Aged Care Australia Spring 2009

Voice of the aged care industry Spring 2009

28th Annual Congress

Print Post Approved PP324494/0065

Official Publication

IN THIS ISSUE: IBM Transforming Care through Communication ACAA Congress 2009 The National Congress you can’t afford to miss!

End of Life Decisions For persons with impaired capacity Workforce National registration for nurses, opportunity or burden to bear?

COVER STORY

The Africa Connection Chance, goodwill, and the power of storytelling

Front Cover: SAGE and the Africa Connection – a remarkable story.

Voice of the aged care industry Spring 2009

contents

27

47

National Update

65

47 Profile of a Successful Software Implementation

68 Apartments for Life

2 CEO’s Report 5 Presidents Report

Workforce

76 Extra Services Today

6 NHHRC Summary of Key Issues

51 Employee Turnover – What is the Real Cost?

78 Lessons from the Other End of the Ditch

52 The Hiring Interview: Seven Secrets for Success

83 Atlas of Productive Ageing

10 State Reports 20 Congress 2009

73 ACFI - The Current Impact

80 SAI Global Business Awards Success

27 The Africa Connection

55 National registration for nurses, an opportunity or another burden to bear?

84 A dangerous combination for care staff – professional boundaries and personal interests

Profile

Sponsor Articles

86 Centenarians

33 Dr June Heinrich

57 Airline seats and aged care beds

87 Calendar of Events

Technology

58 Free Online Dementia Training

Cover Story

37 Transforming Care through CThe 41 Aged Care IT Vendors/Suppliers Forum 42 We Want 21st Century Healthcare Now 43 Dubbo Aged Care facility implements Panasonic Toughbook H1 MCA

PRESIDENT VICE PRESIDENT DIRECTORS

EDITOR PRODUCTION

Bryan Dorman Francis Cook Tony Smith Mary Anne Edwards Viv Padman Geoff Taylor Kevin O’Sullivan Rod Young Jane Murray

90 Product News

60 End of life decisions for persons with impaired capacity Editorial 65 SAGE Comes of Age

45 Gartner Industry Research

ACAA OFFICE HOLDERS

59 Reverse Auction Platform saving you money on energy costs… now and in the future!

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

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

Aged Care Australia is the official quarterly journal for the Aged Care Association Australia

Adbourne PUBLISHING

Adbourne Publishing PO Box 735 Belgrave, VIC 3160

Advertising Melbourne: Neil Muir (03) 9758 1433 Adelaide: Robert Spowart 0488 390 039 Production Claire Henry (03) 9758 1436 Administration Robyn Fantin (03) 9758 1431

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

www.adbourne.com

Aged Care A U S T R A L I A | Spring 2009 |

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national update

CEO’s Report

H

owever, it is unlikely that any significant change is likely to occur before late 2010, due to both the likely costs of the reform package and the holding of the next election sometime during 2010.

Rod Young CEO, ACAA

CAP INDEX ESSENTIAL There is no doubt the Government is interested in considering a range of options for the reform of the broader health system including aged care.

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Does any aged care provider believe they can maintain quality services if all Government is prepared to pay by way of additional subsidy for next financial year is a .6% increase in subsidy?

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Therefore aged care has a problem unless Government is willing to consider issues for reform in both a short term and a long term context.

The first short term issue the Government must address is an aged care specific index approved in next year’s budget for the 2010/11 financial year.

On current trends the current COPO (Commonwealth Own Purpose Outlays) which is based on current year CPI and safety net wage adjustments could be as low as .6%; that is correct .6 of one percent.

The CAP index was introduced in 2005 following a recommendation in the Hogan Review that the then Government pay an additional index to aged care providers as the industry could not vary prices, had limited capacity to achieve significant productivity reform and had existed under the COPO annual index system for nearly ten years which had lead to a significant decline in net income as compared to actual costs impacting on the industry during the same period.

The current Government agreed to extend the CAP Index for the 2007/08 financial year as the review the previous government had committed to undertake had not occurred by the time budget deliberations had been finalized in 2007.

Accompanying this decision was the creation of an interdepartmental committee to review the CAP Index and advise the Government on what the aged care index for the future should look like. Aged care providers took an active interest in this review with

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seventy submissions being made to the review committee. This report was to be delivered to Government in time for a decision in the 2008/09 budget deliberations.

The decision by the Government to increase the single age pension and to provide a specific percentage of that pension increase to aged care providers lead to the Government deferring any decision on the future index for aged care.

Therefore aged care is still waiting. Will the Government agree to treat aged care differently and recognise the need for the industry to be paid something more than COPO? In 2009/10 likely to be around the .6% mark.

Does any aged care provider believe they can maintain quality services if all Government is prepared to pay by way of additional subsidy for next financial year is a .6% increase in subsidy?

Are you concerned by this possible outcome?

If you are, then ACAA would suggest we all need to be approaching our local politicians to convey our concerns that aged care quality and therefore our residents will be seriously impacted if the Government does not change the current funding formula.

The average subsidy paid by Government in the 2008/09 financial year was $96.00. Therefore if we receive only .6% index funding increase for next financial year; then the average subsidy received by you the provider will have the magnificent increase of 57.6 cents per resident per day. That is not sufficient to maintain quality service delivery in aged care. n

national update

President’s Report Bryan Dorman, President, ACAA

Following this report you will find a summary of the aged care specific recommendations from the National Health and Hospitals Reform Commission report to Government. The summary lists the recommendations, makes a comment on each then asks a range of questions about how the recommendation might impact the aged care industry or whether there are other options or alternatives that should be considered.

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strongly recommend that everyone with even a remote interest in aged care read the summary of the recommendations and discuss the issues with your friends and colleagues. The government has been undertaking a series of consultations over recent weeks with the main focus being the broader health system.

Consultation on the aged care issues is predicted to occur during October. It is important that all of us participate in this dialogue. The time the Prime Minister and other Ministers have so far given to the consultation process gives the strongest possible indicators that this Government is interested in considering the options and hopefully making some serious decisions to drive reform in the future.

ACAA strongly believes that the Government’s response to the NHHRC report will be the best opportunity for a number of years to undertake a major reform program in the aged care industry.

You may ask whether reform is actually necessary?

ACAA believes that there is a need to consider what we think the industry will need to look like in 2025. If we think that we will need to be very different in eighteen years time then it is absolutely essential that we start the reform process today.

Aged care is now a large industry.

240,000 staff, 220,000 clients, 3600 service providers and sites across residential and community care. Nearly $10B in government outlays and nearly $2B in new and replacement building stock each year.

we change the current arrangements any future government is going to concentrate on how to constrain expenditure on aged care rather than how we continue to provide a quality service to our clients.

In addition if we as an industry are going to come anywhere near meeting the projected growth in demand the industry will need to spend $21B in building works between now and 2020.

Any consideration of the current scheme will clearly indicate that this $21B is not going to occur unless we undertake some major surgery to the current capital raising capacity of the industry.

These are just a few examples of the reasons why ACAA believes that we need to have substantial reform. That does not mean we support all the recommendations from the NHHRC, and indeed we do not, however we do need to be fully committed to the debate and we all need to be prepared to discuss with our political representatives what we believe we deliver the best possible outcomes for our clients, our residents; who after all are our reasons for doing what we do. n

National Health & Hospitals Reform Commission – Summary of Key Issues follows on page 6

From a government expenditure perspective if nothing else changes by 2020 Government outlays will be in excess of $18B per annum. Unless

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national update

SUMMARY OF KEY ISSUES – National Health & Hospitals Reform Commission Recommendations

Comment

Issues to be considered

Overall Report: Contains 123 recommendations

ACAA endorses the release of the report which can be a major driver of reform in the health and aged care systems in Australia.

Does the Report deal satisfactorily with the issues of acute care, primary care and aged care integration?

Recommendations 42 to 53 relate to ‘Increasing choice in aged care’.

The Report sets out key reform priorities for both health and aged care.

Recommendations 54 57 relate to ‘Caring for people at the end of life’.

However the narrative and the recommendations are often difficult to marry-up.

The Prime Minister has approved a six month consultation process before the Government will commence the task of formally deciding on a Government response to the 123 recommendations.

ISSUE 1: Aged Care Planning and Allocation Process

Report proposes abolition of ACAR Round

Recommendation 42 Removal of restrictions on number of aged care places an approved provider can put in the market place with the objective of increasing competition and supply

Remove current restrictions on the number of places an approved provider can offer.

Recommendation 42 Change the allocation formula from beds per thousand aged over 70 year to beds per thousand aged over 85

The claimed intention is to generate more aged care places, and by association consumer choice and investment by uncapping supply.

However, demand and price remain substantially capped which means basic economics is being ignored.

The removal of value in the allocated licenses could negatively affect the value of care providers, asset base and therefore impact their borrowing/financing capacity.

ACATs to determine place numbers Note that the total number of places per region is proposed to be effectively controlled via the ACAT assessment process. That is, presumably the ACAT is allocated a certain number of places per region and this number is the same as would have otherwise been allocated via the ACAR round process.

Concern that ‘competition theory’ is flawed in regard to the ‘ACAR’ round and ‘competition’.

Government retains price control. Government retains funding control. Government retains regulation control.

Thus would ‘competition’ work in practice?

Serious concern that there would be an ‘over supply’ in areas which are ‘attractive’ to providers eg Eastern Suburbs but limited interest in low income, rural and remote areas. Homeless? Disadvantaged?

Fundamental Question – What is the view of ACAA members on this competition proposal?

Are there any changes suggested about how this ‘competition’ proposal could be modified?

What would be the impact on your financial status if Government adopted recommendation 42?

What is the status of the approved provider? Does DoHA retain control over who can provide aged care services?

ISSUE 2: Bonds in High Care and Consumer Contributions to cost

Recommendation 43 Accommodation bonds or alternative approaches as payment options for accommodation in high care provided that removing the regulated limits on the number of places has resulted in sufficient increased competition in supply and price.

It is important to note that the NHHRC Report raises the key issue of ‘bonds in high care’.

The industry has been calling for a solution to capital income capacity for many years.

It is a positive for our industry that this issue was formally raised in the final report.

What are the solutions aged care should be prepared to accept and when if government continues to reject bonds as a solution?

As there is already a 7% oversupply in the industry today it remains unclear as to when the Commission considered it appropriate for bonds to be introduced into high care. Is it 10% vacancy levels or 15% or higher?

Recommendation 48 That people who can contribute to the costs of their own care should contribute the same for care in the community as they would for residential care (not including accommodation costs).

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There is a proposal for more consistency in user payments across aged care. Again it is suggested that this is a sensible step. With the objective being to give consumers greater choice then financial contribution options should be placed on a par with care service options as well as subsidy support options.

There would be broad industry support for more consistency in user payments, but a lack of detail about what is envisaged.

Comments and suggestions on how such a scheme might work would be appreciated.

Recommendations

Comment

Issues to be considered

The report notes there are effectively only 3 steps in community care services and subsidies. That is, HACC, then CACP then EACH/EACH D.

Are there any impediments to a seamless funding stream that reflected the clients needs?

ISSUE 3: Flexible Range of Care Subsidies Recommendation 47 That there be a more flexible range of care subsidies for people receiving community care packages, determined in a way that is compatible with care subsidies for residential care.

The report recommends a more flexible range of care subsidies for people needing community care.

The ‘Implementation Plan’ at the rear of the Report (Appendix H) proposes five new funding points between the current CACP and EACH levels.

ACAT re-assessment should not be necessary when moving from one level to another.

Will this proposal enhance consumer choice?

Are aged care providers supportive of the concept?

The proposal for five additional funding points between CACP and EACH would have significant benefit provided ‘consumers’ could seamlessly move from one level to another as their needs changed.

ISSUE 4: Greater Consumer Choice

Recommendation 49 That people supported to receive care in the community should be given the option to determine how the resources allocated for their care and support are used.

This recommendation creates the first step in a series of recommendations that enhance consumer choice.

Are aged care providers supportive of this recommendation to enhance consumer choice?

Individuals get an opportunity to receive direct funding via some form of ‘personal budgets’ which they control or more transparently negotiate with a service provider.

Individuals get greater choice between community and residential aged care

Recommendation 50 That once assessment processes, care subsidies and user payments are aligned across community care packages and residential care, older people should be given greater scope to choose for themselves between using their care subsidy for community or for residential care.

Notwithstanding this, we note that, given the increase in frailty and complexity of care needs, for many elderly people residential care will remain the best and only viable option for meeting their care needs.

The level of care subsidies should be periodically reviewed to ensure they are adequate to meet the care needs of the most, frail in residential settings.

In the lead up to freeing up choice of care setting, there should be a phased plan over five years to enable aged care providers to convert existing low care residential places to community places.

Recommendation 44 Information to support effective decision making availability of standardised information about aged care providers to support effective decision making

Are providers of residential care concerned that this recommendation is likely to impact demand in residential care?

Or are frailty and dependency levels now such that this recommendation is unlikely to impact residential care demand?

This recognizes the limitation of enhanced community care where inadequate voluntary carer support is available and residential care is the only option.

ACAA has argued for many years that a regular , at least five yearly, benchmark cost of care, independent analysis of the actual cost of care is required, if Government and industry are to understand what it is that providers are expected to provide, at what quality and in what volume?

Do aged care providers agree with this assessment?

In relating this recommendation back to recommendation 42 & 43 there is a clear need for Government to understand that if the capital stream created in low care due to lump sum contributions disappears because providers move the places into the community and inadequate provision is made for capital raising from other sources then infrastructure spending will become frozen.

Is a benchmark cost of care supported by the industry?

Additional information about ‘provider performance’ posted on a website for consumers to exercise greater choice.

Will this option be attractive to aged care providers?

If adopted is a five year review process sufficiently frequent?

Is it likely to impact industry capital raising capacity?

Are there other alternatives that should be considered?

Will this recommendation achieve the objective?

What information should be displayed?

Where should the information be displayed?

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national update

Recommendations

Comment

Issues to be considered

This issue has been on the COAG agenda for at least two years. When previously considered by the aged care industry it has received general support.

Are there reasons why ACAA would not support this recommendation?

ISSUE 5: HACC and ACAT to the Commonwealth

Recommendation 45 Consolidating aged care under the Commonwealth Government by making aged care under the Home and Community Care (HACC) program a direct Commonwealth program.

It would mean transferring approximately 540,000 HACC clients from state responsibility to Federal Responsibility.

Recommendation 46 Development and introduction of streamlined, consistent assessment for eligibility for care across all aged care programs. This should include: • transferring the Aged Care Assessment Teams to Commonwealth Government responsibility; • developing new assessment tools for assessing people’s care needs; and integrating assessment for Home and Community Care Services with more rigorous assessment for higher levels of community and residential care.

ISSUE 6: Better and innovative use of technology and communication

Recommendation 53 The safety, efficiency and effectiveness of care for older people in residential and community settings can be assisted by better and innovative use of technology and communication such as:

Transferring of HACC aged care clients to Federal responsibility would almost automatically drive systems change for common assessment tools across the whole aged care program.

Under the current structure if ACATs are to continue in the role of gatekeeper then it would appear essential that their role, function and accountability move from state/territory control to federal government

The Report proposes a substantial increase in the use of technology in both residential and community care settings.

• supporting older people, and their carers, with the person’s consent, to activate and access their own person-controlled electronic health record;

There is little doubt that people are interested in having greater control over their health information.

Access to personal data will enhance this control and personal responsibility

• improved access to e-health, online and telephonic health advice for older people and their carers and home and personal security technology;

Supporting a person in their own home with assistive technologies and electronic health records will add to the capability of service providers and workforce efficiency

• increased use of electronic clinical records and e-health enablers in aged care homes, including capacity for electronic prescribing by attending medical and other credentialed practitioners, and providing a financial incentive for electronic transfer of clinical data between services and settings (general practitioners, hospital and aged care), subject to patient consent; and

Recent uptake by aged care providers of a range of IT technologies can clearly demonstrated the industry is using such technologies to improve performance and achieve workforce efficiencies.

• the hospital discharge referral incentive scheme must include timely provision of pertinent information on a person’s hospital care to the clinical staff of their aged care provider, subject to patient consent.

Hospital/aged care clinical documentation transfer is a constant problem for aged care staff. An electronically enabled discharge/referral system would improve workforce productivity.

Enabling e-prescribing, electronic dispensing and supported electronic medication administration will further improve efficiencies, productivity and avoid adverse medication administration events.

Creation of industry wide consistent tools would make sense. Are there any alternate views?

Is there any objection to Federal Government takeover of ACATs? Is there any reason why ACATs should not be responsible for gatekeeper assessment functions?

Is there broad industry support for greater use of technology?.

How will consumers gain access to such support?

There is currently no funding mechanism available in Australia to support consumers or their care providers to procure and deploy many assistive technologies currently available.

What strategies do aged care providers suggest should be employed?

What type of assistance would aged care providers need to participate in a broad range of IT initiatives

It is assumed a solution to this issue would receive universal support?

ISSUE 7: Staff Training Recommendation 51 That all aged care providers (community and residential) should be required to have staff trained in supporting care recipients to complete advance care plans for those who wish to do so.

Advanced care plans have been demonstrated to reduce end of life admissions to hospital and to receive favorable responses from the families of care recipients as a preferred to course to end of life care.

Does this represent aged care providers view of future service provision?

Attracting and retaining sufficient servicing GPs in aged care is proving difficult in many parts of Australia. ACAA has argued for some years that the existing funding arrangement with GPs needs to be restructured to allow a bulk contract or service retainer to be negotiated.

Are there any reasons why aged care providers would not support this recommendation?

ISSUE 8: Funding for sessional and on-call medical care Recommendation 52 That funding be provided for use by residential aged care providers to make arrangements with primary health care providers and geriatricians to provide visiting sessional and on-call medical care to residents of aged care homes.

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national update

ACAA - NSW Charles Wurf, CEO ACAA-NSW

Reintroducing Aged Care Business Services ACAA-NSW has now concluded its internal restructure, and has launched Aged Care Business Services as the ongoing name for the wholly owned and operated business services for aged care providers.

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009-10 is the 30th anniversary of the Association’s ongoing involvement in specialist business support for aged care, and the underlying philosophy has not changed in those

30 years. ACAA-NSW engages dedicated staff with a highly specialised understanding of aged care to deliver services in an efficient and very cost effective way.

Aged Care Business Services is a division of ACAA-NSW and the new name follows consolidation of our service delivery in the first half of 2009, with the successful implementation of new and upgraded software systems. As Business Services are provided through the Association, earnings from these Services are reinvested in the activities of the Association, to the benefit of the industry in which we are all engaged.

In a time of great change, in an increasingly hostile regulatory framework that requires specialised and costly business systems, the option of an industry-based service provider for critical tasks remains as relevant as ever.

Financial Services Aged Care Business Services provides a comprehensive package of transactional accounting services for aged care providers. This service can be tailored to a specific aged care provider, and builds on the experience of 30 years operating in the Australian aged care system.

Aged Care Business Services can offer a complete accounting solution for any aged care provider, with processing and reporting services tailored to your requirements.

Resident Claims and Billing Aged Care Business Services provides a complete resident accounting service. Aged Care Business Services understands the specific requirements of the Aged Care Act, and our service delivers a monthly resident billing function and a monthly lodgement and monitoring of the departmental claim / payment statement.

Resident claims and billing can be offered as a separate module, ensuring this vital administrative task accounts for all income or it can be structured as an integral part of comprehensive Financial Services.

Consulting Services Aged Care Business Services has experienced consultants with direct operational experience in Australian aged care.

Consulting services are designed to operate as Continuing Advice, or in response to individual needs.

In an age of heightened compliance activity at all levels, coupled with a once-in-a-decade change to the resident funding system, an experienced Aged Care Business Services consultant can monitor compliance and benchmark revenue maximization.

Payroll Services Aged Care Business Services has comprehensive Payroll Services dedicated to aged care providers. Payroll Services understands the nature of the aged care workforce, and operates a high volume processing capacity, at all times applying the intricacies of employment conditions to a 24 hour a day roster.

Payroll Services currently processes payroll for aged care providers covered by Awards, NAPSA’s and enterprise agreements. n

national update

Aged & Community Care Victoria Gerard Mansour, CEO ACCV

ACCV’s annual Rural Mini Conference, held in Echuca in August saw nearly 100 aged and community care providers from across Victoria come together to consider key viability issues for our rural and remote Victorian services.

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he conference acknowledged that every stress and pressure currently faced by the aged and community care industry is always more pronounced and challenging for our rural communities.

ACCV has consistently voiced the needs and concerns of our rural Victorian aged and community care members through submissions to the National Health and Hospitals Reform Commission and Senate Inquiry into Aged and Community Care.

Through these processes, ACCV continues to strongly represent the needs of rural services to receive much greater support.

ACCV has called for the Commonwealth Government to undertake an urgent review of the real costs of doing business for aged and community care providers. This should include recognition of the pressures, lack of resources and real costs of providing aged and community care services in rural, regional and remote areas.

Importantly, our rural services suffer from the inadequacy of the existing rural viability supplement. For example, data from 2007/08 shows that the average amount of funding for homes receiving the residential viability supplement averages only $32,000 nationally and $22,000 in Victoria and the total budget outlay for all residential facilities was less than $20 million.

Contrast this to the fact that one vacancy in a high care bed can result in a loss of over $60,000 of income and it is obvious how inadequate the current rural viability supplement is in practice.

Despite a modest increase in this year’s federal budget, there is no doubt that the level of funding for the residential and community care rural viability supplements must be increased.

The solution lies in two areas.

Firstly the current guidelines for the rural viability supplement must be modified. Under the current guidelines, the entitlement for the supplement is based primarily on the distance from the nearest regional centre. As a result there are inequities where needy small rural communities are ruled out from much needed support. Secondly, the formula for determining the amount of funding must also be changed by substantially increasing the amount per resident to more appropriate levels.

There can be no doubt that the financial viability of our rural aged care homes and community aged care services must be addressed. The solution lies in the Government addressing the rural viability supplement as a priority matter in their response to the Senate Inquiry and the National Health and Hospitals Reform Commission’s Final Report.

ACCV Policy and Research Committee The ACCV Board recently established a Policy and Research Committee. Representatives from industry and academia attended the inaugural meeting of this new ACCV Committee in August. It will play an important clearing house role and contribute to the state and national research agenda. n

national update

Aged Care Queensland Anton Kardash, CEO Aged Care Queensland

Over the past months with renewals of subscriptions, AGM’s etc ACQI has been aiming for consolidation and a focus on the fundamentals of service delivery to members. To this extent significant emphasis has been placed on improving the value proposition for members of the association.

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With the review of organizational functions finalized and consolidation of positions occurring within the organization ACQI is set to perform at even higher levels in the future.

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s a result ACQI has continued to drive service delivery in four critical areas:

1) Intelligence gathering and advice giving 2) Member support 3) Advocacy; and 4) Training Feedback from members has indicated that while ACQI was able to deliver in most of these areas, it has been inconsistent, often due to the availability and knowledge of staff. Our response to this issue has been to undertake a mid year staffing restructure, which has provided the basis for a more multidisciplinary approach with an improved depth of industry knowledge across all staff.

During the year our training arm (AICD) has undertaken a review of its functioning following a significant change over in staff. In particular the service has moved from a calendar based, course and workshop approach to a more dynamic member need driven approach.

I was pleased to attend the AICD graduation ceremony for the 34 Diploma of Endorsed Enrolled Nursing students. With our partner South Queensland Institute of TAFE (SQIT), we held a gala event for students and their families at our new training facility. This year has seen a strengthening of the relationship with SQIT as we plan for expanded quality services for the future.

Within member services the following examples of activities demonstrate our commitment to improved service. They include an eMentoring project aimed at remote support of staff and managers including the development of a CD-ROM, an Indigenous Employment Mapping project, the development of a comprehensive selection of consulting services to members, improvement to the Retirement Village Accreditation Scheme, responses to the Department of Health and Ageing and the Aged Care Standards and Accreditation Agency for the review of the Complaints Investigation Scheme and Aged Care Accreditation and the redevelopment of our association website.

On a day-to-day basis ACQI staff handle all manner of requests for assistance, advice, support and mentoring.

Our Board has also engaged in significant activity over the past few months including a review of governance policies, the commencement of a constitutional review and governance training.

These activities have been designed to improve member service and represent the very tip of the iceberg in terms of planned activity. With the review of organizational functions finalized and consolidation of positions occurring within the organization ACQI is set to perform at even higher levels in the future. n

national update

ACAA - WA Anne-Marie Archer, CEO ACAA-WA

Security of Tenure is set to get tighter In light of the release of the WA Department of Health Protocol, regarding the Security of Tenure for residents in aged care facilities, we are watching with great interest to see what sort of impact this may have on WA Providers.

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A Health have indicated that the protocol has been developed to facilitate a consistent approach for WA Health services when working with patients who are existing aged care residents and whose ongoing care needs have changed.

It is important to acknowledge that the WA Health guidelines, although within the provisions of the User Rights Principles of the Aged Care Act 1997, do raise a number of concerns, particularly for low care facilities.

The main concerns flagged to date have been from low care services that may struggle to accommodate returning residents that have changed care needs from low to high requiring a more complex level of care.

The current protocols do recognise the need for facilities to be provided with a realistic timeframe to set up additional specialised care services, such as additional skilled staff, however, it is the provider who will be required to broker and fund these additional services until an alternative facility with appropriate care services is identified.

We are not sure where the facilities will find the additional financial and human resources to meet the notable change in care needs, nevertheless, they will be required to accommodate these changes as per the provisions of the Act. Some of the other concerns we have raised with WA Health include: •

The impact on rural and remote services in regards to accessing trained staff;

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Potential difficulties for facilities who may have to transfer an existing resident to another facility when that resident refuses to transfer once all the requirements of Security of Tenure have been met;

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Potential impacts on facilities re-accepting existing residents who have mental health conditions; and

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“

We are not sure where the facilities will find the additional financial and human resources to meet the notable change in care needs, nevertheless, they will be required to accommodate these changes as per the provisions of the Act.

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•

Concerns around infection control, equipment and consumables in providing for the changed care needs.

It is understood that this protocol is to ensure that there are not unnecessary responsibilities and pressure put on the State health system for existing aged care residents post the treatment of their acute and/or subacute care, as the hospitals are not considered to be appropriate alternative accommodation.

During a recent education session we were reminded of all the provisions of Security of Tenure including the fact that the alternative accommodation does not necessarily have to be acceptable to the care recipient who has been asked to leave, or the care recipient’s representative. However, the alternative accommodation does have to be available and able to provide care that is suitable to meet the needs of the care recipient.

Having spoken with my counterparts in other states it would appear that these protocol guidelines are being introduced and adhered to in hospitals throughout Australia.

One of the positive messages we have received from the industry is that it may ensure that the State health services responsibility for good discharge planning and the need for clear, detailed and specific information about a returning patient’s care needs are, with particular emphasis on identifying changes.

Feedback from our members would indicate that it will be low care services that will experience the greatest impact of this protocol and we acknowledge that many facilities already have very good working relationships with the State health services.

Our main concern is around any aspects of this process that cannot be negotiated between the discharging hospital and the aged care facility and in those instances we would encourage our members to keep us abreast of these events. n

national update

ACAA - SA Paul Carberry, CEO ACAA - SA

On Friday 21st August, we held our Annual Dinner and Awards night. This is the third such event and one which has become an important part of our annual calendar.

“

The dinner is about

much more than a good night, it’s about recognising and celebrating staff who have done exceptional work.

”

T

he ACAA-SA Board made the decision to hold these dinners in 2007, with a couple of key objectives in mind.

The first was a simple one. To have a big night out, with good food, dancing entertainment, where our members, staff from all levels and our sponsors could mingle and have a good time.

We all know that aged care providers and their staff work under constant pressure; trying to do their best for residents, staying on the right side of the compliance and accreditation regimes, and doing it all on skimpy funding.

This year our dinner was attended by 220 people and, by all accounts, they all had a great night.

But the dinner is about much more than a good night, it’s about recognising and celebrating staff who have done exceptional work. We ask our members to nominate people whose efforts have made a real difference to the lives of residents and relatives, who’ve gone above and beyond the call of duty, or who have shown great initiative and innovation in their work.

The people nominated can be in any role, at any level. The written nominations are reviewed by a panel of three judges, who are all from outside the aged care industry.

This was the second year we have held the awards, the number of nominations was up on last year and the quality of nominations was very high.

Our judges were asked to select four finalists and then rank them to arrive at a winner, and I’m pleased to say the judges’ decisions were very closely aligned. Nominees included a resident liaison officer, a director of care, and two lifestyle and programs coordinators.

They each received a certificate of recognition and a $150 gift voucher.

Winner of the “Aged Care Excellence Awards” Marilyn Nowicki. She is being presented her award and prize by Kim Gilbert from Zenith Insurance Services.

The winner was Marilyn Nowicki, Lifestyle Coordinator at Springfields Residential Care, a two-year-old facility in Adelaide’s northern suburbs, which is run by Padman Healthcare.

Marilyn received a winner’s certificate and a $1,000 travel voucher.

Of course, events such as this are only possible through the generous support of sponsors, and I’d like to thank Bankwest, Guild Insurance, HESTA and Zenith Insurance for being major sponsors of the dinner and awards, with special thanks to Zenith who sponsored the winner’s prize.

Other sponsors for the evening were NASANSB, Lynch Meyer Lawyers and Employers Mutual who sponsored lucky prizes for our guests, and McNeil Surgical and Health Management and Nursing Service, who helped out with printing and table decorations. n

Aged Care A U S T R A L I A | Spring 2009 |

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national update

ACAA Congress 2009 15 – 17 November • Melbourne Convention & Exhibition Centre Online Registration Available Now http://accv.com.au/ACAACongress/Registration.aspx Aged Care Association Australia is proud to invite you to the National Congress in Melbourne 2009, “Our Journey Beyond Today” to be staged within the new Melbourne Convention

A

CAA Congress is now in its 28th year. This event has been established as a key industry event which is a highlight on the annual calendar with strong support by industry.

Always a highlight to any ACAA event is the social program and 2009 is sure to be no exception.

Exhibition Centre. This venue

Exhibitor & Delegate Reception

boasts the world’s first 6 green

Monday 16th November

stars rated centre making it environmentally sound with state-of-the-art technology.

Join us as we take a step back in time aboard our double decker buses to historic old Melbourne Gaol. Buses depart from Melbourne Convention & Exhibition Centre.

Congress Dinner ‘Viva Las Vegas’ Tuesday 17th November Join us in style at the Crown Palladium of pure indulgence and dancing showgirls... you will need to attend to find out more!

A strong program has been compiled reflecting key industry trends & issues. Some highlights from the program are: Dr Sally Cockburn Congress Facilitator Dr Sally Cockburn is a GP with over 25 years clinical experience, but she is probably better known for her 18 year media career as Dr Feelgood, host of the highly successful late night radio program Pillowtalk, which aired in the 1990s and her regular TV presentations. These days, she has her own weekly radio program, Talking Health, on Melbourne’s 3AW and appears on The Morning Show on Channel 7.

Behind the scenes, Sally is passionate about patient and community issues and is active in health policy and education at many levels. She sits on the Board of Vic Health and Monash Medical Foundation and is deputy Chair of Family Planning Victoria. She is also a patron or ambassador for many health support agencies including RDNS, Melbourne Osteoporosis Support Group and Lord Smith Animal Hospital.

Sally is renowned for bringing sensitive issues out of the closet with humour and sensitivity and leaving her audiences feeling good!

Professor Neville Norman The Economic Scene: The last year and the year ahead Your view of economics will never be the same after listening to Professor Neville Norman. One of Australia’s leading economists and keynote speakers, Professor Norman discusses the economy and its future in a style which is entertaining as well as authoritative, informative and relevant to everyday business practice.

Associate Professor of Economics at the University of Melbourne since 1992 and senior advisor to many business and State and Federal government bodies, Professor Norman is able to shed light on business issues and opportunities in relation to any industry.

Professor Norman is an articulate, entertaining and informative speaker with a gift for making complex issues relevant and understandable.

Aged Care A U S T R A L I A | Spring 2009 |

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national update

Program Highlights (continued) Mike Munro The Power of Vision - A Pasty Faced Nothing Mike Munro began his career as a journalist in 1971 as a 17-year-old copy boy on The Australian and The Daily Mirror newspapers. After completing his cadetship he remained with the Mirror for seven years before joining Sydney’s Channel 10 News in 1978. Eleven months later he returned to newspapers and was posted to New York by Rupert Murdoch to work in News Limited’s American bureau and The New York Post.

Mike is perhaps best known for his candid interviews with such stars as Madonna, Barbra Streisand, Bette Midler and Katharine Hepburn on ‘60 Minutes’, for his ground-breaking and provocative reports for ‘A Current Affair’ and for the “honest raw emotion” of ‘This Is Your Life.’ This Is Your Life had not been out of the annual top 10 regular programs for all its six years and averaged a national weekly audience of more than two million viewers.

His autobiography, A Pasty-Faced Nothing, which documents his journey from a childhood of poverty, degradation and abuse to acclaim and popularity, was released in 2003. Mike retells this inspirational story, entitled “The Power of Vision” to all manner of audience.

Steve Simpson How Your Organisational Culture Impacts on Performance: Introducing UGRs Steve Simpson is an international speaker, consultant and author based in Queensland, Australia. Described by UK based e-Customer Service World as ‘Australia’s leading corporate culture authority’, Steve has created the concept of UGRs® which is receiving global acclaim as a tool to understand and improve organisational culture.

With unique insights that help organisations to profit from an improved culture, Steve is a Past Chapter President of the Australian Customer Service Association, and he has been an evaluator in the Australian Customer Service Awards. He was an invited member of an international team studying standards of World Class Customer Care, organised through the US based SOCAP. He has also achieved international recognition as a Certified Speaking Professional (CSP) the highest speaker accreditation recognised by the International Federation of Professional Speakers.

Steve will introduce us to the globally acclaimed concept of UGRs - which can be used as a tool by aged to providers to boost organisational culture.

Mark McCrindle Engaging with an Ageing Population. The Gold in the Grey: Understanding Current Trends and New Futures Mark McCrindle was trained as a Psychologist and his research into the emerging global generations is now recognised internationally. Mark is a Social Researcher and he is accredited with the Industry’s highest accreditation Qualified Practising Market Researcher.

He is the Director of McCrindle Research which counts amongst its clients over 50 multinational organisations and 100 of Australia’s largest corporations. His highly regarded research and reports into the changing times and emerging trends have developed his reputation as a futurist, demographer and a social commentator.

Mark is renowned for his engaging presentations. Mark graduated from the University of NSW with a BSc (Psychology) and he has completed a Masters degree majoring in Social Trends.

Chris Caton The Economy - The Big Picture and Some of its Impacts for Retirees Chris Caton is the Chief Economist for BT Financial Group. He was Chief Economist at Bankers Trust from 1991 until July 1999. From 1994 to 1997, he was also Chairman of the Indicative Planning Council, which advised the Government on matters relating to the housing industry.

Previously he worked in the Treasury, the Department of the Prime Minister and Cabinet, and for an economic consulting firm in the United States.

Chris was educated at the University of Adelaide and the University of Pennsylvania.

Paul Gregersen Australians Are Different: A Global Survey of Aged Care Residents After graduating in civil engineering, Paul pursued a career in general management beginning with the international mining conglomerate, RTZ Limited.

A senior Bupa executive at director level, Paul has healthcare expertise in both funding and provision having begun his Bupa career managing Bupa’s largest UK hospital. During this period, Paul led a US$18million renovation of the hospital whilst increasing returns and patient and staff satisfaction indices.

Paul has a good knowledge of healthcare systems in different countries around the world and experience of managing at a senior level in international insurance businesses, primary care and secondary care. He has been directly involved with Bupa’s businesses in Singapore, Hong Kong, United States and Denmark as well as the UK.

Aged Care A U S T R A L I A | Spring 2009 |

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national update

ACAA Congress 2009 15 – 17 November • Melbourne Convention & Exhibition Centre Trade Exhibition

Domain Placements

NAB Health

The Trade Exhibition will commence with the Welcome Reception on Sunday 15th November and will be open to delegates on Monday 16 and Tuesday 17 November. The following exhibitors are just some of the suppliers who look forward to meeting delegates at the 28th Annual ACAA Congress.

EBOS Healthcare

National E-Health Transition Authority

Eclipse Computing (Australia) Pty Ltd

Nationwide Health & Aged Care Services

Electrolux Laundry Systems

Neller Pty Ltd

Epicor Sortware Pty Ltd

O’Brien Glass Industries Ltd

Fit2Work

Orion

HCL International Pty Ltd

Ozone Laundry Systems

Aged Care Association Australia

Health Industry Plan

Paul Hartmann

Aged Care Channel

Health Super

Protectabed

Aged Care Developments

Health Vision t/a MPS Australia

QPS Benchmarking

Aged Care Standards & Accreditation Agency Ltd

Healthsolve

Questek Australia Pty Ltd

HESTA Super Fund

Rhima Australia

Hynes Lawyers

Richard Jay

I. On My Care

Safety Link

iCare Solutions

SCA Hygiene Australasia- TENA

IMB Limited

Scangroup

INERVA PTY LTD

Smart Caller Pty Ltd

Insite

Smith & Tracey Architects

iSOFT

The College of Nursing

Kimberly-Clark

The Essence Consulting Group

Laundry Solutions

The Guild Group

Leecareplus

The Ideal Consultancy

Management Advantage

ThomsonAdsett

Materialised P/L

Unicharm Australasia

Continence Foundation of Australia

McNeils Surgical/ Aust. Medical Importers

Webstercare

Creek Solutions Pty Ltd

Medicare Australia

Deflecta Crete Seals

Medirest

Dentident P/L

Miele Australia

AIM Software AirLiquide Health Care AIS Healthcare Aqualogic Laundry Systems Assistive Technologies P/L Austco Communications Pty Ltd Australian Ageing Agenda AutumnCare Systems Bunzl Outsourcing Services/ Sanicare Campana Systems Catering Industries Pty Ltd Clifford Hallam Healthcare (CH2) Commonweatlh Bank

Westpac Banking Corporation Zenith Insurance Services

For more details on exhibiting and registration contact the Congress Organisers: ACCV Conferences & Events T. 03 - 9805 9400 events@accv.com.au http://accv.com.au/ACAACongress.aspx

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Spring 2009 | Aged Care A U S T R A L I A

cover story

The Africa Connection (out of Africa!)

This remarkable story is one of chance, of goodwill, of connection, of the power of story telling and is a classic example of how fast our world is shrinking. It’s told by Judy Martin, from architectural firm, ThomsonAdsett. Judy is also the organiser of the well respected SAGE Aged Care Study Tours, www.sagetours.com, and if you have never seen the human version of a ‘cat on a hot tin roof’ then here’s one now. It’s Judy. She is one excited lady and hearing her excitement over this story gets anyone who hears it inspired and ‘ready for action’.

After visiting the Drakensberg Mountains region we were travelling in a fairly rural and remote area and my husband noticed we were getting near the historic Zulu battlefields area.

Here is the email Judy sent:

We were in this isolated, remote country because ‘He’ wanted to drive to a place called ‘Rorke’s Drift’ where a major battle had occurred in the 1800s. The country reminds me of outback NT, dry, hot, dusty, mostly flat with mountain ranges in the distance. It’s very isolated. Now Rorke’s Drift is not just a little town you ‘drop into’. It is miles from anywhere and the actual drive to the town is on pot-holed gravel roads through very remote Zulu tribal lands. It is literally ‘in the middle of nothing and nowhere’, all the more amazing we found ourselves heading there.

“Our son is on a twelve month Rotary exchange in South Africa, so we are visiting him and having a holiday here en route meeting you all in London for the SAGE trip. This is what happened to me.

If you want to know more about why Captain Martin wanted to visit this remote locality, check the website www.britishbattles.com/zulu-war It tells a remarkable story of the Zulu Wars and

T

his ACAA journal recount comes from talking directly to Judy, and her story posted on the IAHSA Blog, plus an email Judy sent to her SAGE delegates while travelling in South Africa en-route to London to meet them all for the SAGE UK tour (with planned attendance at the IAHSA conference). IAHSA is the International Association Homes and Services for the Aged, of which ACAA is a member.

the Battle of Rorke’s Drift, where over 500 Zulu warriors died defending their home country. Eleven Victoria crosses were >

Aged Care A U S T R A L I A | Spring 2009 |

27

cover story

< awarded after the battle ended. Only 17 British soldiers were killed.

Now back to Judy’s story…

On arrival at Rorke’s Drift, where there were a few old run down and well used British outstation buildings, a few round Zulu huts and other buildings scattered amongst the gravel and paddocks, we realized we had reached our destination.

My daughter and I were walking along a gravel road across one of these paddocks toward our car when we passed two Zulu ladies walking in a field. They said “Hello, how are you?” in Zulu and we began talking. One lady asked where we were from, and we returned the question. She then said she was from a town far away and that she was walking to work. I said “It’s a very small town here, where do you work?” and she pointed to a little group of buildings up the hill a ways and said, “I work at the old persons home”. Can you believe that! An old persons home in the middle of nowhere!

population of the Earth is closer together now than it has ever been before.)

I then told her I also worked with old people’s homes and she asked if I would like to come and look at the home.

Honestly there was hardly a village for miles and here in the middle of nowhere (with not even a store in the town) was an aged home.

I told her I was going to an aged care conference in London next week! We swapped names, notes, laughing, hugging and organised that I would meet her ‘matron’ in London should we indeed be at the same place. I said I’d email… she told me they have no computer!

She showed us around! There were 2 small buildings that were home to 67 residents – mainly homeless people they have found living in the bush, one lady they found living under a tree, another in an old derelict shed.

EMSENi (the name of the old people’s home) are a not for profit (obviously) and survive on government grants, pensions and money they can raise – they are all poorly paid, have NO resources, and are in the middle of nowhere (literally). They have a new little brick building they have just built, and are very proud of.

We walked into the main room where there were a crowd of about 30 old persons gathered around a little wood heater. She told them our names and that we were from Australia. My new ’friend’ Jabu, then mentioned that they had saved and saved and along with help from their friend ‘Margie’ [Margaret van Zyl, CEO, Pietermaritzburg & District Council for the Care of the Aged], their matron was travelling next week for a trip of a lifetime to an ageing conference in London to talk about their home. I could not believe it!

Were we going to the same conference?

Could this be a classic case of the ‘Six Degrees of Separation?’

Note: (This hypothesis is as follows: any two individuals could be connected through at most five acquaintances, proving, according to some, that the

It made me think what an amazing place the world is and how it came to be we were at Rorke’s Drift to see battlefields and I stumbled across an Aged Persons Home? There had to be a reason why I was led there – I must try to do something for this poor little home in the middle of nowhere. Now let me think how... (I had 3 more hours of remote pot-holed gravel roads then a long flight from Johannesburg to London to think about it!)

And that is just what Judy and the SAGE contingent did. Marigold Mncube, EMSENI Matron, Judy, Margie and the SAGE group DID finally meet at the IAHSA conference.

During the conference the SAGE Delegation, driven by Judy and one of the delegates Lynn Bruce, CEO St Jospeh’s,

Sydney, decided to ‘adopt’ the Emseni Old Age Home and passed the hat raising almost GBP1000. (Note: they actually ran an illegal ‘chook raffle’ that had every Australian delegate who was ‘selling’ raffle tickets, trying to explain the nuances of an “Aussie chook raffle.’ It worked.

People didn’t ‘buy’ tickets, they donated their ticket money! The prize? A fluffy fake chook! They are now working out how to make this an ongoing link through both donations and in-kind support and ongoing SAGE tours will ask delegates when booking if they are willing to donate $50 of their booking to EMSENI. >

Aged Care A U S T R A L I A | Spring 2009 |

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cover story

< Marigold was booked to showcase a poster presentation on her Aged care home. SAGE delegates attended along with other conference attendees and they were blown away by Marigold’s humble commitment to care for the poor elderly in rural South Africa. She runs a home in an extremely remote area and provides “meals on foot’ to rural villages, meals at night for children orphaned by AIDS and a community health program with little to no funding but she provides all with an enormous passion to help.

Inspired by this turn of events IAHSA are now going to build on the opportunity presented through this wonderful story by establishing an International Global Community Program through which organisations across the International Ageing Network can link up to help those Aged Care Homes less fortunate. It helps that the new IAHSA Board Chairman is an Australian - Glenn Bunney from Sundale Homes QLD. If you are interested in being part of this special program, in any way, email IAHSA iahsa@aahsa.org.

Is Judy Martin any less excited now than she was then. Short answer? No. She is still pondering the how and why, telling all and sundry about this remarkable story. She told me she still gets goose bumps when she tells it thinking about how it all unravelled!

The thing that excites her most is the raison d’etre for SAGE is Studying and Advancing Global Eldercare, by a strange twist of fate a small day out in Africa has truly made this possible.

Where will it lead, who knows, but already it is leading to a better world for many who are hardly in a position to do much about their lot in life on their own and THAT is the power of storytelling… n

www.sagetours.com SAGE study tours are a joint initiative of ACAA, ACSA and ThomsonAdsett aimed at senior executives in the industry travelling to another country to look at Aged Care, seniors living and community practice, Government policy and industry in general.

2010/11 tours are in planning: • HK/China in July 2010 • NZ in September 2010 • East Coast USA Nov 2011 (in conjunction with next IAHSA conference) See advertisement on page 67 of this issue.

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ommercial quality health & aged care linen, bedding and towels are an asset to any healthcare establishment especially when they assist your facility to comply with accreditation standards.

Bed linen and towels are the items with which your patients and residents have the most direct contact. To ensure your patients and residents feel both comfort & quality, these items must meet the highest healthcare standards and perform tirelessly every time.

creasing) that has been mercerized (to increase yarn strength and fabric lustre), Sanforized (to reduce shrinkage to 1.5% as opposed to up to 6% for non-Sanforized fabric) and double singed (to prevent pilling). A coloured healthcare quality sheet should also be vat dyed so as to be bleach and chlorine resistant. Sheeting fabric manufactured and finished to these standards should meet AS 3789.6, the Australian Standard for healthcare fabric, which is the most rigorous Standard for sheeting in Australia.

commercial quality Healthcare linen, bedding and towels to suit every level of healthcare and aged care accommodation requirement. All products are designed for use in commercial applications and for commercial laundering. They are manufactured to relevant Australian Standards and are easy care, durable and stylish.

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So what makes a towel commercial quality? A Healthcare quality towel should be made from 100% cotton terry toweling with a medium length pile (to reduce pulling), overlocked seams (to reduce fraying) and either no headers or 100% cotton headers (to retain shape). A coloured healthcare quality towel should also be vat dyed so as to be bleach and chlorine resistant.

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To speak with someone regarding your linen, bedding and towel needs please contact your nearest office:

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1300 765 379

profile

Inductee into the Aged Care IT Hall of Fame:

Dr June Heinrich OAM, CEO of BCS NSW & ACT, Chairman of Baptist Care Australia

F

or a start, this kid’s a Westie!

What’s a Westie? It’s a really derogatory term for those who were unfortunate enough to be born in, or grow up in the Western Suburbs of Sydney. Westie’s were almost always regarded as unintelligent, undereducated, unmotivated, unrefined, lacking in fashion sense, really workingclass or almost always unemployed.

(That’s mostly a Wikipedia description, not mine!) This is the breeding ground for Aussie battlers, so we are all told, well battle they have to break free of the restraints that society applies to them.

If you think for a moment that Dr June Heinrich, OAM, CEO of one of this country’s biggest aged care providers has in any way been brought up as a ‘Silvertail,’ from a ritzy or even middle class suburb, complete with a silver spoon in her mouth, think again.

Wikipedia, the font of all wisdom I’m reliably informed, tell me that Westie’s wear flannies, Ugg boots, tight jeans, black t shirts, tight skimpy tops, are rough and tough, male or female. I know from painful experience and being educated in a flash school in a Western suburb, that Westie’s are not to be meddled with or given a bit of lip! Not unless you can run like the wind!

June Heinrich travelled daily by train from her home in those Western suburbs to Fort Street Girls High, in the heart of Sydney, only managing to make it to classes in levels ‘C’ and ‘D.’ Not what you’d call a high performer. It’s no wonder, because she, like all her ‘Westie’ friends were never expected to excel, never expected or encouraged to achieve.

In fact June still remembers when she decided to go back to school to do year 4, and have a go at what was called the Leaving Certificate, her father didn’t speak to her for 3 months.

ask June to pass me the salt.” He was still angry at me for not leaving school and taking up hairdressing. He was self taught and he was desperate for me to be a properly qualified hairdresser.’

The really sad thing is that despite June’s academic achievements, a degree, a Masters and a PhD, her father never once said “well done.”

Her sister went to Teachers College and her brother went to TAFE, not June, she, somewhere, somehow, deep inside decided that she wanted more, and she got there by sheer will power, dedication, self discipline and an old fashioned work ethic, that hasn’t left her to this day.

‘I got a holiday job at the end of year 3, once I passed my Intermediate I saved enough money to pay my own school fees, buy my own text books and on I went to senior High School.’ Stubborn? Resilient?

You be the judge.

An insight to this classic case of “she’s her father’s daughter,” comes from June herself. ‘My father was a very intelligent man, even though he’d had no formal training, but he was also stubborn, I suppose I am a bit of a mirror image of him!’

Now you may find this remarkable, but June says ‘my mother and father have never seen anything I’ve ever done as remarkable, even to this day. My mother

‘Girls don’t go to school, they go to work, get married, have kids and stay at home to raise the family, that’s what my Dad reckoned,’ said June.

‘I still remember Dad sitting at the table at night saying to my sister, “Isabel, ask June to pass me the sugar” or “Isabel,

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profile

Dr June Heinrich OAM, CEO of BCS NSW & ACT Chairman of Baptist Care Australia

used to say to me “What do you do all day? What are meetings, what do you do?” The pressure was on me to stop work and start a family, be a stay-athome mum, as my sister did, not me.

They just did not understand and that’s OK.’ In her first lecture at night classes at Sydney University, the lecturer got up and said “take a look at the person on your left, now look at the person on your right, only one of all three will be left by the end of the year.” June said ‘I made a mental note that was going to be me!’

She completed a BA (Hon) degree, found it quite easy, successfully applied to do an MBA at the University of NSW, one of the first women to do so.

‘I thought it was important to get business management skills.’ She’s been a Primary School Principal, Senior Lecturer at Macquarie Uni, then back to school as a principal again. By the way I forgot to mention that while in America studying for her doctorate, she married, and children followed. When June tells the story it’s almost like an afterthought.

Tragedy struck the family while she was lecturing in the Teacher Education Program at Macquarie University; they lost a daughter to cot death. But for June life must go on, so along came another daughter.

‘I decided I’d had enough of schools and wanted to go into adult education. I became the first principal of Macquarie Regional College with about 200 part time teachers on dozens of different campuses. It was fantastic.’

‘I remember when we got our first old computers, with switches, they were BBC computers. We moved into employment training for women re-entering the workforce. We also provided classes for young people with disabilities. It was all great fun.’ June was building a reputation for being at the forefront of change.

As if that’s not enough she then took on training prison officers, probation officers and gaol superintendants when she became the Foundation Principal of the NSW Corrective Services Academy. ‘I used to tell them that if they didn’t treat prisoners properly then they were partly to blame for those prisoners becoming even more dangerous when they reentered society. But the old time, so

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Spring 2009 | Aged Care A U S T R A L I A

“

June is also known as a great IT innovator, hence her induction into the aged care IT Hall of Fame this year.

‘I still remember my first fax machine, my first Apple computer. I loved it.

”

called tough prison officers used to call the decent officers, ‘Care Bears. Sometimes change comes slowly!’

If you hadn’t already guessed, this Westie loves a challenge. She soon became Assistant Commissioner, responsible for training and education, Human Resources and Prisoner Welfare. She left to join Ryde Council, always trying to live fairly close to her home that was in the Eastwood/ Carlingford area.

Finally 15 years ago she was approached to join BCS. So why has she stayed so long in this organisation, when her life’s experience suggests she likes to move on to new challenges reasonably regularly.

‘Running BCS is still a challenge; it’s constantly evolving and changing. I started with a budget of 28 million and 700 staff; it now has a budget of 200 million and 3,600 staff.

June is also known as a great IT innovator, hence her induction into the aged care IT Hall of Fame this year. ‘I still remember my first fax machine, my first Apple computer. I loved it. IT can make a huge difference to our capacity to provide effective service to older Australians. It also makes jobs more rewarding and less boring. It removes a lot of the hack work.

‘Our big challenge is managing community care effectively; we are going to have to embrace IT in a big way in order to cope.

We have a diminishing workforce and an ageing population, if we don’t get this right, the community is in trouble, not just BCS. That’s a bit scary!”

‘I think I’ll start to look for something else to do next year sometime, sixteen years is long enough this time, so I’m keeping my eyes peeled for a new challenge.’

So if anyone has a suggestion, contact June Heinrich at BCS in Sydney, because I don’t think the word ‘retirement’ exists in June’s dictionary. n

technology

Transforming Care through Communication Samarinda Lodge, a small aged-care facility shows how using smarter communication technology can improve resident care.

S

amarinda Lodge is a not-for-profit residential aged care facility in Australia with around 40 residents. With a ratio of only one care giver to every six residents, staff members need to be able to communicate effectively with each other, and locate residents quickly, to enable them to maximise time spent on resident care.

The facility had been using walkie-talkies, pagers and mobile phones to assist communication efforts, however a detailed on-site time and motion study revealed that these existing communication tools were not working effectively, resulting in a reliance on face-to-face communications. In fact, staff were spending up to 25% of their time walking up and down the corridors to locate and confer with other staff members on resident care. Privacy was also a concern, as the walkie-talkies could both pick up and transmit other conversations taking place on the same radio band. There was real concern that the private medical information of its residents might be overheard by external parties.

Samarinda Lodge recognised that technology could play an important role in addressing these challenges, but with no inhouse IT support, it needed a low-maintenance solution which could be easily used by non-technical staff.

Residents can also use the phones in their rooms to directly contact staff members.

The new solution has transformed how staff and residents communicate, and has directly improved patient care by allowing staff to be more efficient and responsive to patient needs. Introducing the Vocera communication badges meant staff no longer needed to carry around bulky walkie-talkies, pagers or mobile phones. In the first month alone, staff productivity went up by 10% (staff costs account for 75% of all costs).

Earlier this year the Centre for Health Innovation conducted an analysis of the tasks and activities undertaken by Samarinda Lodge staff using the Vocera system and concluded the following: •

Communications between staff was reduced from 16% of total minutes (147 minute in the trial) to 6% (or 56 minutes)

•

Walking between tasks was reduced from 10% of total minutes (or 89 minutes in the trial), to 4%, (or 43 minutes)

•

Time spent upon resident care increased from 51% of total minutes, (or 476 minutes), to 68%, (or 634 minutes)

The solution identified and implemented proved to be a positive investment, allowing staff to increase the time they devoted to residents by more than 30 percent. With an estimated return on investment (ROI) of just under $200,000, the payback period would be less than one year.

This study provides clear evidence that the implementation of Vocera has resulted in an increase in the amount of direct time devoted to the care of residents at Samarinda Lodge. Specifically the study has shown that the application of the Vocera systems can drive efficiency gains of 33.2 per cent.

Working with IBM who provided the consulting, design and implementation services for the project, Samarinda Lodge identified that communication badges from Vocera would meet the facility’s specific needs. The badges, weighing less than 60 grams, allow staff to communicate hands-free, using voice commands whilst on the move.

Given the success of the communication badges, Samarinda Lodge continued working with IBM to enhance patient care through the introduction of smart technology solutions. Most recently a ‘location services’ solution has been added to the system based on RFID technology, which includes Cisco’s location appliance and AeroScout hardware and software. This ground-breaking technology allows the facility to keep track of wandering residents, and satisfy their requirements under the Duty of Care Aged Persons Act. Taking

The solution consists of several components including a wireless computing infrastructure, communication badges from Vocera, a new Internet Protocol (IP) telephony solution from Cisco that replaced the organisation’s PABX telephone system, and the facility’s existing nurse dispatch system. The solution enables staff to easily and securely call any resident’s room, and any other staff member or the front desk from any location, as well as continuing any task at hand since the solution is hands free.

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< this approach gives residents more independence, allowing them to wander more freely around the home. At the same time staff are always aware of each patient’s location, and the safety of the facility is easier to manage.

In conclusion Tanya Gilchrist, CEO of Samarinda Lodge said, “IBM together with Cisco really took the time to understand our operation and that’s reflected in the way IBM provides all the maintenance and management services. We have lots of technology now but we still don’t have an IT department.”

Andrew J Barton, Solutions Manager Aged Care A/NZ, IBM Australia concluded, “The Vocera Communications solution provides both staff and residents with positive outcomes, resulting in improved staff morale and an improved resident experience. In short, in the fast growing hospital and aged care industries where staffing levels can be challenging, the Vocera Communications solution really helps to maximise patient and resident care.”

The return on investment for Samarinda Lodge as a 40 bed facility was apparent within a year of implementing the Vocera system. IBM’s experience with Vocera within Aged Care indicates that a typical site of 100-120 beds requires about 20 Vocera badges. Pricing for a system like this is approximately $16,000 (AUD) for the Vocera system software and about $9,500 for 20 badges and associate chargers and lanyards. To implement the system in an aged care setting using predefined templates would require about 5-7 days of professional services time that includes, design and consulting, implementation and of course training in the use of the product. As Vocera is a voice application, a Wireless LAN is required and the design and implementation of this would be a separate task, although we are quite often asked to perform both pieces of work in sync.

IBM Australia is able to lease all of the components and services for the whole Vocera solution. As a guide, leasing solutions over a 3 year period, paid monthly in advance, are available from $1,300 per month to approved finance clients.

IBM’s global financing division can provide advice on reducing up-front capital costs.

For further details about IBM’s Aged Care Solutions visit our Website http://www.ibm.com/services/au/agedcare or call us on 1800 557 343. n

technology

Aged Care IT Vendors/Suppliers Forum - 10 August 2009

By Caroline Lee Information technology vendors and suppliers to the aged care industry met again for their third forum meeting chaired by Peter Wilson, on 10th August to discuss the decisions and findings of two sub-committees nominated at the previous forum in May. The members of these sub committees represented various software, hardware and networking suppliers, led by software company CEO Caroline Lee. The groups looked at the structure of a future association and the Action items the group would address over the coming year.

I

t was agreed at this meeting that an AGM would be held in October for the group’s first formal Association meeting, lead by the Association’s inaugural committee members, with registration in New South Wales to be arranged by software company CEO Mark Audley. The Aged Care Industry IT Council were represented at this meeting by Rod Young and IT council chairman Suri Ramanathan, supporting the move by the group to formalise the entity they would be working with.

Also at this meeting, presentations were made by members who had been asked to represent the vendors at various Department of Health and Ageing and Medicare meetings.

Peter Staples had attended a Medicare Australia meeting on behalf of all members, outlining the issues the vendor industry faced regarding interface capabilities and support, which Medicare members positively embraced. Peter Maloney (iCare) attended an ACFI committee meeting with DoHA representing vendors and their issues / needs regarding IT systems and ACFI validation activities, highlighting the need for further education of all levels of government regarding the industry’s IT system capabilities. Both representatives reported back willingness of both areas of government’s support for ongoing dialogue and issue resolution.

IT Council Chairman Suri Ramanathan presented and discussed the national direction and initiatives highlighted in the final report of the NHHRC issued by DoHA in July. The vendor association will be integral in the activities of the council in providing leadership and direction to the recommendations issued in the report, which significantly consider the needs of

aged care and the key role aged care plays in the larger health sector environment. Suri’s and the IT council’s work over the past year promoting aged care were rewarded by the future initiatives listed in the national health reform’s report.

The meeting finished with a video presentation of the national ITAC conference held in Sydney in May and a discussion regarding ITAC 2010. The inaugural committee members who offered to form the required association initial structure were Caroline Lee (Leecareplus), Mark Audley (WeCare), Ross Copping (Nunatak Systems), David de Bhál (Virtual Practice), John Perkins (Ethan Group), Chris Gray (iCare), Bart Williams (Questek), Martin Wildsmith (Eclipse Computing). The AGM will be held on October 1st at the Holiday Inn, Melbourne (to be confirmed) at which forum participants will be asked to formally register their association membership and to form the first year’s committee members. n

technology

We Want 21st Century Healthcare Now Dr George Margelis Intel Australia Digital Health Group

I

t is fair to say that you cannot separate aged care from health care. It is a sad fact of our physiology that the older you get the more likely you are to be affected by some sort of disease, most likely a chronic one. This is a consequence of the good healthcare system we have in Australia. We do a great job in keeping people alive, as evidenced by our high life expectancy.

However what we struggle with is keeping them healthy as they get older.

Our current healthcare system is designed to intervene when you are sick and bring you back to health. That system worked fine in the 19th and 20th century, because many people died

young from the various diseases around at those times. It still works great if you are unfortunate enough to be struck down with some disease whilst young, or get hit by a bus.

Where it struggles is managing the millions of people, most of them over the age of 50 who have a chronic disease.

Diabetes, high blood pressure, arthritis, chronic bronchitis, emphysema, heart disease, and many more are now in the realms of chronic disease. Even some of the cancers, which just a decade or two ago were seen as death sentences have become manageable chronic diseases in many respects.

What we need are new models of care that allow us to supplement our current acute care with the ability to manage chronic conditions. It is estimated that chronic disease accounts for 70% of the cost of healthcare in Australia. It is not just the financial cost, but its effect on the individuals we must manage. Chronic disease makes individuals more susceptible to acute conditions. The long term effect of the chronic disease is to decrease one’s ability to respond to acute illness. That’s why during the recent swine flu outbreak, those at greatest risk were the individuals with underlying chronic disease. Better management of these conditions will also help alleviate the demands on our already overburdened acute care sector.

We cannot forget the social burden of chronic disease on those who suffer it, and their families. In the current model of care they need to manage their condition by regular visits to various health professionals. The constant travel, and waiting, and difficulties in coordinating their care takes its toll on the individuals, and the loved ones who try to help them through it.

Imagine if much of this could be done in the comfort of their home. If they no longer had to wait in a doctor’s surgery to check their blood pressure, but could do that at home and ensure that the care team had access to that information.

What if they had the tools to be able to make their own decisions about their health care? What if all this could be done mainly from home, but without losing the benefit of sharing information with their health care providers?

The Australian government has committed to providing high speed secure broadband connectivity to the homes of almost every Australian. Imagine if we could harness that with the right technology in our homes to enable our elderly to stay at home safely and comfortably.

That technology is available today, but we need to let our government and our healthcare providers know we want it.

It is time for us to stand up and tell our leaders that we want better care in our homes. That we recognise that the current system won’t work and that we need to apply 21st century thinking to the problem at hand. The problem is no longer a technology one; it is a failure of imagination in how to use the technology effectively. For that to happen all of us must let our voices be heard. We want 21st century healthcare now. n

Dubbo Aged Care facility implements Panasonic Toughbook H1 MCA

D

ubbo RSL Aged Care Association Ltd in NSW has purchased Panasonic Toughbook H1 Medical Clinical Assistant (MCA) devices, to improve administration processes, reduce paper-based documenting and allow staff to spend more time caring for their patients.

The Aged Care facility is a 187 bed hostel and high care unit across 2 sites, with 148 self care units and a total of 250 staff.

In March 2008, the facility embarked on a review aimed at improving administrative processes. The review found that nursing staff wasted valuable time on paperwork, documenting patient care and medical administration. They chose iCare’s Clinical Care and Medication

Management Solution to improve the level and quality of care of residents, by allowing nursing and care staff to have a single, electronic view of an aged care resident’s health care information.

After researching various hardware solutions including traditional notebooks and Mobile Clinical Assistants (MCAs), Panasonic’s new H1 MCA was the best fit. Its rugged and ergonomic design, as well as its extended battery life and ability to be sanitised with hospital-grade disinfectants, meant it was a perfect solution for the facilities. The H1’s compact, lightweight and slim design was a significant space-saver, and meant easy portability around the facility. The resource recommendation was one device

for every two nurses on duty, bringing the total to 28 H1 units for the facility.

Damian Moore, Dubbo RSL Aged Care Association Ltd said “The Panasonic Toughbook H1 ticked all the boxes when deciding on the solution. It enables staff to document a patient’s progress in real time and administer medication safely at the bedside. Previously, nursing staff would write patient notes at the end of their shift, so some points may have been forgotten or changed. Now information can be recorded as it is happening, improving speed and accuracy.”

Nurses will primarily use the H1 to document a patient’s progress in real time, as well as the safe administration of medication using iCare’s Medication Management System. After verifying the patient’s identity via barcode reader or image on the device, the correct dosage and medication is dispensed. With the touch-screen LCD, staff can sign to confirm that the process is complete. n

ADVERTORIAL

Return On Investment (ROI) Strategies for a New Payroll HRIS

A

re you convinced that your organisation will benefit from a new HR and payroll system but are having difficulty getting budget, senior management buy-in or support?

Below are some suggestions for getting your proposal across the line: Identify Your Pain: What is your greatest headache with your current system? Is it the manual paperwork? Do you spend hours answering staff queries? Can you get the information you need to report to your management? Clearly identify the problems and name them from the outset.

Muster the troops: Who else in your organisation will benefit from a new payroll HR solution? This will most likely include your executive management team, your financial reporting team - even your OH&S team. Find out what they would like to be able to do to make their jobs easier, save the organisation money and make it more efficient.

Involve these stakeholders and include the decision makers from the start.

Understand the tangible from the intangible: ROI will outline the tangible (easily measured in $$$) and estimate the intangible (difficult to quantify) benefits. Studies show that decision makers such as boards etc will not approve recommendations that do not have a compelling ROI or focus only on the intangible. By ensuring you have covered as many tangible benefits as possible means that you will be able to present your case in a more meaningful way.

Gather the facts: How much money and how much time are you currently spending on the upkeep of your current system? How much time do you currently spend on common tasks?

For example: Activity (per transaction)

Manual Process Costs (time/$)

Saving with new solution

Leave

20 mins

80%

Payslip (distribute)

$0.65

100% (via email)

Payslip (enquiry)

10 mins

70%

Say for example you have 500 employees across multiple facilities.

Leave â&#x20AC;&#x201C; assuming you have 8 absences per person, there are 40,000 applications per year for a cost saving of $37,500 per year.

Payslips - Assuming weekly pay runs, electronic payslips save $16,900 per annum. If 5% of staff make an inquiry each pay, the saving is another $5,320.

Get the right information and you can make a very compelling case.

Talk Holistically: After youâ&#x20AC;&#x2122;ve gathered all your information, make sure you highlight all the benefits (both tangible and intangible) that the entire business will experience from your new proposed system.

Think about the impact across all areas of the business. Who will benefit from a more efficient payroll system or better ways to find out leave balances and payslip information? Will workforce planning assist your company towards a better future?

Ask An Expert: Talk to different vendors of various solutions. Each will have case studies. Find out how other similar organisations have achieved process improvements and cost savings through implementing their new solution. n

By Rob Hill, National Business Development Manager, Neller Pty Ltd

technology

Gartner Industry Research Strategic Planning Assumption: In 2009, CDOs (Care Delivery Organisations) will begin to pilot open-source and commercial alternatives to Microsoft Office for users with limited office productivity requirements.

Analysis By: Barry Runyon, Gartner Research

administration, IT, researchers and so on) and provision the most appropriate and cost-effective software.

CDOs should create user profiles, such as “lite,” “knowledge worker” and so on, and use them to negotiate lower license fees and serve as the basis for introducing Microsoft Office alternatives Document compatibility, macro support and interoperability issues must be carefully considered when deploying Microsoft Office alternatives, because they interact with the rest of the CDO. Do not let overly complex Microsoft licensing, maintenance and support agreements result in paralysis and inertia. n

Key Findings: A tough economy will provide the tipping point for CDOs to begin to reduce their dependency on Microsoft Office for users that do not have heavy office productivity requirements and do not regularly use desktop database, spreadsheet and presentation software. CDOs have a complement of power users and knowledge workers primarily found in IT, finance, reporting and informatics areas. These users require a complete and robust office productivity suite and are heavy users of macros, scripts and advanced features. A much larger group of CDO users fall within the 80/20 rule — 80% of them use 20% or less of the overall functionality that the office productivity suite has to offer.

These low-end or “lite” users could be served, under the right circumstances, by a Microsoft Office commercial or open-source alternative, or possibly a Web 2.0 office productivity suite. CDOs will begin to look more closely at these requirements and begin to provision the most appropriate and cost-effective products.

Market Implications: CDOs routinely overprovision Microsoft Office and, therefore, pay more than they should. A challenging economic environment will generate interest in open-source and cloud-based office alternatives. There is evidence that Web-based, hosted office applications are beginning to gain favour. Currently, these products are not used to replace Microsoft Office but rather are deployed as collaborative adjuncts.

Open-source office products are now well established in the Trough of Disillusionment and are projected to climb up the Slope of Enlightenment to the Plateau of Productivity (20% adoption) of Gartner’s Hype Cycle during the next two to five years (see “Hype Cycle for Open-Source Software, 2008”).

CDOs should use this time to investigate office alternatives and segregate a class of homogeneous or low-end users for a potential pilot of an open-source, commercial or cloud-based office productivity application. The pilot should be used to determine specific document compatibility, product fidelity and support requirements for this group of enterprise users.

Recommendations: CDOs should identify the office productivity requirements of their various user constituencies (clinicians, departmental workers,

Reprinted with Permission Publication Date: 27 January 2009/ID Number: G00164625 © 2009 Gartner, Inc. and/or its Affiliates. All Rights Reserved

technology

Profile of a Successful Software Implementation The Padman Healthcare and the HealthSolve Story.

Mike Swinson explores the story behind the recent implementation of HealthSolve software into the Padman Healthcare facilities in South Australia and Queensland.

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he players in this story are Viv and Florence Padman, the founders, owners and driving forces behind Padman Healthcare, Prue Mounsey, the Operations Manager for Padman’s, Nick Cuthbertson and Carolyn Lloyd from HealthSolve.

Before we begin to unravel this IT transformation story, let me paint you a picture of Padman Healthcare. It began in 1984, and has been growing ever since. The operation now boasts 11 facilities, 740 beds and rising. It is in the midst of a $50 million upgrade involving five re-builds/new constructions. It’s a massive vote of confidence in the sector and its future.

The company is the largest private operator of Commonwealth and Funded Aged Care Facilities in South Australia and operate at the upper end of the market.

As Viv Padman says, ‘We strive for excellence in standards of care and have the distinction of achieving ‘100% compliance’ at all our facilities in the Aged Care Accreditation process’.

The business currently employs over 800 staff. Part of that claim to excellence is now in being a market leader in software implementation.

The company’s website is well worth a visit, as it describes the operation in the following terms: ‘All our facilities are fully accredited and promote continuous improvement in quality services. Our sites are results of the work of leading architects with input from our residents, staff, future consumers and our years of experience. Our facilities offer the highest level of comfort, service and care.’

Now to the story about the transformation of the clinical care and financial management of the business from a paper based system to the HealthSolve IT web-based system.

Prior to the purchase of the HealthSolve software, Padman’s like many other operators in aged care was a paper based system.

It was a labour intensive process and no-one really knew if the business was receiving all the income it was entitled to. No business is sustainable under a system like that, especially now

Raj Padman, Caroline Lloyd and Tim Wilson

the new ACFI operation is underway with it myriad of funding classifications.

Viv Padman says his people researched a number of software options and finally settled on an Adelaide based company’s product, HealthSolve.

According the Nick Cuthbertson from HealthSolve, ‘We approached Padman’s as they are the biggest private provider in SA. We had an understanding that they had strong business focus.

We saw them as an ideal company for our product.

‘It transpired they were looking for software at the time and had been looking at iCare, AutumnCare and others,’ said Nick.

‘They put us through the wringer I can tell you!’

Viv Padman said, ‘We realised we had to install a clinical notes IT system to ensure ACFI accreditation and to ensure we maximised our income. They offered to tailor a program around our needs and that was critical for us’.

This echoed by Nick Cuthbertson from HealthSolve.

‘Even though Padman’s were paper based, they had a very well run work process, good documentation. Their people were familiar with it, and had clearly put a lot of work and thought into their overall management systems. I could see this was a really well run tight ship, even though it was paper based.’ >

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Viv Padman said, ‘One of the strengths of this process was that we were having weekly meetings with the HealthSolve people and our senior people. So every week, step by step we would plan the implementation. We would accelerate or pull back at each site depending on how the technology was being accepted and used. I think this fact made a huge difference to a successful outcome.’

That claim is backed by Nick Cuthbertson who says the meetings are now down to one every month.

It’s one of the reasons why we chose HealthSolve’ says Viv Padman. ‘Their willingness to work regularly with us, gave us the confidence that the implementation would progress effectively.’

L to R top – Nick Cuthbertson MD HealthSolve, Caroline Lloyd Manager Clinical Services HealthSolve, Viv Padman MD Padman Healthcare L to R bottom – Kylie Ramsey, Quality Control Manager, Pru Mounsey Operations Manager, Florence Padman DON Padman Healthcare

“

This new software system will mean staff in Head Office will be across what is being claimed at each site, we will be able to compare sites, to compare claims, to compare care, all of this and more is available at the click of the mouse.

”

Prue Mounsey was keen to make sure I understood that ‘One of the add ons that we know we are going to be able to get out of this is the ability of each site manager to drill down in this data base, to create reports on all sorts of things we simply couldn’t do before and for Corporate Managers to audit each site and compare one to another. At the moment any attempt to benchmark or audit is very labour intensive, once this system is fully operational we will be able to keep very close tabs on almost every aspect of the business, less time, less labour!’ She says ‘it’s a wonderful benefit that awaits us.’

Why don’t you check it out!

Prue Mouncey has listed some of the benefits of the HealthSolve software installation: •

Optimize work flow through an efficient set of clinical notes

•

Improved clinical and business decision making

< So Nick said his people realised very early on that ‘It was important for Padman’s that we could incorporate all their critical forms and templates into our software system, which is what we did.’

•

Flexible tools which can be adapted by Padman’s

•

Simple to learn and use – care staff pick it up easily

•

24/7 maintenance and support

Nick said ‘We used their care plan, we put well over 100 documents and forms that Padman’s had in their paper based system and mirrored them in our system. Their staff found the new IT system so easy to use.’

•

Monthly training sessions for various levels of users

•

ACFI scoring and funding summary

•

Clinical report summaries

•

Corporate monitoring capability through high levels of access to key corporate users

•

Measures resident outcomes and various clinical indicators through variance reporting & benchmarking

•

Supports accreditation standards

•

Predicted text/templates to save time

•

Links to policies and procedures to improve staff compliance and knowledge

Prue Mounsey the Operations Manager from Padman’s said, ‘This new software system will mean staff in Head Office will be across what is being claimed at each site, we will be able to compare sites, to compare claims, to compare care, all of this and more is available at the click of the mouse.’

Padman’s say that the new software gives them a bird’s eye view of the business, it enables them to identify problems early on, identify training needs and changes to care practices.

Florence Padman was surprised when she checked the levels of computer literacy in their staff. ‘It was much higher than we thought, so the installation of the HealthSolve software has been easier that we thought it would be. Part of that is because it incorporates all our existing documents and forms.’

Under the new system, care notes are written up at PC workstations, however Padman’s are about to trial a laptop, attached to a care trolley to test how well that combination works.

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Footnote: The installation has gone so well that Padman’s and HealthSolve are about to launch this product into the market so that other facilities can have access to what they have jointly created. The prices, according to Nick Cuthbertson will be very competitive and attractive, particularly to smaller facilities. n * This article first appeared in IT:informer, April 2009 and has been reprinted with permission.

workforce

Employee Turnover – What is the Real Cost?

If you speak to any Aged Care provider about employee turnover, you will hear similar stories stating annual figures of 20% to 30% being considered to be “average”.

Worse than average...they are almost considered to be “acceptable”. Within our industry, the high rate of turnover among frontline employees in Aged Care is a serious workforce problem.

S

o... what IS the cost of such turnover... and what impact does it have on the bottom line of running an Aged Care facility?

It has been estimated that the cost of replacing a frontline employee is as much as 25% of their annual salary[1]. As an average, this equates to something in the vicinity of $7,500. Allowing for 20% turnover, a facility of 80 employees would equate to an annual cost of $120,000. That is a substantial amount of money out of the bottom line profit for any Organisation and has a direct effect on the level of care that can be afforded. In some cases, it can even affect the viability of the Organisation.

Each time an employee leaves an Organisation, a great deal of both financial and human resources are wasted on advertising, interviewing, recruitment and training. In the interim, there is the additional financial burden of overtime for existing employees, or the cost of Agency staff. In addition, what price can be put on the disruption to the most important people of all...our residents?

One way is to invest in effective retention strategies. Far from being an inevitable cost of doing business, providers can measure and track turnover costs, make informed managerial decisions regarding how much they can afford to invest in keeping or retaining employees, and assess whether or not such investments are improving their bottom line. In short, the financial drain created by turnover can be diverted into programs and policies that encourage retention[2].

An Industry Backed Initiative: The ACAA recognises the need for such programs and has implemented and developed the MyBenefits Employee Benefits Program (EBP) as an effective HR strategy to assist in the attraction, retention and reward of employees within the Aged Care industry. Whether your Organisation has 15 or 5,000 employees, the EBP can assist in attracting, and ultimately retaining, quality employees.

For full details, please contact me personally.

What can an Organisation do to lessen this impact?

Brad King

The first step to addressing a problem is the realisation it exists, then calculating to what level it affects the Organisation in a financial sense, and finally implementing strategies to assist overcoming the problem. One of the key factors in reducing employee turnover is the provision of a happy working environment.

Let’s face it, remuneration only goes so far in rewarding an employee. If the Organisation ethic and work environment is the cause of an employee not enjoying their job, an increase in salary or benefits will only go so far. Assuming an Organisation has no problem in this regard, and that there isn’t a bottomless pit of funds to throw at the problem of turnover, what else can be done?

MyBenefits

National Benefits Manager 0413 839 999 Brad.king@my-benefits.com.au

[1] Johnson, Larry - 2005 - REDUCING EMPLOYEE TURN-OVER: WHAT EVERY MANAGER AND SUPERVISOR SHOULD KNOW [2] Seavey, Dorie - 2004 - THE COST OF FRONTLINE TURNOVER IN LONG-TERM CARE

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The Hiring Interview: Seven Secrets for Success

By Dr. Ken Byrne

Assume that you are looking for a romantic partner.

A friend introduces you to someone and you meet for lunch. After an hour or so you both agree that you seem to get on and have much in common. The other person then says “Why don’t we move in together and get married?”

S

ounds bizarre, but isn’t this precisely what we do in hiring a new staff member? We invite them to come and live with us for most of the week. We agree to accept them, “warts and all” (even though we have no idea what those warts may be). We agree to pay the rent, insurance, overheads and so on. And this “marriage” can be very hard to undo.

This article outlines seven steps that are designed to help you avoid hiring the wrong person.

1. Hiring is Risk Assessment Choosing the wrong person can lead to tremendous problems for the entire organisation. This means that the hiring process needs to be properly resourced.

Training should be provided to those who are charged with making hiring decisions.

They should have all of the available tools necessary to do the job properly.

2. Allow Sufficient Time As the example above highlights, we don’t rush into important relationships in our private life. Similarly, when asking a professional to do something for us (preparing a will or designing a home) we don’t insist that it must be done in an unreasonably short time.

In hiring, this means taking your time to get it right. It also means avoiding the common trap of “anyone is better than no one”. If that really were true, hiring would be easy.

3. Hire People For Who They Are, Then Teach Skills People become problem performers because of who they are, not because they don’t know enough. You can teach job skills to the right person. Employers can’t teach kindness, sensitivity to others, honesty or a good work ethic.

Many hiring mistakes happen because the selection decision places too much

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weight on past experience, credentials and apparent skills. While these may suggest that the person can do the job, they tell us nothing about whether the person will do the job, and at what standard.

To manage risk, you need to know who this person really is behind the “mask” present in every job interview.

4. Always Use a Structured Interview This means having a carefully crafted list of questions that are asked in the appropriate order and used with every candidate for a particular role. Some rely on an “off-the-cuff” interview, which consists of a chat and some questions that pop into the mind of the interviewer. This is an extremely high risk approach.

A structured set of questions means that you have a better chance of covering all the major areas that you want to know about.

5. Make Every Question Count Most interviews are limited to an hour or less. This isn’t much time to pick a roommate (and make no mistake, this is exactly what you are doing). It is essential that every second is used constructively.

If chosen carefully, even the most innocuous “warm up” questions will provide useful information. For example, asking an applicant to describe a time when they felt “a significant sense of satisfaction” will reveal a great deal about their values. The applicant who describes winning a highly competitive competition probably has different values than the person who describes resolving a conflict between two friends.

6. Listen to the Answers - Very Carefully Listening well is a rare skill and is essential for the successful interview.

Applicants often will reveal themselves with throwaway lines, casual comments and the manner in which they answer questions.

Perhaps the most common error is asking a question, and then hearing an answer which doesn’t really respond to the question. Many interviewers won’t notice this, because the answer that is given is persuasive. The fact that it avoids the question is overlooked.

Information should always be obtained from two references. These must be from people to whom the applicant reported in a prior job. For young applicants, a teacher is acceptable. (I have seen applicants give referees who were friends, coworkers and in one case their mother!) Insist on two past bosses.

“

If chosen carefully, even the most innocuous “warm up” questions will provide useful information.

”

Reference checking is also an art. Doing it well takes time. It requires putting the referee at their ease, assuring them that what they tell you will be kept confidential, and asking the right questions. For example, “Would you hire this person again without any reservation?” is useful.

A positive answer preceded by a long pause is different from an immediate, enthusiastic “I certainly would!”

of your organisation, this can be a lot of hiring mistakes.

7. Always, Always Check References

A Final Note

Occasionally a candidate will be so outstanding that the interview panel decides that reference checking isn’t necessary. This is another high risk move.

The interview is a limited tool for making hiring decisions. At best, you will be right three times out of four. Often the “hit rate” is much lower. Depending on the size

Dr Ken Byrne is an expert in evaluating job applicants, especially for the aged care and public safety sectors.

Listening well takes self discipline. The interviewer should be listening about 80% of the time. Your job is to learn about the candidate. As closely as I can tell, we never learn anything when we’re speaking.

Special tools have been developed specifically to reduce the hiring risk in Aged Care. These are supported by extensive Australian research. Consider adding these to your risk management process when hiring new staff. n

He is the Director of Safeselect. email: profile@safeselect.net.au www.safeselect.net.au

workforce

National registration for nurses, an opportunity or another burden to bear?

National registration for all registered, enrolled, division 1 and division 2 nurses comes into place in July 2010. This is the result of an Intergovernmental Agreement that took place at the COAG meeting, March 26th 2008.(3) National registration will require nurses to provide evidence of competence including a minimum of 20 hours of continuing professional development (CPD) per annum to retain their license to practice.(1)

T

he majority of nurses have only ever had to pay an annual fee to stay registered. Will the new requirements that include developing a professional portfolio, annual self assessment, professional review and CPD evidence, be the last straw for the overworked ageing aged care nurse?

This is the first of four articles that will outline the requirements for national registration, explore strategies to mitigate the risk and the opportunities it brings for the aged care industry.

National registration will apply to ten health professions including dentists, physiotherapists, medical practioners and nurses. The intention is that national registration will protect public safety, result in a more flexible

national health workforce and ensure that a professional banned from practicing in one place will not be able to practice elsewhere in the country.(3) The Australian Nurse and Midwifery Council (ANMC) has developed a set of national competency standards that nurses will use to assess their continuing competency to practice and identify areas for improvement to meet their registration requirements. The standards include professional, legal and legislative responsibilities; self appraisal of knowledge, skills and attitudes and professional development; care assessment, planning, implementation and evaluation; and developing and maintaining professional relationships as part of the interdisciplinary health team.(2) More competent nurses yes, better care outcomes yes, but what about the risks and is aged care at greatest risk?

Nurses may be even more reluctant (than they currently are) to re-enter the workforce and or move to the aged care sector if they lack the confidence to meet the new registration requirements.(4) Nurses in the aged care sector are older, more likely to work part-time and already report high levels of workplace stress and feel unsupported.(3) The additional requirements for national registration may be the deciding factor to de-register and stop nursing if support with the transition at an organisational level is not provided.

The response so far from the aged care industry to national registration is varied and includes a total lack of awareness about the changes, taking the attitude that it is the nurse’s responsibility to manage, to being proactive and putting plans in place now to support nurses through the transition.

Approximately 35,000 registered and enrolled nurses work in aged care. The

average age of retirement for nurses is 55.

The average age of an aged care nurse is 47.(4, 5) How many will leave prematurely if as one provider has stated “We might do something after it’s introduced!”

How many are more likely to stay if their organisation (as some already have) has a transition plan that provides support to meet the requirements including equity of access to CPD. n References 1. ANMC Continuing competence framework http://www.anmc.org.au/docs/Research%20 and%20Policy/Continuing%20Competencies/ Continuing%20Competence%20 Framework%20-%20Jan%202009%20 Final%20Doc%20for%20web.pdf 2. ANMC national competency standards for the registered nurse http://www.anmc.org.au/docs/Competency_ standards_RN.pdf 3. National Health Workforce Taskforce http://www.nhwt.gov.au/natreg.asp 4. Innovation and Reform – Caring for Older People http://www.nhwt.gov.au/documents/ Innovation%20and%20Reform/Caring%20 for%20older%20people%20discussion%20 paper%2012-2008.pdf 5. Australian Nursing Federation –Australia’s Demographic Challenges http://demographics.treasury.gov.au/ content/_download/subs/Australian_Nursing_ Federation2.pdf The next article will cover the CPD requirements for national registration and explore an e-learning model of CPD delivery.

Deb Shearman Director/Content Manager Moving ON Training Pty Ltd deb@movingontraining.com.au Ph: 02 9999 1993.

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Airline seats and aged care beds accommodation related costs of $65 per Not that long Not-for-loss sector bed. Based on an 8% return and their ago, the airline While income is controlled by the occupancy levels this operator needs to Commonwealth, if we drill down there is achieve accommodation revenue per day industry some flexibility that you can use to achieve of $110.10. This compares to the regulated a better outcome. range of accommodation revenue between focused on seat $33.41 and $119.25 Recently I was speaking with the director occupancy and of a not-for-profit facility and he told me that they wanted to be at the average of sold all seats in a class for the Boost your Bed Accommodation the benchmarks. I think the facility used Revenue same price. Until Virgin Blue benchmarking as a means to validate that they were okay relative to others. However, To achieve these higher levels of Bed took the view that different Accommodation Revenue (BAR) daily, the this will not ensure that they are in the operator may need to employ the airline not-for-loss sector. For this we need to people valued airline seats model and seek out residents who place drill down further. differently. The emergency a higher value on their beds. Like the Facility revenue consists of accommodation airlines who have business, economy, traveller would pay a premium charges & subsidies and ACFI Care related premium economy and first class seats, it payments. While there is a correlation might be time for this facility to consider as would a convenience between the ACFI subsidy and the cost low care and extra service as alternative traveller whereas a flexible of delivering care, the cost of providing means to boost their average BAR. accommodation tends to be fixed traveller would set a different irrespective of the revenue derived (just While income is controlled for the aged like the airline, the cost changes very little care industry, this does not mean that it is value. More recently they have whether the seat is empty regardless fixed. By better understanding the costs even created new classes what price it is sold). To respond to of providing accommodation and the age changing dynamics, operators may benefit of accommodation charges, operators are (premium economy) to further by splitting daily revenue into its two able to impact their overall performance. components of accommodation and care.

In light of the current challenges faced differentiate the value of seats.

A

irlines now use this new flexibility to structure their pricing to achieve a desired occupancy rate and more importantly to achieve targeted revenue passenger kilometres. This allows them to reach a benchmark average income per revenue passenger kilometre.

Aged Care facilities are similar to aeroplanes. You canâ&#x20AC;&#x2122;t change the basic structure however, you can reconfigure the beds and look at opportunities to differentiate the value to different residents in order to maximise the yield you can achieve from your beds (BAR - Bed Accommodation Revenue). This applies equally for the not-for-profit and the forprofit sectors as both are in the not-forloss sector.

Industry estimates suggest that a new bed costs approximately $200,000. Assuming that this requires a return of 8%, this translates to $16,000 per annum and at an occupancy rate of 93% is $47.14 per day net of direct costs.

The costs associated with the accommodation include: cleaning, electricity and services, meals, insurance, rates, repairs, salaries for catering and maintenance employees & related on costs and activity costs. With this data it is possible to determine what is the average daily accommodation revenue required to ensure viability. Under this approach the facility, like the airline, can target and monitor accommodation revenue per day to fit its cost profile. The external comparison that truly matters when you do this is the cost of the bed as this ultimately determines how much income you need to earn to be sustainable.

by the industry, perhaps it is time for some new internal benchmarks that take account of your particular situation. Like the airline, there maybe an opportunity for cross-subsidisation. n

Bruce Bailey, Managing Director, Guild Accountants For more information on benchmarks and how they can help the overall performance of your facility contact Guild Accountants with any queries at agedcare@guildgroup.com.au or call 1800 101 296

As an example of what this analysis can show, one of our clients has aggregate

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Free Online Dementia Training e3Learning are offering a free course in dementia training to all organisations throughout Australia via ACAA’s online learning portal. To find out more go to: http://acaa.e3learning.com.au

I

n response to an ageing population and the unique needs of people with dementia, e3Learning have developed a suite of five online courses to help care workers better understand dementia and provide better care. The training is targeted at organisations with care workers who need to develop a unique set of skills in order to professionally care for dementia sufferers.

Providing this training on an organisation wide basis will ensure ‘best practice’ in dementia care.

The program consists of the following modules: An Introduction; Person Centred Care; Communication Skills; Activities and Occupation; Understanding Difficult or Challenging Behaviour.

are of the highest level of engagement with the use of “best practice” educational methodology such as scenarios, case studies simulations and problem based learning”. e3Learning, via the ACAA online training portal, are offering free the first module of the 5 module program. The course has an assessment at the end, and all trainees who pass will receive a certificate. The free course will come with a hosted Learning Management System, which will give organisations full tracking and reporting capabilities. The free Dementia course will also be delivered with a free course on how to implement this Learning Management System, which is very simple.

Where organisations have more than 100 staff doing the training, they may wish to contact e3Learning if they want implementation assistance which is a simple $250 charge to upload all the staff data and automatically advise all staff by email of their access details.

Providing the courses online provides a high degree of flexibility for users. The course can be accessed via the internet and therefore can be completed anywhere and at any time. This delivery methodology can save an organisation significant cost savings in terms of direct cost savings and lost productivity savings.

This initiative will enable organisations to verify the cost and educational benefits of online methodology first hand. e3Learning is able to provide a suite of 60 online courses that are highly relevant to any health care provider - like Patient Handling, Self Medication, Infection Control, Incontinence, Wound Management, Fire Awareness.

Adam Dunkley, Marketing Director of e3Learning said “the inherent “self pace” and “self directed” features of online methodology can provide learners a better educational outcome in terms of acquisition and retention of knowledge. All courses

For more information contact Adam Dunkley on 08 8221 6422 Email: adam.dunkley@e3learning.com.au Website: acca.e3learning.com.au

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Reverse Auction Platform saving you money on energy costs… now and in the future!

EnergyAction P/L is an Energy Auction House that trades contracts “on-line” through a reverse auction platform. We invite all energy retailers (AGL, Origin, TRUenergy, Country Energy, etc) to bid against each other over a 10 minute transparent window, viewed by the client, to win the lowest price for your current or future electricity contracts.

W

e take clients to auction up to 24 months prior to their contract expiration. i.e. future contracts fixed at today’s lower rates.

Instead of you spending time hunting for the best deal for your energy requirements, we bring the market to you in an efficient and transparent Live On-Line Reverse Auction that drives prices down. You can be confident that energy retailers compete for your business on a level playing field. There are no hidden charges and all processes are accountable and this process is at NO CHARGE. We are paid our 1.5% fee from the winning retailer.

In addition, EnergyAction will be with you at all stages providing energy management advice and help over the course of the agreement. We help you manage energy usage, billing inquiries, power factor, greenhouse emissions and more.

Following are some comments from Churches of Christ Community Care: “In September 2008 we were in the market to procure a new Energy contract for the Havilah Hostel group and were aware that EnergyAction had offered their services to Aged Care Facilities.

I consequently contacted Peter Naylor from EnergyAction in Melbourne and he advised me that they have been very successful in obtaining the best possible energy rate and consolidating various contract arrangements using the reverse auction platform for other Aged Care facilities, along with a myriad of other local businesses.

The auction platform not only revealed the best retailer for Havilah Hostel needs, but also attained an even better result by squeezing the last few percentages points out of the price offerings, revealing a clear winner.

The process was transparent and viewed “on-line” at a scheduled time and date. The follow-up reports with the auction results were also easy to understand.

We envisage saving over $38,000 over 4 years with the results from the reverse auction platform.

We were also pleased that EnergyAction offered an Energy Monitoring Program which allows them to check our bills

regularly for any anomalies or overcharging and organise an onsite visit by their Engineers to provide some insight into our sites’ energy consumption trends and identify areas where the sites may be able to reduce its energy consumption. A comprehensive written report from the Engineers is provided.

Overall, EnergyAction controlled the whole process. Whilst our involvement was minimised, the auction platform meant we were kept informed throughout the whole process and received immediate feedback. The best part was that it cost us nothing.

EnergyAction charged the winning supplier a small percentage of the contract price and we got a great result.” n For more details on EnergyAction contact: Peter Naylor Ph 03-9832 0855 Fax 03-8677 9633 peternaylor@energyaction.com.au www.energyaction.com.au

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End of life decisions for persons with impaired capacity

By Julie McStay Partner, Hynes Lawyers

At the end of a person’s life difficult ethical, legal and medical decisions must be made. Often a person may have lost capacity and some other person needs to make those decisions on their behalf.

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esidential aged care providers should have a solid understanding of the laws relevant to end of life decisions applicable to the jurisdiction in which they operate. They should ensure that their internal systems (which include policies, procedures and training programs) are compliant with these laws and that staff understand who is authorised to make end of life decisions for persons with impaired decision making capacity and how those decisions can be made.

Broadly the law distinguishes between positive acts taken to bring about a person’s death and passively allowing a death to take place. It will always be unlawful to take a positive act to cause a person’s death. But liability can also arise for withdrawing or withholding life sustaining treatment if the decision to do so is inconsistent with what a reasonable practitioner would have done to save or prolong the life in the same circumstances. It will also always be unlawful to withhold or withdraw treatment if the intention in doing so is to bring about death.

There are however circumstances in which it will be lawful to withdraw or withhold medical treatment where the result of doing so will most certainly be death. Decisions to withdraw or withhold life sustaining treatment can also (in some circumstances) be lawful even when that decision is made for a person who lacks capacity to make the decision themselves.

Decisions to withdraw or withhold life sustaining treatment Adults with capacity An adult with capacity can make a decision to withdraw or withhold medical treatment even if the result of that decision will be that the adult will probably die. While the adult’s capacity

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should be correspondingly high where the effect of a decision to refuse treatment will be the adult’s death; a doctor (and potentially a person acting on the directions of a doctor) who provides or refuses to provide treatment contrary to the wishes of an adult with capacity, commits an assault.

Adults who lack capacity When an adult lacks capacity, a decision about withdrawing and withholding life sustaining treatment is more complicated. Generally the right to make a decision about withdrawing or withholding life sustaining treatment for an adult with impaired capacity is more limited than the right of a competent adult to make such a decision.

There are broadly two ways in which decisions might be made about withdrawing or withholding life sustaining treatment from a person with impaired capacity. The first is where the person has given a direction while they have capacity about how they want their treatment managed in the event they lose capacity. The second is where an authorised substitute decision maker makes that decision on behalf of the person who has lost capacity.

While each state and territory has legislated on the right of substitute decision makers to make health care decisions on behalf of persons with impaired capacity1 not every state has legislated to specifically provide the parameters within which decisions about life sustaining treatment can be made for persons with impaired capacity.

Advance directions Legislation in the ACT, Victoria, NT, SA, NSW and Queensland all provide varying mechanisms by which persons can give directions while they have capacity about the treatment they will or will not receive in the future in the event they lose capacity.

In Queensland the relevant legislation allows a person to execute an advance health directive in relation to withdrawing or withholding life sustaining treatment which will, subject to compliance with certain conditions, give a practitioner lawful authority to withdraw or withhold that treatment.

In Victoria a patient who has capacity can sign a refusal of treatment certificate stating they do not want specified medical care (which can include feeding via a PEG tube) but they can not give such a direction to refuse “palliative care”. In the NT and SA legislation provides that a person can give an advance direction about the medical treatment they want in the event they become terminally ill and lose capacity to give directions about their care.

While anecdotal evidence suggests that advance directions are not widely used in any jurisdiction approved providers must nevertheless ensure that their policies and procedures are consistent with the laws which apply in the jurisdiction in which they operate and that staff understand what is required for a lawful advance direction.

Decision by substitute decision makers The Queensland legislation permits decisions about withdrawing or withholding life sustaining treatment to be made on behalf of a person with impaired decision making capacity by a substitute decision maker subject to a number of conditions being met.

In Queensland, consent to withdraw or withhold life sustaining measures is not effective unless the adult’s health provider reasonably considers that the commencement or continuation of the treatment would be inconsistent with good medical practice and the decision is in the adult’s best interests.

When considering the adult’s best interests in the context of withholding or withdrawing life sustaining treatment the considerations will likely include: •

whether it is in the best interests of the adult to continue or withhold the medical treatment, not whether it is in the best interests of the adult for the adult to die – it is generally accepted by the courts that care which has no therapeutic benefit to the adult should neither be commenced or continued;

•

whether the decision to discontinue is reasonable and in accordance with a respectable body of medical opinion; and

•

whether the decision is consistent with the adult’s wishes and to some extent the wishes of the adult’s family – to the extent those wishes are known.

There are differences between jurisdictions as to what treatment can be lawfully refused and the factors that will be taken into account to determine if the authority to refuse, when given on behalf of a person with impaired capacity, is lawful. For example, while in Queensland the patient’s wishes will be one of a number of factors to be taken into account, the Victorian legislation only permits a refusal of treatment if there are reasonable grounds for believing that the patient if they had capacity would have refused treatment.

There are also varying mechanisms by which those decisions can be made. For example in Queensland substitute decisions about life sustaining treatment can lawfully be made (subject to conditions) on behalf of a person who lacks capacity under an enduring power of attorney, by a person appointed by the relevant statutory tribunal or by a statutory health attorney.

But different mechanisms are recognised in each jurisdiction and again approved providers should ensure that their internal policies and procedures are consistent with the laws applicable in the jurisdiction in which they operate.

Palliative care Euthanasia remains a crime in Australia and it is unlawful to do any act which has the intention of causing a person’s death or to do anything which aids another person to kill himself or herself. A person will not however be held criminally responsible for providing palliative care to an adult (namely care directed at maintaining or improving the comfort of a person who is, or would otherwise be, subject to pain and suffering) if an incidental effect of providing the palliative care is to hasten the other person’s death so long as the treatment is: •

given in good faith and with reasonable skill and care;

•

reasonable in the context of good medical practice; and

•

given by a doctor, or the treatment is confirmed in writing by a doctor.

Consent to administer palliative care is necessary. Consent could be provided by the adult, if they have capacity or where they lack capacity by a substitute decision maker, again subject to the provisions of the relevant legislation which applies in the applicable jurisdiction.

Compliance The Accreditation Standards require that an approved provider have systems in place to identify and ensure compliance with all relevant legislation and regulations. Prudent providers will ensure that their policies, procedures and training programs are compliant with the laws that apply in the state in which they operate. Policies and procedures should: •

Identify the methods of substitute decision making permitted for decisions to withdraw or withhold life sustaining treatment and the steps to be taken to ensure those decisions are made in a lawful way.

•

Set the parameters for substituted decisions about palliative care and the steps to be taken to ensure those decisions are made in a lawful way.

•

Identify the enduring documents (eg an enduring power of attorney or an advance health directive) recognised in the state/states in which the approved provider operates and the minimum requirements for validity.

•

Particularise how disputes between decision makers will be managed.

The laws in relation to end of life decisions for persons with impaired decision making capacity are complex. Approved providers should take legal advice to ensure that their policies, procedures and training programs are compliant with the laws applicable to the state or states in which they operate. n 1 Guardianship Act 1987 (NSW); Guardianship and Administration Act 2000 (Qld); Powers of Attorney Act 1988 (Qld); Guardianship and Administration Act 1993 (SA); Guardianship and Administration Act 1995 (Tas), Guardianship and Administration Board Act 1986 (Vic); Medical Treatment Act 1988 (Vic); Guardianship and Administration Act 1986 (Vic), Guardianship and Administration Act 1990 (WA); Guardianship and Management of Property Act 1991 (ACT), Medical Treatment (Health Directions ) Act (ACT) 2006; Adult Guardianship Act 1988 (NT).

editorial

SAGE Comes of Age Report on SAGE Europe Study Tour 2009 including attendance at the IAHSA conference in London The participants in this year’s SAGE Aged Care tours are hardly over their jetlag and already the accolades are flowing in particularly for SAGE founder and tour organiser Judy Martin from ThomsonAdsett, and also for the strong support of ACSA and ACAA.

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he tour ‘stories’ are also starting to surface, none better than this one; because I don’t think anyone who was on this year’s tours to the Netherlands, UK and the IASHA Conference, will ever forget the ‘chook raffle.’ The classic Australian attitude of ‘can do’ in action. (You must read the ‘Africa Connection’ story in this edition.)

I’m not sure if you remember the tour participants who we covered in a magazine article before this recent trip? Well, the same group are about to share with you the most rewarding and innovative aspects of the tour.

Rhys Boyle (CEO Lyndoch, Warrnambool in SE Victoria) headed to Holland because he wanted to get up close and personal with the remarkable ‘Humanitas’ organisation in the Netherlands.

(See the article on ‘Apartments for Life’ in this edition) Rhys had already met its CEO, Dr Hans Becker and has come away from this visit stunned by what he saw.

‘What I wanted to know’ Rhys said, ‘is how Humanitas design and run these facilities. There are a few things I’ve looked at in Holland that I’ve said, “Yep. I can do that here in Australia, particularly their design.” Now I’m back I look at our place through different eyes. I think the way we do things is really institutional. The way they use multi storied buildings, using light and space to open them up is amazing. We tend to shy away from anything that has more than a single story, maybe two at worst.’

Rhys also had a close look at technology and how electronic monitoring is becoming a major area of advancement. ‘It’s still in its infancy, but it is progressing at a fast pace.’ Rhys was also fulsome in his praise of the tour’s organisation, the facilities that were chosen for the visit and the connections made. ‘I loved every minute of it, even though it was full on,’ he said.

What about the ‘chook raffle? ‘Only an Australian would do that’ said Rhys.

Paul Bradley from Anglican Retirement Villages in NSW had a different reason for joining SAGE - ‘I am really interested in how the UK copes with rapidly increasing demands on home based care, community care.’ He told me before he left.

‘I was blown away by one independent living facility where residents are totally empowered to run their own show, it’s so different to here. I think we are paternalistic in how we run our facilities, we don’t mean to be, but we are.’

‘This UK facility had a model of tenure and management that totally empowered the residents but gave them dignity and respect when they started to fail physically or mentally in later life. It was a concept I had dreamt up in my head some time ago, but never seen it in real life, and suddenly there it was and it was working.’

You discover when you travel that particular words can have very different meanings in different countries. Paul said the sign at

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the front of this UK facility said “Very Sheltered Housing,” he was cringing, but in the UK, no-one had a problem with it.

It’s a positive over there.

Now to Pauls comments on….. the ‘chook raffle.’ ‘I think a lot of the Americans were bemused by the whole thing, we had some explaining to do as we went round with the tickets.’

‘I think SAGE has definitely come of age,’ said Jim Raggart, General Manger of Business Development for the ACH Group, ‘because we were introduced to CEO’s of major facilities and organisations and it was the CEO’s who set aside their time to meet with us. As well we met and spent a good deal of time with Des Kelly, the CEO of UK’s peak body NCF (National Care Forum).

It really is so worthwhile to do these SAGE tours. They are so professionally run, you learn so much and can establish great networks and connections, and believe me, the bonds do stay.’

Jim said he had tried to organise a tour before on his own and the result wasn’t good. So SAGE has for him been another outstanding success. He has now participated in two SAGE tours and would highly recommend them to Senior Management in the Australian industry.

‘I was so impressed with the way they deliver care in the UK, through what they call the ‘Extra Care Housing Community.

People are looked after in their own homes, and they can be apartments, something like the Humanitas designs I’ve heard so much about lately.’

Now to the lady who’s idea it was to run the very successful ‘chook raffle.’ The fundraiser that wasn’t really a legal raffle. (You are supposed to get permits because there are laws governing that sort of thing!) Lyn Bruce CEO at Sisters of St Joseph in NSW said ‘have you ever tried to explain what a chook raffle is to a Norwegian who can’t speak much English. What amazed me is that no-one knew what a chook was, not even the Poms. However so many people were willing to donate to the cause once they heard the story’.

As far as the tour and conference was concerned, Lyn wanted to see first-hand how care is delivered in the UK to the ‘have-nots’ of this world. She told me ‘that the UK has a much better system of care delivery, it is person centred, people have far more choice than they do here. We are just starting to change the way we deliver care because I have come back with a lot of ideas that we will implement over time. I think our clients are going to love the changes we make,’ said Lyn.

bodies, ACAA (Aged Care Association Australia) and ACSA (Aged and Community Services Australia).

Judy tells me there have already been tours to China, Malta, Netherlands, USA- Washington, USA – Philadelphia, Canada – Montreal, and Canada – Toronto. ‘That’s what you have missed,’ she said.

However, Judy says planning has started for the next few years and in the wind are tours to: •

2010 --China/Hong Kong in July and perhaps another to NZ in September

•

2011 --Washington (for IAHSA) with an accompanying study tours pre and post conference to New York & Boston and Philadelphia.

Judy told me that IAHSA (The International Association of Homes and Services for the Ageing, representing aged and community care in 30 countries) are interested in SAGE running inbound tours to Australia and that she is looking at bringing a delegation from the US to Australia in 2010 to look at facilities in Australia.

SAGE and IAHSA have developed a strong relationship during the SAGE tours over the years.

Judy said ‘I thought this was a remarkably successful trip, particularly because we have established such close links with the peak aged care lobby groups in the USA and now UK. We established a great relationship with UK CEO of NCF, who, spent a morning with us conducting a round table forum. That afternoon he was talking to the British Prime Minister on release of the UK Green Paper into Aged care. He then came back and briefed our SAGE delegates on what was happening in the UK – hot off the press (literally!) We were thrilled SAGE could provide that sort of high level exposure to delegates. Meanwhile over in the Netherlands the SAGE group were sharing dinner with tour Leader Petra Neeleman CEO Dutchcare and IAHSA board member and ex Chairman Freek Lapre.

‘Being with a delegation overseas when an Australian, Glenn Bunney was elected as the new Chairman of IAHSA, was very exciting. Straight after his election announcement he came back to our SAGE Gala dinner, which was wonderful for both Glenn and the Australians present, to have a large group of senior management representatives from Australia’s aged care industry on the spot to congratulate him - it was very exciting for him and the group.”

‘It was also interesting that a lot of other Australians were at the IAHSA conference and told me they would come on SAGE next time, rather than just go to the conference on their own,’ said Judy.

‘The other thing I noticed was that services in the UK were more integrated than here, across residential, community care, high care and hospital sectors. We will need to do a lot of work and have a different funding model to achieve that here,’ she said.

Judy mentioned it was terrific having Rod Young CEO of ACAA and Richard Gray, the founding CEO of ACSA, and now Director of Aged Care for CHA (Catholic Health Australia) as a part of the UK SAGE delegation. Having peak industry representation is great for both other delegates and the overseas representatives we are meeting with. Judy also commented on Richards history as the longest serving peak industry representative in Australia - he’s a man with immense wisdom and years of experience in aged care.

While the tours are organised and run by ThomsonAdsett’s Judy Martin, they are a joint initiative of our aged care sectors peak

The sharing of ideas, and wisdom – yes!… that’s what its all about. n

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editorial

Apartments for Life in Australia – a Changed Vision of Care What are the values and philosophies that are important to you as you get older? What is the vision you have for your facility?

How important is independence, choice and having control over how you live your life for you and your residents?

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ncreasing numbers of Australia’s aged care providers are being influenced in the design and provision of care by one of the world’s great innovators in this space, Dr Hans Becker from the Dutch based Humanitas Foundation.

Why? Because Dr Becker and his organisation are committed to ‘happiness,’ not efficiency or safety. Those are values that come as a consequence of what they do.

It’s a philosophy that seeks to maximise the residents independence, choice and the right to have a big say over how they live their lives. It is transforming the delivery of care across the world.

Dr Hans Becker is quoted as saying ‘Human happiness - that is the business we are in, not ‘cure and care’. There is not much opportunity to cure when someone has Parkinson’s or Alzheimer’s, or even arthritis in the knees. The care elements have to be there, but they should be in the background.

The attention needs to be taken away from people’s handicaps and instead focus on what people can do and what they enjoy.

Constant focus on medical problems causes what is left of a positive image of life to disappear, and institutions for the elderly degenerate into what my father calls “misery islands.’’

One of the growing list of aged care providers in Australia that has decided to go down the Humanitas path is The Benevolent Society, a not for profit organisation that operates in New South Wales and Queensland.

Its CEO, Richard Spencer says ‘the greatest lesson the Society has taken from Dr Becker and Humanitas is that commitment to happiness. Such a philosophy is far more important than the most sophisticated building and/or elaborate community facilities. Without a deep mutual respect between the organisation, the staff and residents, all we will have is a fancy institution – modern perhaps but still an institution.’

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Before we look in some detail at the Humanitas vision and the ‘Apartments for Life’ project proposed by the Society, some background information for those who don’t know the organisation. The Society is Australia’s oldest charity; delivering services for children and families, older people and in women’s health, community based and respite care, community development and social leadership programs. It also provides community-based care services, residential aged care services and independent living retirement units.

‘Apartments for Life’ A key feature of the ‘Apartments for Life’ model is that it offers older people a chance to remain in their own home – in this case an apartment – throughout older age and to avoid having to move home when their health declines and they require increasing levels of care and support. ‘Apartments for Life’ challenges the oft-held assumption of the inevitability of a move to a nursing home in later old age.

Amazingly, it seems to work and work well. So well that The Benevolent Society has just unveiled their own ‘Apartments for Life’ project in the heart of Sydney. A bold vision for a new way of caring for those in the community who are less well off, unable to finance their way into independent living, as well as those who can.

The report says that ‘Apartments for Life’ is about more than just enabling older people to live in the one place until the end of life.

It is about supporting older people’s control over their own lives and their continued activity and participation in community life.

‘Dr Becker and the Humanitas ‘Apartments for Life’ model have inspired our proposal and we believe it has much to offer Australia. As a community, we know we need new ways of supporting people in older age – that fit with what older people themselves prefer, that give them more choice and which will help us meet the challenges of an ageing population,’ says Richard Spencer.

Humanitas recognised that Dutch older people wanted to: •

remain independent

•

manage their own lives

•

participate in society

and they wanted to avoid: •

being forced to move house

•

frequently changing care services, access points and assessment procedures

•

having different carers all the time. >

editorial

< Humanitas has not built a nursing home for many years and has demolished some that were sitting empty.

Dr Becker says the philosophy has four basic values that underpin the Apartments for Life model: •

Be boss of your own life

•

Use it or lose it

•

An extended family approach

•

A ‘yes’ culture.

So in real life what does that philosophy translate to? Dr Becker.

‘You should be boss of your own life with your own front door.

Then you are truly a resident, not just ‘staying’ in a room that belongs to an institution. You should decide what is important to you, even if it means being drunk at the bar everyday or only eating brown beans.’

This is certainly a new approach and has been incorporated into the design of the Sydney based ‘Apartments for Life’ project.

The Sydney Project The Benevolent Society’s Apartments for Life at Ocean Street project aims to be a new concept in retirement living and aged care – a place where older people can live in their own homes throughout the changes and challenges of later life, with a sense of autonomy and purpose and remain fully connected to their local community.

The site is ideally located in a medium density precinct close to shops, amenities, medical centres and public transport. Many older people in the area already live in older style ‘walk up’ apartment buildings typical of the area, which are difficult and expensive to retrofit to make them accessible. At the heart of Apartments for Life’s purpose is the goal of helping older people in the surrounding community avoid expensive and unnecessary moves to nursing homes, far away from family and familiar networks, so they can fully participate in the neighbourhood they know and love.

The aim is to create an inviting ‘social hub’ and neighbourhood atmosphere that: •

has useful services and facilities for residents

•

is a pleasant place for people to get together

•

has ongoing activities, events and spaces

•

has a café offering meals

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•

has a child-friendly area and basic supplies on sale for people with limited mobility

•

has rooms of various sizes

•

has a dementia day centre

•

has a men’s shed or workshop

•

has consulting rooms for visiting health professionals

•

and is fully integrated into the local community

Residents will have their own apartments, each with its own lockable front door. They have their own private space into which others can come only by invitation, not just a room with an ensuite or a shared room. Forty per cent of the apartments will be dedicated as affordable housing for those living on pensions, or who because of the lower value of their home are unable to afford to pay full price.

Future developments will feature new technological developments in communication, with a view to maximizing the independence of residents. The apartments and the complexes as a whole are designed to be ‘age-proof’, that is, to be liveable for people of any age. Residents would draw on personal and nursing care services as and when required, to be delivered by any of the in excess of 20 community care organisations operating in the area. The Benevolent Society estimates that up to 95 per cent of residents will be able to stay in their own apartment until the end of life.

Each ‘Apartments for Life’ complex has a ‘village square’ at ground level with a range of services and facilities.

On entering an establishment of the Humanitas care organisation, one should as it were be taken by surprise by the exhilarating, warm, happy, activating company culture. Actually, the totality of colours, smells, sounds, artefacts, and people “going about their business”, should in no way remind us of “care”.

The Society’s General Manager Ageing, Barbara Squires visited the UK and Netherlands and was immediately impressed by what she saw. ‘I was looking for innovative models that might help us plan for the future of our residential facilities and villages for older people. What I saw in the UK were lovely places my elderly mother could have happily lived in, but when I saw Humanitas Bergweg, I knew I could have moved in there immediately. It challenged every one of my preconceptions about what was possible in older age.’

The Societies project has not happened quickly, it’s been almost a decade in gestation. This year the plans were finished but are still awaiting approval by Waverley Council.

If you are interested in obtaining more information, visit the Benevolent Society’s website and check out the vast amount of research information and images they have freely available, or talk to someone who has been on the recent Sage Tour of the Netherlands and visited some of the Humanitas facilities.

A detailed report into the Humanitas connection for the Society and its plans for the future direction of care facilities was released earlier this year. (www.bensoc.org.au/uploads/documents/ HumanitasAFLinAustraliaReportJune2009.pdf ) n Footnote: This article was largely drawn from information contained on the website of The Benevolent Society. (www.bensoc.org.au)

Discover the Cater Care difference.

editorial

ACFI â&#x20AC;&#x201C; The Current Impact When ACAA was involved in the negotiations for the implementation of ACFI prior to 20th March 2008 startup, it was agreed by both the Department and industry that one of the major improvements, among others, that ACFI would generate a wealth of data and information that would better inform Government and industry about our clients; their diagnosis, prognosis, disease categorizations, length of stay and a raft of other information that would improve considerably, the ability to plan future services and deploy appropriate resources

T

his opportunity has been recognised by QPS Benchmarking who for the past 18 months has collected information on average funding levels and ACFI Domain scores. Clients of QPS Benchmarking can compare their subsidy level results at a time when management and staff are still learning about the best ways to implement ACFI. The information also provides great opportunity to cross correlate resident needs as assessed by ACFI with other indicators such as care staff work hours, clinical and safety outcomes. These correlations have enabled numerous facilities to challenge the way in which ACFI has been implemented and make substantial improvements.

The information below, provided by QPS Benchmarking provides the industry with some early information regarding the impact of ACFI, at a time when information from the Commonwealth is yet to emerge.

to ensure the most appropriate

QPS Benchmarking

provision of care and support for

QPS Benchmarking provides a benchmarking service for over 14% of aged care facilities throughout Australia and New Zealand. It also provides services for community aged care, day surgeries and small rural multipurpose health care facilities. Since commencing its residential aged care benchmarking program in 1999, QPS Benchmarking has developed an extensive suite of financial, human resource, clinical, resident lifestyle and safety indicators to measure performance in critical areas.

There are four compulsory indicators in the QPS Benchmarking program including average resident income, and the average ACFI domain scores.

From this point, clients can then select from a range of other indicators that fulfill their strategic requirements.

Clients can also access an extensive range of free audits and other tools on the QPS Benchmarking website. The quarterly newsletters contain over 100 articles submitted by clients on their successfully implemented best practice and improvement strategies.

our clients in the future.

â&#x20AC;&#x153;

These correlations have enabled numerous facilities to challenge the way in which ACFI has been implemented and make substantial improvements.

â&#x20AC;?

One of the biggest changes in residential aged care over the past two years has been the implementation of the Aged Care Funding Instrument (ACFI) to replace the Resident Classification Scale (RCS). Performance indicators based on these tools have always been considered compulsory by QPS Benchmarking because these instruments enable QPS Benchmarking to segregate and benchmark clients into high and low care. These indicators also provide valuable correlations between resident acuity (care needs) and other important indicators such as clinical outcomes and care staff work hours.

Prior to the implementation of ACFI, QPS Benchmarking used the average RCS scores to separate its clients into high and low care. Under the RCS system the cut off point between high and low care was 3.0 with the average RCS score for high care being 1.8 and the average RCS for low care being 3.9 in 2007. When ACFI was introduced, QPS Benchmarking created the Average ACFI / RCS Subsidy ($) (for permanent residents) indicator to replace the previous RCS indicator.

From that point onwards the cut off point between high and low care has been $100. QPS Benchmarking clients have displayed increased understanding of the relationship between ACFI domain scores, affordable care staff work hours, clinical and other outcomes. This has helped them drive improvements in ACFI assessments and the management of resources in relation to income.

Average ACFI RCS Funding Table 1 demonstrated the average daily subsidy level for permanent (formally assessed) residents per day, combined data for both high and low care.

Table 1 (see next page) >

Aged Care A U S T R A L I A | Spring 2009 |

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editorial

Table 1

ACFI Domain indicators Table 4 demonstrates the average domain score for ADLâ&#x20AC;&#x2122;s, for all formally assessed residents, combined for both high and low care.

Table 4

Table 2 demonstrated the average daily subsidy level for permanent (formally assessed) residents per day, data for high care.

Table 2

Table 5 demonstrates the average domain score for Behavioural Issues, for all formally assessed residents, combined for both high and low care.

Table 5

Table 3 demonstrated the average daily subsidy level for permanent (formally assessed) residents per day, data for low care.

Table 3

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ADVERTORIAL

Cairns Private Hospital Orthopaedic Ward – GripSox™ Trial Trial period: 16/03/09 to 12/07/09 Sample group: All patients admitted during the trial period for total joint replacement-this included 30 total hip replacements and 75 total knee replacements-total of 105 patients.

Aim of Trial: The aim of the trial was to reduce the incidence of falls in this patient population. All of these patients wear TED stockings post op and anecdotally the staff felt the number of falls was increasing following refurbishment of our rooms and a change to vinyl floor coverings.

Results: Total number of falls on Orthopaedics during the trial period was 6. This compared to a total of 20 falls for the corresponding period in 2008-a reduction of 70% (N.B. these figures are total falls for the period-I was unable to separate out stats for just joint replacements) Other observations: The GripSox™ were easy to use and well tolerated by patients. The largest size seemed to work the best. Smaller sizes tended to slip off when patient was up walking. We applied the GripSox™ over the top of the TEDs as soon as the patients were mobile and encouraged the patients to leave them on throughout their stay in hospital. None of the patients who fell during the trial period had GripSox™ in place.

Conclusion: The use of GripSox™ significantly reduced the number of falls during the trial period. They were well tolerated by the patients and the staff are keen to continue to use them with our patients as an ongoing measure to reduce our falls risk.

Sue Forbes Nurse Unit Manager – Orthopaedics & Rehabilitation Trial Co-ordinator GripSox™ Enquiries: Luke Goodwin Ph. +61 3 9591 0500 E: sales@gripsox.com W: www.gripsox.com

editorial

Extra Services Today James Underwood James Underwood & Associates Pty Ltd.

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t the end of June 2009, the Department of Health & Ageing (DoHA) announced the results of ACAR 2008. Included were the results of the second Extra Services (ES) round for 2008. Some 76 new ES approvals were announced. Added to the 56 new ES approvals in the Feb 08 round, this gave a total of 132 new approvals for ES for the year. This was more than three times the average number of approvals over the preceeding four years, as below.

New ES Approvals Year

Facilities

2004 2005 2006 2007 2008

53 33 51 31 132

Why has there been such an explosion in the numbers of services seeking to gain ES approval?

Background ES is a condition of approval that can be sought by operators of residential aged care facilities. The status is available where a provider provides significantly higher than average standards of accommodation, food and services, and can be sought for part of a service or for an entire service. ES status allows residents entering the ES area to be charged a pre-determined higher fee plus it allows new High Care residents to be levied a bond in lieu of a charge.

What is “significantly higher than average”?

A benchmark list has been used by DoHA since 2003 to detail what needs to be achieved to be a service that is “significantly higher than average”. This list requires services to have 60 points or more out of a possible 100 point list of benchmarks of accommodation, food and services. Many or most newer services already meet and exceed the 60-point threshold and are therefore able to meet the requirement of being “significantly higher than average” without changing what they offer.

•

Most were for part of a service only, not an entire service.

•

Some 75 ES approvals were in the “Private-for-Profit” sector and 57 were in the “Charitable/Religious” sector.

•

Few approvals were for “new services”. Most were for existing, currently-operating services.

•

New approvals were across all states.

•

States that had had a lower proportion of ES places, such as South Australia, caught up in 2008. There were 19 new ES approvals for ES in South Australia.

•

Many, possibly the majority, of new ES approvals in 2008 sought to charge only small additional fees – usually $20/day or less.

•

A number of new ES approvals chose to waive charging any additional fees.

Why so many new approvals?

Just under 10% of all the approved or provisionally-allocated residential aged care places in Australia now hold an ES approval.

Most of these are High Care.

The reason for the large increase in the number of ES approvals in Australian residential care appears not to be a desire to offer a large number of opulent, up-market services with high fees.

The growth in ES appears based around existing High Care services that are already at a good level of service provision and that have identified a need for bonds in High Care to enable them to meet the costs of providing those good levels of resident outcomes of all types.

Providers increasingly see less need to differentiate between “capital” dollars and “operational” dollars as they seek to ensure that the entire aged care service they operate is viable. To achieve an overall successful financial outcome, providers are seeking and gaining the capacity to charge bonds and small additional fees instead of the lesser income option of fixed maximum accommodation charges. n

The nature of New ES approvals in 2008 The 132 new approvals for 2008 have the following characteristics: •

Over 80% of the places are High Care.

•

The average-sized ES approval was for 34 places.

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New approvals for ES places per annum

editorial

Lessons from the Other End of the Ditch Cam Ansell

Occupancy Rates - All facilities

Director, Corporate Services, Grant Thornton 94% 92%

The New Zealand Residential aged care sector shares many of the characteristics with Australia. While the terminology takes some getting used to (and the accents), the needs/ expectations of residents and service delivery methods are basically the same.

90% 88% 86% 84% 82% 80% 2005

2006

2007

2008

Occupancy NZ

A

key difference between the two sectors are in the decentralised funding processes employed through 21 Separate District Health Boards (DHB) which negotiates with residential aged care providers in their district. Another key distinction is the limited formal restrictions on resident charges.

In 2005, New Zealand providers started to levy ‘premium accommodation charges‘ for residents enjoying above average amenities. In a very short space of time, a large proportion of providers (75% of which are For-Profit operators) were charging these fees.

Facilities with Premium Accommodation Charges 50% 45% 40%

2006 89%

2007 91%

2008 93%

The New Zealand Government has recognised the potential problem associated with this approach. There is concern regarding the extent to which DHB subsidies cover these costs and the need for a safety net for older people that cannot afford to pay additional levies. This uncertainty has resulted in a slow down in the construction of new facilities throughout New Zealand. Like Australia, the lack of development in residential aged care comes at a critical time where the nation’s population is rapidly ageing.

However, the New Zealand Government and the industry have been proactive in addressing the problem. The Government and industry have not only acknowledged the current and future impact of the problem, they have worked in collaboration over the past year to develop a strategy to address the current and future challenges.

In a major assignment that will run over the next 12 months, Grant Thornton has been engaged to undertake a comprehensive service review of the aged care sector in New Zealand. The review is jointly sponsored by the 21 District Health Boards and New Zealand residential aged care providers.

35% 30% 25% 20% 15% 10%

The objectives of the Review are:

5% 0% 2006

2007

2008

Extra Service Fees 2006 21%

2007 38%

2008 43%

This came at a time where facilities around the country were reaching full capacity.

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2005 85%

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1. To indicate what are or would be the costs for fair and reasonable service delivery models provided by an efficient and effective provider thus providing the basis for determining affordability of the current and potential models to guide future decision making; and 2. To assess the current (baseline) and future demand for services against the future service delivery models of care to determine the resources required to meet this demand.

Our team will work with industry leaders in the private and public sector throughout New Zealand to explore alternative models of care and service delivery options. At the same time, a major survey will be undertaken to determine the costs associated with service delivery under a variety of conditions.

This co-operation between providers and the government creates an exciting window of opportunity to create an industry that supports the development of service most needed by consumers in an environment of sustainability for both operators and funders. It will enable all participants to voice their priorities and objectives, so that balanced policy alternatives can be considered through a transparent process.

“

This co-operation between providers and the government creates an exciting window of opportunity to create an industry that supports the development of service most needed by consumers

”

into Aged Care, National Health & Hospital Reform Commission, the Grant Thornton Aged Care Survey and the Productivity Commission.

Obviously, this situation has particular relevance to Australia at this most critical time of our history. For the first time since the 1997 reforms, aged care place allocations in the Aged Care Approvals Round (ACAR) 2008-09 were undersubscribed in all States and Territories (except South Australia) and many planned residential care developments have been shelved or abandoned.

Grant Thornton has taken the opportunity to discuss these matters with senior representatives from the Commonwealth Department of Health and Ageing. We have recommended a similar review of the aged care sector as is being conducted in New Zealand. Senior representatives of Australia’s peak bodies have expressed a commitment to working with government on such an initiative, including co-sponsorship.

While these trends are very unsettling, they represent the first steps in reform and some provisions of deregulation. The lack of interest in new places means that the Government no longer controls supply and a level deregulation in price is inevitable. This position has been reinforced by the findings of the Senate Inquiry

An open, transparent review of Australia’s aged care industry and the costs associated with service delivery will enable us to rise above the political obstacles and retrospective thinking to focus on policy to support the growing number of elderly Australians that will need residential care. n

editorial

SAI Global Business Awards Success It’s not often that an aged care organisation can boast success in business awards, when you are up against the big end of town, but this year saw SummitCare (Australia) as a joint winner of the SAI Global, National Award for Business Excellence.

A

ccording to the judges, this year has presented the toughest global economical environment seen since the awards were launched in 1988.

But, even in the face of unprecedented

challenges, the desire to set new benchmarks, and attain excellence, has remained resolute.

As a joint winner of the premier Silver Award, SummitCare was recognised for its dedication to delivering superior facilities and service, its Quality Management Framework that embraces and prioritises feedback from residents and relatives which is regularly canvassed through reviews, satisfaction surveys and complaints.

The organisations business strategies are regularly monitored against actual performance, its leadership is a mix of open, collaborative and continuous improvement. SummitCare was

also recognised for the dedication of its employees, for their passion, professionalism, and an understanding of their contribution to corporate goals.

Just in case you are wondering what sort of performance levels are required to win the Silver Award, organisations at this level have been assessed across a set of criteria which underscore commitment to not only sustaining bottom line results but to superiority of service, commitment to customers, philanthropic ideals, ethical behaviour and environmental sustainability.

Good news is always welcome at any time, in any organisation, so congratulations to SummitCare and its staff. n

ADV ER TO R IAL

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.

editorial

Atlas of Productive Ageing Have you ever wondered how many older people live in your neighborhood? Or how many older adults in your state are meeting health guidelines? A new tool, recently released by the National Seniors Productive Ageing Centre, will allow you to quickly access this information and view it on easy –tounderstand maps of Australia.

The Atlas of Productive Ageing is

the recommended servings of fruits and vegetables.

All of the data is available both in graphical form (as a colour-coded map) and also in excel spreadsheets for further data manipulation.

To use the Atlas, visit www. productiveageing.com.au/site/atlas. php and click on ‘Atlas of Productive Ageing’ – this will take you to the main page of the atlas. Then you can choose whether you want interactive data at state or local government area (LGA). Once you select the geographical region-you will be brought to the main data page. Then to manipulate the data-•

Click on ‘data’.

•

Select the theme, specific topic and gender grouping of interest.

information on the following

•

Select the age group.

themes: Activity, Health, Housing,

•

Analyze your data/Manipulate the map.

a unique resource for information on older adults. It provides

Finance and Population.

T

If you have any questions or comments on the Atlas of Productive Ageing, email Dr. Ellen Skladzien at e.skladzien@ nationalseniors.com.au n

A detailed tutorial is available on the main page of the atlas for further instruction on using the program.

he Atlas has a simple interface which allows users to manipulate data and create color coded maps displaying regional data. Most data are available at the detailed level of local government area. For example, it is possible to create a map of Australia showing the proportion of individuals aged over 50 in each local government area. Or, if you are interested in financial information, you could find out the proportion of older adults in each local government area that have an income greater than $999 per week.

There are over 30 variables available for local government areas and each of these can be broken down by gender and age categories.

There is also additional health and retirement information available at the State level. For example, if you are interested in health, you could create a map showing the proportion of people over the age of 65 in each state who currently smoke, or the proportion of people over the age of 65 who eat less than

Aged Care A U S T R A L I A | Spring 2009 |

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editorial

A dangerous combination for care staff – professional boundaries and personal interests Hynes Lawyers The therapeutic nature of the work undertaken in residential and community aged care creates an environment in which there is a risk that care staff will develop a relationship with care recipients that can breach professional boundaries. Staff must be able to identify professional boundary violations which occur when they place their own needs above the needs of a client.

P

rudent approved providers will implement a policy which defines the parameters of a professional relationship and the principles to be applied by all care staff to prevent professional boundary violations. The policy should state that the approved provider expects all care staff will maintain professional boundaries to a prescribed standard. The policy should state that if any staff member falls below that standard, they will be subject to internal disciplinary proceedings and may be referred to the appropriate external regulatory body. All staff should be trained in the policy.

Content As a minimum, a policy should state that care staff should: •

not engage in a relationship with clients outside of a professional relationship;

•

regard all information provided to them by a client as confidential;

•

never disclose personal information to a client unless revealing the information has therapeutic value to the client;

•

never use information which they have acquired during the course of their professional relationship with a client to advantage themselves in any way;

•

never withhold care from a client as punishment;

•

never cause or threaten to cause pain, suffering or discomfort to a client to coerce them to act in a certain way; and

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•

only touch a client where the touching is necessary to administer care or is part of therapeutic treatment.

Accepting any gift from a client beyond a small, one off token of appreciation has the potential to compromise the professional relationship between the client and the staff member. It also has the potential to compromise the professional relationship between the carer and other clients who may feel that the person who gave the gift is likely to receive better care. The policy should clearly set out the parameters of permitted conduct with respect to accepting gifts and that it will never be appropriate to accept a sum of money or a bequest. It should also state that a staff member should never enter a financial relationship with a client.

In practice Most providers will have policies and procedures in place which state that professional boundary violations are not permitted.

If asked most care workers would state that they understand professional boundaries and that they must not breach them.

However, apart from the most obvious cases of professional boundary violations (for example where a care worker receives a direct and significant gift from a client) there are many more complex scenarios that might arise.

Consider the following examples: A. A care worker has a close relative who is suffering from a significant illness. In the course of caring for a client she discloses her personal situation to the client. The care worker believes in doing so she was helping the client, but the client later revealed that the information disclosed to her by the care worker caused her significant distress.

Unless the disclosure was therapeutic, it was not appropriate.

B. A registered nurse provides care services to a client in his home for many years. The nurse leaves her employment but keeps in contact with the gentleman by phone. During these telephone conversations she discloses to the gentleman that she has some financial issues. The gentleman subsequently offers to lend her some money and she accepts.

The fiduciary relationship of the nurse and client continues even after the nurse has ceased providing care to the client.

A nurse who develops a relationship with a patient, resigns and then accepts money is still in breach of duty owed to the patient. Conduct of this type would be likely to be considered professional misconduct by a disciplinary tribunal.

Although an organisation can do little to control the actions of a former employee, if such conduct does come to their attention a prudent provider would subsequently revisit their policies and procedures and provide refresher training to staff.

C. An aged care worker has developed a fondness for a particular client who has been a resident of the facility for many years. On her birthday the care worker bakes a cake for the client. One of the other clients in the facility becomes resentful that the care worker did not bake her a cake on her birthday.

This conduct may be seen to be an attempt by the care worker to establish a relationship which goes beyond the professional relationship. It also created resentment from another client who may then think she is receiving services to a lesser standard than what others are receiving.

While this is not a significant breach of boundaries it does highlight the possibility that a small action taken with good intentions still has the potential to create difficulties.

D. An aged care worker knows that one of the clients she cares for has a son who is a tradesman. The care worker needs some work done in her home and engages the tradesman. In the course of negotiating price with him she mentions on a number of occasions about how involved she is with his mother’s care.

In this case the care worker is clearly using her position for her own personal gain. The conduct is inappropriate.

E. A resident’s family members regularly present small gifts to a care staff worker on the basis that the particular carer ‘does things so much more nicely for Mum’. At Christmas the client gives the care worker a piece of jewellery which while having sentimental value has little financial value.

It can only be appropriate to accept small gifts if they are merely a token of appreciation and would be unlikely to impact on the professional relationship. It is not appropriate to accept regular gifts if the family think they are “buying” a higher quality of care for their mother.

The care worker should not accept the more significant gift because it could have the potential to impact the professional relationship and it could have a negative impact on other member’s of the client’s family who had their own expectations about receiving it.

F. The son of a client regularly offers small sums of money to a care worker on the basis that in his culture it is appropriate to do so.

Whilst this may be consistent with the son’s culture it is inappropriate for the individual care worker to accept the money. The money should be returned or, with the consent of the family, donated to the facility.

Approved providers should review their existing policies and training programs with respect to professional boundaries to ensure that staff understand what conduct is permitted and what conduct is not. n

editorial

Centenarians.

To be sure, it’s a long life many of us have to look forward to!

By Mike Swinson

She loved chocolate and a damn good drop of French red wine! So what? Don’t you? I do, love it a lot, especially when my kids purchase the sort of red wine my budget can’t afford. Trouble is my palate gets spoiled and then seriously upset later, when all I can provide is a much cheaper bottle. Still that’s life isn’t it?

S

o what am I rabbiting on about this time? Can you guess?

I’m talking about the secret of a ripe and healthy old age, what more could a young fella like me, in his sixties have to look forward to, than another forty or so, active, healthy, years on the planet. Next question, how can I manage to do it?

If I’m as lucky as Jeanne Louise Calment, an elegant, well to do french lady, who is regarded as the world’s oldest (as in credible and measured) person, then it’s already in the bag. Jeanne was born in 1875, finally left us in 1997. Have you done your maths, 122 was my answer! 122 years on the planet! Bloody oath, pardon my French, and guess what, Jeanne was still fencing when she was 85, (no, not as in the Aussie version, with strainers and pliers in hand) but fencing with a sharp rapier, probably matched her wit if the truth be known.

Jeanne (of great genetic stock, because her brother lived to 97, father to 93 and mother to 86, much like my mother’s family!) was still riding her bike to buy red wine from the local winery outlet when she was 100; she fell off the bike at 110 and broke her hip. That’s when she had to move into an aged care nursing home, where she survived another 12 years.

Have you noticed that when people in Australia live to 100, these days they might rate a small piece in the local paper, especially if they have lived a colourful life? Take Rose Smith as an example. Rose celebrated her 100th birthday recently at Catholic Healthcare’s Percy Miles Villa in Kirrawee in Sydney. So why did Rose get mentioned in the papers, well it was Senior’s week and Rose was a star in her own town!

For more than 80 years she was a household name in the Sydney performing arts scene, designing costumes for the Australian Ballet, The Tivoli and Ashton’s Circus. Rose even

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made the early costumes of Tina Arena when the pop princess was making her name as a child star.

So does it help if you have made a name for yourself, kept your grey matter active, probably does; what is it that everyone tells me, ‘use it or loose it?’

Centenarians are everywhere these days, and more and more Australians are going to receive a telegram/email and/or letter from the Queen/King/or GG, Kevin Rudd or his equivalent, congratulating them on achieving this remarkable milestone in life.

Why, because these days if you reach 85, then there is a big rise in your chances of making it to 100 or more, specially if you are female. As we all age, as we all last longer, old’s, the oldies are going to become almost a dime a dozen, so to speak.

Genetics obviously have a lot to do with it, because if Jeanne is any example, it doesn’t have a lot to do with diet and booze! I’m expecting a call from the Heart Foundation later!

Before I go, I want to share another bit of good news about centenarians. In a small aged care facility in Dubbo in Central West New South Wales, up till last week, they had two residents over 100 and both were blokes! Harold Smith and Giovanni Patriciana. There is hope for me yet!

Sadly last week, Harold passed away, leaving his mate Giovanni to carry the male flag of longevity high. I don’t think you girls need any encouragement to keep on, keeping on, it seems to come naturally! It’s us blokes who need a hand!

See you at my 100th birthday bash, it will be a ripper. n

2009–2010 Calendar of Events 22 – 23rd October

15 – 17 November

16 - 18 March 2010

4th International Conference On Creative Expression Communication and Dementia

ACAA 28th Annual Congress

ACQI State Conference & Trade Exhibition

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

T: 07 - 3725 5588 F: 07 – 3715 8166 E: events@acqi.org.au

16 – 18 April 2010

20 & 21 May 2010

17 – 18 June 2010

Ageing with Attitude Expo

ACAA – NSW Congress

ACCV State Congress

Claremont Showgrounds Organised by True Blue Exhibitions in partnership with Aged Care Association Australia WA T: 08 9387 5979 M: 0417 969 126 E: mareene@trueblue-exhibitions.com.au

Sheraton on the Park, Sydney T: 02 – 9212 6922 E: admin@acaansw.com.au

Melbourne T: 03-9805 9400 F: 03-9805 9455 E: events@accv.com.au

Aged Care A U S T R A L I A | Spring 2009 |

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Senior Citizen

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senior citizen drove his brand new BMW Z4 convertible out of the car salesroom. Taking off down the motorway, he floored it to 160kmh; enjoying the wind blowing through what little hair he had left.

“Amazing!” he thought as he flew down the F3, enjoying pushing the pedal to the metal even more. Looking in his rear view mirror, he saw a police car behind him, blue lights flashing and siren blaring.

“I can get away from him - no problem!” thought the elderly nutcase as he floored it to 180kmh, then 220 then 240kmh. Suddenly, he thought, “What on earth am I doing? I’m too old for this nonsense!” So he pulled over to the side of the road and waited for the police car to catch up with him.

Pulling in behind him, the police officer walked up the driver’s side of the BMW, looked at his watch and said, “Sir, my shift ends in 10 minutes. Today is Friday and I’m taking off for the weekend. If you can give me a reason why you were speeding that I’ve never heard before, I’ll let you go.”

The old man, looked very seriously at the policeman, and replied, “Years ago, my wife ran off with a policeman. I thought you were bringing her back.”

“Have a good day, Sir”, said the policeman. n

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product news

To Outsource or not to Outsource – That is the Question

I

ncreasing numbers of Aged Care organisations discover the benefits of outsourcing to improve bottom line performance.

Motivations to outsource include:

• • • • • • • • • • • •

Confidence that services are interactive and proactive Access to experienced industry knowledge bank Costs/ benefits of outsourcing outweigh costs of doing in house Overheads minimisation Need for accurate, timely financial reporting Difficulty finding Aged Care knowledgeable staff Reduce risk of Payroll blow outs To ensure funding and claims entitlements are received Failing to meet audit requirements Business expansion hampered by inadequate financial data Need for better management & work flow practices As a stop gap measure whilst reassessing administration needs

TabTimer’s range includes pill box timers with multiple alarms, lockable pill dispensers, handy pocket reminders, fridge magnet reminders and VibraLITE vibration alarm watches. Large displays and controls make it easy for the elderly to read and operate. A selection of TabTimer’s devices can also be set to flash or vibrate only - making the process of remembering to take medications discrete and timely.

T

abTimer™ supplies a handy range of quality, innovative and affordable medication reminder devices which can be easily set to alarm when medications are due – serving as a handy reminder to help patients, their relatives, carers or nursing staff achieve medication compliance.

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Spring 2009 | Aged Care A U S T R A L I A

To contact your caring Conticare consultant please call (03) 8506 4644.

Learning for the Aged Care Sector continues at CleanScene

C

For more information visit www.

TabTimer.com.au or call 1300 TAB TIMER (1300 822 846 37)

Exciting news!

The seminar program is varied and will be of particular interest to aged care facility managers and business owners.

The Problems of Maintaining Aged Care Facilities, Cleaning in Healthcare and Floor Care – Slips and Falls the Causes and How to Control Them, are seminar topics specifically for managers and workers in this sector.

General cleaning topics to be covered relate to training, the best type of vacuum, carpets, green cleaning. In addition there are business-related sessions dealing with finance and marketing, of relevance to any business during an economic slow-down.

Call Alan Bateman at AIM Software Pty Ltd today for a FREE and CONFIDENTIAL consultation 1300 651 321.

Remembering to administer medications at the right time is being made easier using medication reminder devices now available from exciting new Australian medication reminders company TabTimer™.

With an easy to use shopping cart, Conticare literally brings the storefront to your front door.

leanScene: The National Cleaning & Hygiene Expo, 27 – 29 October this year at the Sydney Showground, has a range of exhibitors and a series of seminar sessions pertinent to the aged care sector.

Just a few reasons why outsourcing is a viable alternative. Whatever your needs AIM Outsourcing Services will tailor a solution for you.

Administer medications on time!

ability to determine the ideal product for their individual situation.

I

ntroducing Australia’s latest stateof-the-art continence consumables website: Conticare.com.au. Conticare was created with a view to providing its customer base with a DISCREET hasslefree online buying experience. The option of phoning orders in is also offered. All products are shipped in black packaging ensuring complete privacy of purchase.

Payment can be made with a VISA or Mastercard or through direct bank transfer.

Conticare methodically lists the absorbency levels of many of its products enabling the prospective customer the

All sessions are included as part of IICRC’s (Institute of Inspection, Cleaning and Restoration Certification) continuing professional development programme.

Full details of the seminar programme are available at www.cleansceneshow.com. au/events.

There is also a wide range of products that will be of interest to businesses active in the aged care sector. For example, infection control solutions including antimicrobial surface coatings and natural disinfectant wipes, non-toxic odour remediation products, software specifically developed for aged care facilities, as well as the latest technology in carpet cleaning.

CleanScene: The National Hygiene & Cleaning Expo, 27 – 29 October 2009 at the Sydney Showground, Sydney Olympic Park, www.cleansceneshow.com.au.

Welcome to Accessibility Healthcare’s Corporate Portal:

be up and running with mulptile secure log-ins in no time at all.

You can have Online Procurement at Your Fingertips... e have spent 6 months and $97,000 developing this unique technology so that your organisation can leverage from Accessibility Healthcare and have your own customised Online Procurement system for Accessibility Products.

As an approved Corporate Customer you now have maximum “Choice and Control at your Fingertips” via our highly customized technology and online ordering system, as well as access to our network of expert professionals, online telephone ordering, prompt supply of products and an efficient referral service for all technical, maintenance and assembly assistance that may be required.

You can become a member of Accessibility’s Corporate program free and

To login as a Corporate Customer simply enter your Username and Password. If you

W

Super and share markets: what can you do?

How’s your super doing?

This question means a lot in times of economic uncertainty. Your super’s an investment, and investors everywhere are feeling the effects of market volatility.

Just contact Kerrie Thomsen or Darren Hall direct on 1300 222 377 or email kerrie@accessibility.com.au to discuss your needs and questions.

Market fluctuations shouldn’t change your goals — you’ll still need super to enjoy retirement.

Investment in undervalued assets can give you the chance to benefit from any future market gains. And super’s concessional tax rate makes it an outstanding long-term investment.

What can you do when share markets seem unstable? The best response depends on your goals.

History shows that, on average over the long term, shares have delivered returns above the inflation rate more often, and more consistently, than cash.

That’s essential if the value of your super is to grow in real terms over time.

Keeping your cool

Get a better grip

Super is best viewed as a long-term investment — even if you retired tomorrow, you might stay invested for another 30 years.

Get a better grip on your super in five steps.

Although you may consider investing conservatively to try to avoid future downturns, reacting after market fluctuations occur might not be ideal.

It may cause investors to sustain losses that they could have avoided if they’d maintained their investments until the market recovered.

They might also miss the benefits of upswings that may occur as economic uncertainty subsides.

Where to invest now?

1. Work out what kind of investor you are.

Complete the quick Risk Profiler at www.hesta.com.au/calculate to get an idea of your current attitude to investment.

2. Decide if your investment matches your profile.

Compare your personal risk profile with that of your chosen investment option using Your HESTA investment choice guide at www.hesta.com.au/yourchoice. Do they match? Would you be happier with another option?

don’t yet have a corporate account with us then please click on “Apply for a corporate account” and send us your details.

Once you have logged in, this section allows you to: • Access the secure online shopping system easily • Review the approved contract(s) for your organisation • Source our Practical and efficient system for the Reservation, Ordering, Quoting, Hiring and Purchase of products • Access full Product information including, specifications, photographs and videos for over 3000 products • Reference our FAQs • Search for products, review and print brochures for clients or colleagues • Check your account and track your quotes, reservations and orders • Request assistance from our customer service team. www.accessibility.com.au

1300 222 377

3. Consider making voluntary contributions.

Use the salary sacrifice and cocontributions calculator at www.hesta.com.au/calculate to see what a difference extra savings can make to your super.

4. Review your insurance.

Download Your HESTA insurance guide from www.hesta.com.au/ insure and make sure you have enough disability and death cover to meet your needs.

5. Consider speaking to a superannuation expert.

HESTA provides members with free advice about superannuation.

To make an appointment, free call 1800 813 327.

Looking to the long term Super is a long-term proposition, so it’s important to ensure you’re comfortable with your investment choices. Visit www.hesta.com.au for more.

Issued by H.E.S.T. Australia Limited ABN 66 006 818 695 AFSL No. 235249 and is about HESTA Super Fund ABN 64 971 749 321. It is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Please note that investments can go up and down. Past performance is not a reliable indicator of future performance. Consider our Product Disclosure Statement before making a decision about HESTA – free call 1800 813 327 or visit www.hesta.com.au for a copy.

Aged Care A U S T R A L I A | Spring 2009 |

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product news

Moving the Business Beyond Spreadsheets with Corporate Performance Management Software

providers, the critical functionality required for corporate performance management is often forgotten, leaving finance departments with a heavy reliance on time-consuming spreadsheets.

F

• •

orest Grove Technology is a dedicated supplier of Corporate Performance Management software.

We specialise in helping companies move beyond a complex array of error-prone, complex, integrated spreadsheets for the business critical processes of budgeting, forecasting, business analytics, financial consolidation and reporting.

While standard accounting packages provide strong solutions to the transaction processing requirements of aged care

Jomor Healthcare

J

omor Healthcare has been a proud supplier to the Australian Healthcare Industry for over 20 years. They are a design and engineering driven organisation with strong commitment to quality and continual improvement. With the recent downturn in the global economy placing increased pressure on Aged care facility operators.

Jomor has released its new value for money “Marion” high-low electronic bed.

The “Marion” has been engineered to provide the Australian Aged Care market with a durable high quality Australian

Cutan

®

A PROPHIX technology solution www.prophix.com.au, delivered and implemented by our Australian based consulting team, can make an enormous difference to corporate financial management in aged care.

A PROPHIX solution can provide:

• • • • •

made product at very competitive price.

This was achieved by optimising the design without compromising product quality, durability or functionality.

Jomor’s Managing Director, Deon Gilbert says “it’s about working smarter not cheaper” keeping a breast of technology and maintaining standards. Deon is passionate about investing and supporting Australian manufacture “We want to keep jobs here in Australia”. By refining our designs and processes we now produce a world class product at competitive prices.

Reevaluating the way we do things we can now produce a high quality and competitive product here in Australia, Then by supporting the product through its life, we

Experts in Occupational Hand Hygiene

D

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.

Spring 2009 | Aged Care A U S T R A L I A

Refer to our ad on page 28 of this issue.

Forest Grove Technology U3/192 Hampden Rd, Nedlands WA 6009 PROPHIX.com.au P +61 (0) 8 9389 5381 F +61 (0) 8 9389 5739 www.forestgrovetechnology.com.au

If you would like to know more about how a PROPHIX Corporate Performance

eb has recently released a new skin care range dedicated to the Aged care sector.

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Budget and forecast functionality; Financial analysis and “what if” scenario modeling; Financial reporting both adhoc and monthly reporting; Rolling reforecast capability; Financial consolidation; Dashboard and scorecard reporting; and, Key performance indicators calculation and reporting

Management System could help your business, go ahead and take the online tour at forecast.com.au, and don’t forget to look for us at the ACSA 2009 Aged Care Conference in WA in September.

Alternatively, review recent client case studies at agedcare.fgtechnology.com.au, or speak to our team directly about how the software has helped other Australian aged care providers and how it can help yours.

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

continue to offer our clients great value and excellent service. The “Marion” Hi Low bed is a perfect example of this available from $1375.

For information on the Marion or any of Jomor’s extensive range visit their Web site at www.jomor.com.au or contact Jomor on 1300 651 235 Email: sales@ jomor.com.au.