Front Cover: Deloraine Aged Care Calendar Girl, Jenny (Nurse Unit Manager)
Voice of the aged care industry Autumn 2009
contents
18
29
42
National Update
Sponsor Article
3 CEO’s Report 5 Presidents Report
61 Building vision: David Lane – a conversation with the chairman
7 State Reports
Editorial
Profiles
64 Study Into Alternate Funding Models
18 Deloraine Aged Care Calendar Girls
66 SAGE – Gadens Lawyers Scholarship
21 The oldest skipper to complete the 2008 Rolex Sydney to Hobart, John Walker
68 Stewart Brown -Does Organisation Size Influence Results?
Workforce
72
24 Attracting Quality Applicants 26 Employee Motivation 28 Pearls of Wisdom = Great Satisfaction 29 A Study Of Lifestyle Satisfaction In Two Regional Facilities Technology
Review of the Accreditation Process, Aged Care Accreditation Standards and Development and Piloting of Quality Indicators
75 International Aged Care Scholarship 76 The Spark of Life® Approach to Culture Enrichment 78 Legionella
32 ITAC 09 Feature 40 ACIITC - Aged Care Industry IT Council
81 Risk Management in Aged Care Facilities
Feature
84 Calendar of Events
45 ACAA Congress 2008 Award Winners
87 Industry News
ACAA OFFICE HOLDERS PRESIDENT VICE PRESIDENT DIRECTORS EDITOR PRODUCTION
Bryan Dorman Lindsay Doherty Tony Smith Mary Anne Edwards Viv Padman Geoff Taylor Kevin O’Sullivan Rod Young Jane Murray
21 The oldest skipper to complete the 2008 Rolex Sydney to Hobart Yacht Race, John Walker
ACAA - NSW
ACAA - WA
PO Box 7, Strawberry Hills NSW 2012 T: (02) 9212 6922 F: (02) 9212 3488 E: admin@acaansw.com.au W: www.acaansw.com.au Contact: Charles Wurf
Suite 6, 11 Richardson Street South Perth WA 6151 T: (08) 9474 9200 F: (08) 9474 9300 E: info@acaawa.com.au W: www.acaawa.com.au Contact: Anne-Marie Archer
ACAA - SA Unit 5, 259 Glen Osmond Road Frewville SA 5063 T: (08) 8338 6500 F: (08) 8338 6511 E: enquiry@acaasa.com.au W: www.acaasa.com.au Contact: Paul Carberry
AGED & COMMUNITY CARE VICTORIA
FEDERAL
ACAA - TAS
AGED CARE QUEENSLAND
PO Box 335, Curtin ACT 2605 T: (02) 6285 2615 F: (02) 6281 5277 E: office@agedcareassociation.com.au W: www.agedcareassociation.com.au
PO Box 208, Claremont TAS 7011 T: (03 6249 7090 F: (03) 6249 7092 E: smithgardens@bigpond.com Contact: Tony Smith
PO Box 995, Indooroopilly QLD 4068 T: (07) 3725 5555 F: (07) 3715 8166 E: acqi@acqi.org.au W: www.acqi.org.au Contact: Anton Kardash
ACAA OFFICES
Aged Care Australia is the official quarterly journal for the Aged Care Association Australia
Level 7, 71 Queens Road MELBOURNE VIC 3000 T: (03) 9805 9400 F: (03) 9805 9455 E: info@accv.com.au W: www.accv.com.au Contact: Gerard Mansour
A BOURNE d
P U B L I S H I N G
Adbourne Publishing PO Box 735 Belgrave, VIC 3160
Advertising Melbourne: Neil Muir (03) 9752 6933 Adelaide: Robert Spowart 0488 390 039 Production Claire Henry (03) 9752 6944 Administration Robyn Fantin (03) 9752 6426
DISCLAIMER Aged Care Australia is the regular publication of Aged Care Association Australia. Unsolicited contributions are welcome but ACAA reserves the right to edit, abridge, alter or reject any material. Opinions expressed in Aged Care Australia are not necessarily those of ACAA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Aged Care Australia may be copied in whole for distribution among an organisation’s staff. No part of Aged Care Australia may be reproduced in any form without written permission from the article’s author.
www.agedcareassociation.com.au
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Aged Care A U S T R A L I A | Autumn 2009 |
1
national update
CEO’s Report Rod Young, CEO, ACAA
Aged Care Financial Status – How much proof does Government require? Over the past several years, a variety of data covering the financial status of the aged care system have all showed very similar results.
F
or the period 2004-05 through to 2007-08 we are seeing a consistent set of data which indicates that the aged care industry is in decline. The data consists of:
• Stewart Brown quarterly reports • the Department’s analysis of the industry’s general purpose financial reports audited accounts 2003/04 and 2004/05 • the Grant Thornton analysis being the contracted party for the 2005/06 financial year for the industry’s general purpose financial reports audited accounts • Bentleys MRI annual financial benchmark 2005/06, 2006/07 and 2007/08 • Grant Thornton financial benchmark 2007/08 Set out below at Table 1 is the comparison of the Bentleys MRI, Stewart Brown and Grant Thornton analysis of some of the major data flowing from the last several years. It is interesting that all of this data has a trend line indicating very similar outcomes.
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ACAA believes that the Government’s decision not to release the audited financial data is because the data will entirely confirm the analysis in the above reports and financial benchmarks.
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ACAA have been calling on the Government to release analysis of the industry’s general financial purpose reports for the 2006/07 and 2007/08 financial years. So far, these calls have been ignored. ACAA believes that the Government’s decision not to release the audited financial data is because the data will entirely confirm the analysis in the above reports and financial benchmarks. How dreadful it would be if Government having imposed audited general purpose financial reports on industry to enable the industry to receive their CAP additional index to then find that that same data clearly demonstrates the industry is in a parlous state. ACAA is frustrated at the refusal of Government to release this data in contravention of the agreement struck with the industry when the CAP index was negotiated. One of the requirements for receiving the CAP was to provide audited financial accounts using general purpose financial reports with an additional obligation unilaterally imposed by the Department requiring aged care specific segmentation of these accounts. ACAA has therefore said to the Government if the financial data from general purpose financial reports is unsatisfactory then please, let’s stop doing it. It is expensive and wasteful. Why continue with the charade? ACAA offers the alternative that was proposed at the time when the CAP was being negotiated that the industry submit on an annual basis to a third party organization capable of undertaking the required in-depth analysis, a simplified set of financial results which could then be analyzed for each provider and the industry generally to give both Government and the industry a clear picture of the status of the industry’s financial viability. n
Table 1
Ordinary High Care EBITDA per bed per annum Average Construction Costs (including land and equipment) Single Room Ordinary High Care per bed per annum Single Room Ordinary High Care Return on Investment
Grant Thornton June 2008
Underwood / BMRI June 2007
Stewart Brown September 2008
$3,189
$3,453
$2,804
$193,600
$175,000
$2,191
$737
1.1%
0.4%
Not Provided
Aged Care A U S T R A L I A | Autumn 2009 |
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national update
President’s Report Bryan Dorman, President, ACAA
HOW MUCH COMPLIANCE CAN ONE INDUSTRY BEAR? After a promising start, the Rudd Labor Government seems to have found it impossible to deal with the major policy issues impacting upon the aged care industry.
T
he only solutions offered by this Government to date, in answer to every policy issue, seem to be the imposition of more and more compliance requirements on an already stressed industry. The number of times you hear from senior nurses throughout the industry that the aggressive and confrontational manner of Departmental and Agency inspectors is encouraging them to leave the industry, because it doesn’t seem to matter to Government how hard they work, what dedication they have and what little pay they receive, Government demands more and more of them for less and less. All the aged care providers I know are out there trying to provide safe, secure and positive workplace environments for a workforce that undertakes an extremely difficult task, often for considerably less pay than their colleagues in other parts of the health system. They see their image, as an industry, constantly portrayed in the media as poor quality with unsatisfactory services and second rate skills. It is also particularly difficult for aged care staff to see this view is also supported by the Minister, who seems to believe the only way to address every aged care problem is to impose more and more compliance on them. Aged care staff want to know what they would find if they turned up unannounced at 8.00am on Monday morning to carry out a performance audit on the Minister’s office; just how many non-compliance outcomes would be found. The industry has struggled to understand why this Minister has set herself on a course denigrating aged care providers and the two hundred and forty thousand staff who work in the aged care industry. It seems the only response to every issue that this Government has had to date is to simply impose more compliance.
ACAA believes that it is about time this Minister and this Government actually understood that the role of a Minister in this industry is at least in part, to protect and speak on behalf of the persons at the coalface who provide the care and services that residents rightly deserve. This industry cannot survive without staff. We cherish our staff and want them to feel satisfied and valued. If we are to maintain a quality service, we require quality staff. Unfortunately, our staff are leaving the industry in droves. ACAA and the aged care industry have no problem with it being open to constant inspection and public scrutiny. However, what regularly happens is that the representatives of Government, namely; Department and Agency treat aged care staff with little respect, outright hostility, or with strong prejudice and an assumption of guilt until proved innocent. I wonder what would happen, if Government inspectors moved away from their aggressive interrogating manner whilst undertaking their inspectorial roles, to a positive attitude and style. It is high time that the Agencies of Government imposing this negative environment upon aged care staff changed their ways. There is no reason why the tasks of these officers cannot be undertaken as effectively as at present, in a much less belligerent manner, with due courtesy shown to all aged care staff. ACAA calls on the Rudd Government to recognize the valuable work that aged care staff deliver to our community and society and start treating this important resource of the Australian community with the respect and courtesy that each individual staff member deserves. n
Aged Care A U S T R A L I A | Autumn 2009 |
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national update
ACAA - NSW Charles Wurf, CEO ACAA-NSW
Award modernisation continues
W
orking to a well established time table the AIRC released two further exposure drafts of Modern Awards with particular relevance to Aged Care: • Aged Care Industry Award 2010;
January 2009 saw the Australian Industrial Relations Commission (AIRC) release its decisions in relation to the Award Modernisation process as it applies to Aged Care.
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With a continuing focus on “safety net” awards underpinning enterprise level outcomes, employment relations will remain a key area for aged care for the foreseeable future.
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• Nurses Occupation Industry Award 2010. The decision to release these two awards responded to two distinct lines of advocacy. The Aged Care Industry Award 2010 is in response to the combined efforts of all Aged Care Industry Associations across both the ACAA and ACSA networks combining in a joint position that there should be a single award covering Aged Care in Australia. The second outcome was in response to the Australian Nursing Federation (ANF) advocacy for an occupational award to cover nurses where ever they may be employed. The exposure drafts announced in January 2009 appear to be in response to both of these distinct submissions. The reality of the exposure draft for an employer in aged care now means that there will be two principal awards applying to an Aged Care workforce, an occupational award applying to nursing staff and an Aged Care Industry Award applying to all other classifications of employment. Upon release of the Award the timetable for response was set to continue with both written and oral submissions required to be delivered to the AIRC before the end of February 2009. The AIRC will now consider those further written and oral submissions prior to releasing its final version of these modernised awards in April 2009.
Full details of the award modernisation process, including all submissions and release of exposure drafts of the award remain available online at the AIRC website www.airc.gov.au. The pace of the timetable for award modernisation is geared to the commencement of the modern awards on 1 January 2010. The next key workload for Aged Care Employers will be in the detail of what the AIRC has called the ‘Transitional Arrangements’. The transitional arrangements will take those currently covered by a State Award/ NAPSA/Federal Award into the modern award. The time table for that process is a 5 year period commencing 1 January 2010. It is in those details that the serious potential cost implications of the modernised award process will become apparent. There is a huge task ahead for the industry to analyse the final version of the award as the transitional arrangements are made by the AIRC. In all of this discussion regarding modern awards it remains important to note that those organisations that have negotiated agreements directly with their workforce will remain outside of the modern award structure. Award Modernisation will remain a complex issue for all employers, as it is likely that Workplace Relations will again feature as a prominent election issue at the next Federal Election. With a continuing focus on “safety net” awards underpinning enterprise level outcomes, employment relations will remain a key area for aged care for the foreseeable future. n
Aged Care A U S T R A L I A | Autumn 2009 |
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national update
Aged & Community Care Victoria Gerard Mansour, CEO ACCV
With baby boomers set to become our next older generation, Australia’s aged and community care industry is now planning ideas to deal with an increase in the ageing population.
T
he 18th Annual Tri-State Conference in Albury saw over 340 delegates from Victoria, New South Wales, South Australia and Queensland meet daily from 1–3 March to listen to industry representatives, colleagues and professionals discuss the issues surrounding “juggling priorities in aged care”. Presentations focused on the practical applications and solutions for aged care delivery within a changing environment. The conference provided an excellent opportunity for those in the aged and community care industry who are achieving best practice through innovation and excellence to share the knowledge and know-how with colleagues and friends. A highlight of the conference was a panel session chaired by the Hon Neil Batt AO on IT for the Aged and Community Care Industry – A Distraction or Core Business. The session saw presentations from the Hon Justine Elliot, Minister for Ageing, Rod Young, CEO, Aged Care Association Australia, Peter Fleming, CEO, National E Health Transition Authority and George Margelis, Health Manager, Asia Pacific Intel Australasia.
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Autumn 2009 | Aged Care A U S T R A L I A
ACCV was pleased to hear Minister Elliot speak on the Government’s position on IT in the aged and community care industry, and talk of the importance of IT access and the significant benefits it will provide to the industry. The federal government has invested $218 million to establish the National E Health Transition Authority (NeHTA) to develop better ways of electronically collecting and securely exchanging health information. ACCV considers it is particularly important that a substantial component of this funding is allocated to address IT priorities for the aged and community care sector. One of the key priorities for our industry is the creation of a single system of electronic national health records. Funding from the federal government is being used by NeHTA to develop the National Electronic Health Record, which intends to contain an individual electronic health record for every Australian. Peter Fleming of NeHTA discussed Phase 1 of the National Electronic Health Record, which involves the development of an Electronic Medication Management system. Currently we have a huge national demand for prescriptions, over 530 million annually. The development of this system is aimed to improve efficiency in the treatment and administration of medications, therefore improving the accuracy and quality of care provided to residents and clients. Results from the pilot program have shown the amount of time spent on manually submitting prescriptions has significantly reduced, leading to improvements in accuracy and quality of care. Both the GP and Pharmacist involved in the pilot were hesitant and uncertain that the program
could deliver its predicted outcomes; both are now pushing for all aged care facilities they are involved with to use the program. To ensure that this program is effective, we now need to push for this program to be tested on a larger sample group, to test real world situations. While delegates welcomed the Minister’s proposed plans for IT developments in the industry, questions were put to Minister Elliot raising the importance of the need for additional resourcing for our industry to allow for these developments to take full effect. Following the success of the oneoff grants to facilities for IT announced in 2005, delegates expressed their view that another significant investment was necessary to sustain IT developments in the industry. George Margelis, Health Manager, Asia Pacific Intel Australasia spoke about technologies that can be used by older adults, caregivers (both professional and informal), health care providers and ageing service providers to improve the quality of care, enhance the caregivers’ experience, efficiencies and cost-effectiveness. These technologies broadly include assistive, telemonitoring, telehealth, telemedicine, information, and communication technologies that intend to improve the ageing or care experience. We, as an industry, need to ensure we are working towards ensuring these technologies and services are available. George Margelis outlined the following seven steps on what we, as an industry, can do to ensure these technologies and services are available. >
national update
ACCV Report (continued) 1. Ensure technology in aged care is based on standards. 2. Investigate what the issues facing aged care are. 3. Work with aged care providers to develop proof of concept projects that help solve these issues using available technology. 4. Test these solutions in real world situations, not just in small pilot projects. 5. Share the learning between groups, get the message out. 6. Influence government to recognise the role of technology in quality aged care delivery. 7. Person centric Electronic Health Records as the basis for communication between all health care delivery sectors. Aged Care Industry IT Council member Rod Young spoke of the IT Councils vision, to improve the care of older Australians through effective use of technology. The future of IT in the aged care industry means using wireless connectivity and ‘smart phones’ for referrals, assessments, medication management, wound care, staff rostering and time sheet reporting. The focus for our industry in moving forward must be on operational business processes and not purely on IT systems. n
national update
Aged Care Queensland Anton Kardash, CEO Aged Care Queensland
At the time of writing this article, the State election has just been called with voters going to the polls in late March. While much of Aged Care lies within the Federal sphere, the election provides the sector with an opportunity to get some “air time”, on the significant issues facing the industry.
A
CQI is very active in the Retirement Living sector and is currently supporting a number of members in the legal challenges clarifying the contract obligations for providers. In recent judgments’, ACQI was successful in clarifying in the Supreme Court the controversy over whether an operator can make residents responsible for the cost of repairs to their units. The decision, which overturned a previous tribunal finding, is that operators can make residents responsible. ACQI is currently in receipt of a number of innovative grants to assist our membership in looking at alternative ways of maintaining and sustaining their operations. One such grant has been recently obtained from the National Rural Primary Health Projects Initiative. This grant is aimed at utilizing current technologies to enhance the development of supportive infrastructures for staff that work in the specific areas of Indigenous Aged Care, Allied Health and Community Based Care. This project takes advantage of available technologies such as Elluminate and Skype to link providers throughout the state in an E-Mentoring Project. ACQI is currently in the process of recruiting sixty participants for this action research project and have gained significant involvement from our more isolated members in rural and some very remote settings. The project has a resource development focus, which it is hoped will make the project sustainable beyond the funding period. This unique project will build on the significant work ACQI has already undertaken in developing service support networks for providers of Allied Health services, Indigenous Aged Care, and in various Community Care programs within our membership. To further support our membership a state grant has also been obtained from the Queensland Gambling Community Benefit Fund to assist in the development of mentoring resources for
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ACQI is currently in receipt of a number of innovative grants to assist our membership in looking at alternative ways of maintaining and sustaining their operations.
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aged and community care providers. In this project ACQI has secured funds to develop CD-Rom Resources to assist members in identifying responsive approaches to staff development and support. On other fronts ACQI, is responding to member demands and actively taking up the issue of Residential Aged Care Accreditation with both the Agency and the Department of Health and Ageing. Member perceptions of the current system is quite negative and while the association and its members support a rigorous quality assurance system, the current one may not be meeting either the industry or residents needs. n
national update
ACAA - WA Anne-Marie Archer, CEO ACAA-WA
WA Deputy Premier; Minister for Health; Indigenous Affairs the Hon Dr Kim Hames, MLA; his Prinicipal Policy Advisor, Christian Allier and Alzheimer’s Australia WA Manager for Research and Consultancy, Jason Burton at the Safe2Walk® official launch 24 February 2009.
Safe to walk in the West Alzheimer’s Australia WA recently launched the first personal alert and location service designed to reduce the risk of people with dementia going missing.
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he Safe2Walk® service that uses the latest in GPS technology to provide a cost-effective solution to a significant issue faced by many people living with dementia was recently launched by the WA Deputy Premier; Minister for Health, the Hon. Dr Kim Hames MLA. It is estimated up to 60% of people with Alzheimer’s disease or other forms of dementia will become lost at some point, which can lead to stress for both the person with dementia and the family. At the launch Alzheimer’s Australia WA Chief Executive Officer Frank Schaper said a person with dementia who goes
missing for longer than 12 hours is twice as likely to be found dead or seriously injured. He said the rights of people with dementia to lead an independent and meaningful life balanced against the risk of the person becoming lost and being injured is a difficult decision faced by family carers on a daily basis. In some cases, carers have resorted to using physical or medical restraints to reduce the risk of the person with dementia going out and getting lost. Safe2Walk® was developed after an extensive two-year study by Alzheimer’s Australia WA. The organisation worked closely with people with dementia and their carers to develop a GPS location device that also offers a simple-to-use one touch mobile phone and panic alert. The service is offered at a low-cost weekly hire fee that it is affordable for most families and is supported by staff in the field of dementia care and assistive technology.
The WA Health Minister Dr Kim Hames commended Alzheimer’s Australia WA on its innovative new service which would benefit hundreds of Western Australians by tackling an everyday problem. The Minister said it would not only ensure that a person with dementia is returned safely and as quickly as possible to concerned family and friends, it will help reduce the burden already borne by our health system and the shortage of permanent care places. Alzheimer’s Australia WA has also been working with the WA Police to explore ways to reduce community resources and time spent on looking for people with dementia when they are reported missing. Assistant Commissioner of Counter Terrorism and State Protection John McRoberts said people with dementia becoming disorientated and going missing is a significant issue for the police and the general community.
The aim of the Safe2Walk® service is to will reduce the burden on carers and at the same time promoting the wellbeing of people with dementia.
He said the Safe2Walk® service is an initiative that will provide the police with useful and accurate information and will enable us to locate a missing person much quicker than before.
It is hoped that this new technology will decrease the likelihood of premature admission into residential care or the need for hospitalisation.
For further information about the Safe2Walk® service, contact Alzheimer’s Australia WA on 1800 100 500 or visit www.safe2walk.com.au n
Aged Care A U S T R A L I A | Autumn 2009 |
15
national update
ACAA - SA Paul Carberry, CEO ACAA - SA
Workforce issues are, rightly, recognised as one of the key factors upon which the aged care industry’s success will depend.
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Positive experiences in aged care in their first years out of training, can only increase the numbers of nurses who choose aged care.
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O
verall, Australia has a workforce which is ageing, and declining in numbers as a proportion of the total population. As we know, workforce ageing is an even greater factor in our industry than in the workforce as a whole; for example the average age of nurses in aged care in 2004 was 47 years. (Inst. of Health & Welfare, Labour Force Survey, 2004). Apart from that, the nature of our industry is highly labour intensive, and with a lower potential than many industries for technology to replace human skills and effort, personal-care robots notwithstanding. For these reasons ACAA-SA has been active in areas which will assist in the recruitment of nurses to our industry. One programme, commenced in 2008, is the coordination with the University of South Australia, of clinical placements for Bachelor of Nursing undergraduates, in ACAA-SA residential facilities. The programme includes workshops by the university for the aged care staff who will be supervising the students during their placements, to ensure that the university’s requirements are met, and that the work the students do whilst on placement gives them a good understanding of the role of aged care nurses.
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Autumn 2009 | Aged Care A U S T R A L I A
Some of the feedback has been excellent, with students reporting to their lecturers that they never imagined “how varied and challenging” aged care nursing was, and how great it was to see the “quality of the relationships” which aged care nurses had with their residents and families. With feedback like that the probability of these students choosing a career in aged care can’t have been harmed. Our Care Management Executive held a debrief meeting with Student Placements Coordinator at Uni SA at the end of 2008, to iron out a few misunderstandings and communication issues, to ensure that the programme in 2009 works even better. An area we are exploring this year is how our members can tap into the graduate nurse programmes, sometimes called graduate transition programmes, run by our hospitals. These are programmes of study workshops and on-the-job experience for nurses in their first year after graduation, to help them transition from nursing students into practicing professional nurses. Some of our members have tapped into these programmes on an individual basis, and we take to develop these models and take them to our wider membership.
Past criticism from students on aged care placements is that they were treated as unpaid carers, clearly not an experience which would have encouraged them to choose aged care nursing as a career.
Once again, positive experiences in aged care in their first years out of training, can only increase the numbers of nurses who choose aged care.
Good communication between the students, their university lecturers and the aged care staff is also an essential ingredient, so that everyone’s expectations are understood.
With an ageing workforce, declining in numbers, we have to attract skilled staff to our industry. These are just a couple of programmes we hope to build upon with that objective in mind. n
profiles
Deloraine Aged Care Calendar Girls
By Mike Swinson
“We won’t be having any rudie, nudie images’. Excuse me, what did you say? I said. ‘There won’t be any nude shots in our calendar’, said Jennie Parfett, who appears on the front cover of this wonderful calendar in a very little black dress and little else.
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ut she is, well covered, sort of. On Page two, January 2009, and there is Ray, the cleaner at Deloraine Aged Care, waving two sausages around, obviously from the nearby BBQ, and talking to two girls who can’t be wearing very much, but who are obviously enjoying themselves enormously, with cocktail glasses in hand! Ray did tell me what it was he said that made them laugh so much, but I’m not sure that I’m about to share it with you, it’s a bit on the raunchy side, trust me. But I can understand why the girls are cracking up with laughter and why Ray has such a grin on his face. Maybe later in this story I might reveal all. This calendar, like many others around the world drew its inspiration from the English movie, “The Calendar Girls” that followed publication of the book “The Shell Seekers’. Jennie Parfett said ‘There had been a lot of negative stories about aged care recently. Some of our staff were talking one day about what can we do to counter these negative images. They were saying that at this facility, we have great staff and we have great residents. Then Kerrin said, why don’t we do a calendar, like the one from the movie?’
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Autumn 2009 | Aged Care A U S T R A L I A
I discussed this with our understanding owners, Richard and Liz and they said, ‘why not, as long as there isn’t any nudity and its done by a professional publishing business.’ A meeting with a local publishing house followed where the guidelines were set, no naked bodies, and no flowers, puppies and images that lead to buckets of damp tissues, it had to be fun, a little different and quirky. I can report it is all of that. The photo shoots had to be filmed on site at the home, and only staff involved. Then it was on for young and old, time was short, Christmas was looming as they searched for volunteers, props and locations. “We picked up red plastic roses for $1.50. This had to be cheap but effective’, said Jennie. ‘We had to find cocktail glasses and little umbrellas, an empty bottle of very expensive French Champagne, and a book called “There’s more to life than Sex and Money’, and we did. ‘The morning of the photo shoot everyone was gathering bags of rose petals from their gardens. It was a hoot, great fun. We spent a lot of time in $2.00 shops I can tell you. My daughter is a jockey, so she donated whips and scull caps’. Now your imagination is going full tilt, isn’t it?
So let’s have a bo-peep at March 2009, with the saucy, naughty, giggling, trio of Irish Lassies, Cynthia, Kobie and Elise. I can just hear the photographer saying ‘higher girls, c’mon, let’s see a bit more leg, bit higher still.’ Resident John lives in one of the low care rooms in the facility. He volunteered his room for a day as it is the location for May 2009. Propped up in John’s bed is Jenny, the Nurse Unit Manager, reading ‘that’ book. “There’s more to Life than Sex and Money,” the copy of which came from the bookshelf of the Director of Nursing. It’s one of her favourites! OOOhhh, you can only imagine the gossip this calendar has engendered. The bottle of very expensive champagne was empty, came from one of the staff who collects…..bottles. When John returned to his room, Jenny, the book, the rose petals and the bubbly were long gone! Can’t have everything John, I’ll bet the calendar has pride of place on the wall! >
profiles
< ‘It’s not easy working in this industry, but this calendar has seen people happier at work, keen to come to work, very few people call in sick now unless they are really crook,’ says Jennie. ‘We now have staff ten pin bowling nights, we are forming a social club, we had a big staff Christmas party, we don’t even have to advertise as much for employees, because everyone knows someone who wants to work here. It’s been wonderful.’
Deloraine Aged Care Calendar Girls
Jennie Parfett says they plan on doing another version next year and already ideas are coming in, people are holding up their hands wanting to be involved. Can’t wait. By the way if you can’t get a copy, you will never see July, ooooohhhh, and footy fans won’t see September, you’ll miss the fashions in the field in November, and check out February and July! Blimey! That’s all I can say. Owner Richard says staff at two other Gold Age facilities are thinking it might be a good project for them.
The last word goes to Jennie, ‘This is a truly good news story involving our Deloraine Aged Care community, focusing on fun, adventure and teamwork! n Postscript to Ray: I want to share with you that Ray, the pinup boy from January is one of the lucky survivors of the recent Victorian bush fires. His house is still standing, but the inside is covered with black soot. He has a harrowing tale to tell of escaping with his asthmatic sister-in-law, as the fire raged behind and around them, of frantically clearing a fallen tree off the road, of being caught by a fallen branch and thinking this is where they would both die if he couldn’t get it off him. As the fire raged around them he drove at breakneck speeds, in almost total darkness, enveloped in thick smoke and flames, at speeds of up 160 km/h to escape the inferno. Of stopping dozens of cars from trying to get back to homes and families, who would of almost certainly perished if they had gone on. He’s a lucky boy and his sister-in-law is a lucky girl indeed.
The oldest skipper to complete the
2008 Rolex Sydney to Hobart Yacht Race Profiled by
Mike Swinson
His surname is Walker, well it is now. When he was a young man living in Prague it was Wachtl. On arrival in Australia in 1949 as an immigrant/ refugee, fleeing from the Russian invasion of his home country, no-one in Australia could pronounce his name, so being a pragmatic sort of a bloke John changed it to the name of a good whiskey and to his many friends he became known simply as Johnny Walker. So began the family’s life in ‘The Lucky Country.
‘Y
ou guys haven’t got a clue what a wonderful country this is, compared to where I came from and what is still going on in some parts of the world.’ These days John Walker is a very young 86 years of age. He still helps to run his family timber business with his son Gary. He is still married to Helen, the girl he fell in love with when he lived in Prague after the war. He never complains about his lot in life, his health, his family, in fact I’d wager that John Walker and complaining are totally incompatible. Scratch the surface and you find that John and Helen probably have a lot that they could complain about, but they choose not to. For John Walker, life is about a glass half full, about being grateful for what
Photograph: Rolex
he has, not for what he and his family endured, not for him the glass half empty.
‘We didn’t suffer any damage, no-one was injured.’
In the 1998 Sydney to Hobart, when the fleet hit a huge storm on entering Bass Strait, John said he heard the mayday calls from stricken yachts Sword of Orion and Winston Churchill, the chilling news that some crew members had been washed overboard and lost. He knew the storm was the worst he’d ever encountered and got his crew together to make a decision: pull out or go on. To go on could be life threatening to them all. He was inundated with messages of thanks from family members when he backed the crew’s decision to return to Eden. Even though John has a competitive spirit, winning wasn’t that important, keeping his crew alive was.
I asked John if he ever had to confront fear when sailing in conditions that were so extreme. ‘Not really,’ he said. ‘During the war I spent three and a half years in concentration camps, compared to that everything I’ve had to face in life since then is a piece of cake. I take things as they come, no matter what life throws at me.’ Understandably John doesn’t like to talk about those three plus harrowing years, as he, his father, mother and brother battled to survive the torment and horror. His mother did not survive. John did tell me that when they were living in Prague, before the Germans invaded Czechoslovakia, they heard stories about what was happening to Jews in >
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profile
that, how would I turn out later in life, that’s when I realise what a remarkable human being John Walker is. How has he managed to survive and prosper, how has he managed to put all that to one side and get on with life, not only get on with it but keep marriage, business and family together, and still enjoy himself? John said, ‘I always maintained that those who survived the concentration camps became much tougher, much more resilient. Everything that is thrown in your way after that experience pales into insignificance. You can handle virtually anything, because you have coped with much worse. If you were lucky enough to survive it makes you stronger for the rest of your life.’ I am at a loss for words, maybe that’s for the best and I can get on with sharing the Australian John Walker story.
Photographs: Rolex
that, ordinary people wouldn’t do that to one another,’ said John. But as we all know, they do and they did. In case you don’t really understand the horror of those camps I want to share with you this extract from the memoirs of a young American soldier, one of the first to enter Buchenwald Concentration Camp. “We saw what we saw, and we remember as we remember. I remember scouting out the area in front of us, ...... there was a monster of a chimney black smoke was pouring out of it, and blowing away from us, but we could still smell it, it was an ugly horrible smell, a vicious smell. Slowly, a ragged group of human beings started to creep out of and from between the buildings in front of us.
< Germany but they couldn’t bring themselves to believe it, it all sounded too far-fetched. Once interred in their first concentration camp, the stories got worse and included rumours of gas chambers and mass killings. ‘It was too much to comprehend, anyone who was normal would never behave like
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Our Sergeant said this is what was called a “concentration camp”, that we were about to see things we were in no way prepared for. The bodies of human beings were stacked like cord wood. The Lord only knows how many there were. Bill, Tim, and I grew very quiet. I was nineteen, Bill and Tim were eighteen-chronologically anyway. We had aged years in a few short hours.” When you sit, as I have and think how would I cope with years in camps like
He is such a nice bloke. His yachting crew love him, many have sailed ten or more Sydney to Hobart’s with him, many of the employees of his timber firm have been with the business for twenty or thirty years. Staff turnover is low. Many of those who leave return a few years later. Over the years the families timber business (www.belmonttimber.com.au) has grown steadily. The business is debt free, because John’s philosophy is to save for the things you want, not for him the need for instant gratification from the accumulation of worldly goods. John’s Sydney to Hobart days are over, well that’s what he told me. ‘Sailing, ocean racing has brought me a lot of joy, but I have promised Helen that I won’t do another Sydney to Hobart.’ One wonders the emotional storms Helen has weathered over the years of John’s ocean racing career. Still, he survived the most horrendous treatment that you could imagine; not only has he survived but his spirit has triumphed over the worst that the Nazi SS could throw at him. That gives you a deeper understanding of why at 86, he’s still living life to the full. When you have witnessed such horrors, seen so many people die, life becomes valuable, something to be treasured. When I rang him one Saturday, guess where he was? Sailing on Sydney Harbour, what else would you expect! n
workforce
Attracting Quality Applicants By Dr. Ken Byrne
As our economy moves closer to crisis, it may seem easier to attract more applicants. Despite this, we don’t necessarily want more people. We want more of the right people. There’s a big difference.
M
ost recruiting suffers from two major problems:
1. Limited analysis of Benefits. Recruitment starts with asking some necessary but tough questions. First is “Why would someone want to work here rather than somewhere else”? If your answer is “we pay better”, that won’t be enough. Money will attract people to a job, but it won’t keep them for long.
Everyone comes to work for psychological rewards. These include the feeling of making a difference, working with pleasant, like minded people, feeling appreciated for their efforts, and being part of a productive team. Of course there are the practical factors such as flexible hours, fair pay and working near home. To attract high quality applicants you must be able to respond to the unspoken question: “What’s in it for me to work with them”? This must be honest. It can only be described by you, and describe it you must.
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2. Fishing in the Wrong Pond. Suppose you want to catch trout. Your chances of success increase if you fish in a big pond that has lots of trout instead of say, a small pond full of guppies. So too with recruiting. Where are the people who are likely to want to work for you? How likely is it that they are reading a small two line want ad, or checking out the Internet? Sure, some might be, but is that the only pond you want to fish in?
“
Attracting the best people first means that you can describe how your job will satisfy their psychological needs.
”
Here are some practical ideas that have proven useful in letting people know about your opportunity. (If you don’t really believe it’s an opportunity, re-read #1 above.)
Create Your Own Internship. Many programs require students to have some “real world” experience. Providing training usually means some supervision in return for temporary labour. This gives you a chance to identify future talent.
The Shopping Mall. If lots of potentially high quality people are at the mall on Saturday, why not go there? Set up a small stand, and staff it with some of your most enthusiastic people. Some large photos and signage won’t cost much, and can be used repeatedly. Lots of people may pass you by, but a lot will stop for a chat.
Use the Media Creatively. Contact the local radio stations and community newspapers. Invite them to do a story on your facility. You need a snappy topic. Something like “The Rewards of Caring” or “A Job with Real Meaning” should work. Ask them to bring a photographer and have staff available who can talk passionately about their job.
Develop A Recruitment Culture. This means that everyone in the organization, from the top down, sees it as part of their job to be on the look out for good people. This is ongoing regardless of whether you’re actively hiring or not. Ask potential applicants if their details can be added to your confidential “Talent File”. Few will refuse. When openings occur, start your recruitment there. Remember though, all applicants have to complete the (hopefully rigorous) screening process.
Using the Economic Downturn. Unfortunately, many people will become unemployed. That means that a lot of hard working, loyal people with life experience on their side will be looking for jobs. Many of them might have never thought of working in Aged Care. Contact the company and offer to send over information about your openings. Even better, ask to come and make a brief presentation.
Good Performers Who Have Left. People leave for a variety of reasons, and circumstances can change. Keep track of them. Often a phone call some months (or years) down the track can have surprising results. They may even have thought of returning, but felt too shy to ask. Develop Relationships With Training Facilities. These people want to help their graduates get jobs. If you develop the right relationship, your agency can become the first “port of call” at graduation time.
Attracting the best people first means that you can describe how your job will satisfy their psychological needs. The next step is to spread the message in all the places where the best people are now. n
Dr. Ken Byrne is an expert is evaluating job applicants, especially for the aged care and public safety sectors. He is the Director of SAFESELECT. Email: profile@safeselect.net.au www.safeselect.net.au
workforce
The Real Cost of Employee Turnover I spend most of my day extolling the virtues of the MyBenefits Employee Benefits Program. Why not? It’s our baby and we are very proud of it. But this week, I have found myself in a situation that has brought the true benefits of the Program to the forefront of MY mind... I have been training a new employee.
S
haron is our new Accounts Manager and will certainly enhance our capabilities... but, naturally, training her has been a time-consuming exercise. Even the fastest learner in the world still has a learning curve. In terms of our organisation, it has diverted my attention away from my key role... that of promoting the Program. Obviously, it is a matter of “short term pain for long term gain”, but I can tell you now it is not an exercise I would like to go through on a regular basis. Now that Sharon is up to speed, we intend to keep her! Training new employees is something that every organisation has to go through, and the larger the size, the more resources have to be allocated to the task. It often seems just as everything is on track, an employee throws a spanner in the works by moving on. That’s where we believe the MyBenefits Employee Benefits Program (EBP) can be a valuable HR strategy. The intent of the MyBenefits EBP is to offer organisations in the Aged Care sector an HR strategy to assist and overcome the relatively high levels of employee turnover in our industry. With the EBP card being owned by your organisation, individuals may only retain the card and its associated benefits as long as they remain employed by you. Hopefully, the card offers
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employees a sufficient enough benefit to have them reconsider leaving your organisation. Every time you have employee turnover, someone in your organisation has to bear the responsibility of training new employees... and your organisation has to bear the bottom line cost. The question is, does the benefit obtained from the Program outweigh the cost of $25 + GST? Obviously, I believe it does or I wouldn’t be doing what I do. We tend to think of it as investing in your most valuable resource... your people. Take a look at what we have to offer for yourself, by visiting our website: www.my-benefits.com.au LOGIN: MB00016 PASSWORD: FEB09 If you like what you see, give me a call. Last of all... welcome on board, Sharon. We are a pretty nice bunch in the Aged Care industry... and I hope you get a lot of value from your MyBenefits Card. n Brad King National Benefits Manager MyBenefits
workforce
Pearls of Wisdom =
Great Satisfaction Ascott Gardens is a 62 bed low care facility in the Central West of NSW (Orange), with 38 general beds and a 24 bed dementia specific unit. The facility is part of the United Protestant’s Association of NSW group of aged care facilities which commenced benchmarking with QPS in 2006. For the past two years Ascott Gardens have consistently achieved above average results in both resident and relative satisfaction.
Volunteers assist in providing additional services to residents
I
n this article Margaret Langford-Smith, the Care Manager for Ascott Gardens shares her philosophy and some of the strategies that have resulted in their high levels of satisfaction.
Pearls of Wisdom It is amazing that pearls are formed by irritated oysters dealing with gritty bits of sand! Margaret points out that at Ascott Gardens, they can identify with those oysters. Many years ago in the early days of Accreditation, management were made aware of the fact that they now had to deal with the outcome standards that related to residents having their “say”. This included collecting information about how residents felt about their home and whether or not management provided appropriate and sufficient feedback. Margaret and her team quickly identified that they could improve in this area, and so the first grain of sand was planted. It was not long before drafting, circulating and collating simple surveys on a regular basis became the norm. The introduction of the Aged Care Accreditation Standards had made Margaret’s team aware of the opportunity to provide residents, staff and visitors with very open lines of communication in relation to feedback. The aim was not only to meet the standards, but to exceed them by promoting feedback and providing progress reports before meetings with groups and individuals. This meant that documentation could be signed off at the end of each improvement process.
Ascott Gardens is now an Oyster farm! The culture of the organisation now means that management and staff welcome criticism and suggestions – they are opportunities to grow pearls. Staff find it very rewarding when QPS Benchmarking reports are received and performance in both resident and relative satisfaction
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compare favourably to other aged care facilities. Management and staff see their results in these KPIs as confirmation that their hard work has paid off. Many different strategies have been implemented over the past two years. The following list highlights the activities and commitment by Ascott Gardens to continue making improvements in the area of resident and relative satisfaction. • A simple ‘What do you think’ form for residents, families and visitors in the front foyer. Everyone, including visitors are shown this form and reminded to use them for suggestions etc. • A Continuous Improvement Tool (CIT) form for staff suggestions and concerns. Staff members are given practice at filling in this form as part of their staff induction. • Annual resident and employee satisfaction surveys which are now done through QPS. The facility finds the breakdown of graphs great and believes that the comments are invaluable. Every suggestion for improvement is written onto a CIT form, to be actioned and taken to meetings for follow up. • Case conferences with residents and their family members about staffing, relevant health professionals etc. This has proved to be very useful for understanding and communicating residents’ needs and feelings. • ‘Share the Care’ family support group meetings – with families able to share with other families. • Volunteers who bring friendship and support. • Residents’ meetings where residents elect the chairman (family representative or volunteer). Issues concerning residents are documented and signed off at meetings. n
A Study Of Lifestyle Satisfaction In Two Regional Facilities The purpose of the study was to identify challenges for social interaction in regional remote aged care facilities and evaluate the satisfaction for lifestyle changes made by the staff to improve outcomes.
Background A study was undertaken by the staff of The Whiddon Group â&#x20AC;&#x201C; Narrabri and Weeronga Hostel at Wee Waa (both in rural NSW). Narrabri has forty three residents and Wee Waa has twenty residents. Wee Waa has recently adopted the benchmarking approach of QPS and comparisons of both facilities have found some interesting results. Results of the Residents Satisfaction Survey and Residents Lifestyle Index identified similar challenges for rural sectors. The matrix indicates areas identified were physical and social outside for both facilities with a score rating of four.
Lifestyle Opportunities
Sensory choir/singing, music therapy (instruments), massages, music therapy, aromatherapy
Score
7
Weight
1.3
Weighted Score
9.0
Physical tai chi, yoga, gardening, dancing, walking groups, hydrotherapy, carpet bowls, boule
Score
4
Weight
1.3
Weighted Score
5.0
Score
6
Weight
1.3
Weighted Score
8.0
As a result of continued evaluation of the Lifestyle Index and Resident Satisfaction surveys, both facilities have put forward improved opportunities for the rural facilities. Art Program In 2006 several local artists were recruited to work with residents and engage them in an art activity program. The program has been a huge success and it culminated in an open gallery wine and cheese night that was attended by the residents, the artists, local business people, Shire Council representatives and the local MP. The open gallery night was videoed and the delight of both the residents and the artists will live long in the memory of >
Intellectual bingo, cards, reading, armchair, travel, story telling, slide nights, guest speakers, medical advice sessions, reminiscence
Social within the Facility choir, music performances, poetry, drama, school visits, happy hour, reminiscence sessions, buddy systems to promote interaction
Score
6
Weight
1.3
Weighted Score
8.0
Social Outside of the Facility regular excursions program e.g. zoo, museums, art galleries, bingo at the local club, over 50 social clubs, visits to other aged care facilities, picnics, open garden visits, walking groups
Score
4
Weight
1.3
Weighted Score
5.0
Score
5
Weight
1.3
Weighted Score
7.0
Sense of Purpose focus groups, fund raising, gardening to improve environment, preparing for fairs/ fetes, gardening for vegetables/fruit, resident advocacy groups
Add weighted scores from the six boxes above and transfer score to summary score sheet
42.0
Maximum achievable score is 60 points
Aged Care A U S T R A L I A | Autumn 2009 |
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< all who attended. Plans for the future include sharing the enjoyment of art with seniors from the community and other nearby facilities. The Veggie Garden Raised veggie gardens have been well maintained by the men folk of the facilities. A great deal of thought has gone into the garden and how to make it accessible to the several residents who look after it. The first feature is that it is located adjacent to living areas and residents can duck in and out of the building to do the odd bit of weeding and return to the cool of the building when they need to. The second feature is that it is built waist high off the ground on a pre made steel platform that enables residents to tend to the garden while either sitting or standing. The third feature is that the gardens are quite narrow so that residents can reach plants and weeds that are in the middle of the garden from their sitting position. Got a Flat Area? Build a Golf Course Have you ever been cheered as you walk onto the 18th green in a golf tournament?
Residents at Narrabri tend to their specially constructed veggie garden
This can be experienced at Narrabri and soon to be at Weeronga. Some willing participants, an enthusiastic crowd, some great staff and a bit of imagination are all it takes!
The Whiddon Group - Narrabri
Aviary And if you have a couple of bird lovers â&#x20AC;&#x201C; build an aviary. It gets the local school children in too. The Whiddon Group - Wee Waa
Conclusion
The benchmarking results indicate that the strategies employed by Narrabri and Wee Waa are achieving sustained and continual improvement.
These are just a few of the extra things that Narrabri and Wee Waa do to improve residentâ&#x20AC;&#x2122;s lifestyles. The study of two similar facilities has allowed us to realise that we are not alone in overcoming some challenges to make life more interesting in the bush and working together has improved outcomes for both facilities. Other choices for residents have been to extend meal time options. The graphs indicate the improved results for Narrabri to 90% and Weeronga to 87%. Further studies will be undertaken with similar facilities to evaluate other opportunities for lifestyle choices. n
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technology
21 & 22 May 2009 Hilton Sydney
W
ith the support of the Aged Care Industry IT Council, ITAC 09 will be held in Sydney on 21 & 22 May, at the Hilton Sydney.
The theme for ITAC 09, Sustaining Quality Through eCare, emphasises the importance of information technology in establishing a sustainable, quality focused aged care environment. The conference will bring together local and international experts across the fields of community care, medication management, assistive technologies and offsite information systems delivery. These critical aged care topics will be discussed from a practical perspective, highlighting the information we need to know now to better manage and design aged care service delivery. ITAC 09 aims to provide something for everyone, from basic hints and techniques workshops for the reluctant user through to presentations and discussion panels from expert speakers and presenters dealing with the broader business and strategic issues facing an industry grappling with the uptake of technology. The ITAC 09 theme of Sustaining Quality Through eCare incorporates the following information streams: • Total Cost of Ownership • Medication Management • Document Management • Open Source Computing • Designing Community Care Systems • Assistive Technologies The conference and exhibition is relevant to a broad range of aged care managers and care providers including: • Administrators
• Care Managers
• Carers
• Chief Executive Officers
• Directors of Nursing
• Hostel Supervisors
• Industry Partners
• Operational staff
• Operators
• Senior Managers
Speaker Highlights • George Margelis, Intel - State of the Art: What’s happening around the world • Steve de Laurier, IBM - Open Standards • Ross Dawson: The Transformation of Aged Care Through Technology • Peter Fleming: E-Health: The Future of Aged Care • Kevin Bloch, CTO CISCO - Scope of Cloud Computing
Exhibitor Listing • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Alchemy Technology Aurion Corporation Pty Ltd Australian Ageing Agenda Australian Department of Health & Ageing Australian Online Directories Pty Ltd Autumncare Systems Campana Systems Pty Ltd Chameleon Technology Database Consultants Australia Eclipse Computing (Australia) Pty Ltd Epicor (Aus) Pty Ltd Ethan Group / Trapeze Fraame Solutions Ltd / Wyndarra Consulting Fred Bergman Healthcare Pty Ltd Hatrix Healthsolve Pty Ltd iCare Solutions Pty Ltd Inerva Pty Ltd Intel Australia Digital Health Group Kwiklee Pty Ltd - Leecareplus® Management Advantage Pty Ltd Medicare Australia - Aged Care Mercury Executive Recruitment Moving On Training (MOT) National E-Health Transition Authority (nehta) Neller Pty Ltd Nunatak Systems Pty Ltd Orana Aged Care Panasonic Australia Austlink Panztel Limited Procura Healthcare Systems Questek Australia Pty Ltd Raisoft Australia Surecom Tunstall Healthcare Vieo Clipsal Aged Care
For more details on ITAC 09 contact the conference managers: HEALTH INFORMATICS SOCIETY OF AUSTRALIA (HISA Ltd) 413 Lygon Street East Brunswick VIC 3057 T: +61 3 9388 0555 F: +61 3 9388 2086 E: conference@itac09.com.au W: www.itac09.com.au
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technology
ADVERTORIAL
Mobile Solutions provide Personal Care Workers with information at the Point of Care
and profitability, not to mention provide a competitive advantage.
T
Electronic Health Record in the field via wireless solutions allows them to access critical clinical patient data in the patientâ&#x20AC;&#x2122;s home, improves the quality of care delivered, and reduces the time spent on redundant data entry.
he challenges facing aged and community care are manifold. With an aging population, an increasing number of patients with long-term chronic conditions, and a shortage of skilled nursing providers, there is an urgent need to improve the effectiveness and efficiency of care provided. If executed well, wireless aged and community care solutions can significantly enhance an organisationâ&#x20AC;&#x2122;s quality of service
A recent North American study showed that Personal Care Workers spend up to 25% of their time, filling in, filing and fiddling with paperwork and other manual processes. Providing Personal Care Workers with access to the
In the office, wireless solutions can be an administrative boon. With visits automatically verified in the field, billing and payroll can be confident in the accuracy and timeliness of the data received.
Further, automated rostering management linked to real-time visit verification reduces the need for and cost of dedicated rostering staff. Mobile wireless technologies ranging from simple telephony solutions to tablet solutions offer the opportunity to improve current workflow process, and propel the quality and efficiency of care to a new level. Not to mention the opportunity to demonstrate leadership and innovation in an increasingly competitive market. Megan Braithwaite is the National Account Manager for the Aged and Community Care software solution provider, Procura Healthcare Systems. She can be reached 07.3310.8732 or at aussales@ goprocura.com. n
ITAC 2009 // Hilton Sydney // Level 3
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technology
ADVERTORIAL
RAIsoft product concept
T
o appreciate RAIsoft you first need some knowledge of the interRAI consortium. Established in the mid 1980’s in USA this international collaborative group of aged care specialists came together to improve the care of older people in nursing homes – with the concept advancing into 30+ countries. Based on rigorous research and vigorous testing, assessment tools now provide the basis for care planning, quality and risk
management, research, and staffing ratios. It is a proven system in many countries leading to improvements in quality of life and function, and reduced clinical symptoms in patients / clients / residents. Commencing with a long term care (nursing home) tool, the suite of assessments has expanded to include home and community care, acute and post acute care, palliative care, mental health, and disabilities. This suite of assessments facilitates continuity and supports the concept of a universal health record for seniors no matter what their situation or place of care. As a multi-disciplinary tool there is valuable information for medical practitioners, nurses and members of the allied health profession. These features enable innovation and electronic health care – to search, share, refer, communicate, and report. RAIsoft specialises in turning this ‘genius’ into an easy to use and simple platform for planning and quality
care. Starting with a holistic and comprehensive assessment a range of useful outputs is automatically generated such as: performance scales e.g. for cognition, ADLs, pain, depression and nutrition; assessment protocols for risks, strengths and needs plus an evidence based guide for care planning; robust quality indicators; case mix indices that identify dependency levels; variety of reports for clinicians, managers and facilities; trends and benchmarking data. Established in Finland in 2000, RAIsoft now operates internationally providing the complete suite of InterRAI products. Local aged care experts with hands-on experience in the implementation of RAIsoft, bring a wealth of knowledge to make RAIsoft easy to use, practical and effective. The use of RAIsoft brings many demonstrated benefits such as: no duplication in data capture, accurate assessment of client / resident, a tool utilised by the multi-disciplinary team, and quality in monitoring and planning.
21 & 22 May 2009 Hilton Sydney
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Autumn 2009 | Aged Care A U S T R A L I A
technology
ACIITC
Aged Care Industry IT Council
T
he Aged Care Industry IT Council (ACIITC) has been created under the auspices of the Aged Care Industry Council (ACIC). ACIC is the peak council of Australia’s aged care providers. It brings together the two key representative bodies - ACAA and ACSA to address the issues affecting the entire industry. MISSION STATEMENT Improve the care of older Australians through effective use of technology.
COUNCIL MEMBERS Mark Barnett, Director, KM Group Wendy Rocks, General Manager Residential Aged Care, Catholic Healthcare Limited Greg Mundy, CEO, Aged and Community Services Australia Graeme Prior, CEO, Hall & Prior WA Suri Ramanathan, Company Director and Chairman of the ACIITC Greg Russell, Director Information Management & Technology, Uniting Care NSW Allan Turner, General Manager Information Systems, Silverchain WA Rod Young, CEO, Aged Care Association Australia
COUNCIL ACTIVITIES In our last edition we reported on the Council Function. We can now report that the Council has expanded its activities and formed additional Sub-Committees to carry out those Functions. The full list of activities is as follows: 1. E-Health Projects 2. Community Care – developing policies for best of breed technology deployment. 3. Microsoft Licensing Fees – ongoing negotiations 4. Choice – to explore and set standards for Technology Choices for Aged Care Industry 5. Supplier Forum – first Forum held 19 March 2009 6. ITAC Exhibition and Conference 7. Partnership Programs – Centre for Health Innovation (CHI) and ozCAST. 8. ICT Directory 9. Education and Communication Each Sub-Committee is spearheaded by a member of the Council. Council is looking to recruit members for its SubCommittees. If you are interested in contributing to the Aged Care IT Council, please contact Lexie Cleary via email clearya@agedcareassociation.com.au and indicate which Committees that you would like to participate in. Please advise your name, job function and the organisation that you are part of. n
awards
ACAA 2008 IT in Aged Care Award winner
L to R: Rod Young, ACAA, Mark Barnett, Aged Care Direct, Keith Merchant, Salvation Army
The Salvation Army, Aged Care Plus with the implementation of the iCare Clinical and Care Management Solution The Salvation Army (Australia Eastern Territory) covers New South Wales (NSW), Queensland (QLD) and the Australian Capital Territory (ACT). The Salvation Army – Aged Care Plus (ACP) coordinates approximately 1,400 residents, 1100 care and clinical staff located in over 16 sites. The Salvation Army ACP offers a combination of Nursing Home, Dementia, Hostel, Respite and CACP’s to the community. The geographical coverage is the Eastern Seaboard of Australia.
A
n extensive review of market software packages was made over a number of months and the conclusion was that iCare offered a full composite of modules to meet our specific clinical and legislative requirements. A specific factor in our nomination of iCare for the ACAA IT Award, was because it
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Autumn 2009 | Aged Care A U S T R A L I A
was evident that their software resulted in improved levels and quality of care with more time at the bedside with of our aged care residents. We did not expect that our care and clinical staff would embrace the package so readily. We anticipated change management issues in the process and its implementation, particularly as the preimplementation survey showed that only 25% of our 1100 care staff were computer literate. We have been impressed with the receptiveness of our staff and their approach to the technology. An extremely diverse culture exists with our employees. Approximately 75% of employees use English as their 2nd language. Using iCare and being trained in this software has not posed any major or significant issues at all. The training provided on the iCare software was such that everyone understood most clearly how to navigate their way around the product with even the very basic of users being able to comply with employment requirements to meet our strict guidelines of accreditation. For many of our staff the change to a computer-based system was a huge step. Some had never used a bank ATM Card or operated a home-based computer before iCare. Therefore, iCare was implemented
gradually, supported by iCare’s excellent training program. We have been extremely delighted with the iCare system itself and how user-friendly it is. A number of staff have advised us that they are now utilising computer technology within their personal lives and have also obtained their ATM Card for use. Increased labour hours are spent actually with the residents to provide even greater care needs as appropriate, instead of hand writing care notes and / or waiting to obtain the resident folder / chart to write in. As one of our carers has emphasized, “what took me an hour to hand write before in progress notes for my allocation of residents, iCare has reduced this to around 15 minutes.” iCare has delivered to The Salvation Army ACP, 100% organizational clinical information transparency – it is the first time, in our long history, that our Organisation has been able to view all our residents clinical information through a single application. For all the reasons noted, hence our reason for nominating iCare for this award. Kelvin Neave – Clinical Information Manager, The Salvation Army – Aged Care Plus.
ACAA 2008 Employer of Choice Award – Employer Category
L to R: Rod Young, ACAA and Upali De Silva, Chelsea Manor
Joint winner is Chelsea Manor Chelsea Manor is a low care seventy bed Aged Care facility situated in the seaside suburb of Chelsea, Victoria.
C
helsea Manor’s staff recruitment process is all about involving the existing staff in making the final decision. We look at attitudes as our main criteria and knowledge, skills, drive and passion for working with elderly are also considered as an integral part in obtaining employment. A Staff development coordinator is employed to support the staff on an ongoing basis. New staff are reviewed by their peers and permanent employment is not awarded unless the team is satisfied with the new employee’s work ethic. On going training needs are facilitated through providing access to three day’s paid orientation, a comprehensive library, computers, Joanna Briggs Institute, Aged Care Channel and participation in internal and external seminars. Staff are encouraged to undertake higher levels of qualifications. Morale is high at Chelsea Manor which is demonstrated by the low turnover of staff and the amount of sick leave taken by staff. On average staff have not used ninety percent of their allocated sick leave. Staff conflict is minimal and resolve their differences with open and honest communication.
work and how to be an effective team member by an experienced staff trainer. A Social Club has been formed which management encourages and facilitate this by providing resources such as a dedicated notice board to inform of the outings, weekly Tattslotto Club and other forthcoming events. Doctors and allied health team members attend many of our functions, developing a wonderful rapport with each other. The workplace is family friendly with the provision of flexible rostering, special leave without doctor’s certificate for family needs, permission to bring their children in an emergency and stay in the library, temporary employment during school holidays and access to free counselling for personal problems. Family members are encouraged to attend functions and feel part of Chelsea Manor. By walking through the corridors of Chelsea Manor, it is easy to see that staff are happy to work here. Friendly banter with other staff, health professionals, residents and family members is evident, annual surveys continue to demonstrate this. n
Staff at Chelsea Manor are provided with training to identify what constitutes team
Aged Care A U S T R A L I A | Autumn 2009 |
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awards
ACAA 2008 Employer of Choice Award – Employer Category
Joint winner is Amana Living
CEO Ray Glickman says Amana Living is thrilled to receive such a prestigious national award.
“W
inning this award is a fantastic result for Amana Living,” he said.
“We have worked very hard to develop a participative culture here so that the contribution of every staff member is recognized and valued and we have introduced numerous initiatives developed by our own staff to make us an employer of choice. “We will strive on to ensure that working at Amana Living can fit with other demands on people’s lives and that the work is highly rewarding and also, very importantly, fun. “We place a lot of faith in our staff in the valuable work they do and we find we are getting great results from them every day.”
Amana Living operates 17 retirement villages, 10 hostels, five nursing homes and three day clubs throughout Western Australia. It provides specialised care for dementia residents and their families, as well as a wide range of community services to people living in their own homes. Amana Living Media Release, 19th November 2009
Highlights of Amana Living’s working environment The Matrix Team, who have introduced a number of celebrated new benefits and initiatives, such as: •
School holiday child care assistance
•
Staff in crisis fund
•
Uniforms
•
Paid parental leave
•
Deferred salary scheme
•
Improved long service, annual and personal leave benefits
•
$500 recruitment reward
Bright Sparks – a system designed to promote innovation and provide a pathway for developing smart ideas. Staff are encouraged to forward ideas which may include: •
Better ways: evolutionary continuous improvement
•
New ways: significantly different and improved approaches sparked by creative thinking
Training – a commitment to the development of staff by providing the following development and career pathways for staff: •
Certificate IV in frontline management
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Diploma in training and assessment
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Certificate IV in community services lifestyle and leisure
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Diploma in enrolled nursing
•
Certificate III & IV in aged care
•
Certificate III & IV in community care
L to R: Rod Young, ACAA and Shellee Chapman, Amana Living Inc, Cottesloe, WA
awards
ACAA 2008 Employer of Choice Award – Employee Category
L to R: Rod Young, ACAA and Leonie Burke, Storm Retirement Village,Taree, NSW
Joint winner is Storm Retirement Village At Storm Retirement Village a team has been developed called a ‘Storm Team’ on the basis that ‘We look after our team members because they look after our residents’. Permanent employees with satisfactory work performance receive: •
A paid day of on their birthday
•
One bonus day off after 2 years’ continuous service
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Salary enhancement
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Two bonus days off after four years
•
Substantial Christmas hamper
•
Free annual flu vaccination
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Paid maternity leave
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Free cappuccino 24/7
•
Optional payout of some annual leave
•
Extra rewards for great performance
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•
Staff discounts on petrol, groceries, cars, mobile phones, plasma tv’s, travel and more
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Employee assistance program (free confidential external counselling)
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Dinner for 2 at a local restaurant for suggestions for service improvement that are adopted
Team Spirit •
Staff barbeques throughout the year
•
Staff Christmas choir sings at ‘Carols in the Courtyard’ for residents and families
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Staff present a pantomime each Christmas for the residents
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‘Staff member of the Month’ chosen for outstanding care of residents. Certificate is displayed prominently in foyer.
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‘Staff member of the Year’ chosen annually and rewarded.
•
Staff input into all committees.
In 2008 Storm Retirement Village conducted a survey. Results of this survey confirmed that 88% of staff are
highly motivated and satisfied within the workplace, and 100% answered that they enjoyed their work. Staff members use expressions such as ‘the best place I have ever worked’, ‘happy to be at work’, ‘supportive’, ‘great communication’ and ‘good team management’. Staff members at all levels of Storm Retirement Village have access to Board scholarships to undertake further education. These have supported staff to undertake courses in nursing from Bachelor of Nursing to Master of Nursing. There is a well developed program with the Apprenticeship Centre to employ school-based trainees in Aged Care Nursing and other trainees. Storm Retirement Village workplace is very family friendly. The rosters are flexible to assist staff with family commitments. Children may accompany staff members to work when minding arrangements are unsuccessful. With this in mind a child care centre is currently being planned. Our workplace is a happy place. Staff are often heard singing in the corridors. n
awards
ACAA 2008 Employer of Choice Award – Employee Category
L to R: Rod Young, ACAA and Grant Burnell, Shoreham House, Victoria
Joint winner is Shoreham House (formerly Shoreham Aged Care Facility) Innovation and Creativity to support staff satisfaction Our employers have coordinated a benchmarking group since 1999 which assists our innovative culture to do better each year. Out’ Latest letter’ system ensures praise told to our employers is communicated also to us. Our Employee Reward Scheme (since 1999) is ongoing, recently all staff received petrol vouchers and thank you letters, for no reason really, other than moving into our new home, Shoreham House. It is easy to be innovative when you’re often ‘thanked’ by management; we actually want to be better. Our employer’s focus on innovative resident lifestyle programs was recognised and highly commended in the 2007 Ministers Awards. We know our efforts are appreciated and noticed. Annually we have the opportunity to appraise our Employers anonymously; there is no better example to illustrate how honest/open our relationship with our employers is!
Strategies to create team spirit Staff meetings sometimes are off site at local wineries or cafés, sipping lattés, staff see each other a little differently
when we are not at work, we wonder if that was Grant & Sharon’s plan all along! Our mentor program gives new staff confidence and a feeling of belonging. Our ‘Thankyou’ culture means we thank each other genuinely a lot. An ‘Open door policy’ is often bandied around by many, but at Shoreham WE REALLY DO have an open and free communication with our employers, as we see them almost every day. With Shoreham House’s building project we are asked for our opinions, we feel ownership. Our strong focus to think about the next shift coming on creates a cohesive spirit. Respect underpins Shoreham as we respect our employers it almost follows that we respect each other as employees.
High staff morale Our employers say ‘hello, how are you?’ ask after family, everyday, if we feel a bit ‘down’, this makes us feel noticed and genuinely wanted and once you have had a taste of the ‘Shoreham way’ it would be difficult to work elsewhere. Through our management appraisal surveys, we know that our requests do not fall on deaf ears. In the past when some shifts have felt
‘rushed’ extra hours have been budgeted for and activated within months of asking. Seeing our employers help out if a staff member needs to go off ‘sick’ or just help out because they have a few spare moments probably is one of the single greatest things resulting in high staff morale.
Family friendly environment ‘Shoreham feels different’ is a common comment by visitors and sales representatives. If we are stuck, our children come to work with us, the residents love this!
A happy workplace Our workplace is not a ‘happy’ workplace it is a phenomenal place! We are treated as individuals; we know all of us have something to offer. Our reputation is phenomenal and this makes us proud, this creates our happy environment. We have never worked for or with proprietors like Grant & Sharon before and probably never will again. Shoreham is special because of our management and their high expectations of us; as a result we have never failed a single accreditation standard. n
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Discover the Cater Care difference.
awards
L to R: Rod Young, ACAA, , Allison Midson, Moving ON Audits, Robyn Bennett, Canterbury Private Nursing Home, Stephen Midson, Moving ON Audits
ACAA 2008 Management Award – Clinical Category
Winner is Canterbury Aged Care Facility Supporting ageing persons suffering from mental health issues, who were previously institutionalised or supported by parents who have now deceased, is an ever-increasing challenge experienced by the health industry and aged care in particular. Following is an outline on the manner in which Canterbury Private Nursing Home supported one individual in particular and the systems, which have been established to support others.
J
ack was admitted in late 2006 from home were he lived with his parents until their death, as a 65 year old gentleman, 1.8m tall, 155kg (from 185kg), diagnosed with Schizophrenia, unstable diabetes, left foot pressure wound and charcot’s foot disease. His initial months saw him speaking into a pillow in front of his face to avoid interactions. His care needs required a complete mental, spiritual, social and clinical assessment and management approach. Canterbury Aged Care staff were unsatisfied with the Schizophrenia label and subsequent care given of Jack which did not adequately address/support his needs. A thorough nursing assessment identified numerous care, behaviour management and social needs, leading staff to a different diagnosis and approach. Closely working with the GP, through regular case meetings with the Aged Psychiatric team (APAT), a diagnosis of Aspergers’ was identified. Support for all staff (maintenance, catering, care, nursing) included APAT education and management mentoring. Staff were guided to alleviate their fears interacting with Jack and to look at this level of mental and social ability. They learnt through observation, how
to manage his needs at his 12 year old emotional level. His subsequent acceptance of staff and combined allied health approach improved his clinical presentation and quality of life. Staff at Canterbury Aged Care continually demonstrate commitment to continuous improvement and Best Practice by attending education and meetings in their own time. Over the past 12 months, 31 hours of meetings achieved a total 225 attendee hours with 54% of attendees present in their own time. For 216 hours of education 74.4% of attendees were present in their own time. With the support of senior nursing staff ‘Jack’ now understands the impact his behaviour was having on others enabling a marked improvement in his quality of life due to more meaningful, companionship and relationships with staff. Staff have learnt to utilise vast erotological professional, nursing assessment knowledge and skills to achieve positive clinical outcomes. The nursing student casual staff workforce, over the past 18 months, have taken this skill and knowledge with them to their next clinical environment. n
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awards
ACAA 2008 Management Award – Manager Category
L to R: Rod Young, ACAA, Allison Midson, Moving ON Audits, Jennene Buckley, Feros Care Ltd, Stephen Midson, Moving ON Audits
Winner is Jennene Buckley, Feros Care Ltd Jennene says that she loves the aged care industry - that is her message when asked about this award.
A
ged care suffers from negative publicity which is disappointing given the truly inspirational, proud and professional conduct of most providers. There are not too many jobs out there where you can go home knowing that you have made a difference in someones life. I want to use this award to attract individuals to the industry who have something to offer. This means developing employment pathways for young adults, encouraging older workers to contribute and attracting senior executives to strengthen professionalism. Ageing population statistics make this drive even more important. My strategy in leading and managing others I lead through enthusiasm, energy and example. I adhere to the merits of integrity, open and responsive communication, innovation and excellence, teamwork, playfulness and fun. These values are a nice fit with my personality and allow me to be leader, mentor, friend, colleague and hard decision-maker depending on the need of the individual or the company. I treat, and expect my staff to treat all stakeholders as an important part of our organisation, whether that be a plumber at our residential sites, our technology
supplier, company member, volunteer or cook. We have built great relationships across our organisation that has created something special that is hard to quantify but underpins our culture. Good deeds return to you 10 fold and that has certainly been the case for me and our organisation. I am not very good at sitting in the office because I believe a leader has to be involved in all aspects of the organisation and I genuinely enjoy working and listening to clients, employees, suppliers and volunteers in order to appreciate the daily operations of a business. It is these interactions that highlight opportunities and obstacles that a leader can champion and address. I have been told that my enthusiasm and energy are contagious. I find that these traits work to my advantage in attracting like-minded people who can see a shared future for themselves and Feros Care. These people are the focus of my mentoring efforts.
a non-confronting nature. With my support, her work resulted in company premiums dropping below industry average by 200%. • Last year I appointed a young staff member with a marketing degree and limited practical experience to our customer service team. I immediately noticed her excellent interpersonal and potential management skills. I challenged her to manage our Community Gateway Project and create a vibrant service and technology culture for a diverse group of staff. With encouragement she has exceeded company expectations.
Two examples of where I have lead others achieve challenging goals:
I have attended leadership courses but inevitably find I struggle to relate some of the theory to my work. For me, while there are some aspects of leadership that are clearly learned, the ability to translate vision into practice by engaging those around you and to walk side by side with your staff on this journey are innate abilities, something you need to focus on when recruiting leaders.
• In 2002, Feros care was facing a devastating string of workplace injuries with claim costs set to increase our premiums by 247%. I identified our Operations Manager as the ideal person to pull us out of this mess. She had great attention to detail and
I consider winning this Award as a win for Feros Care and my family. I plan to celebrate and acknowledge the contribution of those around me and demonstrate to them that what we are doing is special and worthy of recognition. n
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awards
ACAA 2008 Management Award – Facility / Team Category
L to R: Rod Young, ACAA, Allison Midson, Moving ON Audits, Robyn Bennett, Canterbury Private Nursing Home, Stephen Midson, Moving ON Audits
Winner is Canterbury Aged Care Facility In 2003, agency care staff usage at Canterbury Private Nursing Home was at 95%; the average RN Div 1 age was 68 years old. There were no casual / bank staff to replace illness / holiday leaves. This type of position could not be sustained hence a new program was instituted to reduce this to 0% agency staff usage over a 2 month period. This was obtained and has been sustained now for 5 years due to the new program’s robustness.
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F
rom the commencement of the project, one nursing agency was selected as a main provider. In collaboration with the agency fourteen agency staff were provided a two-hour facility orientation and nominated as the Canterbury team. These 14 staff were then nurtured and supported by the organisation to provide the facilities expected level of resident care and support. This ensured that whilst establishing the permanent staff team, cohesiveness of staff practices was achieved. This also allowed for a focus on team building. As a management team, empowering staff became a focus of ensuring job satisfaction. The philosophies of continuous improvement, the nursing process and evidence based nursing education were utilised. For example, any comment / complaint are identified as an improvement opportunity. In order to ensure staff reactions remain positive and non-personal, management demonstrated immediate implementation of staff suggestions and solutions for all issues raised, by identifying evidence based practices first. This encourages staff to continue to report and support issues, also to research solutions and implement them.
Comments from a recent staff survey when asked “what do you like best about your workplace?”: • Friendly supportive colleagues • Enjoyable work • Able to balance work and family • Professional scope of practice • Building my knowledge and skill base with supportive management • Doing something worthwhile • Learning to make a difference for people • Part of a successful team • Achievements recognised Staff at Canterbury Private Nursing Home say that they feel respected and supported in contributing to the effective provision of a quality of life for all residents, knowing their practices are fully supported by evidence base research. This gives them courage and satisfaction in their roles. Individual staff have been allocated positions in various expert clinical portfolios and conduct audits, which further encourages their involvement in deciding the future of the organisations success. n
ACAA 2008 Building Award – Renovated Building Category
The winner is Feros Village Bangalow, NSW
F
eros Village Bangalow was constructed in 1997 to accommodate 30 high-care beds (including a 10 bed special care unit) without a master plan and view to future growth. In 2002, a low-budget 15 bed extension occurred to bring the total bed numbers offered to 45 high without adequate allowances for support service upgrades. Feros Care decided that in order for the village to be viable it had to: • Accommodate a minimum of 64 beds including options for double occupancy. • Expand and upgrade support, administration and common space areas. • More effectively and efficiently utilise available land space. • Offer a luxurious extra service option unique to the region. • De-institutionalise the village and mirror the regions resort/ retreat life style. • Apply the Eden Alternative to design-thinking and transform the facility into a living and healthy community environment. • Create an atmosphere that maximises opportunities for companionship and participation, reflection and retreat. • Give the whole village a ‘face-lift’ that would complement the ‘endenisation’ process and impress. • Create a marketable point of difference both in design and service options. In 2005 Fulton Trotter Architects were appointed to realise the above design brief. Jennene Buckley, Chief Executive Officer of Feros Care said “many of the newer residential aged care facilities have moved away from large centralised dining and activity areas, to a number of smaller independent living and dining areas within a facility. When we visited these facilities, it felt like there was less sense of community and opportunity for resident socialisation”. “The Feros Village Bangalow project created four 16 bed communities; but maintained a centralised dining area with additional, servery and activities areas. This area has become a beautiful, vibrant and busy community hub that residents and families love to spend time in. We have found that there is a 50% plus increase in attendance at meals and activities. We have also found an increase in resident’s choosing staying in these areas in the afternoon and evening rather than returning to their rooms”.
L to R: Rod Young, ACAA, David Lane, Thomson Adsett Architects, Robyn Schneider, Feros Care Ltd, Paul Trotter, Fulton Trotter, Shirley Nelson, Feros Care Ltd The renovation sought to challenge contemporary aged care living perceptions. It hopes to surprise visitors with its community feel and resort-style comforts, instil confidence in care and expand living options. Feros Care is trying to lift the standard of what can be expected in residential care and thereby redefine the experience of ageing. n
awards
ACAA 2008 Building Awards – winner of the new building category
L to R: Rod Young, ACAA, David Lane, Thomson Adsett Architects, Bruce McKenzie, Goodwin House
Goodwin Aged Care Services
Growing older should not mean losing control over your quality of life, including how you live or spend your time. That is the ethos behind Goodwin House. Situated in the heart of the Bush Capital, Goodwin House is designed to offer residents the widest possible range of lifestyle options and make the transition from independent living to aged care as seamless as possible. Housing 108 residents in single and twin bed ensuite rooms, the building has been designed to make the most of its position at the foot of Mount Ainslie, with huge windows providing panoramic views of the bush landscape. Built over three levels, the building’s design does away with long corridors, meaning no resident is more than 25 metres from the open central atrium and lift well. This clever architectural feature allows residents to feel involved in what is happening throughout the house, as
they can hear music from the grand piano, smell the cooking in the kitchen, or just watch the world go by. Radiating out from the atrium are three central lounge and dining areas which provide space for socialising and eating, whilst there are a further seven smaller lounge areas where residents can relax or meet with visitors. But what makes Goodwin House really unique is the range of services and facilities incorporated into its design. Each of the rooms is equipped to provide residents with the highest level of care, while smart sensors throughout the building monitor residents at risk of wandering or falls. The building is also fully prepared for the coming generation of tech-savvy baby-boomer residents, with broadband internet, satellite television and the latest digital technology available in each private room. Goodwin House’s own television channel keeps residents informed of activity programs, outings and even the meal menu for the day, while a sophisticated building management system keeps everything running smoothly. Goodwin’s architects and interior designers were charged with creating a modern, warm and homely feel for every part of the house, and the end result better
resembles a resort than an aged care facility. Gone is the institutional feel of traditional aged care homes; in its place are quality furnishings, a fresh colour scheme and plentiful use of natural light. A wellness centre, day spa, internet café, cinema and bar have also been included in the fit out. A team of full time activities coordinators organise classes, activities and special events in the central activities centre, while the landscaped gardens provide a relaxing setting for residents wanting to get out in the fresh air. For those who need a higher level of care, Goodwin House features a secure wing for dementia residents, complete with its own secure walking track, courtyards and gardens. The dementia gardens contain many features to assist residents with their reminiscing, including an 80-year-old phone booth, an 1851 model Austin A30, a bus stop and a clothes line. By uniting clever, modern design with an underlying commitment to making the facility a real home for those who live there, Goodwin House has set a new standard for aged care in Australia. The future of aged care lies with giving residents the choice and flexibility to age in their own way and Goodwin House has shown how that can be achieved. n
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sponsors
Building vision David Lane – a conversation with the chairman By Jane Guthleben The sight of a war veteran shuffling his weary frame along the long corridor is the type of thing that disturbs architect David Lane’s sense of equilibrium.
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ane tells a tale of having a very long talk one day with the director of nursing at an aged care facility. As the conversation went on, he kept one eye on the monumental effort an old digger was making to get himself along the corridor to the common room for the day’s activity. “Twice a day he did that, and you know what? It took him the whole day. That’s all he did all day – walk backwards and forwards along that long corridor. And this is the type of thing I’m talking about. People have got to live in these buildings we create. Our obligation is to design spaces to enhance the way people live – not to make it any harder than it already is.” Lane is passionate about improving quality of life through the built environment. For him, buildings are way more than bricks and mortar, or even bread and butter for the international firm of architects that started just over 30 years ago in a single office in Brisbane. It is this discipline that underlies his firm’s mission. Lane doesn’t just want to get the next job or win the next tender. He wants to enter into a discussion about bed ratios, and cash flow, and regulations, and sustainability, about where the client sees the project in 20 years and importantly, how to create the best environment, and get the best use out of the site. Often clients can lose sight of the happiness quotient in the building, simply by trying to build the maximum number of beds, because that is what they have licences for. “As an architect are we forcing people to live such an awful quality of life?” he asks. “I’m garnered into action to think about how we can offer the people who use our buildings the best quality of life possible.” Lane is reminded about the competing tensions in any project on a daily basis by frustrated clients and others at conferences and in the industry. So when working on a project, he likes to lay it all on the table, to discuss the many challenges facing the industry: an ageing
population; local demographics; changing expectations about what facilities should provide; the economics of high-care to lowcare beds and their various categories; and the principles and philosophies behind many different models of care. Sometimes it’s hard to remember he is even talking about the design as he ranges across these topics. But clients appreciate the candor and industry knowledge. ThomsonAdsett visited China on one of the SAGE study tours, a visit that provided much food for thought. In China where the one-child policy has curbed population, it has also had the impact of slashing the number of young people who would traditionally have looked after their elders. “There has been a cultural change in China, and there are now often fewer than two people to look after their elders,” he says. “It doesn’t matter where you are in the world, the community must be able to support the needs of the people living there. >
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sponsors
Building vision David Lane – a conversation with the chairman < “But if you can’t easily get into a bath, say, then that may be the factor that in the end forces you to move out of your home, and into care. So whether you are in China, or in outback Australia it is the simple services which can make a world of difference to your well-being.
Also, our mores and tastes will change, lifting expectations of a senior’s super lifestyle with creature comforts that we can not even yet imagine, he says. And all this against a diminishing tax base to pay for it all while balancing dwindling resources amid demand for the highest achievable levels of sustainability. “They’ve paid their taxes and they want the benefits, but there is a disconnect between what people want and what the government will pay.
Lane says the firm is constantly reviewing its practice, reeducating itself and looking for the best philosophies and solutions.
“Is what we are building attractive to the coming generations? Are we turning out facilities that have inbuilt redundancies already?”
“You’re only as good as your last job, as they say,” he says. “You don’t get repeat business unless you achieve particular standards, and have genuine expertise and capabilities.
Looking to overseas, a number of countries are already adopting community integrated facilities, which is the way Lane sees the industry heading.
Lane relishes the challenge of forecasting where the industry will be in 20 years, something that is central to clients’ long-term planning.
“I don’t believe retirement villages in their current form will be around in 20 years. There will be integration of retirement communities. It’s a master planning exercise and it needs government at all levels on board for local planning considerations, as well as social policy planning and building regulation to ensure that current developments have the flexibility and longevity needed to efficiently survive the next few decades.” n
He lists off issues such as urban density pressures building as people retire within the immediate vicinity of where they are currently settled. “The NIMBY (not in my back yard) effect is already alive and well.”
LETTERS TO THE EDITOR Aged Care Association Australia is
interested to hear from you. Maybe you’d like to respond to an article you’ve read or you have an article you’d like to submit. ACAA welcomes letters to the editor of no more than 300 words. All letters must have the writer’s name, address, telephone number and job title clearly written. ACAA reserve the right to edit for reasons of space and clarity. Send to: editor@acaa.com.au or PO Box 335 Curtin ACT 2605.
editorial
Study Into Alternate Funding Models Cam Ansell
Grant Thornton
The Industry has responded to the recommendations of the Grant Thornton Aged Care Survey 2008 by commissioning research into alternate funding models.
I
ndustry groups have moved forward with recommendations from the Productivity Commission, Health and Hospital Reform Commission and Grant Thornton Aged Care Survey to explore the benefits of deregulated pricing models. The research team will compare the impact of changed pricing arrangements to consumers, providers and taxpayers. Grant Thornton will work with industry to develop models based on consumer preferences. To facilitate this, consultation will be conducted with prospective and current users of residential aged care services as well as providers. This feedback will be instrumental in predicting the services most desired by consumers and their preferred payment options. The Grant Thornton Aged Care Survey 2008 explored the impact of Australian Government policy and funding regulations on service quality and consumer choice. The study confirmed that many operators of residential aged care facilities have responded to consumer choice by providing high quality accommodation with increased privacy and service flexibility. These modern facilities
generated the poorest financial return because the currently over-regulated funding models do not reward superior service offerings. This disincentive to invest has stemmed the flow of developments and redevelopments in Australia at a time when demand for modern high care infrastructure is at record levels. Grant Thornton’s report indicated that investment would be stimulated through the deregulation of pricing arrangements. This view has been supported by the recent findings from the Productivity Commission and the Health and Hospital Reform Commission. All three major reports found that the residential aged care industry was over-regulated and the effect has been detrimental to both the consumers and providers of aged care services. While it has long been argued that provider performance was being impacted by increasing resident acuity levels and inadequate subsidy indexation, the Grant Thornton survey revealed that the growing number of modern facilities was also depressing financial performance averages – refer Figure 2. This is because the funding mechanisms do not recognise the increased costs associated with the construction and operation of modern high care facilities.
Figure 2 – Declining Industry Performance – Net Profit – Residential Care
Figure 1 – Net Profit/Loss - Residential Aged Care
This emerging trend is perhaps the most significant, because it relates directly to the viability of investment in the forms of accommodation most sought by residents and their families.
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Figure 3
While some have argued that the performance of the top quartile should be used as a benchmark for industry performance, surveys conducted by Bentleys MRI, Stewart Brown and Grant Thornton all confirm that older, multi-bed services consistently outperform modern, single-bed facilities. Figure 3 presents a comparative analysis of the top and bottom quartile of the Grant Thornton Aged Care Survey 2008. Grant Thornton anticipates that a well balanced pricing model would encourage the development of the aged care services most desired by consumers. They estimate that short to medium term development and redevelopment would stimulate over $20 billion of infrastructure investment across Australia. The scoping work will be undertaken at a number of facilities to project the likely impact on service delivery, financial performance and subsidy levels in a deregulated environment. A representative profile of facilities will be selected to facilitate more comprehensive research at a later date. Fieldwork for the study is being conducted in April and May 2009 with an expected release date in June 2009. Grant Thorntonâ&#x20AC;&#x2122;s consultation with industry representatives in Europe and New Zealand is assisting in the project design for a third study into the cost of delivering care â&#x20AC;&#x201C; the second recommendation from their 2008 survey research. Project commencement is planned for commencement in August 2009. n
editorial
SAGE â&#x20AC;&#x201C; Gadens Lawyers Scholarship Winner â&#x20AC;&#x201C; Dale Hunt, Group Operations Manager, Hawkesbury Living The opportunity to take another SAGE tour with Judy Martin and her team was already a high priority after the SAGE Canada tour last year and all the benefits that our organisation has received as a result. However the scholarship from Gadens Lawyers was a terrific bonus especially in these difficult economic times.
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ast year, I had the pleasure of undertaking the SAGE Canada tour which studied Aged Care alternatives in Montreal, Ottawa and Toronto as well as attending the IFA conference. The resulting information and contacts made are already proving beneficial for our organisation as we identify new opportunities and also re-look at some of our existing practices. The people that were on the tour with us were all a pleasure to
spend the 12 day trip with, and all became friends as well as a network that is willing to share knowledge and information. People such as this would be extremely expensive to gather in one organisation but through tours you can develop a nucleus of information beneficial to all. As our organisation is involved in three separate industries, I do attend a number of tours and conferences but this tour last year was certainly one of, if not the best, that I have attended in the past 10 years. Judy and her team were so professional and the planning so well done, that no time was wasted and the trip was full of useful knowledge that could be applied to our own business. The scholarship from Gaden Lawyers is really appreciated as it takes some of the pressure from our business but it also illustrates why Gadens have become so successful in the Aged Care market as Arthur and his team are truly a part of the industry that understand the needs of its people and the need for relevant education as we seek paths of continual improvement. n
The aged care and retirement village industry is, like all other industries, facing a difficult economic environment at the moment. It is exactly in these circumstances that organisations must increase and maintain their energies to continue to explore ways of doing things better and learn from other people and jurisdictions. As a national practice group assisting and advising the aged care industry it is incumbent on organisations such as ours to help gather information and knowledge. That is why Gadensâ&#x20AC;&#x2122; national aged care and retirement village practice is pleased to support the SAGE scholarship.
editorial
Does Organisation Size Influence Results? We have often been asked whether organisational size has any bearing on profitability. Many hold the view that bigger is better, and that there is some profit advantage to be obtained the larger an organisation becomes. In this article we look at a recent benchmark survey to see whether this view is borne out in the data.
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sing the Stewart Brown Aged Care Financial Performance Survey of the year ended 30 June 2008 we examined two aspects of profitability: operating profit and administration costs. In a future article we will consider the usefulness of the EBITDA performance measure and propose an alternative.
OPERATING PROFIT We analysed data submitted by 59 not-for-profit organisations representing 282 facilities and 20,112 residential places. We measured the size of an organisation using the number of beds/ places, the number of facilities and total operating income. For the purposes of this analysis we concentrated on residential care. The graphs below show the average operating result of the organisations using these three different methods. Note that operating results exclude all “capital” income and are expressed in dollars per occupied bed day. The shapes of these graphs change with the composition of each group. Despite these differences, there are a number of things in common. Perhaps surprisingly, organisations with the highest average operating profit tend to be “medium sized organisations”. This group comprises organisations with between 12 and 16 facilities, most of which are relatively small by today’s standards.
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Each facility would average between 40 and 60 beds and have operating income of between $1m and $2m. This would make the majority of their facilities low care. This is also in line with our other data which shows that low care facilities with between 40 and 60 beds are the most profitable group on average in our survey. The second common trait is that the group immediately preceding the peak group is the one with the lowest average operating profit. These are generally organisations that have grown beyond a one or two site organisation. They have between 5 and 8 facilities totalling between 300 and 500 beds with income averaging approximately $2.5m per facility. The other consistent aspect is that after the peak, the average profitability does drop off again as the organisation size increases. However, it does not decrease to the lowest levels, rather it appears to drop off to about the average operating loss level, at around $2.70 per bed day. This would indicate that there may be no advantage or disadvantage to profit as the organisation size grows beyond a certain level. Whilst this analysis is limited by the factors mentioned earlier, it does provide some further insight into what drives profitability. It also poses some questions for future analysis. ADMINISTRATION COSTS We conducted a survey of administration costs in 2006, albeit with a limited number of organisations participating. However, the survey did give some insight into the range in levels of administration costs as well as the various methods used to allocate these costs across organisations. Due to the high level of interest in this area, we are planning to re-visit this detailed analysis of administration costs as part of our March 2009 survey. The table below from that 2006 survey shows administration costs as a percentage of the total revenue of the organisation – including all non-aged care revenue, should there be any.
Analysis of Corporate Administration Costs as % of Total Revenue
Over $40m
Between $10m and $40m
Under $10m
Total
Average (Total Costs/Total Revenue)
10.9%
11.1%
10.0%
10.9%
Average of individual ratios
9.4%
10.7%
10.3%
10.1%
Median
9.6%
11.9%
10.8%
11.0%
Lowest
1.9%
6.1%
6.5%
1.9%
Next Lowest
7.9%
11.0%
6.8%
6.1%
Highest
14.7%
12.3%
13.9%
14.7%
Range
As can be seen, the range between the highest and lowest is significant. Interestingly, the organisations with the greatest amount of revenue had the highest administration costs as a percentage of revenue. The other factor to point out is that in the group with revenues of between $10m and $40m, if the lowest organisation is excluded, the range for the remaining organisations is relatively small. This is in contrast to the other two groups.
The composition of administration costs in that survey indicated that: â&#x20AC;˘
The use of consultants is more prevalent in the larger organisations
â&#x20AC;˘
Wages constitute a significantly higher proportion of the total costs in the smaller organisations continued next page >
editorial
•
Depreciation and rent are both significantly higher in the very large organisations, whereas it might have been expected that one would substitute for the other
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The larger organisations are also more likely to provide benefits to management over and above the FBT free limit.
June 2008 Survey The survey of the year ended 30 June 2008 saw administration costs continuing to increase. In high care they increased by $1.77 per bed day and in low care by $3.06 per bed day. Across all facilities in the survey the average increase was $2.43 per bed day. This increase was somewhat expected given the additional resources that have been required to implement changes to systems and procedures surrounding the roll-out of ACFI and the Securing the Future package. It will be interesting to see what happens in the coming 12 months to see whether there is any reduction in these costs, with most of the system changes having been made, or whether these cost increases will be maintained or increase even further over time. Organisation Size as a Factor For this analysis we measured the size of the organisation in two ways: number of facilities and the number of residential beds. No account was made of other activities that may be undertaken by the organisation, nor the methods for allocating administration expenses across each activity.
At the lower end of the graph, those groups with up to 10 facilities, the data fluctuates considerably. After this point it generally trends upwards until the last group with over 19 facilities where the costs appear to decrease again. The trend over all is for the administration costs to increase as the organisation gets bigger. This last group is interesting. It includes the largest group in the survey which has a large number of smaller stand-alone facilities. These types of facilities would generally have a lower direct administration cost at the facility level. As can be seen the average costs of this group is similar to the average costs of the group with between 1 and 2 facilities. When we measured the size of the organisation based on the number of residential aged care beds we got a slightly different result. There appears to be a point midway along the graph where the average cost reaches a maximum point and then after that there is a drop and then a gradual increase again. This dropoff point is somewhere between 500 and 750 beds. The trend line overall is one that points to the average administration costs increasing as the number of beds being administered increases, although the slope is much smaller than that in the previous graph. When comparing the two graphs, there are some similarities in that costs appear to increase to a peak level then drop-off and then increase again. In both cases the overall trend is for average administration costs to increase as the organisation gets larger. There may be a number of reasons for this including: •
Some of the largest groups have their own office space remote from their facilities and often this means significant rental expense. The smaller groups and stand-alone facilities would be more likely to use office space within an existing facility and not pay rent.
•
The larger groups are more likely to have a more sophisticated information technology infrastructure including staff. This would also include significantly higher levels of expenditure on software and its development.
•
There is a likelihood of duplication of staff or underutilisation of staff in the larger groups. This would be where there is clerical staff at “corporate” office as well as a level of clerical and administration support staff at each facility. The way these staff are utilised may not be optimal.
It is likely that whilst there are certain advantages in having a large corporate office such as more effective information systems, consistency in policies and the ability to provide support across the network of facilities within the group, the savings through “economies of scale” are not as evident. FINALLY It would be interesting to see whether the private sector results would show a similar pattern to those outlined above. We would expect in that group leaner administration costs overall, and some benefits of scale. Management performance does have a huge influence on these results and may distort this type of analysis as their impact is clearly not uniform. Perhaps an analysis of CEO remuneration compared to these results may prove very interesting! n
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Resident Satisfaction is OUR BUSINESS
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stablished in 1977, Catering Industries is Australia’s leading, privately owned contract catering company. We are specialists in catering to the aged care industry, where we manage the catering operations for over 55 clients from private, government and charitable organisations covering all levels of care including Extra Services. We pride ourselves on our ability to meet client expectations regarding:
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Fixed price catering solutions
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Nutritious and tasty meal choice
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Dietary requirements, including modified foods
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Menus approved by consultant dieticians
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OHS and Food Safety Programmes
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Takeover, training and development of staff
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Accreditation support
We have in place industry leading Quality Management Systems and ISO Accreditation to standard AS/NZS 9001 : 2000. All facilities under contract with Catering Industries are supported by our enthusiastic and experienced operational management team – who not only are highly educated in aged care catering standards – but all whom are trade qualified chefs with a passion and flair for food. Having seasoned professionals managing your catering enables you to concentrate on your core activity – CARING FOR RESIDENTS! Currently servicing New South Wales, Canberra and Victoria – we are commencing operations in Queensland in 2009. Come and visit our exhibition booth at the Aged Care Conference in your State, or call us today for a no obligation free consultation. JONAS CUSCHIERI NATIONAL MANAGER – BUSINESS DEVELOPMENT Ph: 1300 364 092 (toll free) Email: jonas@cateringindustries.com.au Web: www.cateringindustries.com.au
editorial
Review of the Accreditation Process, Aged Care Accreditation Standards and Development and Piloting of Quality Indicators ‘In response to the Minister’s announcement in the second half of 2008 that a review of accreditation will occur, DoHA circulated terms of reference for the undertaking of the review. Set out below is the ACAA response to those terms of reference.’
A
ged Care Association Australia (ACAA) would like to thank the Department for the opportunity to comment upon the processes being engaged in by the Department to undertake a Review of the Accreditation Process, Aged Care Accreditation Standards and Development and Piloting of Quality Indicators. We have a number of comments to make regarding the proposed process and have set these out below.
General In the opinion of ACAA, it is unfortunate that the proposed review is being limited to the three subject matters outlined above, namely: •
Review of the Accreditation process
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Review of the Aged Care Accreditation Standards
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Development and Piloting of Quality Indicators
ACAA believes that there is a significant component of a quality improvement system which is lacking from both the current system and from the proposed review, namely; an organization that operates outside the compliance framework administered by the Department and purely focuses on quality systems management and development for our industry. Such a body should be totally independent of and separate from both the industry in question and the legislative regulator. In this instance, the Agency is neither independent from the legislative regulator (The Department) nor does the Agency operate as a standards development and systemic improvement organization. ACAA has always been supportive of the implementation of a quality improvement framework for the aged care industry, and in that context, recognizes that the current system has had significant beneficial effects for the overall quality framework and quality service delivery provided to care recipients within the Australian aged care system.
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However, there is confusion within the aged care industry as to the role, function and delineation between the Agency and the Department that it is almost impossible to unpick. ACAA therefore believes that the only way to break this nexus is to include within the review process the consideration of a contestable market for quality improvement services and not the monopolistic system that currently exists.
Review of Accreditation Process The whole tenor of the review process is couched in the context of the Department undertaking the review on behalf of the industry. The industry should own the quality improvement framework and not have a process imposed upon it. If one looks at other quality improvement systems, one will find that many are owned and driven from within, not ones being driven within a legislative compliance focused environment such as is proposed in this review process. The comparison with the Australian Council on Healthcare Standards would indicate a much stronger and relevant involvement of industry in the development new standards and the application and management of those standards when delivered into the care environment. This is not to diminish in any way the proposed reference group to advise the Department, however it does strongly indicate the nature of the review process being driven here by the Department and that is, that the industry will be almost excluded from the process of discussion, debate and development of the new scheme over which it should have ultimate control and input rather than being driven by the Department which comes to this issue with a solely bureaucratic compliance focused view rather than a quality improvement long term systemic framework for ongoing industry improvement. Nowhere in the suggested process of the Review of the Accreditation Process, Aged Care Accreditation Standards and Development and Piloting of Quality Indicators other than an indication that the work of the project will be reported to the Ageing Consultative Committee, is there any ongoing suggestion that the industry will have a wider opportunity to discuss the process and the outcomes. ACAA would strongly recommend that the process proposed be amended to ensure that at various stages along the path of the development of the standards, the review of the process and the development of quality indicators that a broad ranging discussion occur with the industry with the intention of having a considerable dialogue about the proposals being considered and the alternatives that the industry would find most attractive and useful in the long term development of the industry’s quality systems.
ACAA would reiterate that the process being proposed seems to be a review of the existing compliance focused process and does not in any way seem to move the industry into a growth improvement process or into an environment of maturity but simply retain the status quo with some possible update of existing arrangements.
Review of Accreditation Standards ACAA has been calling for a review of accreditation standards which have been in place now for ten years without any amendment, alteration or change and hardly, in many instances, reflective of good quality care and clinical practice, though the current processes and procedures have changed enormously over time. The relationship between an assessorâ&#x20AC;&#x2122;s view of quality improvement and the industryâ&#x20AC;&#x2122;s is on many occasions, rather ad hoc. ACAA would consider that the whole framework of the existing four legislative standards and the forty four expected outcomes needs to be reconsidered and realigned. It would be preferable for instance, that the four legislative standards be removed from legislation and the legislation simply refer to a requirement to meet the accreditation standards as the embedding of these four standards within the legislation makes future change, amendment and growth with new practice extremely difficult.
ACAA has for many years supported the view that the accreditation standards cannot be a static instrument and should never be left in a static state for a period of ten years in the future. Rather, there needs to be an ongoing process for the review of standards and that those standards are a living breathing instrument that reflect current practice and have the ability to change over time. At the same time, there needs to be sufficient flexibility within the standards that reflect that there is often more than one acceptable way of undertaking a particular procedure or practice and that quality delivery can occur in a multi dimensional framework. ACAA does not see reflected within the process for the review of accreditation standards any mention of quality indicator systems already in place or the opportunity that we now have in a review process to use information technology or effectively, to undertake quality improvement monitoring remotely, rather than the current proposed site visitation programs both announced and unannounced. Aged care is entering a fairly dynamic future and should be capable of having much of the desk audit and oversight processes engaged in by the Agency undertaken in a very different model. Many of the indicators of quality improvement are readily accessible in an IT supported quality indicated system which can be reported on monthly or quarterly to a quality improvement organization and which can clearly show trends up or down in quality outcomes.
editorial
< In addition, there appears to be no linkage between the quality improvement process and the capacity of the industry to deliver on improved standards within its available resources. It is an erroneous argument to say a certain quality of service must be achieved when there is inadequate resourcing of both human and other resources to achieve that outcome. At the moment there is a total disconnect between what government and society says they expect from aged care services and the demand for better and more sustained quality outcomes whilst not recognizing that at least some aspects of those expectations have a resource component. In other words, the standards and quality expected of aged care providers have risen substantially in the last fifteen years. The simple comparison of the current state of building stock for instance with single room ensuited units now being the standard across the industry, has not been reflected in the operating costs associated with a larger building envelope and yet government claims that certification including space and privacy, is part of the overall quality improvement agenda. There is a real concern across the aged care industry of the paper based demands being imposed by accreditation. This is in both the context of assessor inability to utilize electronic information when available and in the context of accreditation driving large volumes of policy and procedural documentation to provide evidence to assessors of systems utilization. There is little recognition amongst assessors about the very flat management structures within aged care facilities and often onerous tasks that providing this documentary evidence imposes upon one or two managers within the average aged care facility. This paper driven process is in many instances proving hugely negative for aged care managers and driving many out of the industry. In other instances, it is simply making aged care an unattractive place for clinicians to work as compared with any other part of the health system, the red tape and paperwork driven processes imposed upon aged care provider staff by accreditation, is burdensome. Though it is probably outside the purview of this process, it nonetheless needs to be mentioned that the aged care industry is very dependent upon the approximately 6,000 manager/ clinician managers who undertake the roles of Directors of Nursing, Managers, Deputy Directors of Nursing and Care Managers. Basically, these are the people who manage the facilities, supervise the staff, ensure quality systems are delivered and residents receive appropriate care. This system is totally dependent upon the capacity of this group of persons to deliver quality systems and when they get into difficulty, it is not uncommon for the aged care facility to also get into difficulties. In essence, this is the group upon which the whole foundation of aged care quality systems is based. There is a substantial need for long term leadership development and mentoring of this group to ensure that they have the skills and support to maintain quality systems and care services.
Development of Quality Clinical Indicators ACAA would support the development of quality clinical indicators that have been thoroughly researched and piloted within the aged care setting. ACAA would be anxious to ensure that a set of quality clinical indicators are developed and employed as a more appropriate and accurate methodology for quality improvement assessment
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than the indicators currently being utilized. ACAA would want to ensure that development of quality clinical indicators does not simply expand the number of hurdles that aged care providers are expected to jump in order to meet accreditation but rather that the development of quality clinical indicators will as a priority, develop a set of indicators which are more astute at assessing quality of care, rather than simply adding a further burden to industry reporting. ACAA is aware that there are already two quite substantial providers of quality indicators across the Australian aged care system covering approximately one third of aged care sites and would hope that the work that these two groups have already done will be utilized in any review of possible quality clinical indicator data for the future. There are already strong indications that these two providers are supporting their clients to ensure the maintenance of quality care outcomes and that both systems have endeavoured to integrate their data analysis and data service provision with the accreditation systems utilized by their clients. The work undertaken by Campbell and Associates resulting from the Australian National Audit office referral of the Aged Care Standards & Accreditation Agencyâ&#x20AC;&#x2122;s ability to demonstrate quality improvement, does indicate that there are other methodologies that could be engaged which do not rely upon quality clinical indicators as the only source of data to ensure quality outcomes are being achieved. ACAA believes that some of Campbell and Associates work be further explored to see whether there are simpler methodologies that could be engaged that may have more relevance to consumers in the future than the quality clinical indicator path that is proposed in these pilots. ACAA is also anxious that the review of the standards and the piloting of clinical indicators used other standards organizations skills and expertise to support their review process. ACAA has taken the liberty of discussing the process with Standards Australia who have indicated a preparedness to apply their expertise in standards setting to assist the work of the review. ACAA would therefore want to ensure that the expertise residing with other organizations such as Standards Australia is utilized to inform and assist in the review process.
Technical Reference Group ACAA would propose two nominees to the Technical Reference Group, namely: â&#x20AC;˘
Irene Mooney Executive Manager - Residential Care Bethanie Group Inc PO Box 79 CLAREMONT WA 6910 PH: (08) 6222-9000 E: irene.mooney@bethanie.com.au
â&#x20AC;˘
Pam Bridges Residential Care Manager Aged Care Queensland Inc PO BOX 995 Indooroopilly QLD 4068 PH: (07) 3725-5555 E: pamb@acqi.org.au
INTERNATIONAL AGED CARE SCHOLARSHIP WIN AN INTERNATIONAL SCHOLARSHIP TO FURTHER YOUR KNOWLEDGE AND EXPERTISE IN THE DELIVERY OF AGED CARE SERVICES.
T
o encourage innovation in the Australian retirement and aged care industry Kell & Rigby together with St. George Bank is offering a scholarship for a senior manager in an Australian aged care organisation.
The scholarship provides the opportunity to travel overseas in 2009/2010 to explore and learn about the latest trends and approaches to providing aged care services to older persons. The successful applicant will have the opportunity to gain first-hand experience in the way accommodation is designed, built, funded and financed in creating communities and great places for older persons to live and be cared for. The successful applicant will be expected to provide a Project Report on return, deliver papers at relevant Peak Industry Retirement and Aged Care Conferences and publish articles in industry magazines and journals. The scholarship is valued at $20,000 and applicants are required to provide a comprehensive budget, outline of research/study to be undertaken and expected deliverables as part of their application. The Scholarship Committee with representatives from Kell & Rigby Living, St. George Bank, ACAA-NSW and ACSA NSW & ACT will assess the applications with shortlisted applicants interviewed by the committee. The successful applicant will be announced at the Kell & Rigby Conference, Who Drives the Aged Care Model? to be held at the Sheraton Four Points, Sydney on Friday 7th August 2009. MORE INFORMATION AVAILABLE BY CONTACTING SUSANNE MACRI ON 0408 230 240 PROUDLY ENDORSED BY ACAA-NSW AND ACSA NSW & ACT
Aged Care A U S T R A L I A | Autumn 2009 |
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editorial
The Spark of Life® Approach to Culture Enrichment By Jane Verity and Hilary Lee Facilities around Australia that have implemented the Spark of Life Culture Enrichment Program have been experiencing outstanding feedback from the accreditation department both during spot checks and audits. The purpose of this article is to provide readers who may not have heard of Spark of Life with a background to the approach and the new culture enrichment program.
F
or the last 20 years, Jane Verity, with the team at Dementia Care Australia, has been developing and globally implementing the Spark of Life Approach to dementia care. The approach creates an environment that enables residents, staff and families to think, be and act in a way that enriches the lives of other people. It has been described as a step-by- step guide to implementing the essence of person-centred care and Eden Alternative. Facilities adopting this approach position themselves as proactive and innovative organisations that stand for excellence in dementia care.
Jane Verity and Hilary Lee
Spark of Life draws on concepts and inspiration from occupational science, family therapy, systems theory, psychotherapy, group therapy, grief counselling, neuro linguistic programming (NLP), symbolism, person-centred care, Eden Alternative, social constructivism and appreciative inquiry. The Spark of Life Approach is now implemented as a culture enrichment program for all levels of an organisation. This program was co created by Jane Verity and Hilary Lee from the insights gained through Hilary’s Masters research. The program works on the notion that culture change starts from management and ripples out to every area of the organisation. The Spark of Life Culture Enrichment Program involves everyone from management and board members to all health care professionals, personal carers, volunteers and family members. Their role is to build a compassionate culture of love appreciation, enthusiasm and optimism, where each team member is encouraged to work beyond boundaries, is confident and empowered to try new ways of working and free to express their ideas. Features that set the Spark of Life Culture Enrichment Program apart include: • Education involving the entire organisation • Powerful presentations creating lasting shifts in mindset and attitude • Ongoing multi-level support for leaders, staff, and families • Torchbearers program to keep the spark ignited in everyone
The Spark of Life Culture Enrichment Program has broad application across healthcare and is practiced in residential aged care (high and low), in acute settings, day centres and the community. An International Best Practice Evaluation of the culture enrichment program is now being implemented in Australia and New Zealand. Initial research outcomes on this program for staff, volunteers and families include: • A new insight and appreciation of the importance of their attitude, which led to a shift in their thinking and approach towards people with dementia. • Learning practical and constructive ways to improve the lives of people with dementia such as building positive relationships based on empathy, patience and a supportive partnership. • Communicating in new ways, enabling people with dementia to feel valued. • A general change in their approach to care resulting in enriched teamwork and a joyful, and a positive approach to solving problems together (Lee, 2008). The results of a Spark of Life Culture can be divided into 2 parts, reduction of direct and indirect costs and increased quality of care delivery For further information on the Spark of Life Culture Enrichment Program including the supporting research, please visit www.dementiacareaustralia.com n References: 1.
Lee, H. (2007). Masters in Science (Research). Thesis: The impact of the Spark of Life program on the personal and emotional wellbeing of people with dementia: carer’s and families perceptions. Curtin University of Technology, Perth.
2.
Lee, H. (2008). An evaluation of the Spark of Life Culture Enrichment Program. Report available on www.dementiacareaustralia.com
• Unique program for dissolving difficult behaviour • New problem solving strategies for the entire team • Insight and skills to work beyond boundaries
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editorial
Aged Care Industry in Australia
Legionella Legislation Reaches South Australia By Roz White October 1, 2008. Public and Environmental Health (Legionella) Regulations 2008 are launched in South Australia.
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For years most system owners of Cooling Towers have been aware of the potential dangers of a Legionella Outbreak and have been proactive in instituting “best practice” However Warm Water Systems are relatively new to the target zone. Premises that are likely to house a warm water system are: •
T
his Legislation now mandates that owners of High Risk Manufactured Water Systems take responsibility for the preventative maintenance of their systems, in a proactive way; the systems must be registered with the governing local council and independently audited and tested on an annual basis. Therefore, minimizing the risks to the health of their sites, employees and the general public. The regulations target in particular, Cooling Towers and Warm Water Systems. The latter area of the target zone is in part, the most challenging. Many System owners, Business owners, Facility Managers, Maintenance Supervisors, are unclear on what constitutes a Warm water system. The South Australian Health Department defines a Warm water system in the following manner.
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warm water means water that is not more than 60°C and not less than 30°C;
•
warm water system means a reticulated water system that distributes or recirculates warm water through the majority of its branches at a nominal temperature of 45°C by means of a temperature controlling device.
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storage water heater a water heater that incorporates a thermally insulated container in which the water is heated and stored for subsequent use. Heated water must be stored at a minimum temperature of 60°C to inhibit the growth of Legionella bacteria. A storage water heater does not include a calorifier. 1
Residential Care Facilities, Aged Care Facilities, Hospitals, Food handling /packaging facilities, Wineries, Dairies, Abattoirs, Schools, Kindergartens, Day Care Centers, Sporting Facilities, Prisons, institutional facilities and larger buildings/businesses.
If you think about it in these terms; does my facility have potable water in it? That is, do we have food processing/preparation areas, shower facilities, kitchens, bathrooms where hot water runs from the taps? Most people think that if they have a hot water service or storage heaters then they have a hot water system. This is not always the case. To give you a layman’s rule of thumb quick check, ask yourself the question, Can I run all the outlets off my water system simultaneously at a temperature of 55-60 degrees and that the water is stored at a temperature of greater than 60 degrees? If you can’t then you have in effect a warm water system and not hot as you may have believed. If in doubt have your system checked out and a competent person sign the system off as either hot or warm. The Health Department has mandated authority of audits to the Local Councils and therefore Environmental Health Officers or an independent qualified competent third party auditor. Below I have outlined the specific clauses in the regulations 12.1 for the definition of annual inspections. Legionella Regulations 2008 Page 8 Section 15(2)-(a)-(i) and Section 15(3) (a) requiring the owner, within the period specified in the notice— (i) to cause an inspection of the water system to be carried out by a competent person (not being the owner or person responsible for the operation and maintenance of the system); (3) In sub regulation (2)(a)(i) a reference to a competent person is
a reference to a person whoâ&#x20AC;&#x201D; (a) is knowledgeable in the operation and maintenance of high risk manufactured water systems; and (b) is sufficiently competent to ensure that high risk manufactured water systems are operated and maintained as required by these regulations; and (c) has qualifications or training in water treatment of high risk manufactured water systems. Legionella Guidelines 2008 12.1 Annual inspections Regulation 15 requires that annual inspections of cooling water systems and warm water systems are to be performed by either the relevant authority or a suitable third party auditor and entail a thorough investigation of the operation of the water system for compliance with requirements of the Legionella Regulations. In addition, 1 sample of water will be collected from each cooling water system and 2 samples of water will be collected from each warm water system for the determination of the presence and number of Legionella. The cost of testing and the annual inspections will be borne by the owner. Third party auditors are required to submit to the authority written reports setting out the findings of the annual inspection and the results of the microbiological testing.
All existing towers and Potable Warm Water Systems were required to be registered with the Local council, by 31 January 2009. In some Council Zones this time line has been extended to April 01, 2009. Independent Auditing must occur before October 1, 2009. Most Councils across South Australia are informing system owners to engage an independent third party auditor as Local councils are under resourced and in many instances do not have much experience with Manufactured High Risk Water Systems. n Roz White is a Senior Auditor with Auditing Australia. She has over 30 years water treatment experience, is a member of the Institute of Plant Engineers Australasia & the Facility Managers Association. She is an Accredited DHS Auditor for High Risk Manufactured Water Systems and is currently the only active accredited High Risk Manufactured Water Systems auditor in South Australia. Should you require any further information and or clarification, please do not hesitate to contact her: Roz White - DHS Acc.Auditor, M IPEA. M FMA Auditing Australia 16 Saratoga Drive, NOVAR GARDENS, South Australia 5040 Mobile: 0428 830 436 Email: roz.white@iinet.net.au ABN: 55 769 399 373
References 1. http://www.dh.sa.gov.au/pehs/legionella-regulations-guidelines-sept08.htm
editorial
THE 84 YEAR-OLD BRIDE The local news station was interviewing an 84-year old lady because she had just gotten married – for the fourth time. The interviewer then asked her questions about her life, about what it felt like to be married again at 84, and then about her new husband’s occupation. “He’s a funeral director” she answered. “Interesting,” the newsman thought. He then asked her if she wouldn’t mind telling him about her first three husbands and what they did for a living. She paused for a few moments, needing to reflect on all those years. After a short time, a smile came to her face and she answered proudly, explaining that she first married a banker when she was in her early 20’s, a circus ringmaster when she was in her 40’s, later on a preacher when in her 60’s, and now in her 80’s, a funeral director. The interviewer looked at her, quite astonished, and asked her why she had married four men with such diverse careers. “Easy, son”, she smiled. “I married one for the money... two for the show... three to get ready... and four to go!”
Risk Management in the Aged Care Sector The need to ensure that elderly and often frail members of the community are provided a proper and safe environment with responsible duty of care means that the Aged Care sector is one of the most heavily regulated, audited and scrutinised sectors in the built environment. Aged Care facility owners and managers therefore need to be especially vigilant in ensuring that the compliance requirements are met. Derek Hendry from the Hendry Group provides a building inspector’s perspective with some risk management and compliance advice.
Building alterations compliance and contractual issues Some building contracts require the head contractor (builder) to perform maintenance (including essential safety measures and essential safety provisions) in the building during the defects liability period. If this is the case, the builder needs to keep a record of all inspections, tests and maintenance works performed in a logbook. Also, where this is the case the Aged Care facility manager should be aware that the builder’s auditors or inspectors of essential safety measures may not be as rigorous as those independently employed by the facility managers, since negative reports may have a cost impact on the builder.
Aged Care facility managers should ensure that contractors (and the consultants engaged to design) who install and commission these systems are contractually bound to ensure that commissioning is done to a specific standard, and furthermore, that a signed “contractor completion certificate”, detailing the sign-off of important features in the building. Where the building alterations are proposed by tenants, other issues to be considered by the Aged Care facility manager include: • Any proposed building works or alterations that require a town planning permit (development approval) or building permit are not to be raised with a controlling authority without first obtaining the Aged Care facility manager’s consent in writing • The tenant must be required to provide a copy of any statutory approval or consent together with the approved drawings and documentation to the Aged Care facility manager before building works are allowed to commence. • The tenant or tenant’s contractors must provide to the Aged Care facility manager statements, certifications or certificates as required by the Aged Care facility manager for the inclusion in the essential safety measures logbook preparation to the controlling authorities or other interested parties on an annual basis or when required.
Essential Safety Measures compliance – the importance of managing the process Some managers have observed contractors doing drive-bys, where they attend the premises long enough (say, ten minutes in total) to fill out the logbook. To perform the inspection / testing routine properly should take a minimum of 45 minutes, and unfortunately this sort of occurrence is not uncommon.
There are numerous cases of shortcomings when producing evidence and records to prove that the appropriate maintenance has taken place over the preceding 12 month period, and the fact that most building or facility managers rely on the provider to do the right thing. The reality is that a comparison of results from actual routine maintenance delivered against the requirements of the Regulations and Australia Standards shows a consistently poor level of compliance – a fact borne out by Glenn Talbot from Verified. As a compliance service bureau managing and tracking fire safety maintenance delivery for thousands of buildings nationally, Verified accumulated data proves that simply engaging a specialist maintenance service provider is not going to deliver the service level outcomes for which the owners or Aged Care facility managers are being charged. There is a significant disparity between what is required and what is being delivered in the marketplace. Various methods are employed to audit the performance of maintenance contractors, but each has shortcomings, some of which are: Inspection of logbooks to determine the extent of compliance • Costly double-up, as it is a manual process • Knowledge of the inspector, who needs to understand all tests and frequencies required (from weekly to 24-yearly) and then place the results into a spreadsheet to ensure all the tests results have been captured. • High number of test sheets (up to 180). • This only provides a historical report, and provides no opportunity to manage the process real-time to ensure testing is completed. • Logbooks and records go missing, get damaged and burn. Requesting the Contractor to provide a copy of all log sheets. •
Most contractors find this difficult, as it is a manual process for them to filter out specific test sheets.
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Test sheets can be filled out after the date.
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The high volumes of test sheets involved, and the storage required. >
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editorial
Risk Management in the Aged Care Sector (cont’d) •
The additional staff workloads involved in analysing each test sheet to ensure all the requirements are met. They require expertise on the regulations and standards requirements.
Aged Care facility managers need to ensure that they have a working understanding of their compliance obligations, and robust record management processes in place, should they ever need them in a court of law.
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A contractor or consultant signing an annual statement does not meaningfully reduce the risk to the facility manager. Legislation specifically nominates the owner in a number of sections or regulations and applies penalties to each.
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Not all Australian Standards for maintenance automatically apply to essential safety measures in a building. In many buildings the owner determines the extent of compliance, as some regulations are silent in these matters.
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The issuing of an occupancy permit or occupation certificate in a number of jurisdictions does not warrant that the building complies with the Building Regulations or BCA. It only advises that the building is suitable for occupation.
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A building undergoing refurbishment does not automatically mean all services installations and elements have to comply with today’s regulations and standards.
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The issuing of a maintenance schedule by the controlling authority should not be automatically assumed to be accurate as items have been found to be missing, included when not installed in the building, wrong standards nominated, frequencies of inspection inappropriate, a wrong address indicated, critical performance-based solutions not included and wrong owners nominated.
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Aged Care owners or facility managers should take care not to assume that all contractors or assessors know the regulations, BCA or standards.
The following lists some points that will clarify issues often left open to interpretation and misunderstanding: •
Signing an annual statement is not certifying that the building complies with the Building Code of Australia (BCA).
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Maintenance legislation only requires existing essential safety measures in the building to be maintained and does not refer to the number of services to be increased, repositioned, altered or updated.
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Altering an essential safety measure under most jurisdictions will require a statutory authority to issue an approval before work commences.
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A building inspected by a council or fire brigade for compliance and passed, does not validate the whole building as complying with the Building Regulations or BCA.
A DVE RTORIAL
MAXI-CARE PROMOTIONS PTY LTD
T
he team at MCP would like to take this opportunity to introduce ourselves. We have over ten year’s experience in the medical industry and 30 years in the engineering industry. Our customers at MCP have the greatest respect for our team as we are a dedicated family business which develops equipment with the assistance from the medical industry. The help we received from the nurses in Victoria also changed us as a company due to the nurses talking about their needs in the industry. They were grateful to MCP as they finally found a company that would listen to their needs. Our company concept with floor & low level care beds was an entirely different way of giving care for nurses but the profession knew that they needed this change to help their patients and residents feel safe. Our family team at MCP also provide unique service to our customers eg: maintaining electrical and manual equipment for the medical industry with the assistance of Linak Australia P/L with their training procedures which our service team are accredited. As a dedicated family company we manufacture all our own beds which are made in South Gippsland, Victoria, Australia. This makes it possible for our team to custom design and build your beds to meet your requirements, as has already been achieved in the marketplace for numerous customers. Our Vision • Supply equipment to the marketplace that is user-friendly • Search for ways to constantly improve our products • Supply products for a safe environment for all • Focus on new products that are suitable for the medical industry • Expand our distribution into the marketplace • Increase our export overseas • Outperform our competitors See our ad on the opposite page for contact details.
An Aged Care facility’s insurance policy should be a prime consideration in the formulation of an effective risk management policy. It is advisable to locate your building’s insurance policy and read the fine print concerning exclusions. For example, a malfunctioning electrical system that causes fire damage in your building could have been foreseen in the performance of an electrical safety report.
Emergency Evacuation Compliance Effective emergency planning does not have to be rocket science, but an effective emergency evacuation plan should cover all potential emergency scenarios and then consider them in relation to the specifics of the Aged Care facility in question. The plan should cover all the designated actions employers and employees must take to ensure employee safety from fire and other emergencies. Facilities such as Aged Care facilities are occupied 24/7, with staffing levels varying considerably during this period and as a consequence, the number of staff available to fulfil emergency duties will vary throughout the operating hours of the facility. It is critical in the first instance that a sufficient number of staff are allocated to coordinate and implement the emergency plan. Aged Care facility managers need to realise that it is their responsibility to develop an emergency management plan that not only addresses the best way to evacuate people to an evacuation control point, but to account for the number of people to be evacuated at any given time. For further advice specific to your situation or a comprehensive explanation of the information you have at hand, seek expert advice. n
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2009 Calendar of Events 14 & 15 May
21 & 22 May
2 - 5 June 2009
ACAA – NSW Congress 2009 ‘Celebrating 21 years at Congress’
ITAC 09 (Information Technology in Aged Care) ‘Sustaining Quality Through eCare’
13th Annual Alzheimer’s Australia National Conference 2009
Star City Hotel, Sydney Contact: ACAA-NSW T: 02-9212 6922 E: admin@acaansw.com.au W: www.acaansw.com.au
Hilton Hotel, Sydney Conference Managers: HISA T: 03 9388 0555 E: itac09@hisa.org.au W: www.itac09.com.au
Adelaide Convention Centre South Australia W: www.plevin.com.au/ alzheimersconference2009
18 & 19 June
20 – 22 July
13 – 16 September
ACCV State Congress
IAHSA’s 8th International Conference
ACSA 2009 National Conference
‘Leadership Beyond Borders’
‘Get up, stand up!’
Melbourne Park Function Centre ACCV Conferences & Events Contact: Matthew Monaghan Tel: 03 9805 9400 W: www.accv.com.au
Queen Elizabeth II Centre London, England W: http://www.iahsa.net/london/
22 – 23rd October
15 – 17 November
4th International Conference On Creative Expression Communication and Dementia
ACAA 28th Annual Congress
Adelaide Convention Centre Contact: All Occasions Management T: 08 8125 2200 F: 08 8125 2233 E: shanna@aomevents.com W: www.alloccasionsgroup.com/ CECD09
‘Our Journey Beyond Today’ Melbourne Convention and Exhibition Centre Conference Managers: ACCV Conferences & Events Contact: Matthew Monaghan T: 03 9805 9400 E: events@accv.com.au W: www.accv.com.au/acaacongress
Perth Convention Exhibition Centre Conference Secretariat: EECW Pty Ltd T: 08-9389 1488 F: 08-9389 1499 E: info@eecw.com.au
industry news
interest basically relates to soundly accreditated homes, whether they are fully matured businesses on ones having scope to improve.
eccles Aged Care Realty
Melbourne Based – Australia Wide
EXPERTS IN AGED CARE SALES FOR OVER 50 YEARS Will you have regrets in 2010? Without doubt 2008 was a shocker of a year coming after some 12 years of unbridled prosperity and easy credit. Unfortunately the economic guru’s, whiz kids with MBA’s, central bankers, politicians and almost everyone who should have known better ,decided to defy the lessons of history. But 2008 is behind us and while 2009 will be a challenging year it is worth remembering the old adage,”sell in boom –buy in gloom”. Hence we pose the question, “Will you have regrets in 2010?” Any sale or purchase contemplated today would, in all probability, not be approved and settled much before the end of September. Suddenly 2009 is almost over and it is then likely, that decision makers will be seeing improved conditions starting to emerge. Recessions generally last a short time by comparison to periods of prosperity. The key to keen buying is timing and from our discussions with many Providers it is clear that 2009 presents an excellent opportunity. To the question, have values fallen the answer is YES, however not dramatically. It is more the case that that values (prices being offered and or paid) are probably at the level of what was in hindsight, a realistic level over the past year or so. To the other question, are there “bargains” to be had, the answer is (in our view) NO. There have been some well documented failures, but our primary
Cutan
®
D
Consequently we are pleased to have the opportunity to provide a brief overview of a number of opportunities we have for sale. We can arrange an inspection of any facility at a time to suit and can provide comprehensive “due diligence” information to assist your decision making process.
Some Great Buying Opportunities! • Mornington Peninsula: Two very modern low care facilities, one a 125 room Leasehold, the other a 50 bed “going concern” facility. • Melbourne, north-eastern suburb: A near new 68 bed, low care facility enjoying a high occupancy rate and several ILU’s • Melbourne, outer east: 85 bed facility (75 high care) comprising renovated cottage style building, and a new wing. Totally compliant, plus the land and permits to extend to 130. • Victorian provincial centres: We are instructed to offer a select number of new and near new facilities. All are superb “state of the art” facilities. • Melbourne, outer east: A 2008 compliant 60 bed high care facility; soundly renovated with a new wing recently added; $105,000 per bed. • Allocated Places: 60 relocatable places at $55,000 per place. • NSW and Queensland: Ranging from southern NSW to far north Queensland we offer 5 rare opportunities comprising a mix of high and low care. Five “state of the art” facilities, all in critically high demand and hard to obtain locations with demonstrable growth. Eden 85 places, Balina 85 places, Pottsville 150 places, Tugan 90 places and Cairns 60 places. Eccles Realty Pty. Ltd. Licensed Estate Agents 755 Station Street, Box Hill Victoria 3128 03 9890 9466 PHIL ECCLES 0419 960 419 BILL CAREW 0412 539 717
Experts in Occupational Hand Hygiene
eb has recently released a new skin care range dedicated to the Aged care sector.
The range consists of a mild foaming hand soap, Alcohol Foam hand sanitiser, moisturising cream and a complete 3 in 1 shampoo, conditioner and body wash.
All products are designed to be used in easy to use dispensers. Deb Australia & New Zealand Tel: (02) 9794 7700 Website: www.deb.com.au
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industry news
Wisdom Activities
W
isdom Activities was established in 1999 and since then has been providing appropriate activity and therapy resources for those who work with the unwell elderly. We are a business based in Perth Western Australia. Despite being located in the most isolated city in the world, we market and sell successfully around Australia. The prime motivation is to provide those who work and spend time with our aging population with purposeful activities and user friendly resource books to assist them in their valuable task. The manager of Wisdom Activities has had over ten years working as an Occupational Therapist within a variety of Aged Care facilities specialising with those who are in middle to late stages of dementia.
“Maintain your brain” is a common catch cry within our community aimed at warding off dementia related diseases. The idea is that dementia is not necessarily an inevitable part of aging but can be fought against, prevented and contained through early diagnosis and good management. Stimulating your brain with continued learning, puzzle solving and maintaining connections with society can all assist in minimizing the progress of any dementia related illness. As well as this, moderate exercise such as daily walks assist in good circulation and therefore increased blood flow to the brain. Wisdom Activities recommends “Yoga for the Mature Years” a DVD specially designed for the elderly to exercise mind and body maintaining health and independence. Music is also a highly successful media used to engage the elderly, the CD “Shall we Dance” is purpose designed for bed or chair bound elderly people.
It incorporates specific music routines with narrated gentle sitting exercises which can be modified to suit exercise programmes. Now more that ever, positive focus is on the aged and their appropriate care. Wisdom Activities provides the experience and customer service to meet the activity related needs of our ageing population in homes, community care centres or aged care facilities. Resource books with up to date ideas and information are available for workers in aged care who have a variety of skills to serve our aged population. n See our ad on page 30 of this issue.
GripSox™ – non slip safety grip socks
G
ripSox™ were designed by Melbourne physiotherapist Luke Goodwin and launched on to the market in 2005. Having worked as a physiotherapist for over 10 years, Luke has seen first hand the physical, emotional and financial effects that falls have in the community. Research suggests that 1/3 of people over 65 years of age fall each year with 10% of these falls resulting in an injury. GripSox™ are now an internationally recognized product in the area of falls prevention, with many hospitals, aged care centres and exercise studios using GripSox™ to assist with the safety of their clients. These special features of GripSox™ make them ideally suited to the hospital and aged care environment:
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Increased safety & hygiene
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Worn easily over compression stockings
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Clinically trialled in Australia
GripSox™ received excellent feedback when they were presented at the 2008 Australian & New Zealand Falls Prevention conference in Melbourne and we continue to undertake further clinical research into their effectiveness with falls prevention management. GripSox™ can be purchased individually or at special wholesale prices when ordered in bulk.
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95% cotton for breathability
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5% elastane helps accommodate swollen feet
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Seamless toe for pure comfort
For further information or to place GripSox™ orders please call (03) 9591 0500 or go to www.gripsox.com n
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Withstands high temperature laundering
See our ad on page 54 of this issue.
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Autumn 2009 | Aged Care A U S T R A L I A