abreast of swiftly changing technology, something Heather Dillon of Vision Senior Living identified as a common training need among their village managers. It is, therefore, perhaps unsurprising that the major outcome of the formal review was to shape a core training programme for managers that aims to address these common and key aspects. Owens says there are specific areas in which managers need to be well educated and effective, such as event management, pastoral care of their residents and handling people in the early or moderate stages of dementia. Sales and marketing, property issues and everyday management of time are also important areas. The findings of the review revealed the need to focus on the compliance requirements of the Retirement Villages Act and Code of Practice for village managers. For this reason, the core training programme will be largely derived from what is required to comply with the Code of Practice. A series of seminars that speak to the aforementioned key areas of village management will supplement this core training. These seminars will include the shared experience of industry leaders, peer group support and the availability of experienced mentors, according to Owens. Surely a more standardised approach begs a more universal delivery? The RVA agrees. “We are also endeavouring to develop some of our training in an e-learning environment, which recognises the requirement for new managers to be up to speed with key technical
issues quickly in an environment and setting that is accessible to them but doesn’t involve a need to spend time out of the village,” says Owens. Collyns believes online training will overcome the problems typically associated with face-to-face training, such as cost, venue and time considerations. However the RVA hasn’t ruled out running some refresher courses on a face-to-face basis so people can network and share experiences. The amendments to the Code of Practice – when they come through – will provide a good opportunity to run some training sessions around New Zealand. Collyns envisages the managerial training extending to more “agecentric” issues, such as recognising dementia in a village and dealing with difficult people, as individual modules; such courses would be provided by specialist trainers. No doubt this will require the involvement of providers like Health Ed Trust; their ACE programme may be a benchmark for many managers when employing staff, but it currently doesn’t address the training needs for the managers themselves. Managerial training is also an untapped area for Careerforce. “We don’t have any training specific for retirement village managers. We do work heavily with retirement villages but that is more focused on their staff at the grass roots,” says Helena Coolen of Careerforce. Looking across the Tasman, Villa Maria – a major provider of residential, community and disability services in Victoria – partnered with RMIT University to develop a one-year Diploma in Management course, which focuses on management and leadership skills in the context of aged care. The course is apparently part of the organisation’s strategic plan to develop its leadership and management as well as allowing for career pathways and helping retain staff. Would such an approach suit our organisations and systems? Quite possibly, but it is clear there is no ‘one-size-fits-all’ approach to village manager training. The core training programme currently in development by the RVA is bound to be supplemented by organisations addressing specific training needs as they arise. This hybrid approach will hopefully serve to maintain the core of high-calibre managers currently running our retirement villages.
FOCUS Education & Training
Survey findings help pave the way
for home health training A review of home health training has prompted a drive to up-skill its workforce. JUDE BARBACK finds out more. training. Approximately 31 per cent of community support workers hold this level of qualification, with 12 per cent working towards it and a further six per cent working towards the level 3 National Certificate in Community Support (Core Competencies). Julie Haggie, chief executive of NZHHA, is focused on raising the percentage of level 2 qualified staff in the home health sector. In two years she would like to see the number of staff with level 2 move from 31 per cent to 40 per cent and in ten years to 100 per cent. She is also keen to see an increase in Level 3 training in both individual units and the entire certificate. Martin Taylor, chief executive of New Zealand Aged Care Association (NZACA), agrees that in an ideal world caregivers would obtain level 3 training. While Taylor believes most providers are good at encouraging staff to work towards their level 2 and level 3 qualifications and provide the necessary on-the-job training, he says the current avenues for career progression are inadequate. He believes a senior caregiver position that provides a stepping stone from caregiver to registered nurse would be useful. Careerforce is driving the development of level 4 and level 5 qualifications, which might help to quell some of Taylor’s concerns
about ‘staircasing’. However, for these more advanced levels of training to be effective, they need to be recognised contractually with the appropriate funding in place. Haggie’s goal of up-skilling community support workers also hinges on contracts and funding. Funders are increasingly demanding level 2 training in some of their newer contracts with providers. There is a degree of irony here, however, as home care is funded primarily by government organisations that contract with providers on a ‘fee for service’ basis, meaning a certain number of hours of support are allocated following an assessment of need. With low contract rates set by funders and no regular contribution for trainer payment or staff training
time, there is often little incentive for workers to take on the training. The survey also identified more specific skills gaps among staff involved with elements of complex client care, such as dementia, diabetes, post-operative care and autism. Careerforce has since restructured its core competencies to allow providers to build a qualification tailored to their needs. Haggie agrees that training shouldn’t just be for training’s sake, but should provide workers with the necessary skills to do their job effectively. A worker helping with housework may not need any training, whereas a worker providing support for someone with dementia or a chronic condition might need elements of level 3 training.
natIonaL LCp oFFICe neW ZeaLanD
NZ NAtioNAl lCP trAiNiNg DAys 2012 the liverpool Care Pathway for the Dying Patient (lCP) is an integrated care pathway that guides the delivery of evidence-based, best practice care of dying patients and their family/wha- nau, irrespective of diagnosis or care setting.
Workshop Dates anD Venues Friday 4 May 2012 Auckland Crowne Plaza Friday, 25 May 2012 Christchurch Commodore Friday, 1 June 2012 Wellington West Plaza
This day has made me feel more supported and given renewed confidence to help deliver the LCP as a supportive tool for the dying patient and their family/wha-nau.
ike the retirement village sector, home health is an area which has also had the benefit of a recent formal review of its training and education. The survey, administered by Careerforce working alongside the New Zealand Home Health Association (NZHHA), identified literacy and numeracy as the most significant training needs for community support workers. As a result, Careerforce has secured Tertiary Education Commission (TEC) embedded literacy and numeracy funding for 2012, which will allow grants of $100 for each trainee who completes both a literary assessment pre- and post-training. Careerforce also provides professional development workshops on how to administer the national literacy and numeracy assessment tool, as well as access to relevant workbooks and reports. Employers can take advantage of the Skills Highway initiative, a website developed by the Department of Labour to provide assessment and measurement tools to assist with numeracy and literacy training. The survey also revealed that over half of community support workers do not hold the level 2 National Certificate in Community Support Services (Foundation Skills), despite it now being considered minimum
DetaILs time: 9.00am – 4.00pm Cost: $180.00 per day to register go to: www.lcpnz.org.nz Minimum for course to proceed: 15
www.insitemagazine.co.nz | February/March 2012 13
Christmas Cracker Caregiver Competition Entries Meet winner, Lois Cossey, and the seven other wonderful caregivers nominated for the INsite/NZACA Christmas Cracker Caregiver Competition. WINNER: LOIS COSSEY (Selwyn Oaks Retirement Village)
Nothing is ever too much for Lois. It’s always, “Sure that’s fine, I will do that,” “Do you mind if I take that home and fix it?” “Yep, sure, happy to do that for you,” and “Yes, no problem training the new staff.”
February/March 2012 | www.insitemagazine.co.nz
When I think about the word caregiver and what that means, I think about Lois. She has worked us for 24 years, having worked in every area of our facility – at all levels of care – showing total compassion and love throughout this time and continuing to do so. Nothing is ever too much for Lois. It’s always, “Sure that’s fine, I will do that,” “Do you mind if I take that home and fix it?” “Yep, sure, happy to do that for you,” and, “Yes, no problem training the new staff.” Not forgetting too that Lois is always there for her work colleagues, taking them to the doctors, covering their shifts at short notice. She helps others in as many ways as she can and does even more for our residents. She treats them as her family. Being a local girl she has grown up with many of our residents’ families, and always puts their needs and concerns first and always takes the time to talk and listen. She looks out for everyone. We at Selwyn Oaks Retirement Village are privileged to have her as one of our caregivers. As a new manager I have nothing but praise for her acceptance and helpfulness towards the new team during our early days. It is rare that you meet someone who is totally selfless in all regards. Each day we are blessed to have her working for us. She is the epitome of the perfect caregiver. I can’t think of anyone more deserving. Carol Andrews, manager – Selwyn Oaks
RUNNER-UP: SULITA ALEFOSIO (Pacific Homecare, Papatoetoe)
Sulita Alefosio has been a caregiver with Pacific Homecare for over three years. She works full-time, assisting seven elderly and disabled clients. One of Sulita’s clients, Miriama Tuialii, says, “Sulita is marvellous. I feel so well looked after and cared for. She has a lot of consideration for an oldy goldy like me. I have a lot of trust in her. Sometimes she does
things for me beyond her duty. She sees things that need to be done and does them. She never has to be asked. I can’t do many physical things for myself, so she really helps me, but she does so in a nice way that makes me feel still feel good about myself. In the mornings I sit in my room and say a prayer. Sometimes Sulita will come in and give me a cuddle and join me. All of these things mean I still have a good life. That is what is important.”
HIGHLY COMMENDED: ORLANDO OLVINA (Hodgson House Aged Care Centre, Tauranga)
Perhaps we could describe Orlando as a ‘favourite’ of the residents at Hodgson House. Orlando has been with Hodgson House from 2009.Orlando is the ‘can-do guy’ of the place. He works in most of the wings as a caregiver. Is a male caregiver a problem for some residents? “He is not a male caregiver, he is “Orlando” so that is OK!” we hear from the residents. Apart from caregiving, Orlando took up other responsibilities as coordinator of the inco pads distribution system. He also is a well-known entertainer as a vocalist and has performed at residents’ functions. Every home should have a “can-do guy”! - Joop Wieringa, manager, Hodgson House
HIGHLY COMMENDED: ANN DERHAM (Torbay Rest Home) Ann Derham is a ‘cracker’ in our facility. Ann always puts the residents’ needs first. An example of this is she never goes home until every resident is settled and their needs are met. Ann qualified as an on-site assessor for the Aged Care Education (ACE) course, supporting and assessing many staff through the ACE course. Ann leads the other staff to provide a very high standard of care. She is particularly successful in using validation therapy with residents with dementia and teaches staff to successfully use the therapy. Ann plans special events and leads staff in entertaining residents. Ann has worked at Torbay Rest Home for 18 years and we think she deserves an award as an outstanding caregiver.
HIGHLY COMMENDED: KRISHNA CHAND (Pacific Homecare, Papatoetoe)
Krishna Chand is a full-time caregiver caring for six elderly and disabled clients. He is a humble man with an ethos and values that are important today. Krishna says his work ethic is based on the cultural values of his home country. “In our culture we have a lot of respect for our old people and we care for them when they get sick or old. My father was sick while I was living in New Zealand so I missed looking after him. That motivated me to do this kind of work and care for others. The cultural values of Pacific Homecare, which are love, care and professionalism, relate to all the clients I work with. We give love and receive love back as well. With professionalism, I am continuing to learn new skills in the field and through training, and that is great.” Krishna received the most appreciation cards of any caregiver employed by Pacific Homecare in 2011. Having been recognised by his clients for his excellent work, Krishna was awarded Employee of the Month for September 2011.
HIGHLY COMMENDED: WENDY ROBINSON (Hodgson House Aged Care Centre, Tauranga)
Wendy has been working as a caregiver (healthcare assistant) at Hodgson House (Anglican Care) for close to four years. Wendy is totally dedicated to her job. She has a real love for ‘her’ residents, and always goes the extra mile. Her very positive personality lifts up the wing. We always know when she is around. Nothing is a problem. “Let’s do it” is her motto. Wendy is well and truly multi-skilled. Apart from caregiving, she steps in to assist the divisional therapist when there are activities to be organised and carried out. She delighted our residents by performing with her group as a belly dancer! Our Wendy is a STAR! - Joop Wieringa, manager, Hodgson House
HIGHLY COMMENDED: LORRAINE PARTRIDGE (Freeling Holt House)
Let me introduce our recently immigrated English healthcare assistant, Lorraine. We are very happy she has chosen to work with us and, although a relative newcomer, she has become an invaluable employee. Lorraine comes with a huge heart and huge 30-years-plus experience as a carer in the UK. She has been permanently on staff for just a few months but has taken the shifts usually hard to cover – the split shifts covering both the busy periods in the day, early morning and early evening. She is a personal favourite of many of our residents and she has a kind nature for the ones who make the least noise. A no-nonsense approach to her daily tasks is just one of her qualities. As a registered nurse you know you can trust her to alert you to anything of consequence and have full faith in her abilities.
HIGHLY COMMENDED: LUCINDA KING (Freeling Holt House)
Our healthcare assistant Lucinda King is one of a kind. Her manner, tone and caring attitude make her a pleasure to work with; she does our facility proud. We are a very busy private hospital with many residents extremely unwell on a daily basis, suffering from complex end-stage disease processes. Lucinda’s calm and caring manner exudes confidence to her patients, especially when they are upset or stressed. Lucinda has been with us for just on two years now; she is a valued member of the night duty team, and is well liked and well respected by her peers. She works tirelessly and goes beyond the call of duty wherever necessary. She is a true gem and well deserves any recognition for her attributes. - Tina Boulton, Helen Lovell clinical manager
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www.insitemagazine.co.nz | February/March 2012 15
On the soap-box...Todd Jenkins Each issue, INsite seeks opinion on a contentious issue concerning aged care and retirement.
When are Village Operators going to become Contracted Homecare Providers?
Ask yourself: why not become a provider and give your residents better care and earn a little revenue at the same time?
Metlifecare Greenwood Park is a contracted DHB homecare provider. Over the last ten years we have provided a range of home care services for the village residents within their own homes. The Bay of Plenty DHB has, as part of its vision, a home-based care system, which is an enabler of the Ageing in Place strategy, an alternative to residential care. As a result we trialled a very successful three-year pilot programme from 2001, which led to Greenwood Park negotiating a contract to provide ongoing personal care and home help for our residents. One of the main advantages of being an onsite provider is the ability to offer services in small blocks of time (10 to 15 minutes) as there are few commercial considerations to be made around travelling between resident homes. Home-based care often works better for residents when they receive multiple visits over a 24-hour period. Another significant advantage of an in-house service is that the village nursing team is consistently in touch with every resident receiving support in the village. The service’s close-at-hand nature and our residents’ confidence in ongoing relationships with the care team help to reduce over-servicing. This promotes independence and allows residents to feel confident in staying in their own home. As a contracted provider you are subject to DHB audit standards, which give assurance as an operator that you are meeting industry standards. Residents still retain the right to
choose their provider but in the 10 years that we have been a contracted provider at Metlifecare Greenwood Park, only a handful of residents have chosen to use an external homecare provider. In my role as Village Manager, I am confident that I have my ‘finger on the pulse’. Not only do I know the state of residents’ health, but as a contracted provider we also see revenue come in to the Village. This can create a platform for a host of other services the operator can provide with the same staff, creating efficiencies for the business. Many retirement village operators are well placed to provide these contracted services to residents. Julie Haggie of HZHHA comments in INsite (Dec-Jan issue) that “DHBs are reducing the number of providers to seek ‘cost efficiencies’”, but as an industry we need to work hard to convince DHBs that we can provide a cost-efficient service that has qualitative benefits to help reduce service dependency and movement to residential care. Ask yourself: why not become a provider and give your residents better care and earn a little revenue at the same time? The DHBs across New Zealand do not have a common approach toward retirement village operators as homecare providers. We need to work individually and collectively to bring about change and a more consistent approach. I suggest that you start by finding out when the next round of Homecare Contracts are being reviewed by your DHB and talk to them about how you can be involved. I believe with perseverance and a good proposal more DHBs will adopt this proven model.
Response from Bay of Plenty District Health Board (BOPDHB) Helen Mason, general manager planning and funding, BOPDHB Bay of Plenty District Health Board (BOPDHB) has for some time contracted with Metlifecare, a retirement village operator in Tauranga, to provide home-based support services to eligible residents living independently within their retirement village. A contract was granted following a successful pilot of the service. The approach supports the Government’s Ageing in Place strategy. The model of support provided has a restorative focus, which means that the type of support provided promotes recovery and aims to prevent deterioration in a person’s independence, where possible. Residents must first undergo a needs-assessment process
to determine their level of need and eligibility for publicly funded services. From the DHB’s view, the advantages are that services can be flexible, provide consistency of care, provide choice for residents and be cost effective. The provider is subject to the same quality standards and audit processes as all other contracted providers of home-based support services to BOPDHB. All services contracted by BOPDHB are evaluated and reviewed in accordance with our purchasing policies to align with government strategies and achieve the desired outcomes for our population and represent value for money.
Got an opinion? Have your say online at www.insitemagazine.co.nz 16
February/March 2012 | www.insitemagazine.co.nz
Spotlight on... Gardens G ardens serve a very important purpose for the elderly. From the benefits derived from the sensory components of a dementia unit garden, to the creativity and exercise from maintaining the garden of their retirement villa or family home, gardens play a significant role in the lives of the older generation. Joanne Adams, who researched the benefits of everyday experience in the garden as part of her Master of Health Sciences at La Trobe University in Australia, discovered that gardening provided physical, mental, emotional and even spiritual benefits to older gardeners. In addition to the obvious health gains of keeping active in the garden, Adams found that elderly people benefitted from “learning through doing” – an important aspect of engaging with a garden. Her research also revealed gardens help older people make connections with the past; certain smells, sights or plants evoke strong memories of gardens from when they were younger, or of family and friends associated with those gardens. Conversely, planting a seed that will grow or establishing a garden that will provide a habitat for
New Zealand’s first sensory garden for dementia patients
Lonsdale dementia unit in Foxton, Manawatu, is brand new – it opened on 1st December 2011. Before the eight-bed dementia unit could officially open, Lonsdale had to satisfy DHB requirements to include an exercise area for residents. Aroha Ellwood, facility manager at Lonsdale, says this gave them a great opportunity to establish New Zealand’s first sensory garden specifically designed for dementia patients. The garden allows the dementia residents to step into a comfort zone aimed to decrease their anxiety and improve their mood, physical health and mobility. It includes a beach area, a green for activities such as lawn bowls, an aviary, a bus stop, a letterbox, barbeque, garden bed and a washing line all helping to provide the all-important cognitive and sensory stimulation. Ellwood says that even in the short time the unit has been opened they are already starting to see the benefits of the garden to their patients. “We ask the residents, ‘Have you checked the mailbox today?’ and they know exactly where you mean,” says Ellwood. “Things like the mailbox and the bus stop help with their memories too.” Lonsdale aims to provide personally-centred care that focuses on the needs of the residents. The layout of the unit aids this approach. Ellwood describes how the garden extends down one side of the L-shaped, unit allowing residents the freedom to go in and out of the unit and to enjoy use of the garden as they please. “We find that we only have to lock
the main entrance door and keep the other doors that open onto the garden unlocked for residents.”
“Gardening’s in the blood”
Dick (93) and Marnie (87) Mackesy are keen gardeners. The couple have owned their villa at Summerset in the Vines in Havelock North for eight years and are immensely proud of their garden. As it happened my telephone call was answered by a breathless Marnie, who had been out in her garden. “I’m currently redesigning the front garden,” she says, “I’m making it more structural – not masses of flowers.” The changes are due to Marnie’s failing eyesight, which she doesn’t intend to let get in the way of her passion for gardening. She is keen gardener from “way back”; her previous garden in Auckland was photographed many times and even appeared in the very first issue of House & Garden magazine. Marnie says her villa garden is a very important aspect of her life. In addition to the aesthetic front garden, the couple have fruit trees, grapevines and a vegetable patch. They also had a new patio built. They have established the garden from scratch as they bought a newly built villa. “There are a handful of [residents] that really garden,” says Marnie. “You can do what you like to your grounds, as long as you can do it yourself. [Staff] are always ready to help lift heavy things, but I would rather pay to have something done than bother them.” “I love gardening; it is in my blood,” she says. “And Dick pulls his weight too!”
birds and animals helps older gardeners to think about the future and their place in the broader environment. Adams also found that gardens also provided opportunities for social interaction, a topic for conversation with others. Perhaps the most significant findings of Adams’ research were that gardens helped people to relax and feel less anxious and, remarkably, aided recovery from ill-health. On a practical level, Dave Fisher, a director of Fisher Morris Property Developers, a firm that has developed many retirement village sites, says that gardens and grounds are an important consideration when starting a new project. Fisher says his firm tries to keep gardens very simple as in his experience villages will begin to tailor the garden to their tastes and to suit the residents. “We aim for tidy, attractive, easy-care common areas. Usually around the three-year mark of a village opening, it will begin to take on its own personality.” Providing a relatively blank canvas for resident villas is even more important as typically residents like to establish their own gardens according to their personal taste.
Gardening at home
Trevor Hitchcock, 87, lives at his home in Matamata. His wife, Enid, passed away suddenly in February last year. Initially daunted by the prospect of life on his own, Trevor considered selling their home and moving into a retirement village or care home. However, he soon realised that with the help of services like ‘meals on wheels’, a medic alarm and visits from the district nurse when necessary, he was able to remain in his own home. Trevor and Enid had both always been active gardeners and they would often work alongside each other in the garden, tending to the vegetable patch or keeping the flower-beds weed-free. With Enid sadly gone, the garden has become more significant than ever to Trevor, evoking poignant memories. Practically, it gives him a hobby and an opportunity to keep fit. Once a dairy farmer, Trevor is used to being in good physical shape. Between gardening and his morning walks, he is able to do so. Trevor lives on a street filled with picturesque gardens, which are tended by people of the same ilk; their gardens are often the source of neighbourly conversations and Trevor often shares his home-grown fruit and veg with others. Among these neighbours is a friend of Trevor’s, whose wife died the same day as Enid and who has also opted to remain living at home, largely for the same reasons as Trevor. It is now nearly a year since Enid died and Trevor is coping well. And his garden is flourishing.
www.insitemagazine.co.nz | February/March 2012 17
Up close and personal with... Rosemary Westley INsite catches up with Rosemary Westley, manager of Rosewood Park Retirement Village and winner of the 2011 Village Manager of the Year title. then see, once they are settled in, how happy and stress-free they are, it is worth every little bit of hard work.
INsite: What was your reaction when you learned you had taken the 2011 Village Manager of the Year title? Rose: I was shocked that I had won, especially being from a small village up against other multimillion-dollar villages. I was really thrilled that all the hard work and changes that had been put into the village had been recognised.
INsite: What are the biggest challenges and frustrations of managing a village? Rose: It is always hard seeing when a resident is at the stage when they need to move into 24-hour care. This is tough for everyone in the village as we are all part of a large family. Possibly one of the hardest things is when my client is desperate to come into the village, but they haven’t sold their own home. Sometimes their house has been on the market for a year.
INsite: What do you believe is your key to success with regards to managing Rosewood Park? Rose: My key to managing Rosewood Park successfully is being honest, and keeping up good communication, which includes listening to what our residents and the village owners want and need. Being innovative, using initiative, and always thinking of ways to improve. Keeping within budget is a must as well, especially in these economic times. INsite: I understand you brought about many changes at Rosewood Park. What changes did you make, both practical and cultural? Rose: I have raised the awareness of Rosewood Park throughout the community by marketing the MiLife brand. With our empty villas I create a warm and inviting atmosphere that gives people a true sense of being at home in our village. My floristry knowledge and experience have given me skills in landscaping and colour and a flair for design, which I have used in the gardens at Rosewood Park. I have made our residents feel like they “belong” here and that MiLife Rosewood Park is “their” home. It is a community within a community. It doesn’t matter what nationality or religion you are or have, you are welcome. I have created a lovely atmosphere here that visitors and residents alike frequently comment and compliment me on. INsite: What inspired these changes? Rose: I saw opportunities to create a better atmosphere for the residents, and to enhance and improve the management of the village. From past experience in various business fields, I have learned that the environment that you live in is very important to your wellbeing. If where you live looks pleasing to the eye, and is clean and tidy with happy people that care and listen, then you have created that “quality of life” that is desired. It goes a long way to a happy and healthy existence. INsite: I read you were once a florist. What led you from flowers to village management? Rose: I had always enjoyed working with people and creating stunning arrangements for people to enjoy, whatever the occasion. Listening to 18
February/March 2012 | www.insitemagazine.co.nz
INsite: What advice would you give to a new village manager just starting out? Rose: Listen to what the owners and residents want and need for the village. Then research, get advice, and work within the budget. If you are ever unsure, check with your head office/CEO.
what people want was always paramount. Often the client would express the reason why they are giving flowers, which would in turn allow me to understand and create something suitable for the occasion. Becoming the manager of this retirement village has allowed me to put to use many of the skill I developed as not only a florist, but a small business owner.
INsite: What aspects of village management do you enjoy the most and find the most rewarding? Rose: I love seeing joy on the faces of my residents which comes from creating a new garden, or putting on a nice afternoon tea. Making a person feel appreciated, wanted perhaps and even listened to, when the world is such a busy place, is very important to me. I love selling villas, meeting new potential residents and showing them everything we have to offer them at Rosewood Park. My clients more often than not will tell me their story, and why they feel the need to look at coming into a village. When I can fulfil their dreams and wishes, and
Ask yourself: why not become a provider and give your residents better care and earn a little revenue at the same time?
INsite: What do you see as the biggest challenges the retirement and aged care sector are currently facing? How do you think these should be addressed? Rose: The biggest challenge is the downturn in the market; many find it a struggle to sell their home at a price that enables them to come into a village with some savings as well. I believe more pressure needs to be put on real estate agents as they hold much influence over the house prices, and how the market goes. INsite: What are your leadership philosophies? Rose: »» Treat others as you want to be treated »» Have passion and love what you do »» Always look for ways to help people »» Have determination »» Learn business skills and have a good understanding of business »» Have compassion, time, patience and tolerance and learn to listen »» Believe in yourself. INsite: Who or what inspires you? Rose: The desire to make people happy and give them a good quality of life inspires me. In the back of my mind I always ask myself “would I like that?” INsite: Outside of work, how do you most like to spend your spare time? Rose: I enjoy spending time with my family and friends. I also love doing home improvements, gardening, reading, watching movies, and travelling. And making the most out of every day is a big thing for me.
Let’s snoop around...
Ocean Shores Retirement Village JUDE BARBACK gets a chance to snoop around a retirement village in the Bay of Plenty.
t is morning-tea time at Ocean Shores and a cluster of staff are enjoying a cuppa in the sunny, spacious office area. They are a pleasant bunch headed by Sandy Quigley, who has managed the village for the past five years. As Sandy gives me a tour of the village, I note their friendliness extends to all the staff and residents I encounter. Sandy herself is very approachable and has an easy manner. She has had a varied career, including working in the military and insurance broking. She is clearly a “people person”; as she points out, every position she has held has involved people. Ocean Shores retirement village, sold several times in the time Sandy has been manager, is now owned by Lend Lease, an Australian-owned company who own and operate five New Zealand villages and 65 Australian villages. Sandy says Lend Lease’s introduction of many policies and procedures, while tedious at times and responsible for far more paperwork, has provided a good point of reference, a source of ‘back-up’. There is a particularly strong focus on health and safety, with regular staff meetings on this topic and staff involvement in workplace inspections. Sandy points proudly to the Safety Passport certificate on her office wall – testament to a course she completed online. Health and safety is an interesting aspect for retirement villages. Sandy says that while adherence to New Zealand laws is important, it goes further than that in retirement villages due to the needs and frailty of some of the residents. It is a fine line because, with many people living independently in villas and apartments, you don’t wish to trespass too much on their personal space and freedom; at the same time, the onus is on the retirement village to ensure their residents’ safety. Despite being under the umbrella of such a vast organisation, Sandy says she can still bring about change in her village. She shows me the new computer suite and the barbecue area near the bowling green, which are products of Sandy following through on residents’ suggestions. Sandy says she confers regularly with residents, listening to what they want from their village. Most of this happens on a formal basis, through meetings with the residents’ committee, which consists of eight residents (of some 280) who are elected each year. But Sandy also receives input from residents on an informal basis too, which I saw first-hand. On our tour we encountered Dorothy, who asked Sandy about getting some red cushions for the newly renovated lounge. “I love the chairs, but it all lacks colour,” she says, before interrogating Sandy on how much budget might be available for cushions. The residents’ pride in the village – their home, after all – is endearing. Sandy says it is common for residents to have their say on the facilities and the appearance of the village. Apparently they can be particularly opinionated on the grounds and garden – something I have heard other managers say too. In many ways it is the residents who run the
You can sleep soundly at night in the knowledge you are safe. We have plenty of fun. And the facilities aren’t too bad either...”
village. I was fortunate enough to happen upon the entertainment committee having their meeting. They were in the midst of planning all manner of fun activities for the months ahead, including a garden party, a residents’ morning tea, and free trips courtesy of travel firms. It is clear that there is plenty to keep them entertained. Carol, a member of the committee and resident of two and a half years, loves living at Ocean Shores. “The people are fantastic,” she enthused. “And the security is wonderful. You can sleep soundly at night in the knowledge you are safe. We have plenty of fun. And the facilities aren’t too bad either,” she jokes, with a twinkle in her eye directed at Sandy. Carol is right though: the facilities are far from bad. Ocean Shores is comparable to a resort with its bar, restaurant, newly renovated lounge, hair salon, pool and spa area, gymnasium and so on. Although clearly intent on providing a great lifestyle for residents, the care aspect is there too. I met Jane, a registered nurse and the emergency response supervisor, who manages a team of five registered nurses. One nurse is always on call to respond to emergencies. Although these tend to be of a medical nature – cardiac problems, falls, skin
tears – Jane and her team need to be prepared for everything, from birds getting trapped in a villa to evacuation in the event of a tsunami. On a more day-to-day basis, the emergency response staff serve an important function in addressing the health concerns of residents as well as providing an ear to listen to them. “Sometimes they just want a chat,” says Jane. “And sometimes we need to help manage their pills or keep family informed of health issues or treatments.” Nurse Vivianne was running the drop-in clinic during my tour, where three people were waiting to be seen. Among them was another Dorothy, who described the clinic as “very convenient”. In fact Dorothy was a keen advocate for Ocean Shores in general. “I’ve been here longer than I’ve been anywhere,” she said. “I would recommend it to anyone. The [staff] are helpful, kind and cooperative. And I feel safe here.” It was the second time in ten minutes the safety and security aspect of village living emerged and it reinforced for me how vulnerable people must feel as they get older. According to RVA surveys, safety and security are top priorities for residents. The combination of feeling safe, comfortable, cared-for and sociable is obviously working for residents at Ocean Shores. Sandy points out a series of photographs taken of residents with Santa Claus and among them is Linda Hopkins, who has just turned 104. I am staggered to learn that Linda lives in a villa and still cooks her own meals and I can’t help but think that village life makes a strong case for longevity. Of course many residents are far from hitting the century mark and I meet a younger bunch in the restaurant: a gaggle of women and one longsuffering man reading a Countdown catalogue. They are enjoying morning tea and a chinwag. “We’re the information table,” announces June, “Not the gossip table!” and they all giggle. Clearly it is a regular social event enjoyed by close friends. When quizzed further, June admits there is more to Ocean Shores than her mid-morning cuppa. “This place has a real sense of warmth, space and friendliness that you don’t always find at other villages,” she says with a degree of smugness. It is, after all, about keeping things “comfortable and fun for the residents”. Sandy is mindful of keeping things affordable for them too. This is made particularly difficult with things beyond the village’s control, such as council rates, which Sandy describes as “crippling”. The council does not cover expenses for residents that they do for people outside of retirement villages, such as a burst water pipe, for example. I felt indignant about this issue, but although the RVA has apparently looked into it, Sandy seemed resigned that it was unlikely things would change. If there are other niggles in the operation of Ocean Shores, they weren’t visible during my visit and I left feeling impressed with the immaculate grounds, the demeanour of the staff and the verve of the residents. www.insitemagazine.co.nz | February/March 2012 19
A typical day in the life of... Liz Black LIZ BLACK, an activities co-ordinator at Frances Hodgkins Retirement Village in Dunedin, shares a typical day at work.
have worked as an activities coordinator for resthome-level care at Frances Hodgkins Retirement Village in Dunedin for 17 years. Over this time, I have gained great experience in putting together an interesting and diverse programme, catering for the needs of residents on an individual and at a group level. Ongoing training is offered with activities seminars held annually for Ryman Healthcare staff and monthly meetings and in-service training at our village. A day in my life at work consists firstly of organising and ensuring I have everything in place to carry out an effective programme. Communication with others on duty including the nurse manager, activities and care staff and the chef are all important so that the day runs well and maximises resident participation. I start the programme each day with a half-hour newspaper-reading session, thus giving residents local and world news as well as informing them on what is organised for the day. Mornings include a ‘triple A functional fitness’ exercise session, encouraging fitness and strength at a safe level. They are 30 minutes long and are held twice a week. Other physical activities include bowls, boccia, petanque and walks outside. Floral appreciation, gardening, baking and craft are
scheduled during the month as well as quiz sessions and team quizzes. Spiritual needs are met by organising weekly church services covering five different denominations; ministers also visit individual residents by appointment. The Public Library offers a fabulous service, choosing books to satisfy the individual needs of residents. I issue these books weekly and also oversee a book group, which is run by two wonderful ladies who come to the village every month to share books and interesting topics on travel, art, gardens and movies with the residents. Van outings are very popular and at least two are on offer each week. We go to many destinations and all residents are given the opportunity to go out. Scenic outings to various locations are organised as well as meal outings to hotels, fish and chip lunches, shopping trips, visits to gardens and private homes, and picnic teas to watch cruise ships leaving the harbour. Short outings in the car are also available. Entertainment takes place once or twice every week and the bookings are generally made at the beginning of the year. There is wonderful variety including piano, classical, country and western, easy listening, sing-a-long, school choirs, dance groups, preschools, multicultural groups and drama. The entertainment brings added diversity to the
programme and is very uplifting, making people happy and creating a lovely atmosphere around the rest home. We have several larger functions during the year with village barbeques, a family fun day, birthday celebrations, mid-winter solstice, Christmas parties and larger entertainment events. To add to the organisation and implementation of the activities programme, there is also time spent on documentation, recording, creating care plans and ongoing evaluations. I aim to encourage a good level of independence for residents within a safe environment, always looking to their individual needs and wishes. It is busy, with never a dull moment, but it is a very satisfying job that I love.
Last word... Tony Ryall, Minister of Health
ike many governments around the world, the National government is committed to supporting our elderly to stay in their homes for as long as they can. And if an older person moves into residential care, then we want them to be safe and happy that it is the right choice for them. When we took office in 2008, there had been mounting public concern around issues of poor care in some rest homes. One of our first actions was to begin improving the auditing and monitoring of resthome services. We have introduced spot auditing of rest homes, and require audit results to be published in plain English on the Ministry of Health’s website. Family members and older people can now see and compare audit results of resthomes online. We also introduced new rules that require auditing agencies to be approved by an international agency, and that is to improve their accountability at the same time as looking at ways to reduce duplication in auditing. These tougher conditions will improve the auditing itself and improve transparency and confidence in the way resthomes are audited. Regular, personalised assessments for people living in aged residential-care facilities are being progressively introduced throughout the country. 20
February/March 2012 | www.insitemagazine.co.nz
People living in these facilities will have their health comprehensively assessed at least every six months. We are supportive of the aged residential-care sector, and we recognise that there have been shortages of appropriately qualified staff. We have just added aged residential-care nurses to our voluntary bonding scheme, and 25 per cent of nursing graduates who registered interest in the scheme in 2011 are either currently working in, or intending to work in, aged care. In 2009, we put an extra $72 million over four years into improving and supporting rest home nursing supervision and we have provided extra specialised training for 300 aged care nurses. We know with the ageing population and the trends we’re already seeing that demand for dementia services will continue to increase. In Budget 2011 we put an extra $44 million over four years into dementia care, which is expected to deliver almost 200 extra dementia beds in the next two years. And moreover, DHBs have been required to pass through aged residential care’s share of increases to DHB funding. As we look to the future, we need to recognise that we are doing our planning on the back of the worst economic downturn since the 1930s, and we need to be responsible with taxpayer funds to ensure there is some certainty for future services.
The Aged Residential Care Service Review has been a vital tool in planning for the future. This major project was, and its follow up continues to be, a collaboration by the aged residential care sector, DHBs and the Ministry of Health to help plan for the future. By 2026, almost a million New Zealanders will be over 65 years of age and the number of New Zealanders over the age of 85 will increase from nearly 50,000 to more than 125,000. Planning is essential because populations are shifting. The Ministry of Health estimates that a third of DHB populations will shrink, a third will stay the same, and a third will expand significantly. People’s expectations are also changing. People want greater choice and an assurance of quality and safety. They want a more personalised service that meets their individual needs. Clearly these trends will have a huge impact on the demand for aged care services. Our ability to meet these demands will depend on two things: how prosperous we are as a country, and how well we use our resources. The immediate focus is on new models of care that can achieve better services within existing resources, and aged-care workforce training. It is important that the government continues to work with the sector, the ministry and DHBs to make sure we can meet projected needs in future.
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