Front Cover: ITAC Hall of Fame inductee, Allan Turner
Voice of the aged care industry Winter 2009
contents
22
29
74
National Update
Workforce
63 Dancing into Happiness
3 CEO’s Report
47 Award Modernisation and the Aged Care Labour Marker
67 Breaking New Ground in Dementia Care in Australia
49 Talent Pools Essential in Today’s Labour Market
70 Georges Manor Opening Ceremony “Directions for Aged Care”
51 Australian Health Workforce Ministerial Council - Communique (Fed)
74 ‘Active, Independent and Upright’
Sponsor Articles
81 Aged Care and Retirement Village Update
53 Plan for disaster; protect your facility’s assets
83 Calendar of Events
6 State Reports 19 Congress 2009 Profiles 22 Sharyn Hamilton 25 Allan Turner Technology 29 ITAC 09 Conference, Award Finalists and Winners 34 5 Minutes With Andrew Barton, IBM 35 Technology Development in Regional and Remote IT Facilities 36 Informatics and technology-based aged care approaches 40 Microsoft Academic Volume License Transition Program 46 Aged Care Technology Suppliers Forum
ACAA OFFICE HOLDERS 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
54 Secrets revealed about a relationship that has lasted nearly 20 years and is still going strong
78 The Real Value of SAGE Advice
85 Product News
56 Aged Care Manual Handling Online – A blended solution 57 Reverse Auction Platform Saving You Money On Energy Costs Editorial 59 Health care decisions for persons with impaired capacity
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
67 Breaking New Ground in Dementia Care
4 Presidents Report
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
A BOURNE d
P U B L I S H I N G
Adbourne Publishing PO Box 735 Belgrave, VIC 3160
Advertising Melbourne: Neil Muir (03) 9752 6933 Adelaide: Robert Spowart 0488 390 039 Production Claire Henry (03) 9752 6944 Administration Robyn Fantin (03) 9752 6426
DISCLAIMER Aged Care Australia is the regular publication of Aged Care Association Australia. Unsolicited contributions are welcome but ACAA reserves the right to edit, abridge, alter or reject any material. Opinions expressed in Aged Care Australia are not necessarily those of ACAA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Aged Care Australia may be copied in whole for distribution among an organisation’s staff. No part of Aged Care Australia may be reproduced in any form without written permission from the article’s author.
www.agedcareassociation.com.au
www.adbourne.com
Aged Care A U S T R A L I A | Winter 2009 |
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national update
CEO’s Report Rod Young, CEO, ACAA
The release by the Senate Finance and Administration Standing Committee Review into Residential and Community Aged Care Report 29 April 2009 was a breath of fresh air for an industry that has struggled for the past two years to convince Governments of both political persuasions that the industry has major financial difficulties.
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he Senate Report was a unanimous report of all major parties participating in the Inquiry into Residential and Community Aged Care.
Almost everyone presenting to the Inquiry or making a submission had one particular view of the state of the industry with the one exception being the Department of Health and Ageing. Either we (the industry) are all wrong or the Department is wrong. There seems very little room for grey between these two positions. Needless to say, the Inquiry determined to accept the views of the aged care industry that there are serious flaws in the current systems that urgently need addressing and recommended a range of options that Government consider in their response to the Senate’s report. The Senate Report can be viewed at http://www.aph.gov.au/ Senate/committee/fapa_ctte/aged_care/report/index.htm
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If this growth in demand is to be met, aged care providers will need to invest in excess of $21B to upgrade, replace or build new infrastructure by 2020.
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It should also be noted that the National Health and Hospital Reform Commission released their Interim Report several months ago with their final report due to be handed to Government in June 2009. The NHHRC Interim Report contained a number of recommendations in respect of the aged care industry with Chapter 6 being devoted entirely to recommendations regarding the structural reform of aged care. The Senate Inquiry and the NHHRC Final Report are two components of a broader whole that needs to be considered by Government, the industry and consumers with the objective of a consensus view being formed as to the strategic directions that the industry should adopt to ensure that we are in a healthy position to provide quality services to our future residents and clients. The size of this sector is going to need to almost double over the next twenty plus years. This in itself calls for a system of funding which is clearly capable of growth, sustainability and financial strength. If this growth in demand is to be met, aged care providers will need to invest in excess of $21B to upgrade, replace or build new infrastructure by 2020. If Government does not wish to see aged care return to a position of significant undersupply and accelerating excess demand then providers and financial institutions need to be able to have certainty within a financially stable and logical environment to be able to make that level of investment between now and 2020. ACAA calls on the Government to work with the industry to explore the options generated by the Senate Inquiry and the NHHRC Final Report to ensure that we place aged care in the strongest possible financial position and the best structural and governance frameworks to ensure future growth and quality service provision can be maintained over the coming decades. n
ACAA warmly welcomed the release of the unanimous report of the Senate Inquiry as it strengthened the position taken by the industry for several years and provided the Minister and Government with a course of action that if adopted would create the potential for significant change in the way in which the industry operates and more particularly provide the structures that would allow the necessary reform agenda to be developed and implemented within a reasonable period of time.
Aged Care A U S T R A L I A | Winter 2009 |
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national update
President’s Report Under the auspices of the Bryan Dorman, President, ACAA
Aged Care Industry Council, ACAA and ACSA Directors, Presidents and CEOs plus
INDUSTRY LEADERSHIP TO DRIVE CHANGE
representatives from Catholic Health Australia and Uniting Care Australia met in April to commence the difficult and long term process of reaching
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It was agreed that the aged care industry must develop a position in respect of its medium to long term future direction and ensure a whole of industry position is put to government regarding our policy positions.
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a consensus of what the aged care industry should look like in 2025 and to create the road map that will actually support the industry to move from the structure of today to delivery of a future system twenty years hence.
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his first meeting between the combined industry representatives was in all respects, a highly positive and exciting event. There was considerable agreement regarding the need for reform with a wide agenda considering the many scenarios and options to be considered in developing a medium to long term strategic vision for the industry. This industry initiative was most welcomed by all in attendance. The primary intention of the day was to initiate a program to work towards a strategic plan for the Industry, recognizing that this would not be achieved in one session. ACAA & ACSA Federal CEOs
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Winter 2009 | Aged Care A U S T R A L I A
were tasked with collecting and collating discussion notes from the day and distilling from these, an agreed set of objectives and options for a medium to long term strategic view for the industry. It was understood by all, that this process will necessitate several iterations before consensus would be reached among the federal and state arms of the two federated bodies as well as our other major industry providers. It was agreed that once a high level of consensus is reached amongst the industry representatives, the next step would be to involve a broader base of stakeholder groups such as consumers, unions, and governments to detail the options as well as explore consensus between the providers and other stakeholders and then to develop a united perspective. The recent Senate Inquiry Report was released at the end of April and the pending final report of the National Health & Hospital Reform Commission Report is expected to be delivered to Government in June 2009. In view of these reports, the Forum initiative by Industry was considered to be extremely timely. It was agreed that the aged care industry must develop a position in respect of its medium to long term future direction and ensure a whole of industry position is put to government regarding our policy positions. As ACAA president I was therefore very pleased with the holding of this first combined ACIC strategic forum. I believe that it will place the industry in a solid position to proactively develop and take an agreed policy stance to government, which will dovetail with consideration of issues arising from the Senate Report and the NHHRC Report over the next six to twelve months. n
national update
ACAA - NSW Charles Wurf, CEO ACAA-NSW
Fair Work Act commences July 2009 1 July 2009 will see the commencement of the Fair Work Act.
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his is substantial new legislation from the Rudd Government to comprehensively replace the Workplace Relations Act. The Workplace Relations Act was the vehicle which contained the Howard government’s Workchoices provisions.
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These new provisions will apply to all employers in aged care, and there is an extended transitional period ahead over the 5 years commencing 1 January 2010.
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The Fair Work Act ushers in the second round of comprehensive changes to Australia’s system of industrial relation in the span of some 3 to 4 years. In addition to the passage of the Fair Work Act, there is further legislation in the Parliament awaiting passage. The two additional pieces of legislation have been introduced as The Fair Work (Transitional Provisions and Consequential Amendments) Bill 2009 and The Fair Work (State Referral and Consequential and Other Amendments) Bill 2009. These Bills have not been passed as at June 2009. The main features of the new system, in brief, are: • a new body, Fair Work Australia (FWA), to replace existing tribunals and agencies; • the National Employment Standards (NES), setting minimum conditions for all national system employees, from 1 January 2010; • a system of ‘modern awards’ to provide an additional safety net for most employees, again commencing in January 2010; • provision for the making of single or multi-enterprise agreements, subject to new obligations to bargain in good faith, and a test that requires each employee to be better off overall than they would be under an applicable award; • retention of most of the existing restrictions on taking industrial action; • broader access to unfair dismissal complaints, with employees excluded only if dismissed during a qualifying period of service (generally 6 months, or 12 months at a small business), or if they earn over an income threshold and are not covered by an award or agreement; • a new set of ‘general protections’ against other forms of discriminatory or wrongful treatment at work; • a broader right for unions to enter workplaces, though still subject to many restrictions; • new rules on the extent to which employees retain their entitlements when transferring from one employer to another. These new provisions will apply to all employers in aged care, and there is an extended transitional period ahead over the 5 years commencing 1 January 2010. Aged care employers will need to make considered decisions in the coming years as employment conditions and salary levels are impacted by the complex interaction between existing enterprise agreements, the traditional Award/NAPSA system, and the emerging system of Modern Awards/National Employment Standards. n
national update
Aged & Community Care Victoria Gerard Mansour, CEO ACCV
Aged & Community Care Victoria recently held the inaugural ACCV State Awards for Excellence.
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he establishment of these State Awards promotes and recognises excellence across all fields of the aged care industry. The Awards celebrate significant contributions to the quality of life of older people, people with disabilities and their carers. The Awards also acknowledge efforts to increase public confidence and community involvement in aged and community services. The six award categories are: Employee, Organisation, Volunteer, Trainee, Media and Industry Supporter.
An overwhelming number of nominations were received and judged by an independent judging panel made up of industry supporters and professionals who had the difficult task of selecting the finalists and winners. ACCV was delighted to see the outstanding accomplishments of our industry showcased with the announcement of finalists and winners in six award categories at the State Awards Dinner. The achievements by individuals and organisations highlights the commitment of our passionate industry who are dedicated to providing quality care and have a deep respect for the dignity of Victoria’s elderly. It is the significant contribution of these individuals and organisations that make up the back bone of our industry. Over 170 industry representatives and guests came together at the State Awards dinner to celebrate the outstanding success of the finalists and winners. Our industry has countless unassuming professionals and volunteers who generally don’t look for thanks or praise. ACCV was delighted to see the exceptional achievements of the aged care industry recognised with the announcement finalists and winners of the ACCV State Awards for Excellence. In a new initiative for the industry, all finalists and winners received special ‘seals’ of recognition which they will be able to display at their facilities and on their correspondences and marketing materials.
The Winners June Longmore, who first walked into the McKellar Centre, Barwon Health in 1981 to see if she could help, was announced as the winner of the Volunteer Award. June uses her sewing talents to make cushions, bags and doilies that residents can personalise. This year Baptcare took out top honours in both the Organisation and Employee categories, with Brad Cooper being announced the Employee Winner. Baptcare’s strong focus on developing a positive and engaged employee culture has seen their staff turnover dramatically decrease from 45.5% in 2003 to 9.72% in 2009. Ringwood Area Lions Aged Care took out the Media award owing to their positive portrayal in the media on how they encourage residents to continue to be involved in domestic activities including keeping a kitchen garden, baking, crafting outdoor furniture and even brewing their own beer. Management Advantage, who provide aged care specific software, have displayed ongoing service and support to the aged care industry for the past 17 years, and this saw them take out the Industry Supporter Award. Amalia Araujo of Mecwacare is currently undertaking Level 4 studies which will provide her with a division 2 Registered Nurse Qualification. Her commitment to furthering her qualifications has been rewarded by being selected as the winner of the Trainee Award. n
See table of finalists and winners next page >
ACCV State Awards for Excellence
Category
Finalists
Winner
Employee
• Brad Cooper, Baptcare • Lynette Lewis, Wintringham • Michelle Willison, St Catherine’s Aged Care Facility, Catholic Homes
Brad Cooper, Baptcare
Volunteer
• Bob Martin, Villa Maria, Gateway Mount Waverley • Dorothy Martin, Warramunda Village • June Longmore, McKellar Centre, Barwon Health
June Longmore, McKellar Centre, Barwon Health
Trainee
• Amalia Araujo, Mecwacare • Fran Beall, Melbourne City Mission • Sarah Knabel, Southern Cross Care (VIC)
Amalia Araujo, Mecwacare
Media
• Benetas • Ringwood Area Lions Aged Care, Lionsbrae • Villa Maria
Ringwood Area Lions Aged Care, Lionsbrae
Industry Supporter
• Eden in Oz • Management Advantage • Verso Consulting
Management Advantage
Organisation
• Baptcare • Lyndoch Warrnambool Inc • Sheridan (Kyabram & District Health Services)
Baptcare
national update
Aged Care Queensland Anton Kardash, CEO Aged Care Queensland
The past few months have been particularly busy for ACQI, as we have focussed on the delivery of two key conferences for association members, the reinvigoration of our training services and the provision of a more intense member support service.
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he ACQI State Conference is a rare opportunity for association members to come together and not only hear about new ideas but also to celebrate the success of our industry. As always a valuable experience is the extensive networking that occurs, including the stories and ideas that are swapped over a cup of coffee.
The state conference is also an opportunity for the industry to recognise excellence and ACQI was pleased to announce at the conference dinner the winners of the state awards for excellence. They were Elaine Simpson, Regis Group, winner of the Employee Award and Wesley Mission Community Care – Gympie, winner of the Organisation Award. Congratulations to these worthy winners. ACQI not only provides member service to the Community and Residential services but also to the wider Retirement Living sector. This year the conference was held at the Hyatt Regency Coolum - given the floods and the economic down turn, it was certainly well attended. Of significant interest to the association has been the move by Retirement Living members to look at more integrated models of service and care within the village setting. A position that even 10 months ago was not commonly held amongst operators. Our Member Services Unit (Community Care) will host the National Community Care Conference next year from 1 – 4 June 2010. Work is well underway and the event promises to deliver an excellent showcase for innovation and community care responses into the 2nd decade of the 21st Century. Internally ACQI is restructuring to provide higher levels of support and service to members. In particular we have undergone a process of reinvigorating our training arm. It is concerning that in economically tough times; one of the first areas organisations seek savings in is staff training. ACQI has changed its service model to be more responsive to member changing needs, rather than repeat the traditional fixed and rigid yearly program. Through analysis of our member support services activity we have identified a worrying trend amongst members of not investing in middle management. Often when staff is promoted internally or recruitment is undertaken and a high quality candidate is found, it is unfortunate that new placements are not capitalised upon by a thorough induction and introduction to the operating procedures of the organisation. It is clear that investing in staff needs to be seen as an investment in future success. Our member Services Unit has established a Consulting arm to provide middle management coaching and E-Mentoring. In addition we have experienced strong demand for gap audits, risk management, ACFI audits and intensive support during periods of non-compliance even to the extent of being appointed as Nurse Advisers for non-compliant services. We believe these approaches are indicators of our collective knowledge and capacity to support members in crisis or members who wish to improve client and business outcomes – in summary a process of putting knowledge and experience into action for the exclusive benefit of members. Our commitment to workforce issues has been exemplified by our intensive examination and costing of the Award Modernisation implementation process, indigenous employment mapping projects and establishment and ongoing support of the Young Professionals in Aged Care Network. It has been a busy period in a very large state but we believe we are focused on the key issues facing the industry and value the opportunity to engage with ACAA at a national level to compliment our state based approaches to bringing core issues to the attention of the Australian Government. n
national update
ACAA - WA Anne-Marie Archer, CEO ACAA-WA
Swine Flu and the annual influenza season West Australian aged care providers are once again preparing for the annual winter influenza season and we encourage them to access the resources available via the WA State Government.
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CAAWA was actively involved in the WA Government Human Influenza Pandemic Taskforce that resulted in the West Australian Health Management Plan for Pandemic Influenza 2009.
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We wish to encourage all aged care providers in WA to keep the lines of communication open to their residents’ friends and family about the pending swine flu and annual influenza season.
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This Plan is freely available online at http://www.public. health.wa.gov.au/3/541/3/plans__pandemic.pm One of the key issues covered in this plan is the preparedness planning and specifically in regards to diseases outbreak management in residential aged care settings. The following components are featured in the WA Health Management Plan for Pandemic Plan 2009: •
The development of a register listing all aged care facilities in the State to which the Health Department has access to on an as needs basis
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The promotion of annual influenza vaccination of both staff and residents, particularly those staff who provide direct patient/resident care
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For each facility to maintain an influenza/pneumococcal vaccination register of all residents and staff. Similarly, family members with frequent contact with residents should be advised to have an annual influenza vaccination
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Completion of infection control training by all caregivers
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The institution of improved institutional surveillance and reporting mechanisms to Public Health Units enabling the rapid detection, reporting and appropriate management of suspected pandemic influenza cases and contacts, and the protection of non-exposed residents, staff and visitors within a facility. In this regard, A Practical Guide for the Management of Influenza Outbreaks in Residential Care Facilities in Australia was updated
In addition, we have been activity pushing a public message to the wider community urging families and friends to be mindful that the frail and elderly can be more susceptible to viral infections; and influenza for the elderly can have dire consequences. In particular we have highlighted that it is crucial that people think twice before visiting relatives in a residential care environment if they have a cold or are generally unwell. We are all aware that aged care providers have their influenza pandemic plans and management strategies in place; however, we hope that a consumer awareness strategy will ensure providers do not have to initiate these planning provisions. We wish to encourage all aged care providers in WA to keep the lines of communication open to their residents’ friends and family about the pending swine flu and annual influenza season. If WA providers are seeking updates on the latest information on the status of the swine flu; the WA State Health Department is maintaining regular updates on their website at http://www. public.health.wa.gov.au/2/949/2/swine_flu.pm n
national update
ACAA - SA Paul Carberry, CEO ACAA - SA
“When will the government get past short term patches, and produce policies which give us some certainty about aged care’s future?”
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his was a question put to me following a recent forum we ran for our members. I had to admit two things; (a) it was a vey good question and, (b) it was one I couldn’t honestly answer. The forum was held in the week following the 2009-10 Federal Budget where, once again, we saw some fiddling with funding, but nothing more. An increase in daily fees flowing from the single pension increase, coupled with the freezing of CAP adjustments. At best, a small funding gain in the first year, followed by losses thereafter, leaving my provider’s query about certainty for the future as a question still on notice. It’s not as if the Government has lacked information as to the need for greater policy foresight, or lacked suggestions about how they might go about it. In March this year, an Access Economics study commissioned by several large provider organisations found that, in order to break even on building costs over a 25-year period, the accommodation charge would need to be 50% higher than at present. An earlier study by PricewaterhouseCoopers found that, there would be a shortfall in aged care building funds of $5.7 billion by 2019.
Despite the obvious consequences of a failure to provide enough aged care beds to meet future demand, neither the budget, nor anything else emanating from the Government, gives any hint of how it proposes to tackle this problem. In April, a unanimous Senate Inquiry report recommended that the funding indexation formula be reviewed as to its adequacy in relation to costs. This is not a new idea, and echoes a mountain of data pointing to the inadequacy of the funding model, and to the increasing financial stress on the industry as a result. In it’s submission for the 2009-10 Federal Budget, the industry’s peak council, ACIC, again called for an indexation method that meets the cost of care. Once again, the Government has left such vital considerations to another day. To add further to uncertainty about the future, the Modern Awards which are due to commence on 1st January, 2010, will add significantly to our members’ wages costs in South Australia, with no corresponding suggestion from the Government that these increases will be funded. Concerns about the awards driving up costs are being echoed by other industries, including the cleaning industry, and restaurant and catering. In a recent interview on ABC Radio in Adelaide, the Deputy Prime Minister placed great emphasis on the cushioning effect of the transition phase of the implementation of the awards, in response to concerns about cost increases in a time of economic downturn. We hope it turns out that way. On a more positive note, we recently celebrated the gazetting by the South Australian Government of reforms to our medication regulations which now enable enrolled nurses to administer drugs of dependence in high care facilities. This removed an unnecessary and illogical impediment which had existed for many years. Also, it’s gratifying to see that our education program continues to receive strong support from providers in South Australia. This is tangible recognition by providers that their staff are their most valuable asset, and that investment in their continuing education and development will always pay dividends. n • In the state budget handed down on 4th June, 2009, all residential aged care facilities in South Australia were exempted from land tax.
national update
ACAA Congress 2009 15 – 17 November • Melbourne Convention & Exhibition Centre 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 Exhibition Centre. This venue boasts the Worlds first 6 green stars rated centre making it environmentally sound with state of the art technology.
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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. The event is also supported by a large trade exhibition. The Congress is complimented by a diverse social program.
Always a highlight to any ACAA event is the social program and 2009 is sure to be no exception.
Exhibitor & Delegate Reception
Monday 16th November 2009 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! >
national update
< A strong program is being compiled reflecting key industry trends & issues. Some highlights from the program are:
• Connecting & Communicating with Young People
Professor Steve Allsop, Director, National Drug Research Institute, Curtin University
• What Leadership Isn’t- Cracking the corporate culture introducing UGRs
Steve Simpson
Steve Simpson CSP is an author, consultant and international speaker who heads up Keystone Management Services based in Australia. He has spoken to audiences in Australia, the UK, the US, New Zealand, Dubai, Tanzania, Singapore, Malaysia, Thailand, India, Ghana and South Africa.
• Engaging with an ageing population. The Gold in the grey: Understanding Current Trends, New Futures
Mark McCrindle, McCrindle Research
• “Quality, Trusted Care: Finding New Ways Amid Local and Global Challenges”
Alyssa Huber-Clarke, Aged Care Consultant, Northbridge USA
Alyssa has 18 years experience in senior living, health care and aging services; consulted to the American Health Care Association (ACHA), the American Association of Homes and Services for the Aging (AAHSA) and more than 40 private and non-profit member businesses. Career focus is on economic growth, societal trends, legislative impact, care models and workforce challenges.
ACAA National Awards Don’t forget to submit your application for one of the ACAA National Awards which are held in conjunction with Congress. Look for the flyers inserted in this issue of the magazine or download them directly from the ACAA website at www.agedcareassociation.com.au
The ACAA 2009 Awards categories are: •
Excellence in Management Award – in the division of clinical, manager or facility/team
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Employer of Choice Award – in the division of employer or employee
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Building Award – in the division of new building or renovated building
For more details on exhibiting and registration contact the Congress Organisers: Melissa Hillman ACCV Conferences & Events T. 03 - 9805 9400 events@accv.com.au http://www.accv.com.au/ ACAACongress.aspx
profile
The people who keep the wheels of aged care quietly turning Mike Swinson profiles Sharyn Hamilton, a part time bus driver for Nurses on Wheels. ‘When my Mum had a stroke about 7 years ago, I left Avis and worked at Blakehurst Aged Care, as a carer for 2 days a week. I helped look after 20 people who all lived in self care apartments, helping with cleaning and washing and meals. I did that for about 4 years.’ ‘One of the reasons why I did this was because I like older people, I like mixing with them, they are fun, they have great stories to tell, great experiences in life to re-live and I’m a good listener. I also had a great relationship with my Grandparents and they gave me a lot of help and support in life, so I like giving something back. I also wanted to know more about aged care because Mum had a stroke and I needed to know as much as I could about what was needed to look after her.’
‘We take the young girls out in our bus on Monday, (the young ones are in their 70s and early 80s) the older ones on Tuesdays, (mostly over 90) and it’s boys only on Wednesdays. When it’s time for lunch, the young girls want to eat out, at a club or cafe, the older ones just want something to eat on the bus, so they don’t have to get up and walk and the boys; they are easy because all they want is the same thing, a pie and chips and a beer.’ 22 |
Winter 2009 | Aged Care A U S T R A L I A
M
eet part time bus driver for ‘Nurses on Wheels’, and a lady with a great sense of humour, Sharyn Hamilton. Sharyn, a former domestic carer has been driving buses, taking older Australians out on daily tours for four years. Sharyn grew up in the suburbs of Southern Sydney, she was school captain of Lilli Pilli Primary but left high school when she was 16 years old to go to work. She used to work behind the desk for Avis Rent a Car, at Sydney Airport and in the office in Kings Cross. ‘I sure met a lot of interesting and colourful people when I was working there, especially early on Sunday morning when you opened up the office! We had all sorts trying to get in and they didn’t want to rent a car either. It was an eye opener for me.’ Sharyn is married, has three adult kids and a mum who is wheelchair bound and living in a nursing home just down the street.
‘I could go on and on about what I call dysfunctional families, but I won’t. I see the impact of broken families and fractured relationships on the older people I look after all the time. Sometimes it’s really sad.’ Sharyn is obviously a keen observer of human nature, she has noticed during her time as a carer and driver, that the oldies who are well adjusted, who still, as she put it, ‘had their marbles,’ were the ones who read the paper, who listened to the radio and the news, who took an interest in life and what was going on around them. Those who kept themselves active with activities like knitting or playing cards. She said she also noticed almost all of them had close families and people to visit them. Many of the ones she saw sitting all day and not involving themselves in activities, who didn’t seem that interested in life were very lonely. ‘I’ve been driving the bus for Nurses on Wheels for a bit over 3 years. I travel with a nurse called Liz and up to 10 oldies. You can’t come on the bus unless you can manage to get on and off unaided, so we
don’t take anyone who is in wheelchairs or can’t walk. Monday and Tuesdays are for girls only, Wednesday for boys only. The boys like it on their own, because they all reckon the girls talk too much. Yet on Thursdays when we have a mixed bunch there are two boys who talk their heads off, they are worse than the girls.’ Monday is the younger girls group who are all in their 70s and early 80s. ‘They are really quite out there, they want to go shopping, they want to eat out, and they want to walk near beaches. They’ll go to the clubs for lunch, out to watch the movies, every day we try to accommodate an idea for an activity or a place to visit from someone on the bus who has a good idea.’ Sharyn’s bus trips take her from the Southern suburbs of Sydney to Wollongong or North to Palm Beach. The destination seems to depend on who is on the bus, what they want to do and where they want to go. ‘Tuesday’s group are all older, in their nineties, and they love their coffee from our favourite shop in Cronulla, the Ice Cream Cafe at Cronulla Beach. They are sticklers for their routine, are a bit lazy and don’t want to get off the bus sometimes. They grumble a bit if we make them do too much. ‘The highlight of their day isn’t the bus trip, it’s the TV program ‘The Bold and The Beautiful’ at 4.30pm. They have to be home for that!’ Sharyn told me that when they take the boys out on Wednesday, all they want are chips, meat pies and a beer. ‘We do like to feed the birds in Centennial Park, well one of the boys does. We have to keep a close eye on him, as he goes chasing the birds and he could easily fall in one of the nearby lakes or dams.’ Sharyn says it’s wonderful seeing people get so much enjoyment out of a simple activity. Yet when she talks about ‘the bird chaser’ her voice is tinged with sadness. ‘He lost his wife to cancer a few years ago. He is 78 and has cancer himself. Liz has to make sure he gets his pain medication when he comes on the bus with us.’ ‘When you face something like that it, knowing that some of these people I take out don’t have long to go, it toughens you up emotionally. With some of these people I only see them once a week, but I count them as my friends, they are always interested in what’s happening with my
The big attraction for everyone who goes on the bus tours is the Christmas extravaganza.
‘Working in aged care is mentally draining and exhausting, day after day, going home, thinking about some of these older people who have no-one to visit them, no-one from their families who bothers to come and see them, that’s probably the hardest thing for me to cope with.’
‘When I was interviewed for this job, I was asked if I sang or danced? I said no, but I could give it a go! I can make people laugh, my Grandad used to say “you should be on the stage Sharyn.”
‘Then I compare that to the fun and laughter we have on the bus, some of the ‘young girls’ bring copies of emails with jokes and we all have a great laugh. It’s what makes life worthwhile!’
‘Liz, the registered nurse I work with and Kerry the other bus driver, we all put this Xmas show together. We get all the bus groups involved and they dress up. You wouldn’t believe it, the boys love dressing up as girls, they can’t help themselves. Last year they dressed up for Priscilla, Queen of the Desert. It was a hoot. A lot of them forget their lines and just head off on the stage and do their own thing. You just shake your head sometimes but they are having fun and that’s all that matters. We have kids in, one year we had belly dancers, magicians, they all love it.
Nurses on Wheels Inc. Is a non profit charitable organisation, partly funded by government, serving the South-East corner of the Sydney community. n
family. I know that death is a part of life so I have toughened myself up in this job. You know it’s hard at times, but I still cope.’
All their families come and we all have a great laugh. It’s fun. ‘I don’t do this for the money, because the pay in aged care isn’t that great, I do it because I like it. The mental workload is huge, you are an integral part of every client’s life, they know you well, you know them and you are always aware that it is the final part of their life.
Opposite page: Sharyn and the Tuesday girls Top: Monday girls – Sharyn, Joan, Val, Kerry, Betty, Joy & Lee Above: Thursday boys – George, John & Ken
Aged Care A U S T R A L I A | Winter 2009 |
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The Allan Turner Story By Mike Swinson Late last month a quietly spoken, quiet achiever, Western Australian Allan Turner, was named as one of two inaugural inductees into the Aged Care IT Hall of Fame. His award came as part of the annual ITAC (Information Technology in Aged Care) Awards celebration gala dinner in NSW.
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llan’s induction into the Hall of Fame recognises his lifetime of service in various IT management positions and currently as General Manager, Information Management of Silver Chain, the largest community care provider in Western Australia. The recognition comes as Silver Chain is in the midst of rolling out one of the biggest and most adventurous IT projects in its history. ‘We have had this program on the books for some time,’ said Allan, ‘but it had to be cost neutral and it wasn’t until smart phones arrived that we could see instant cost benefits and away we went.’ Silver Chain is a very large organisation, with over 2,500 employees and 400 volunteers, it services over 39,000 clients in locations from Albany, to Perth, East to Eucla and North to Carnarvon. It is an organisation that has been at the forefront of IT adoption for years and its mobile technology has already been used for a wound prevalence survey of patients in WA public hospitals as part of the WA Health Departments Wound West project which is drawing international attention. More details on the project are available from the WA Department of Health website at http://www.health.wa.gov.au/ WoundsWest/home/. >
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identified areas of savings, increased staff productivity and client advantages. The combined positives far outweighed the negatives, so the project was expanded to include all field staff. ‘It wasn’t just cost neutral, which was the board’s stipulation,’ says Allan, ‘it will mean multi-million dollar savings for Silver Chain due to better and more efficient processes. It will also mean we are finally a truly connected organisation, where we can reach every staff member instantly and they can talk to us, that’s what I’m most excited about.’ ‘Don’t get me wrong, there are problems,’ says Allan. They include:
“
I love IT, it never sits still, life is always changing. IT re-invents itself every few years, even at my tender age I like that and I like resolving problems, I have to, introducing new IT systems creates problems
”
< Allan was still a bit shell shocked when I spoke to him, soon after he had received his award. ‘Quite frankly my first response was shock then I thought, there must be a mistake, they must have got the wrong person, I’m not an aged care specialist, I’m in IT. But upon reflection it is pleasing to be recognised by your peers. ‘I love IT, it never sits still, life is always changing. IT re-invents itself every few years, even at my tender age I like that and I like resolving problems, I have to, introducing new IT systems creates problems,’ he said.
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His new project will create, has created all sorts of headaches and problems, but it comes with huge advantages, hard and soft. Allan Turner is managing a million dollar rollout of over 2000 smart phones to Silver Chain staff across Western Australia. Like ‘Wounds West’ it’s another project that is attracting international interest. Allan told me ‘that for 20 years, Silver Chain has been fortunate to have had executive leadership that understood IT and knew it had the capacity to change the way we live our lives, to add value to home and community care. This latest project is living proof of that philosophy.’ He is quick to sound a warning for all those managers who think they can introduce new technology into a large organisation easily.
•
Tracking 2000 mobile smart phones
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Enabling every phone with specific software
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Teaching staff how to use them
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Overcoming resistance to change
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Different phones with different features
‘Some phones have GPS, some are Wi-Fi, some have a camera, they get lost they get broken, they get dropped down toilets, they get left in McDonalds. When they aren’t connected to anything with a cable, problems of asset management compound enormously.’ Allan says ‘What about user acceptance? How do you successfully ask a 55 year old nurse, who hasn’t been in front of a computer, who has a mobile phone that she hardly uses, who may, just may have learnt to send sms messages, to accept and use this smart new gadget?’ Allan tells me the advantages of the new technology are almost endless. Silver Chain can instantly: •
See how well a client is progressing, no matter where they live
‘Resistance to change is one of the biggest roadblocks to effective use of this type of technology. Don’t for one moment think that introducing technology like this to a workforce meets with everyone’s approval and support, it doesn’t and it won’t.’
•
See how well or badly a wound is progressing
•
Update every employee’s timesheets electronically
•
The smart phone project began back in 2005 with 100 hospice nurses using mobile phones enabled with Silver Chain’s own software. The success was immediate and better than expected. It identified areas of concern, like the not so great mobile phone coverage in WA. ‘No matter what the Telco’s tell you,’ says Allan. It also
Message every staff member when required
•
Access more accurate client information
These are 2000 smart phones, with touch screens, configured with Silver Chains own software, enabling staff to enter all relevant client care information from the clients home, send images of wounds or
ulcers to a distant specialist if required, do their timesheets on, send messages, use as a personal phone, keep their own mp3 files, music or images of the family. ‘We had to make sure that once data and images were entered, it didn’t matter if the phone couldn’t connect to the network instantly, that the phone was smart enough to send that data automatically once a connection was established, independently of the operator,’ said Allan. ‘We made sure they only enter the data once, and once it’s in it’s also secure.’ If you are wondering if smart phones are just a gimmick, think again, international research by Gartner says by next year, smart phones will be in over 1 billion homes across the world and in Australia it will reach nearly 5 million. Optus research says that 73% of the Australian business’s they surveyed plan to use smart phones in their business in the next 2 years. ‘I’ve been told that many other community care organisations from around the world
are interested in this project and how it helps us manage client care and wounds in the WA community. That’s great. ‘I don’t think many people understand the power of a connected network, what you can do with that technology. I think it’s a very powerful tool and will benefit us and our clients enormously as time goes by.’ n CONTACT INFORMATION TURNER, Mr Allan General Manager, Information Management Silver Chain Silver Chain House OSBORNE PARK WA 6017 6 Sundercombe Street Mob; 0419 907 357 Phone: (08) 9242 0293 Fax: (08) 9242 0268 Email: aturner@silverchain.org.au Website: www.silverchain.org.au
The other inductee into the IT Hall of Fame is June Heinrich, the CEO of Baptist Community Services, based in NSW. Her profile will appear in the next issue.
technology
ITAC 09 Conference and Awards I don’t think I have ever seen such excitement. The two girls from Kempsey, from Cedar Place, a very small aged care facility had won the National ITAC award for Best Implementation of the Year (under 150 places category) for 2009. They were speechless, almost beside themselves with excitement.
‘W
ait till Kempsey hears about this, I have to ring my staff straight away and let them know, it’s all their doing,’ said CEO Mary Henry. Early next morning they flew back to Kempsey, straight into the eye of that nasty low pressure system that inundated her home town and sees Cedar Place battling to cope. ‘Many of our staff are stranded and can’t get to work.’ When I tried to contact the editor of the local paper, the Argosy, I discovered is also stuck at home, without power and emails. It’s all go in Kempsey. ‘There is no doubt’ said Rod Young, the CEO of Aged Care Association Australia (ACAA) ‘that government needs to ensure that the right financial supports and systems frameworks are in place that will continue to attract investment from aged care providers to continue to deploy IT solutions that maintain quality services at high levels of efficiencies.’ While the ITAC annual awards are the highlight of the Conference, there is more, much more to this two day event. I will reveal the other winners further down the story! ITAC09 is a unique opportunity for software and hardware vendors to meet and greet new and existing customers. It is a unique opportunity for facilities to begin the process of research into what is the best investment in IT for them. It’s also a chance to talk to the IT specialists from the big operators, to see why they chose the software or infrastructure they have, how they are coping with the financial imposts Microsoft is making on the aged care sector. Take Greg Russell, the CIO of Uniting Care NSW and ACT. Greg is not polite when he describes the multinationals grab for cash, facing as he is a hike of nearly 400% in licence fees. Others, like Paula Carleton, the CIO of Baptist Community Services, a large not for profit operating in NSW, said the impact of the Microsoft fee hike will mean less money for services BCS provides for the homeless and for women’s shelters. Many of these organisations are now researching software that can operate from what is called Open Source, free of licence fees. If you were at ITAC, you could have attended the afternoon session on the first day, to hear different views on the benefits and disadvantages of Open Source. One of the most remarkable presentations came from the General Manager of Information Management for Silver Chain in WA, Allan Turner. It was a lesson on ‘herding cats.’ Ever tried it, well Allan reckons he is learning fast as he tries to keep control
of 2000, yes 2000 new smart phones that are being handed out to every care provider in his organisation. It’s a digital revolution and is being watched by other community care providers from around the world. Allan has been at the forefront of IT innovation for many years and his dedication was rewarded when he was one of two inaugural inductees into the ITAC Hall of Fame. Allan told me ‘I feel humbled by this recognition; I am just an ordinary bloke doing his job.’ Trouble is no-one else thinks he’s ordinary, because he’s constantly doing extraordinary things. The other inaugural inductee into the Hall of Fame is Dr June Heinrich >
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< who couldn’t attend. June is the CEO of Baptist Community Services. She works as hard today as she did when she was much younger. She has taken BCS from an annual budget of $28 million and 800 staff, to a budget of $183 million, with 3,500 staff, over 700 vehicles, 2,000 beds, 2,000 village ILUs, 1,100 CAPS and EACH programs, and 60 HACC programs. Get the picture, this lady is something else! Welcome Dr June Heinrich and Allan Turner to the ITAC IT Hall of Fame, it’s an honour that is well deserved. The conference also featured sessions on designing community care systems, on Total Cost of Ownership, in other words understanding what the total cost of IT investment will be, not just the cost of the software or hardware or both. I met John Perkins from the Ethan Group, whose stall had a ‘real coffee’ facility, expertly run by Danielle, yup, she was a real Barista. It’s a great way to attract interest in your offering. You need to talk to John if you want to review any of your
hardware resources, phone systems, wireless networks and so on. There are substantial productivity gains to be had. (That translates into saved $$$$, in some cases, lots of $$$$$.) The awards night revealed the new IT Company of the Year, iCare. The company provides Clinical, Care and Medication Management Management solutions for aged care in both Australia and the United Kingdom. Managing Director Chris Gray told me the award will underpin the expansion of his companies push into the UK market. He said ‘our company have never lost a client since 2002.’ The other award went to Barwon Health, the regional healthcare provider in the Geelong district of Victoria. Barwon Health won the award for best Software Implementation for facilities or providers of over 150 beds. Barwon Health has invested a substantial amount of money in their IT package and by the sound of it, will repay that investment in no time. They no longer have to produce and store
thousands and thousands of paper based documents and that’s just one small advantage. There are many more. Sue De Gilio, CEO of Barwon Health says that the benefit to staff and patients from the adoption of the new technology is far-reaching. “We have numerous sites, which presents problems with accessing patient’s records. This system not only ensures that clinicians can access patient records anywhere, anytime; it also protects the patient’s medical history.”
revolution, so if you get a chance, get on the bandwagon before it’s too late! Then there was Bill Deveney, former Lord Mayor of Melbourne, former CEO of Melbourne’s Major Events Corporation, a man almost crippled by severe back injuries and constant pain who shared his vision for a unique aged care, community based centre for indigenous Australians at Shepparton in Central Victoria. Watch that space! The awards are run under the auspices of ACAA, ACSA (Aged & Community Services Australia) and HISA (The Health Informatics Society of Australia.)
“By having all a patients details in one location, care planning is made so much easier and staff are not tied down with administrative tasks, freeing them up to spend more time actively caring for patients,” she said.
Chris Gray Managing Director, iCare Solutions Pty Ltd. Ph: 03 9653 8100
You missed listening to a fascinating presentation from Ross Dawson, globally recognised as a futurist and authority on business strategy. He sees the changes in technology in aged care as an exciting
Mary Henry Facility Manager of Cedar Place. Ph: 02 6563 1177
Contacts
Sue De Gilio CEO of Barwon Health. Kate Nelson, Director, Communications, Marketing & Community Engagement. Barwon Health. Ph: 03 5226 7707
Finalists and winners next page >
technology
Finalists and winners Aged Care Industry IT Awards - FINALISTS IMPLEMENTATION OF THE YEAR Over 150 Places Category
IMPLEMENTATION OF THE YEAR Under 150 Places Category
1. Barwon Health McKellar Centre
1. Alphington Aged Care
1. HealthSolve
2. Cedar Place Aged Care
2. iCare Solutions
3. St Lukeâ&#x20AC;&#x2122;s Care
3. Australian Finnish Rest Home Association
3. Management Advantage
4. UnitingCare
4. Grant Lodge
2. Bupa Care Services Pty Ltd
ICT COMPANY OF THE YEAR
4. Thoughtware
Aged Care Industry IT Award - WINNERS IMPLEMENTATION OF THE YEAR Over 150 Places Category
IMPLEMENTATION OF THE YEAR Under 150 Places Category
ICT COMPANY OF THE YEAR
Barwon Health McKellar Centre
Cedar Place Aged Care
iCare Solutions
HALL OF FAME June Heinrich, Chief Executive Officer, Baptist Community Services In recognition of industry leadership, drive and innovation in systems wide IT deployment Allan Turner, Chief Information Officer, Silver Chain To honour the valuable contribution and leadership in the area of technology in the Australian aged and community care industry
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technology
5 minutes with Andrew Barton, Mid Market Solutions Manager Aged Care A/NZ, IBM Australia Ltd
“
I know that labour charges in the aged care sector range from 70% to 85% of most facilities or organisations costs. That’s a huge burden, we can offer a technology solution through the use of the Vocera devices that will increase staff productivity and reduce labour costs. Sometimes the financial savings can be substantial.
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”
ndrew Barton is IBM’s Mid Market Solutions Manager for Aged Care in Australia and New Zealand.
He has taken on this specialist aged care role at his own insistence, because he sees the capacity for IBM to make big difference in the cost and quality of care delivered throughout the sector, through the adoption of new technology. Q: ‘What are some common difficulties/roadblocks that you see aged care facilities facing as they try to deliver better resident care? A: ‘From some basic research done at a small Victorian aged care facility, we know that staff can spend 25% or more of their time, walking the corridors, searching for residents or other staff. The installation of the Vocera Communication system can reduce that wasted time substantially. It optimises communication time and efficiency/collaboration that improves staff satisfaction and the resident experience.’ Q. What are the key operational benefits of the Vocera Communication Solution? A: ‘Because Vocera is a lightweight, voice activated wireless communication device that can utlilise industry standard Network Architecture, it allows nursing staff/carers, in fact anyone wearing it to easily communicate almost entirely hands free. ‘Staff simply log-in when they arrive at work, they can receive messages and/or communicate with other individuals, groups or the entire network if required.’
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‘Judy Moore, an RN at Samarinda Lodge in Victoria says no matter where she is in the facility, she can ask the system to call someone from maintenance to fix a problem, she can talk to the entire facility in an instant and she can keep tabs on wandering residents more easily.’ Judy says ‘We don’t work harder, we just work smarter.’ Q: How has IBM been able to help aged care facility clients improve care? A: ‘The technology is easy to install, easy to understand and easy to use, even if staff have limited IT experience. Staff quickly gain confidence in its use and realise its capacity to make their workload easier and more efficient. The technology also allows a facility to meet its ‘duty of care’ commitments, while allowing residents greater freedom to move around the facility.’ ‘Samarinda Lodge has experienced a 10% increase in productivity in the first month with the IBM Vocera solution and both staff and resident morale has improved as the staff get to spend more time with residents.’ Q: What impact is there in relation to staff and softer benefits like staff morale? A: ‘The so called ‘soft’ benefits include improvement in staff morale, the retention of existing staff, because the work is less frustrating and more rewarding and the attraction of younger nurses who expect to work in a high technology area in Aged Care. ‘Add to that increased flexibility, because productivity is higher, facilities may not need to call in as many agency staff or casuals when fulltime staff get ill.’ Tanya Gilchrist, the CEO of Samarinda Lodge says ‘IBM took the time to look after us when we installed the Vocera System, they supported us as we introduced the technology, our staff now have more time with residents and it’s made their jobs a whole lot easier.’ n Contact details: Andrew Barton Mid Market Solutions Manager Aged Care A/NZ IBM Australia Ltd E: abarton@au1.ibm.com T: 02-9928 0218 M: 0409 227 866 www.ibm.com.au/agedcare
Technology development in regional and remote IT facilities Much has been touted about the productivity savings that technology can bring. As stated by one Aged Care CEO in Melbourne: “My return on investment was 14 weeks, and I can service 20% more beds with the same amount of staff.”
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large number of commercial organisations have benefited from technology, but the vast majority of not-for-profit aged care providers are missing out on the potential benefits particularly in regional and remote areas. According to John Perkins, Director, Ethan Group “Many notfor-profit aged care organisations don’t have the finances, staff or specialist knowledge to overhaul their inadequate IT systems which enables them to operate in a centralised, standardised environment with up-to-date business applications or a layer of technology on which to build richer, more business-oriented applications.” Productivity benefits that are being seen by regional and remote facilities include:
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Saving time by reducing time spent on administrative tasks
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Automation of duplicate processes
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Eliminating the need to re-record information
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Improved outcomes for residents
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Improved accuracy, quality and availability of resident information
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Increased sharing of information within the facility eg nurses to kitchen, staff to GPs
Through their leading role in the ConnectCare project, which is supported by $5.6 million funding from the federal government, Ethan Group has collaborated with a whole ecosystem of organisations to develop affordable, innovative solutions that save costs and give back time to the staff and residents of aged care facilities. Steven Richards, CEO of Nambucca Valley Care, which is taking part in the ConnectCare project says that IT is crucial for small regional facilities: “First of all from a context viewpoint we look after people in the final years of their life, for the rest of their life. We are doing that with limited financial resources, over 50% of all aged care facilities are losing money, a significant majority can’t afford to rebuild and so to get efficiencies in operations is crucial to the vital work we do.” n
technology
Informatics and technology-based aged care approaches Acknowledgement: A version of this article was presented as a peer-reviewed paper at the 2008 Health Informatics Conference, Melbourne. The conference paper was titled, Implementing technologybased care and management systems for effective aged care outcomes: Issues and recommendations. Authors: McDonald, T., Hardy, J., Kwok, C. and Lee, C. Permission has been granted by HIC 08 for publication of this revised version.
Authors Professor Tracey McDonald, RSL LifeCare Chair of Ageing, ACU National Ms Caroline Lee, Managing Director, Lee Total Care With acknowledgements to J. Hardy, C. Kwok, D. Hawkins and T. Sherwood who were involved in the initial project.
An understanding of potential hurdles in implementing contemporary systems of information technology (IT) in the aged care context can help with successful introduction of technology-based approaches to aged care tasks. In this article a case study of RSL LifeCare ANZAC Village, NSW is used to show how factors influencing staff uptake and proficient use of IT were incorporated in a change management informatics strategy.
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Background Among the challenges facing health and welfare policymakers is an ever-increasing demand for services to meet the needs entitlements of an ageing population, and evidence of good, safe care provision. Efficient management of government subsidised services can occur with smart systems that apply informatics to a range of service elements. Among possible gains from technological strategies is savings of managersâ&#x20AC;&#x2122; and staff time, along with greater accuracy and completeness of client records and service outcomes. In the residential aged care industry regulatory compliance risk is considerable. Aged care providers need to ensure that they not only provide safe and effective services to residents, they must be able to provide evidence at short notice that such has occurred. The role of government in these contexts includes the promotion of healthy, active ageing (Soar & Seo, 2007); support for improvements in documentation quality and efficiency, and e-commerce. A major strategy by the Australian Government has been to introduce a new funding model, the Aged Care Funding Instrument (ACFI) (Australian Government Department of Health and Aging, 2008; Cullen, 2007; Hogan, 2007) developed in parallel to e-health through aged care e-health connectivity projects. Potential benefits of e-health include increased safety and quality; improved access to appropriate care; a shift to coordinated care and increased workflow of the health workforce, and the ability to embed evidence-based practice as the foundation of health care interventions (AHIC, 2007). In order to facilitate uptake of information technologies by aged care service providers, the Department of Health and Ageing invited computer software providers to register and work with the department and Medicare Australia in overcoming design compatibility and practical issues to deliver full range of software options to the aged care industry in any location. Some software issues remain to be resolved particularly in relation to compliance auditing processes developed initially around paper-based documentation.
Case Study Setting In 2007 the RSL LifeCare ANZAC Village in Sydney undertook a whole-of-organisation approach to introduce a system of contemporary IT management, care and treatment services emphasising prevention of health deterioration and maximising quality of life. Within six months a wholesale change was achieved across the Village comprising 460 residential aged care clients at various levels of need for aged care.
Solution
(ii) Training
(i) System design
Prior to training, staff were grouped according to their IT skill levels to participate in sessions designed around their learning needs and the IT skills required in their work roles. In all 310 employees, including registered and enrolled nurses, assistants in nursing and care service employees, allied health staff and recreation aides, undertook the LTC training. A total of 1,147.5 hours of training occurred averaging 3.7 hours per staff member. After training, and before each area ‘went live’, staff underwent a 10 minute competency assessment. When the competency of the staff member was established, each was set up with their LTC username and password.
Workflow issues around documentation systems for care, treatment and management needed to be overcome. These included maintaining continuity of records during the transfer from a paper-based system to the IT system; and also ensuring that the IT system, Lee Total Care (LTC) included all aspects of information needed for regulatory compliance under the Commonwealth Aged Care Act 1997 and Quality Principles (as amended). The IT system was synchronised with the development of staff skills in using computer-based records. Staff training in basic IT usage and intensive skills enhancement included group learning and on-to-one coaching. Established IT systems were modified to integrate commercial software for which further staff training was needed. A systematic approach was undertaken to the staged implementation of LTC across all low and high care units of the RSL ANZAC Village. A staff ‘computer knowledge survey’ was the first step in change management. The results guided the type, content and frequency of training sessions required. Skill levels varied widely across staff within each unit and between different units. Overall 17.6% of respondents had no computer knowledge at all; 36% had a basic understanding of computers; and 46.4% had a good working knowledge of computers and their usage.
During implementation the LTC system prompted some changes in work structure and practices. For instance, past restrictive work practices included only registered nurses completing all care documentation (Angus & Nay, 2003). All care staff, whose usual role was completing observational checklists such as bowel charts, sleep assessments etc, were invited to use the LTC system and needed to be shown how to write online progress notes, complete incident forms and record assessments (Ryburn, 2007). Some managers were not fully supportive of care staff undertaking LTC training because of concerns about the quality of care documentation which had previously been a registered nurse responsibility. >
Informatics and technology-based aged care approaches (cont’d) < Each area was scheduled for a system ‘go live’ date by which time all documentation needed to be done on the computer using LTC. Low care managers in hostels were quite keen to commence and many expressed delight at the teamwork created as staff helped each other on the computer to master the system. The two trainers have maintained a watching brief and on-call availability for the areas in which the system is ‘live’.
Uptake An essential aspect of the project and its implementation was staff motivation and predictably some embraced the change while others were more resistant or lacking in confidence. On the whole staff reactions were surprisingly positive and even those who showed initial reticence embraced the change following training and coaching. All sessions were tailored to individual need and learning pace and provided in a way that ensured personal privacy. The main implementation issues related to: (i) Skill levels, workloads and professional roles (a) Computing skills of participants (b) Maintaining a functioning paper-based system (c) Professional and work role skill levels (d) Workload issues with new system (e) Role delineation issues (ii) Age of care staff (a) Middle-aged staff with English as a second language felt vulnerable (b) Younger staff tended to be computer-savvy and over-confident (iii) Other Health Providers (a) Allied health staff reluctant to commit to an electronic system (b) Hostel managers and enrolled nurses like the LTC system (c) Administrative staff liked centrally located information (iv) Challenges and Barriers (a) Overcoming reluctance by some staff and keeping pace with enthusiastic early adopters of the change was a challenge that stimulated the RSL LifeCare trainers and IT support team. Innovative, catered training sessions made participants feel welcomed, relaxed and valued. (b) Consistent messages and openness about the change were achieved with all training materials written in plain English and computer technology jargon kept to a minimum. A staff newsletter “Chatterbox” and coloured flyers around the Village announcing sessions and successes.
Ongoing implementation Informal audits of the system documentation ensure that workflow occurs and the organisation is able to manage regulatory compliance risks. Ongoing training for existing staff and training of incoming staff in use of the system is initiated
within work areas where highly proficient staff are paired with newcomers where possible. Trainers provide coaching and refresher sessions. A FAQ area on the company intranet shares questions and answers that have arisen during training and feedback.
Results The key to success in implementing this IT change within the Village was the program planning and acknowledgement of learner problems. Attention was given to finding solutions for individuals as well as the group. As well, management commitment of financial, time and human resources to the project was an essential success element. Of the registered nurses, managers and support staff involved in IT training, implementation and proficiency coaching, 75% reached mastery of all aspects within three months of commencement.
Discussion and implications It was realised that change implemented within a care context with traditional reliance on non-technology solutions requires management commitment to (i) adequate IT resourcing (ii) organisational culture of support (iii) acknowledgement of staff input and innovation; and (iv) evaluation of outcomes for staff, managers and clients. Management commitment to the project was crucial. The LTC software system, staff training time and resources, trainers, supporting documentation and training materials all assisted the implementation of a system that was both multilayered and diverse across RSL LifeCare. Quite apart from the cost of the Lee Total Care system, commitment by RSL LifeCare management and Board to staff training was extensive and is ongoing. Training costs were $28,687 including work release time paid at their base rate, $28,500 for trainers, and additional computers at $14,500. In hindsight, a project of this size required a fulltime project manager and assistant rather than it being an addition to the chief trainerâ&#x20AC;&#x2122;s existing full time role. Trainer and assistant roles now encompass overseeing LTC project management, training, troubleshooting and arranging for upgrades and remedial coaching. Our initial anticipation of staff reluctance to embrace change was unfounded. Most staff were keen to learn and those who were reluctant at first, soon learned that support and assistance was available and that they were not expected to do it all by themselves. n 1
Ehealth can be defined as the electronic management of health information to deliver safer, more efficient, better quality healthcare.
References Angus, J., & Nay, R. (2003). The paradox of the aged care act 1997: the marginalisation of nursing discourse. Nursing Inquiry, 10: 130-138. Australian Government Department of Health and Aging (2008). www.health.gov.au/acfi. Accessed 21st April 2008 Australian Government Department of Health and Aging (2005). www.health.gov.au. Accessed 20th April 2008 Cullen, C. (2007). The financial impact of entering aged care Australasian Journal on Ageing, 26 (3):145-147. Hogan, W.P. (2007). Outcomes from the aged care review. Australasian Journal on Ageing 26 (3):104â&#x20AC;&#x201C;108 Reeves, J (2007). E-Health Connectivity Proof of Concept Project. http://www.healthconnectsa.org.au/OurPrpojects/ AgedCareeHealthConnectivityProject/ Accessed 20th April 2008 Ryburn, B. (2007) Comprehensive geriatric assessment Australasian Journal on Ageing, 26 (3): 149-149. Soar, J., Seo, Y. (2007) Health and aged care enabled by information technology. Ann. N. Y. Acad Sci 1114:154-61.
Microsoft Academic Volume License Transition Program
a. b. c. d. 1.2 2)
Charitable Institution Charitable Fund Health Promotion Charity or Public Benevolent Institution; and Not be listed as a Non-Qualifying Public Charity Organisation in section (4). Qualifying Per Se Organisations
Certain organisations are eligible based on their primary mission area. To qualify under section (2), organisations must:-
Microsoft is in the process of reviewing the existing
2.1.
Hold Charity Status: and
licensing arrangements for aged care providers who
2.2.
Be organized and operated exclusively as one of the following:
have previously had access to the academic discount
a) A recognized Hospice that provides time-limited, end-of-life care intended to provide relief from suffering, treatment of pain and other distressing symptoms, psychological and spiritual care, a support system to sustain the individualâ&#x20AC;&#x2122;s family, and care and support for loved ones following a death; services may include pharmaceuticals, medical equipment, and 24 hours a day, seven days a week access to assistance and may be provided in the home, residential-care facility, or in a freestanding hospice residential facility;
licensing structure. Many aged care providers will be seriously affected by this decision. If you have not yet reviewed the likely impact on your organization check out the FAQs on the ACAA website at www.agedcareassociation.com.au
F
ollowing are details on the eligibility criteria from Microsoft, this document is also available for download from the ACAA website.
b) Stand alone residential aged care facilities that receive funding from the federal government under the Aged Care Act 1997 (Stand alone requires a facility to be independently recognized with charitable status from the ATO and NOT controlled by, owned by or affiliated with a larger Healthcare organisation);
Microsoft makes discounted product licenses available to its authorized charity resellers for resale to customers who are eligible Charity Organisations. Such customers are also eligible for Microsoft Software Assurance. Microsoft makes charity customer eligibility determinations at its sole discretion and uses the categories and definitions below as guidelines in making them. These guidelines may change at times and without notice. You can see the latest version of these eligibility guidelines at http://www.microsoft.com/licensing/programs/ open/openscharity.mspx. Organisations are classified into four significant categories as per Microsoftâ&#x20AC;&#x2122;s definition of a Charity Organisation.
Eligible Charity Organisations Organisations that are eligible to acquire licenses as a qualified Charity Organisation are defined in the following section:1.
Qualifying Public Charity Organisations
2.
Qualifying Per Se Organisations
Ineligible Organisations Organisations that are not eligible to acquire licenses as a qualified Charity Organisation are defined in one of the two following sections:-
c) Humanitarian assistance and disaster relief organisations; or d) Voluntary health associations and clinics that provide services on a free or sliding-fee basis and employ only volunteer medical staff (other non-medical staff can be paid); and All organisations under categories (1) and (2) above must devote all of their resources for charitable purposes to qualify as a Charity Organisation. Holding Charity Status from ATO as a result of non-charitable activities does not suffice and does not make an organisation eligible. 2.3. Not be listed as a Non-Qualifying Public Charity Organisation in Section (4)
Ineligible Organisations 3)
Non-Public Charity Organisations
3.
Non-Public Charity Organisations
Any organisation that does not meet the criteria outlined in Section (1) at the highest level of the organisation and for any subsidiary, branch, or division.
4.
Non-Qualifying Public Charity Organisations
4)
Eligible Charitable Organisations 1)
Qualifying Public Charity Organisations
To qualify under category (1), an organisation (including all subsidiaries, branches, or divisions) must meet all of the following criteria: 1.1 Have an Australian Business Number (ABN) and have the one of the following Tax Concession Status issued by the Australian Taxation Office (ATO):
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Winter 2009 | Aged Care A U S T R A L I A
Non-Qualifying Public Charities
Even, if an organisation otherwise qualifies according to the criteria set forth in Section (1), it will be deemed ineligible if the organisation (or any subsidiary, branch, part or division requesting licenses as a Charity Organisation) falls into one of the following categories: a) It pays (or otherwise makes available) any portion of the funds or properties it holds or receives for the benefit of any proprietor, member, shareholder, or trustee. b) Has, as part of its organisation/parent company/parent entity, an organisation that on its own will not qualify for Charity Status. See above. >
c) Government Organisation/Agency: The organisation, even if it has a charity registration or Charity Status, will not be eligible if it is a government agency or entity. d)
Academic institutions eligible to participate in the Microsoft Academic Open License program as a Qualified Educational User, as that term is defined in the Microsoft Academic Open License agreement.
e) Disqualifying healthcare Organisations include, but are not limited to, the following: (i)
Hospitals – Healthcare Organisations that have a governing body, an organized medical staff and professional staff, in-patient facilities and which provide medical, nursing, and related services for ill and injured patients 24 hours a day, seven days a week.
(ii)
Healthcare networks and health plans – Hospital owned vertically-integrated delivery systems, Integrated Delivery Systems (IDS), and managed healthcare networks, including Health Maintenance Organisations (HMO), Point of Service (POS) Organisations, Preferred Provider Organisations (PPO), and other specialty networks.
(iii) Ambulatory healthcare organisations – Freestanding nonprofit healthcare organisations, including public health centers, medical/dental clinics, preventative healthcare offices, military clinics, mobile services, and occupational health centres (Note: Certain ambulatory healthcare organisations are eligible to acquire licenses under Section (2).
(iv) Assisted living healthcare Organisations – Organisations that provide assisted living in congregate residential settings that provide or coordinate personal services, 24 hour supervision and assistance (scheduled and unscheduled), and health related services. (v)
Health research Organisations and research laboratories – Organisations with the primary mission of providing systematic investigation of heath-related topics, including research development, testing and evaluation, designed to develop or contribute to the knowledgebase.
(vi) Home Healthcare – Organisation that provide healthcare to individuals in their place of residence. f) Political, labour, and fraternal Organisations
Note Regarding Your status as an Eligible Charity Organisation If you lose our status as an eligible Charity Organisation subsequent to licensing products under this agreement, you may continue to use copies for which you are licensed, but you may not submit a new order for licenses of software assurance licenses as a Charity Organisation. You may renew expiring Software Assurance for licenses and Software Assurance purchased as a Charity Organisation by submitting orders for Software Assurance under any other Microsoft volume Licensing programs for which you quality. n
technology
Aged Care Technology Suppliers Forum On 19th March and 20th May Aged Care technology supplier forums were conducted to provide an environment for open exchange and dialogue between software providers, hardware and infrastructure suppliers supplying the community and residential aged care industry.
T
he Aged Care Industry IT Council (ACIITC) auspiced the meetings, as itâ&#x20AC;&#x2122;s function is to promote and facilitate the aged care industry to gain efficiencies, to support workforce capacity, achieve greater productivity more effectively and; increase Quality Care. By bringing together the various suppliers to the industry, it enabled the group to discuss current barriers to product development and opportunities for industry development. It also enabled the group to discuss issues regarding the industryâ&#x20AC;&#x2122;s understanding of Technology, how suppliers can support education, skills development and leadership. At the forums, vendors indicated a wish to form an Aged Care Technology Supplier Association. The purpose of such would be to, amongst other things, develop a set of standards and code of conduct for Suppliers to be viewed as a group of professionals working for the industry, as a collective voice, raising industry issues and concerns and providing advise and solutions for such to government, thereby contributing to outcomes. The vendors also discussed the key roles such an association could take including, with the IT council, defining global best practices and working together towards achieving such. An association could also work towards influencing e-health policies, facilitating direct communication between Vendors and the Government. Together it was determined vendors could foster innovation, cooperation and collaboration between Venders both large and small. Various firm Action items for an association are still to be determined however initially it was decided, following the creation of a White Paper and the forming of various subcommittees, that the group could work with each other, DoHA, Medicare Australia and the Aged Care Standards And Accreditation bodies to increase IT awareness and educate regarding the current available systems in the industry. The group plan to meet again in a couple of months. n
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Winter 2009 | Aged Care A U S T R A L I A
workforce
Award Modernisation and the aged care labour market Charles Wurf CEO, ACAA-NSW
Aged care is currently at a time of profound change in the system of workplace regulation. Modern Awards have been made that will cover aged care employees and there will be an extended transition period commencing from 1 January 2010.
T
he scope of these Modern Awards and how they interact with existing enterprise agreements and the old system of State-based Awards will have a significant impact on all employers in aged care. At the same time as Award Modernisation is proceeding, Minister Elliot released the second report on the Aged Care Workforce in December 2008, analysing data supplied as at 30 June 2007. As background, participation in the Aged Care Census and Survey that provides the data for the Report is one of the conditions imposed on the industry as part of the additional subsidy indexation for CAP (the Conditional Adjustment Payment). The report is available from the Departments website or go directly to http://www.health.gov.au/internet/ main/publishing.nsf/Content/ Working+in+aged+care-1 The Report is prepared for the Department by the National Institute of Labour Studies (NILS) and is titled Who cares for Older Australians? A picture of the residential and community based aged care workforce 2007.
There is a wealth of statistical data on the aged care workforce contained in the report. For the residential workforce there is now comparative data for 2003 and 2007, with the community workforce surveyed for the first time in 2007.
There has been a clear growth of the residential aged care workforce between 2003 and 2007. There is no doubt that the aged care workforce will continue to grow, in both residential and community, in the future.
Over the 4 year period from 2003 to 2007, the residential aged care workforce grew by approximately 20,000 total employees. There was a distinct change in the mix of staff working in aged care, with a decline in the number and proportion of Registered Nurses, a larger number but smaller proportion of enrolled nurses and a large growth in the number and proportion of personal carers (broadly defined to include assistants in nursing and care worker classifications). Allied Health Professionals remained a fairly static proportion of a growing workforce.
A quick analysis of the combined total employment in aged care shows that nearly 250,000 Australians were employed in aged care as at 30 June 2007. An extract of 2 tables for both residential aged care and community care is outlined below from the 2007 Report. The following tables indicate the overall size of the aged care workforce and the distribution of the direct care workforce across occupations. (more tables next page)
Table 3.1: Estimated total employment in residential aged care homes
Total employees
Total direct care employees
Total equivalent full-time direct care employees
2003
156,823
115,660
76,006
2007
174,866
133,314
78,849
Table 3.2: Occupation of the residential aged care workforce (employment and distribution), Homes Census, 2003 and 2007 (per cent)
2003
2007
Occupation
Number of persons
Equivalent full-time
Number of persons
Equivalent full-time
Registered Nurse
24,019 (21.0)
16,265 (21.4)
22,399 (16.8)
13,247 (16.8)
Enrolled Nurse
15,604 (13.1)
10,945 (14.4)
16,293 (12.2)
9,856 (12.5)
Personal Carer
67,143 (58.5)
42,943 (56.5)
84,746 (63.6)
50,542 (64.1)
Allied Health
8,895 (7.4)
5,776 (7.6)
9,875 (7.4)
5,204 (6.6)
Total number
115,660
76,006
133,314
78,849
Aged Care A U S T R A L I A | Winter 2009 |
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workforce
Table 5.1: Estimated total community based employment in aged care
Total employees
Total direct care employees
Total equivalent full-time direct care employees
87,478
74,067
46,056
Table 5.2: Distribution of the community based aged care workforce, and new hires, by occupation (per cent)
Data from Employees
Data from Outlets
Occupation
Whole workforce
New hires
Number of persons
Equivalent full-time
Registered Nurse
10.2
10.6
10.2
13.2
Enrolled Nurse
2.4
2.4
2.7
2.6
Community Care Worker
82.6
81.8
81.8
77.8
Allied Health
4.8
5.1
5.3
6.4
Total number
74,067
46,056
Award Modernisation and the aged care labour market
Talent Pools Essential in Todayâ&#x20AC;&#x2122;s Labour Market It is no secret that an organisation is only as good as its key people, from its current and future leaders to its frontline employees. Aged care is no exception to this and in fact our industry continues to face one of the most chronic labour shortages witnessed in any sector, along with an increasing demand for great people.
T
he current forces of demand and supply, combined with significant advances in technology, have altered the way that employers interact with job seekers in todayâ&#x20AC;&#x2122;s labour market. Technological advances, facilitated by the widespread adoption of the internet over the past 10 years, have resulted in the emergence of a new industry, the e-recruitment industry. This new industry has further been supported by increasing pressures to reduce candidate cost per hire and time to fill.
E-Recruitment or online recruitment as it is often referred to, has 3 core components; the careers website, advertising jobs on the internet (e-sourcing) and e-recruitment (or candidate management) systems. Essentially e-recruitment connects employers and prospective employees and brings them together via the internet. It is about providing Human Resource professionals with the tools they need to be more strategic and to look for longer term solutions across the Health sector. Increasingly Australian employers are adopting e-recruitment as a key tool to manage labour shortages. Most organisations start with a simple careers site and advertising on commercial job boards such as Seek and MyCareer, then over time move onto the more sophisticated internal practises enabled by an e-recruitment system. An e-Recruitment system is a web based, online recruitment management software which is essentially a talent pool and candidate management system. It facilitates the collaboration of all parties involved in the recruitment process including hiring managers, recruiters,
executives with approval delegations, advertising mediums or partners, applicants (job seekers) and Human Resources. It is a software package designed to streamline candidate attraction, sourcing, assessment and hire. Amongst other things it allows the user to create employment positions, approve requisitions, plan media strategies and manage the entire administrative process online. From a strategic perspective it then stores all previous candidate details so the organisation can build its own talent pool. The organisation is then able to interact on an ongoing basis with job seekers via their careers website. A fully functional talent pool, supported by strong recruitment processes can reduce recruitment costs by 25-50%. These cost reductions are achieved through 1) a reduction in time to fill 2) minimising advertising costs and 3) process efficiencies. Mercury e-Recruit specialises in the Aged Care sector, tailoring their e-recruitment system to the needs of individual Australian hospitals, not for profits, aged care and community organisations. n Lesley Stewart Business Development T: 03 9645 5500 lesley@mercury.com.au www.erecruit.com.au
Aged Care A U S T R A L I A | Winter 2009 |
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workforce
Australian Health Workforce Ministerial Council - Communique (Fed) The Australian Health Workforce Ministerial Council reached a national consensus on how the new National Registration and Accreditation Scheme for the Health Professions will work.
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his will deliver improvements to the safety and quality of Australiaâ&#x20AC;&#x2122;s health services through a modernised national regulatory system for health practitioners. The Ministerial Council acknowledged and welcomed the very high level of participation by consumers, practitioners and regulatory bodies in the consultation process to date. Over 1,000 people have attended forums around the country and over 650 written submissions have been received in response to the consultation papers issued in 2008 and 2009.
As a result of the consultation process and the feedback received, the Ministerial Council has determined that a number of changes should be made to the original proposals put forward, in particular in the areas of accreditation, the role of state bodies and complaints handling. A copy of the communiquĂŠ is available from the Australian Health Workforce Ministerial Council website. Go to http://www.ahmac. gov.au/site/home.aspx and click on the link in the Media Release section on the homepage. n
Discover the Cater Care difference.
sponsors
Plan for disaster; protect your facility’s assets From the storms in the Mackay region to the tragic Victorian bushfires, natural disasters have wreaked significant damage and loss in recent times. Aged care was not untouched by these events with a number of facilities evacuated.
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he need for aged care to be prepared for the threat of natural disaster is clear and reflected in the recent announcement that aged care homes applying for Government funding must take natural disaster planning into consideration. It follows that you also need to consider planning the protection of your facility and its assets in the event of a disaster. Your first consideration when protecting your facility’s assets is having appropriate insurance cover against unexpected events. To maintain adequate insurance cover for your facility ensure that you have sufficient sums insured. Ask yourself, does the amount of insurance cover you have match the amount it would cost to replace your facility? If you can’t answer this comfortably you should review the value of your assets and your cover. In the crucial time when you need to make a claim, you don’t want to be left underinsured. Be sure to inform your insurer of any changes in replacement value to your facility’s assets and you’ll ensure that you have appropriate protection when you need it most.
Guild Insurance dealt with a facility that experienced significant damage from the storms in Mackay. By working with the facility’s management we were able to help minimise any further damage and disruption. It’s crucial to not only have the right insurance in place, but also the right support from your insurer.
Overcoming interruptions
Make adequate protection for your assets a part of the natural disaster planning for your facility. Ensure you have sufficient cover including adequate sums insured and business interruption cover and an insurer with the right level of service who can help you to get your facility up and running as fast as possible. n
Beyond insurance cover on the ‘face value’ of your assets, the costs of interruption to your facility’s operations can quickly add up. It can take significant time to recover from a major loss and damage to your facility that causes an evacuation or relocation of residents could prove particularly difficult and expensive, especially when accounting for transporting high care residents and medical equipment. In the event of a disaster the demand for construction and like services can also surge and delays can be longer than expected. Having sufficient sums insured for business interruption ensures your facility is covered from loss of income, loss of rent and increased working costs associated with your facility being disrupted by insured damage.
Talk to your local Guild representative about protecting your facility against natural disasters on 1800 810 213 Guild Insurance Limited AFS Licence No. 233791
Aged Care A U S T R A L I A | Winter 2009 |
53
sponsors
Secrets revealed about a relationship that has lasted nearly 20 years and is still going strong:
Star Gardens And ThomsonAdsett
By Mike Swinson This is a story about a successful relationship. These days in business it is unusual to find a company that can boast a large number of long term commercial relationships. These days in life it’s unusual to find too many successful, personal long term relationships, so what are the critical ingredients behind this one?
T
he two key players are Nigel Faull, the CEO of the Star Gardens Aged Care Facility at Beaudesert in SE Queensland and Pino Gentile, Director of Architectural Services from the Brisbane office of ThomsonAdsett.
The Star Gardens facility was established in Beaudesert in the early 1990’s under the direction of its board who are members of the Star Gardens Group, part of the Freemasonry family. Until recently the small facility was operated for the owners by Blue Care, now its run independently by the Star Gardens Board.
growth do you need? Where do you go to get the job done, how much can your business afford to invest in the project? How do you pick a partner for a multi-million dollar project? Key to the success of this relationship has been the combination of a client, with a clear mandate for their future and a firm of architects who have based their practice on knowing the business of aged care. The ThomsonAdsett team also brought with them a safe and efficient working environment, the ability to share a vision and the capacity to design quality home environments for the residents in care. Pino Gentile said, ‘Star Gardens have had a long association with ThomsonAdsett, as we were the architects for the original 53 bed facility. Being invited back to work with a client and help them to plan the future of their business is a gratifying and humbling experience.’ As leaders in the field of aged care design, ThomsonAdsett was able to draw from their large stable of experienced architects and offer Nigel Faull the personal attention of Pino Gentile as the team leader.
‘We had to grow or go. If we didn’t grow we would not survive.’
Pino recalls the initial client meetings; listening to the client group and working through their ideas for the new building. ‘A key driver was to look at how extra beds on site could make the facility work better. We didn’t want to just add another wing up the back of the block. We wanted to tie it into the existing facility in a way that it improves how the whole facility works. We discussed early on not just this expansion but plans for future development on site.”
How many aged care facilities in Australia have faced that tough decision in recent times, and how many more will have to face it in the years ahead? But what does ‘grow’ mean? How much
Nigel Faull said the design had to be flexible. ‘We have a mix of high and low care; the new building has been constructed so it can become all high care.’
When he took over as CEO at Star Gardens, Nigel Faull said he realised that there were tough decisions ahead.
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Winter 2009 | Aged Care A U S T R A L I A
Rainbow wing as it is known is the new 24 bed wing which ties in to the existing high care and hostel wings; providing improved staff access through the facility and also in the process providing the opportunity for an underutilised central garden to become an active outdoor area for staff, residents and visitors alike. The rooms all have private en-suites; the building has been wired through-out with data cables complemented with an IT wireless environment. The facility now boasts a dementia specific area, a pampering room for pedicures and manicures, a cafe area, theatre and activities centre. They have just started a Star Gardens staff basketball team and provide a bus for residents to come and watch the games. Nigel tells me they love it! ‘Pino Gentile and ThomsonAdsett know our people, they know what we think, they know what works in this facility because we have told them, and they know what doesn’t work,’ said Nigel. To tie into the existing floor levels and to overcome a steep site the Rainbow wing stands as an elevated building. At first glance it looks peculiar standing up on concrete columns but as Pino Gentile reveals, the obstacle of a difficult site has become the opportunity for the next stage in the development of the facility. ‘With the structure and services already in place, plans are now underway to continue with the next stage in the development of Star Gardens as the lower storey of the new Rainbow wing,’ he said. Nigel Faull told me ‘we have ended up with 77 beds on site and have lodged an application for another 26 beds. What we do in the next development will really shape what the site will be. I need to be sure that the business we are building is sustainable and also future proof as much as possible.’ He said. ‘Building for aged care is tough enough, combine that with the issues of sustainability and future proofing it is a tall order.’ I can see the smile on his face, down the end of the phone as he says “I don’t think we could have done it as well or as easily if we hadn’t been working closely with ThomsonAdsett. ‘The ThomsonAdsett team know what Star Gardens is about, they know the culture of our organisation and they know what works in this industry but best of all they take the time to listen to us and work with us through each stage of the project,’ said Nigel. When I asked Pino to talk to me about Nigel he was forthcoming. ‘Nigel has been a great client to work for,’ he said. ‘Through the journey which has been the development of the Rainbow wing he has demonstrated his strong knowledge of the industry and drive for his organisation’s success. With the confidence of his board behind him he has taken some brave decisions along the way and the facility as it stands today is a testament to the leadership he has shown.’ This is another key ingredient in the mix of a successful relationship, recognising and acknowledging your partners strengths. Pino added ‘I also know that he respects my skills and those of my colleagues at ThomsonAdsett and that working together we make a good team. At the end of this process we have developed a friendship based on mutual respect, and leading into the next stage of development for Star Gardens we will continue to build on these solid foundations.’
Pino Gentile summed it up this way. ‘As architects, we have the skills and experience to lead a project from the initial sketches and discussions through to the handing over of keys at the end, but without a collaborative approach of listening to and working with all involved with the project you will not get an appropriate outcome. Sometimes in architecture we see mini-drama’s and even melodramas. Not here, not with Nigel, he’s been a delight to deal with.’ So it is worth extra effort to make sure you get the relationship right from the beginning, ask any relationship counsellor, they’ll tell you that’s a great relationship recipe. n
Contacts Pino Gentile Director of Architectural Services ThomsonAdsett p.gentile@thomsonadsett.com
Nigel Faull CEO Star Gardens n.faull@stargardens.org.au
sponsors
Aged Care Manual Handling Online – A blended solution Training staff in Manual Handling is problematic. Motivating staff to attend traditional training, maintaining a consistent message, high costs, and training staff in regional areas are all challenges that are currently faced by Aged Care facilities. Research indicates that 58% of all injuries in aged care facilities are due to Manual Handling; nurses, carers, cleaners, laundry, maintenance, administration and kitchen staff are all at risk.
T
o meet this challenge head on, Eldercare have partnered with e3 to leverage the latest technology in elearning. With a blended solution, Eldercare gets the best of both worlds. Concepts can be introduced online prior to a hands on session with an instructor, providing improved learning outcomes with proven results. The new course in Aged Care Manual Handling is due for completion mid year. The course has been developed in partnership with Eldercare which has been recognised by SafeWork SA as ‘Employer of the Year’ for their achievements in the area of manual handling training and a unique ‘train the trainer’ program. Physiotherapist and content expert Michael Filsell says ‘The course is not designed to replace the group training experience, but to complement learning outcomes’. At Eldercare, staff will be trained online before attending a session with Physios. ‘The benefit for me, is that staff attend the session with the same fundamental understanding’. Aged Care Manual Handling has been developed using expert content, professional instructional design, audio, scenario based learning, high levels of interactivity, and assessment of competency. It has been written from a ‘No Lift’ policy perspective and in line with national legislation. The course covers topics such as:
• Why manual handling injuries occur • Physical principles relating to manual handling • Practical direction performing manual handling tasks • Awareness of risks associated with manual handling in the aged care sector, and how to control them. Delivered on e3’s hosted Learning Management System, all data is tracked and reports are available to ensure compliance and assessment results. ACAA members can visit acaa.e3learning.com.au to access more information covering online learning, and to access a free online course so that they can see how easy online training can be. To register your interest in Aged Care Manual Handling and other online training solutions please contact Adam Dunkley on adam.dunley@e3learning.com.au. n
Adam Dunkley Marketing Manager T 08 8221 6422 E adam.dunkley@e3learning.com.au W e3learning.com.au
Reverse Auction Platform Saving You Money On Energy Costs 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 a client. “In September 2008 we were in the market to procure a new Energy contract for the Havilah Hostel group and was 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
Peter Naylor Ph 03-9832 0855 Fax 03-8677 9633 peternaylor@energyaction.com.au www.energyaction.com.au
editorial
Health care decisions for persons with impaired capacity By Julie McStay Partner, Hynes Lawyers
Aged care providers must frequently manage the challenges associated with care recipients who have impaired decision making capacity. The laws relating to the provision of medical treatment to care recipients with impaired capacity are complex and vary from state to state. An approved provider should ensure that their internal systems (which includes its policies, procedures and training programs) are compliant with the
Training, policies and procedures Prudent approved providers will have comprehensive internal systems in relation to the provision of health care to persons with impaired decision making capacity. They will have appropriate policy and procedures which are compliant with the laws relevant to the state in which they operate and they will have a training program which ensures staff understand who is authorised to make decisions about health care for persons with impaired decision making capacity and how those decisions should be made.
Basic principles Each state and territory has legislation regarding substitute decision making for persons with impaired decision making capacity and while there is no national system of laws in relation to making health care decisions for persons with impaired capacity there are however a number of basic principles which apply universally. An approved provider’s internal systems should adopt and reflect these universal principles and providers should ensure that all staff involved in the provision of medical care for care recipients who lack capacity or who deal with substitute decision makers for those care recipients have a clear understanding of them.
laws applicable to the jurisdiction in which the
The basic principles can be summarised as follows:
approved provider operates.
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Every adult is presumed to have capacity.
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The presumption of capacity can be rebutted.
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A care recipient lacks capacity to consent if they lack the ability to:
– understand the nature and effect of the decision; and – communicate the decision in some way.
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A care recipient who has capacity can consent, or refuse to consent, to any medical treatment – even if the refusal of treatment will result in death.
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If the care recipient lacks capacity, consent to medical treatment (or to refuse medical treatment) must be provided by someone who is authorised to provide that consent on their behalf.
T
his article is the first in a series of four focusing on the laws in Australia relevant to making health care decisions for persons with impaired decision making capacity.
This first article will provide a broad summary of those laws and consider how they should be incorporated into an aged care provider’s internal systems. The remaining articles in the series will address some more specific issues that are likely to arise in an aged care setting in respect of health care decisions for persons with impaired decision making capacity, including:
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managing disputes between substitute decision makers;
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the use and validity of enduring documents such as powers of attorney and advance health directives; and
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The provision of consent will not make treatment that would otherwise be illegal, legal.
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decisions about withdrawing and withholding life sustaining treatment.
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Consent must be obtained for all medical treatment except treatment which is life saving, minor or uncontroversial. >
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Health care decisions for persons with impaired capacity (cont’d) •
Consent must be voluntary.
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Consent must be specific to the treatment.
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A medical practitioner engaged by a care recipient will have primary responsibility for obtaining consent for the medical treatment provided by that practitioner.
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Responsibility for obtaining consent may shift to the approved provider if the medical practitioner has delegated the task of obtaining consent.
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An approved provider is responsible for obtaining consent for any medical or nursing treatment which is provided to the care recipient by the approved provider.
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A paid carer should never attempt to provide consent to medical treatment on behalf of a care recipient.
Whilst there is no uniform test for the circumstances in which a substitute decision maker should give consent for medical treatment on behalf of a person with impaired decision making capacity, the law in each state broadly operates on the basis that consent should be given where the provision of medical treatment (or the decision to withhold it) is in the adult’s best interests. It is also broadly accepted that whilst the adult’s wishes (if they are known) should be taken into account in determining best interests, they are not determinative.
Compliance with relevant legislation 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 specific legislation which applies in the state in which the approved provider operates. Approved providers who operate across multiple jurisdictions should ensure that these internal systems accurately reflect the legislation for each state in which they operate. An approved provider should ensure that their internal systems are compliant with the laws applicable to the jurisdiction in which they operate in respect of matters such as: •
The particular methods of substitute decision making for health care decisions which are recognised in the state/states in which the approved provider operates.
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The circumstances in which Tribunal consent is required for a particular type of health care.
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The types of enduring documents (eg an enduring power of attorney or an advance health directive) which are recognised in the state/states in which the approved provider operates and the minimum requirements for validity.
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Whether decisions about withdrawing and withholding life sustaining treatment (such as removing a PEG tube) can be made by a substitute decision maker and if so what steps must be followed to ensure those decisions are made in a lawful way.
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How disputes between decision makers will be resolved.
â&#x20AC;˘
The circumstances, if any, in which it is permissible to use force in the administration of medical treatment to a person with impaired decision making capacity.
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The requirements for consent to the use of restrictive practices in the state/states in which they operate.
The laws in relation to health care decisions for persons with impaired decision making capacity are complex and vary across the country. 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 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).
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editorial
Dancing into Happiness Residents in a facility North West of Sydney[1] participated in a trial to ascertain the effect of a unique form of dance-movement on depression. The program became a finalist in the Positive Living In Aged Care Awards, Bupa Business Awards and The Aged Care Channel ‘Idea Of the Year’ Award.
T
he group was conducted by Lyn Masters; a Dance Therapist, Physiotherapist and Feldenkrais Practitioner, who used a synthesis of all these modalities. The program has been developing since 1996, when Lyn studied under Professor Leventhal, one of the world’s leading authorities in dance therapy. One of the reasons the program was introduced was that residents wanted a program with more variety than their usual exercise program. Depression is also a considerable problem in the aged, and dance therapy, as a psychotherapeutic technique addressed this as well as other physical aspects of exercise. The program was conducted over a 12 week period, with residents undergoing a Cornell Depression Scale assessment pre- and post-trial[2]. Residents attended the class once to twice a week, for about 30 minutes. The level of mobility of residents ranged from those chairbound, to mobile residents who used a variety of walking aids. Participants had a mixture of complex medical conditions, such as dementia, stroke, osteoporosis, Parkinson’s disease, lung and heart disease.
Social bonding, stimulation of memory, fun, expressing creativity and emotions are a few of the benefits of the program. It also provided a relief of tension; as well as reducing the fear of loneliness and isolation through the effects of touching[3]. Added to this is the growth of awareness, which Feldenkrais[4] focuses on, with movement being the basis- particularly through the muscles. Implementing a trial held a number of challenges, however; such as residents being ready to attend class on time and with some residents wanting their friends from outside of the trial group to attend also. After participating in the group, residents would share some of their experience with other residents, which could have impacted on the trial’s results, also. This continuation of the class activity after the group finished, also was indicative of the depth of the residents’ engagement in the process. The program helped improve services in the facility, by providing a forum where residents could express their feelings and emotions in a supportive environment; and used their creativity to transform these in a manageable way. So instead of staying in a negative state, residents moved on to a more positive focus. Behavioural issues were addressed by visiting the core of the dynamic. This often resulted in residents interacting with staff
in a more light-hearted way, which inturn can make staff’s work more enjoyable and effective. After the trial, 50% of residents had improved their depression score and 50% of their joint range. The mobility score, which included balance and gait, improved in 75% of the group. Aids, nurses and allied health professionals have been trained by Lyn in an Introduction to Dance Therapy. This has given them ways of making exercise classes more effective, as well as interacting more empathically with residents, involving strategies for behavioural issues. The program enabled the aid to use both their and the group’s strengths and interests in the class. n 1. The program was carried out at Bupa Retirement Village Dural. 2. Cornell Depression scale assessments were implemented by Agewell Physiotherapy. 3. Levy. F.J. Dance Movement Therapy A Healing Art. p245. 1992 National Dance Association. 4. Feldenkrais.M. Awareness Through Movement. pp36, 37. 1980 Penguin Books.
Lyn Masters is a Consultant Dance Therapist who runs dance therapy groups in aged care facilities, as well as workshops for carers. She also conducts groups for the general public, team building workshops in organisations and private sessions. For further information Lyn can be contacted at Empowerment Dance on (02) 9872-8878 or lmasters@tpg.com.au
Aged Care A U S T R A L I A | Winter 2009 |
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switchboards. During the inspection, he identifies all the thermal abnormalities, about 90% of which you can’t see, but he can with his camera and his expertise. After the inspection, he prepares a formal report detailing all the abnormalities he has observed, and includes some other images of the various plant and facilities, he has inspected. And, your insurance company will applaud your actions by being proactive towards plant maintenance. Further, a Thermoscan™ has the potential to prevent major downtime caused by a switchboard failure and possible ensuing fire.
e are currently in tough economic times. Therefore, money is tight, and the resistance to spend has escalated, making maintenance an expensive necessity. However, we must continue paying our insurance premiums, and hope that we will never ever get a return on this investment.
One thermal abnormality observed during a regular inspection, had the potential of costing at least two days downtime and the losses would have amounted to around $2 million. The problem was repaired with a replacement switch and one and a half hours of scheduled downtime, much cheaper than unscheduled downtime.
So, the need to keep your plant and facilities operating effectively requires that funds must be allocated to preventative maintenance. The alternative is gloomy.
And, to help with the decision-making, it has been reported, that where the cause of a fire can be established, in 80% of cases, it is an electrical fault.
Another form of insurance is a regular Thermoscan™ inspection. The difference is you do get a return, one that can potentially help save you many thousands of dollars.
When engaging a thermographer to carry out the Thermoscan inspection, it would be wise to select operators who are specialists in their trade. All of Thermoscan’s™ Field Operators are qualified and Electrical Fitter/Mechanics and all are trained at Melbourne University to Level 1 Thermography standard A.I.N.D.T. n
You get a qualified Electrician and Level 1 Thermographer to visit your site and examine all your electrical and mechanical
editorial
Breaking New Ground in Dementia Care in Australia By Mike Swinson The remarkable story of the Heritage Lakes facility in South Morang in Melbourne, run by Derek and Cheryl Markham.
‘T
he relatives of some of our clients are amazed at the changes in their loved ones since they have been here at Heritage Lakes. They see them becoming calmer, quieter, happier, less aggressive and angry, even though they may have been showing those symptoms for some years. We invite families to participate in the training we use, some love it, and unfortunately some don’t want to know about it.’ Derek Markham. ‘The proof of the success in the design of the facility and the care philosophy we use, based on the Hearthstone Way, is with us every day. We are constantly seeing residents who are happier, more content, not nearly as angry or aggressive as they once were. It’s wonderful to know it’s all working at last.’ Cheryl Markham. Cheryl and Derek Markham are the owners and managers of the Heritage Lakes facility. This is a unique and groundbreaking facility. There is nothing like it in Australia. Other providers in Sydney and Adelaide are researching the Hearthstone way, but are yet to turn it into bricks and mortar.
Derek Markham says ‘eight months into the program we now have a team of carers and health specialists who all want to be here, who are happy working with these new methods of care. It’s still new to us all, and is being monitored and changed all the time.’ If you are someone who is involved in the care of those who suffer dementia, you would do well to visit this Melbourne based facility, or at least visit the website. www.heritagelakes.com.au The website describes the Hearthstone Way© model of care for people living with Alzheimer’s as follows: ‘The program is the result of over 15 years of research by Dr. John Zeisel and his team in Boston, USA. The model is based on a nonpharmacological approach coordinated with medical care. The treatments include cognitive strengthening and life quality programs, focusing on connecting with the emotional centre of people with Alzheimer’s.
Staff are trained in therapeutic approaches to activities, interactions and personal care, that significantly contribute to the well being and happiness of individuals ... as loved ones are given the opportunity to flourish in a holistic approach to providing the best possible lifestyle. When you first walk into the Heritage Lakes facility, you are confronted by rich colour schemes. According to Cheryl Markham, that’s an integral part of the unique care philosophy. ‘People are engaged, when you walk in, you can tell that even though we have a lot of residents with dementia, it doesn’t look like almost any other facility I know.’ >
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you know what I mean. I’m the sort of bloke that would love a shed and there must be plenty more like me out there in the community. In fact I tell my wife often, that before we move to a smaller house and garden, it must either have a shed, or somewhere I can build one! The facility has an active arts program; (Artz in Action) cooking sessions and many other activities that help keep residents with dementia happy and occupied, doing something they love. Derek says, ‘the referral agencies were sending us dementia sufferers with a history of aggression and/or anger. After an initial settling in period we see virtually no aggressive or angry behaviour at all. That can be and has been pretty tough on staff, but things have settled down now.’ Each of the facilities wings has a name; The Boulevard, The Avenue and The Promenade. There is a main bar in the dining area and a place called ‘The Pub’ which is like an old fashioned pub. The Avenue is more for socialising. The Promenade continues with the ships theme and travel posters. Just in case you thought, ‘that’s it’ I’ve read all about it now, not so. I have a surprise for you. At Heritage Gardens and at Hearthstone in the USA, Dr Cameron Camp is used as a behaviour specialist. Dr Camp uses Montessori methods to engage residents and help care staff cope with dementia. It’s working so well that Dr Camp is now a regular visitor to Heritage Gardens and runs training sessions for their staff and others who may be interested. Dr Camp was formerly Professor of Dementia Research at The Meyer Institute in the USA. ‘His philosophy includes trying to communicate with people who don’t seem able to talk anymore,’ said Derek Markham. ‘You can use handwritten notes or large signs if eyesight is a problem. Once you start communicating in simple ways it’s amazing how relaxed residents become, it can be quite moving at times.’ < Heritage Lakes is a brand new 70 high care and 50 low care bed facility. Its design was finalised after a consulting team had travelled the world, the UK, Europe and the USA, searching for an evidence-based way of caring for those who suffer dementia. Derek Markham says finally they found the Hearthstone site in Boston, Massachusetts. ‘There are places in Sweden that were good, some in Germany, even some in Australia, but it was Hearthstone that finally ticked our boxes.’ Cheryl Markham says ‘when you walk in, you are instantly struck by the colours we have used. Yet people feel really comfortable with it. It doesn’t look like a hospital or health based facility at all. We wanted it so that when people walk in they feel comfortable, they feel relaxed in the spaces. ‘The dining area, with porthole mirrors is called the Captains Table, it’s set in the fifties and it’s almost like you were dining at the Captain’s Table, on board a ship. People love it.’
‘I’ve got ladies here who suffer quite serious dementia, they may not see me for two or more weeks, who still recognise me, ask me to sit down and it makes them very happy, even though I may not speak their language at all. The Hearthstone way is all about saying “we are still here”. ‘We have applied for more beds for our next project,’ says Derek. ‘The new section will be even better because we have learnt from our mistakes. So far we have probably gone $150,000 over budget. We had to find staff who were willing to learn new ways of caring and that includes health specialists like Diversional Therapists. It’s taken us a while to get the right staff and we have been in training for months, with help of Dr John Zeizel, Dr Camp and others from Boston.’ Both Derek and Cheryl say this has been a collaborative project in every sense of the word. ‘We couldn’t have done it without the help, training and support of the Hearthstone people,’ says Cheryl.
Heritage Lakes has themed areas, such as the Boulevard that looks and feels like Hollywood, the Promenade that encourages residents to go for a coffee or just a walk. A wellness garden area where they can stroll for as long as they like, it’s safe and secure. They also have a shed where men can potter about in a secure and familiar environment.
As John Zeisel, the founder of the Hearthstone methods said in a recent Aged Care Australia publication “learning to separate the triggers of dementia behaviour, from the symptoms is critical. Most people think anxiety, aggression, wandering and agitation as symptoms, they are not. Once people realise that, it is much easier to address the actual symptoms.”
Sounds like just the place for me if I develop dementia. Without a shed, I would go, well, maybe not stark staring mad, but
That’s exactly what is incorporated into the design and care of Heritage Lakes facility. n
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editorial
Georges Manor Opening Ceremony â&#x20AC;&#x153;Directions for Aged Careâ&#x20AC;? By Professor Warren Hogan Following is a manuscript of a presentation by Professor Warren Hogan at the opening ceremony of Georges Manor facility (NSW) on Wednesday 18th March 2009. The opening was declared by the Governor of NSW, Professor Marie Bashir.
1. Recognition The board and management of Advantage Care are to be congratulated on bringing into operation this new unit offering residential aged care services. The need to provide additional capacity in this way reflects the relative growth in the numbers of older people in the Australian population and to show some further increase three years hence. Those few years, very clearly, are not much longer than the time it takes to plan, gain approvals of many sorts and then erect such a facility as this. This effort is all more commendable for having been implemented in what has become the testing economic times now besetting the Australian economy and, inevitably, the congeniality of our society. The immediate impact is on the bases for funding the capital outlays required for structures like this one, Georges Manor, and the many more to be needed in the years to come. Around 2012 the proportion of those in the over-70 age group will show an initial acceleration with the inevitable additional claims for support in either residential care settings such as offered here at Georges Manor or in domiciliary situations being mainly the recipientâ&#x20AC;&#x2122;s own home be it house, apartment or retirement village.
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2. Challenges What is most welcome at this time is the growing public recognition for a strategic reappraisal of the policy directions pursued by successive governments over the past decade and more. Last September the Productivity Commission offered a comprehensive study of aged care services and the implications from the way trends in the provision of those services were developing. Just recently the National Health and Hospitals Reform Commission provided an interim report which had much to offer about provision of services to the elderly. Much emphasis in both reports is laid upon the need for aged care services to be more responsive to the needs of the users of those services and their families. The issues posed in these two most recent contributions provide an impressive challenge to existing arrangements at a time of difficult economic circumstances and harsh fiscal prospects. More than ever the times call for intellectual and professional agility to explore effective alternative measures to secure better outcomes for users and governments from the aged care expenditure allocations. Centrally planned and directed requirements are at the core of existing policy strategies for aged care services. These have brought inefficiencies and rigidities to the way those services are offered. Users of those services and their families have been afforded few opportunities to influence the extent and quality of services. What we have in Australia, and have had for all too long, is a system of regulated scarcity. Aged care activities are bound by a set of restraints which discourage management performance, curtail competitive relationships between participating entities, limit access to services by rationing the provision of beds in residential facilities and community packages in domiciliary settings, handicap any quest for quality of services provided by restricting choices available to users of services, and not allowing boards and management of aged care entities any flexibility in investment and pricing decisions except with respect to accommodation bonds.
3. Choices Funding of aged care services should be directed through users of services and their families just as readily as with present arrangements attaching funding to beds. By issuing vouchers to
residents and potential residents for the value of the care to be met by government, these users could determine in discussions with the provider of their choice, the type of service suited to their needs as specified by an Aged Care Assessment Team (ACAT). Similar provisions would apply as with domiciliary support. The recipients, by taking their vouchers to aged care facilities are then better placed than now to judge the best place in which to secure the level of care suiting their wishes. The determination of need would be made as at present through the ACATs. The difference would be simply granting the users of services in aged care the same basis on which they and all other Australians secure basic health care. The fiscal budget is exposed to decisions of each individual in the population over which no direct control is exercised. The Australian Government is exposed to the moral hazard of open access to government funding. What applies to the population as a whole and to the elderly for access to medical advice, is withheld from the provision of aged care services. This is discriminatory.
4. Flexibility Choice is no less important for boards and management of aged care entities whether “for profit” or “not for profit’. By being able to determine their investment outlays on new or replacement capacities as well as adapting their offerings of care types including respite, in their facilities, boards and management would be responsive to specific needs of users which may be seasonal as well as structural. The underlying purpose is for enhanced competition and stimulus to quality, the two going hand in hand. The existing regulated procedure for bed allocations should be abandoned leaving the investment decisions to boards and management of entities providing facilities. They would be responsible for making investment decisions and determining the range and quality of services to be offered. Some reservations may be expressed about the applicability of these arrangements in remote and those rural spheres where supporting services are lacking. In these circumstances there are grounds for implementing an auction system with bids sought on the fiscal support needed for capital outlays and operating budgets were facilities to be established in those locations. This approach has the advantage over the existing administrative bed allocation device in that existing regional providers and potential newcomers may bid on equal footing.
5. Funding Investment Funding issues bear upon the ways development of new facilities, such as this new Georges Manor, and the provision of government subsidies for the operating provision of care and accommodation. Given the fiscal strains inevitable with the current financial and economic turmoil, there is every reason to explore means to foster investment outlays in light of the need to expand facilities to meet future demands. Accommodation bonds have been the one flexible funding measure available to boards and management. Accommodation bonds apply in low care, in extra service high care and are perpetuated in the processes of “ageing in place”. Bonds are a form of corporate debt provided by the resident or resident’s family which is repayable except for an annual charge, the
“
More than ever the times call for intellectual and professional agility to explore effective alternative measures to secure better outcomes for users and governments from the aged care expenditure allocations.
”
retention sum. The interest on the bond accrues to the provider as a contribution to servicing the cost of capital embodied in the aged care facility as does this annual retention charge, itself limited to five years duration. The bond is a loan contribution towards the costs of provision of a residence. Thus it has similarities to the minimum payment and servicing costs of a mortgage on an ordinary residence. However, bond requirements are subject to some minimum value of assets held by the resident. Accommodation bonds are not permitted in ordinary high care. The impact of this distinction is to make investment in ordinary high care facilities less attractive than in any other type of aged care facility. Yet high care needs must increase relatively to low care in coming years, especially so with the greater quest or reliance on various categories of domiciliary care being a feature of recent decisions by successive governments. The distinction drawn between extra service high care where bonds may be sought, and ordinary high care where they may not, brings a remarkable discrimination. Those with substantial assets may “buy” their way into high care by offering substantial bonds. Those lacking substantial wealth, not concessional and assisted residents alone but including those of relatively modest wealth, are not able to offer anything to support the provision of services for them. Thus the discrimination is against the less well placed in Australian society Justification for this discrimination based upon preserving the family home is inexplicable. If there was any merit in that proposition, this should mean the prohibition of accommodation bonds altogether. Moreover the bond, as pointed out already, is a loan subject to some small deduction, so the family estate is not reduced substantially.
6. Funding Operations No less compelling are issues bearing upon funding operating costs in aged care facilities. The direction of government policy is, for this government as with the previous one, the provision of facilities in which single bed and two bed en suite rooms are the dominant feature. Hence a funding system which does not allow for adapting to this type of facility, will impair provision of these facilities. What is evident is these types of rooms rather than the larger multi-bed rooms are more expensive to operate. Thus there is an immediate need for government to sharpen a focus on inducements embodied in their pricing of subsidy payments for residential accommodation to secure the effective development of facilities meeting the stated goals of specific room layouts.
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Georges Manor Opening Ceremony (continued)
7. New Approaches What has been addressed so far are possibilities for bringing user influences to bear on the existing policy framework in order to achieve a greater responsiveness to users’ needs. What should be explored given the duress and fiscal restraints flowing from these economic and financial turmoils are new ways to provide care. This is what the Productivity Commission and the National Health and Hospitals Reform Commission are pointing to in their writings. Let us contemplate possibilities. First, might it not be timely, now that successive governments have tended to give greater emphasis on domiciliary care rather than residential, to extend the thinking to separate completely the care costs in aged care provisions from the accommodation costs. In some ways we do that now but inevitably mix the two when it comes to funding and pricing details. There must be scope for innovative boards and management to offer care services jointly to those in residence as we witness it here at Georges Manor and to those living in retirement village settings, independent living units and long-established houses. Something like this is in place with some comprehensive providers.
Secondly, this tentative possibility could be tested further with placing more independence in users’ hands by adopting possibilities already in place in some countries with cash payments to users and their families whereby they could determine the care services they require. In this context all in this country must acknowledge just how stodgy has been the Australian unwillingness to experiment with these possibilities. This lack of innovative leadership tells much about established policy rigidities. Thirdly, the co-ordination of care services to assist the elderly in potentially traumatic circumstances might be secured more effectively by closer ties between General Practitioners and aged care services. But this would require a degree of flexibility to be afforded boards and management for bed use not available under the existing regulated regimes. This co-ordination should moderate demands on hospital facilities where nursing staff have less experience with treating the elderly, while ensuring general practitioners readier access than at present to secure care for their patients. This type of commitment might mean a much greater role for ACATs in managing the commitments of their approved elderly clientele between types of care. These are three possibilities well worth exploring beyond the reconstruction needed to enhance the offerings under the existing conservative rigidities of long-standing arrangements. n
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editorial
‘Active, Independent and Upright.’ By MIke Swinson
I know that’s how I want to be when I ‘get on a bit.’ Active, independent and upright, depending on my intake of red wine at the time of course!
I
know that we get frailer as we age, my kids are constantly telling me that ‘I am getting on a bit!’ All I will admit to is that when I do forget how old I am and work like a navvy for a day or so, my slowly ageing body lets me know in no uncertain terms that I’ve gone too far. Knees swell up, the back aches, or worse still it spasms. It comes to us all. When I heard how BallyCara had been lauded for its groundbreaking research into falls, and received the National Best Practice in Aged Care Award for its Active, Independent and Upright program facility, I was personally interested and more than a bit excited. There is hope for me and others after all! As an introduction to the story let’s first of all meet ‘Mary,’ (not her real name) a resident of the BallyCara Retirement Village community. Mary is fast approaching her nineties; she became a resident after a number of falls at home. Before this program began, Mary was known at BallyCara as a ‘faller,’ someone who staff had to monitor constantly. Her self confidence and self esteem were low. She didn’t participate in social activities much and spent a lot of time alone. As we know, living with the fear of falling can wreak havoc on our capacity to cope with life. Mary is no exception. “We had a good falls management program throughout our facilities, but we wanted to do something innovative and achieve greater outcomes,” said BallyCara General Manager Marcus Riley. “Falls are one of the greatest risks to the health and independence of seniors today. Falls are the single greatest cause for people over sixty five ending up in hospital, and have a major impact on the health system, not to mention the personal trauma that comes with a serious fall.” Marcus Riley is keen to share the success of the trial with as many other facilities, their staff, residents and health providers as possible.
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“The program showed it was possible to halve the risk of a fall, the single largest cause of hospitalisation in people aged over 65. Our team collaborated with a number of experts to devise a falls-prevention program that was trialled with more than 120 residents of varying age and mobility.” The result was a greater than 50 per cent reduction in falls over 12 months. Marcus said the program included some key elements: •
Fall definition, they used the World Health Organisation definition
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Consistency of messages across different staff levels and facilities
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A step by step approach
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Educating everyone; staff, residents and external health providers.
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Medication review to reduce side effects that might increase the risk of falls.
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Introduction of the FRAT. (Falls Risk Assessment Tool)
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Activity programs, including a ‘sun exposure’ program, to lift intake of vitamen D
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Monitoring resident participation
croquet lawn, and parkland reflecting the Australian bush. It’s well within walking distance of the nearby coast. n
Contact details Marcus Riley, General Manager of BallyCara Ph: 07 3203 7511 Email: mriley@ballycara.com
“We thought we could improve things by 25%, we hoped for 30%, but as the figures began to show up, as time progressed and the trial went on, we noticed a massive improvement of more than 50% falls reduction for over 120 residents,” said Marcus. So what’s happened to Mary? Marcus says the transformation in Mary has been extraordinary. Remember, she was classed as a ‘faller,’ someone who had to be closely monitored. Mary has fallen once in the past 18 months, and that fall happened in the first six months of her exposure to the program. She has been a year without a fall! Not only is Mary involved in the exercise program, her self confidence has blossomed, and she has become one of the ‘educators’ in the resident’s garden walks, her medication has been adjusted so that it doesn’t affect her mobility. She is socially active and her life is richer. It doesn’t get much better than that! Twice a day, on most days Mary can be seen taking groups around the 13 hectare site! Marcus Riley said the program was a collaborative one with input from clinical staff, care staff, residents, their families plus external health providers; doctors, physio’s and pharmacists. “Education for staff, residents, relatives and health providers was critical. We didn’t want to rush things, so we worked incrementally. It was a step by step process,” he said. “We needed to review and refine each stage before moving on to the next phase. There is no reason why this program couldn’t be used by almost every aged care facility or retirement village in Australia.” BallyCara is a retirement living and aged care community with over 450 residents. It has independent and assisted living units, a nursing home and two hostels. It has low care and high care accommodation and a secure specific dementia unit. The complex sits in 13 hectares of landscaped gardens, complete with a walk through bird aviary, large wetland with walkways,
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ADVERTORIAL
Since its launch in 2003, Total Aged Services’ CAREX has developed into one of Australia’s most popular & valuable industry events.
Sydney CAREX 2009 July 15 & 16 Rosehill Racecourse
An event like no other, CAREX offers attendees a fabulous one stop professional development environment for review of products & services, education, networking and research. The mix of exhibitors and products/ services on display is unique & diverse - from acuators to agencies, beds to bandages, catering equipment & crockery, furniture to foam mattresses, manual handling equipment, nursing services, safety equipment, wheelchairs & walkers … In addition to the exceptional line up of exhibitors, Sydney CAREX 2009 will once again feature a terrific line up of free mini workshops. So if you are a manager or clinician, supervisor or student, health professional or carer, other
Dementia & Recreation National Conference 2009 October 13 & 14 The Sebel Albert Park, Melbourne
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Based on the success of the 2007 & 2008 events, Total Aged Services is excited to once again present its Dementia & Recreation National Conference in 2009. Each year this conference aims to be more than a professional forum - it seeks to demand your attention, engage your professional senses & re-energise your enthusiasm. Given the name of the conference, a great percentage of delegates will be Recreation/Lifestyle Professionals or Diversional Therapists but in truth this is an event designed for all managers & staff with a commitment to & passion for quality lifestyles for people with dementia.
professional or staff member working in the industry, this is your event & your opportunity. Whether you work in the acute, community, disability or residential sectors, we bid you the warmest of welcomes! Open from 0930 to 1600 on both days. Attendance at Sydney CAREX is free and registration can be done online (in the CAREX section of www.totalagedservices. com.au) or completed “at the door” when you arrive. For other information regarding CAREX including venue location, parking, Workshop information & registration again visit the website or contact: Wayne Woff (Manager, Total Aged Services) P: 03 9571 5606 / 0422 484 209 E: office@totalagedservices.com.au W: www.totalagedservices.com.au Also for interested product & service providers to the Health & Aged Care Sectors bookings for the 2010 Melbourne CAREX will open in June 2009. Again contact Wayne Woff if you are interested. n
Cognisant of the range of settings (residential, community or in the home) that recreation services are provided to people with dementia, this conference will a unique forum for information, education, discussion & debate. All enquiries to: Wayne Woff (Manager, Total Aged Services) P: 03 9571 5606 / 0422 484 209 E: office@totalagedservices.com.au W: www.totalagedservices.com.au n
An Obituary printed in the London Times
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oday we mourn the passing of a beloved old friend, Common Sense, who has been with us for many years. No one knows for sure how old he was, since his birth records were long ago lost in bureaucratic red tape. He will be remembered as having cultivated such valuable lessons as: Knowing when to come in out of the rain; Why the early bird gets the Worm; Life isn’t always fair; and Maybe it was my fault. Common Sense lived by simple, sound financial policies (don’t spend more than you can earn) and reliable strategies (adults, not children, are in charge). His health began to deteriorate rapidly when well-intentioned but overbearing regulations were set in place. Reports of a 6-yearold boy charged with sexual harassment for kissing a classmate; teens suspended from school for using mouthwash after lunch; and a teacher fired for reprimanding an unruly student, only worsened his condition. Common Sense lost ground when parents attacked teachers for doing the job that they themselves had failed to do in disciplining their unruly children. It declined even further when schools were required to get parental consent to administer sun lotion or an aspirin to a student; but could not inform parents when a student became
pregnant and wanted to have an abortion. Common Sense lost the will to live as the churches became businesses; and criminals received better treatment than their victims. Common Sense took a beating when you couldn’t defend yourself from a burglar in your own home and the burglar could sue you for assault. Common Sense finally gave up the will to live, after a woman failed to realize that a steaming cup of coffee was hot. She spilled a little in her lap, and was promptly awarded a huge settlement. Common Sense was preceded in death, by his parents, Truth and Trust, by his wife, Discretion, by his daughter, Responsibility, and by his son, Reason. He is survived by his 4 stepbrothers: I Know My Rights; I Want It Now; Someone Else Is To Blame; and I’m A Victim. Not many attended his funeral because so few realized he was gone. If you still remember him, pass this on. If not, join the majority and do nothing. n
editorial
The real value of SAGE advice SAGE Europe Study Tours 2009 11th July to 22nd July including attendance at the IAHSA conference in London Ever thought of packing your bags and heading off overseas with a group of like-minded people from Australia, to see how aged or community care is delivered, designed and operated in another part of the world?
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AGE tours offer Australia’s aged care executives this unique opportunity. Have you ever thought about why people sign-on for one of these tours? Well four participants in the upcoming UK/Netherlands have agreed to share their reasoning for going. Rhys Boyle met the CEO of Netherlands based provider ‘Humanitas’ earlier this year and was really impressed with what he had heard about the Dutch organisation. At a recent aged care conference he was talking to SAGE tour organiser Judy Martin from architecture firm ThomsonAdsett; she told him there were two Humanitas facilities on the tour list of the upcoming Netherlands trip, he was hooked. ‘What I want to know’ he said, ‘is how they do that, how they design and run these facilities to attract people. Humanitas is financially well off and they have a waiting list. I’m fascinated.’ Paul Bradley from Anglican Retirement Villages in NSW has 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. I hear good things about what they are doing over there and I want to see what we can do better.’ ‘For me it’s a critical time to look at facilities and services in the UK and see what other people are doing,’ says Lyn Bruce from the Sisters of St Joseph in NSW. ‘I am trying to expand our services and I want to make sure that we are doing it the best we possibly can. In particular I want to see what’s happening in providing home based care to the ‘have-nots’ of this world, because that’s who we look after.’ ‘I tried some years ago to organise my own tour of aged care facilities and it was a debacle compared to the professional way the SAGE tours are run and organised by Judy’, said Jim
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Raggart. Jim was so impressed with the professionalism of his first SAGE tour a few years back he is returning for a second trip, because he sees the possibility of so many positive outcomes for the ACH Group in South Australia. (He’s so keen to go he is paying his own airfares!) ‘This current tour program is incredibly comprehensive, they will get us into not only aged care facilities in the UK, but we will see several different styles of aged care. With Judy, the tours are so well organised, the places you visit are stunning examples, by that I mean they may not be the best but they are worth seeing for a variety of reasons,’ said Jim. Jim Raggart is so excited about the tour as a whole, bus trips and all. ‘You get locked in a bus with David Lane the [MD] of ThomsonAdsett for six days, that by itself makes this trip a bargain. I’m also travelling with industry leaders like Rod Young and Richard Gray. The dinners and discussions after visits to facilities mean I get a comprehensive view of what we have just seen, not just my take on things. I wouldn’t miss it for the world. While the tours are organised and run by ThomsonAdsett’s Judy Martin, they are a joint initiative of the aged care sectors peak bodies, ACAA (Aged Care Association Australia) and ACSA (Aged & 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. However, she says planning has started for tours for the next few years and in the wind are tours to: 2010 --China/Hong Kong and perhaps another to NZ 2011 --Washington (for IAHSA) with an accompanying study tour to New York & Boston Judy revealed 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. You will hear more from SAGE when the weary, but invigorated, travelers return to Australia. n
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editorial
Aged Care & Retirement Villages Update By Arthur Koumoukelis
NSW Tribunal Decides On Allocation of Costs Between Villages
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ith the continued growth and consolidation of the retirement village industry, it is inevitable that more and more operators will operate across state boundaries and multiple facilities. They will as a result, continue to incur costs that relate to the establishment of the portfolio but at the same time generate benefits for residents through economies of scale, branding, security and choice. At the same time, residents have been concerned to ensure that only costs relating to their village may be passed on to them. These costs are typically in the nature of administration costs or imposts such as payroll tax. Both affect for profit and not for profit operators. These matters have given rise to much discussion between operators and residents particularly as reviews of the legislation have occurred as has been the case in New South Wales. Most relevantly, up until now, there have been conflicting decisions in Queensland and New South Wales as to an operatorâ&#x20AC;&#x2122;s entitlement to recover the impost of payroll tax from residents as part of the general services in their maintenance charges. Queensland cases say you can, New South Wales decision said you could not. Both operators and residents have been waiting for clarification as to operation of the relevant Retirement Villages Act to explain the position and provide guidance. On 21 May 2009, the New South Wales Consumer, Trader & Tenancy Tribunal handed down its decision in the matter of Australian Retirement Homes (No 2) Pty Ltd v Minkara Retirement Villages Resident Committee RV 08/41351 which has provided clarity for all parties as to the principles involved in incurring and allocating costs across numerous facilities. gadens lawyers acted for the operator in the case. That decision has brought the New South Wales position in line with the Queensland position to confirm that the impost of
payroll tax that was included by the operator in its statement of proposed expenditure for the financial year ended 30 June 2009, could form part of the statement of proposed expenditure. A copy of the decision is available on the gadens lawyers website at http://www.gadens.com.au/documents/20090526143539706. pdf The principle that is relevant to both residents and operators is that it confirms the Retirement Villages Act and Regulation is structured to ensure transparency and fairness to both in that the Act envisages a person may be the operator of more than one village and can apportion the expenditure between the villages as long as the method of calculation of apportionment is disclosed. In the particular case, the Tribunal accepted that the obligation to pay payroll tax as a result of the corporate structure of the applicant to be an item that can be recurrent charge in respect of wages and salaries and part of the proposed expenditure. Though the case dealt predominantly with payroll tax, it assists the industry to emphasise that the Act does work to confirm such costs can be passed on but in doing so, ensure transparency of information to residents as to the costs of living in the village.
Guide to legislative framework for villages and nursing homes
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ith many new participants in the industry and the convergence of care into villages and aged care operators looking at retirement villages, it becomes more important for those new entrants and new employees working in the industry to understand the difference between a nursing home and a village and what they both mean. To assist new entrants into the industry, gadens lawyers has prepared a brief outline of the legislative framework regulating retirement villages and nursing homes. This outline is available on the gadens lawyers website at http://www.gadens.com.au/ documents/20090526115427706.pdf n
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ADVERTORIAL
Flood-proofing your aged care facility Floods can be devastating for aged care facilities, but the extent of damage can often be significantly reduced with some good planning and preventative measures.
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loods affect more people around the world each year than any other form of natural disaster. Indeed, two of the costliest insured events to take place in Australia in the past 40 years were caused by floods - the 1974 Brisbane floods and the Newcastle storms.1
Is your aged care facility located in a floodprone area? Are your premises situated in close proximity to a river/natural waterway (whose banks can overflow), near the coast (and vulnerable to storm surge) or in a low-lying urban area where flash floods can occur during heavy rainfall? Zurich Risk Engineer Roger Hancock says that while the best flood minimisation strategy is to find an elevated position that’s low-risk, there are many steps that aged care facility owners can take to help ‘flood-proof’ premises in less optimal locations. “Thanks to the wonders of modern technology, it’s now possible to construct new premises or modify existing buildings to increase their capacity to withstand water inundation and reduce flood damage,” says Hancock. “Quite often, modifying an existing property can be relatively inexpensive and make the premises more quickly habitable following a flood.”
Sizing up the risks Hancock says that important factors that aged care facility owners need to consider when devising a flood protection plan include:
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• potential sources/types of flooding (e.g. natural watercourses, sea/storm surge, groundwater, ruptured water mains, blocked drains/sewers etc.) • likely frequency of flooding • predicted maximum flood levels for the location • likely flood duration. “The type and impact of potential flooding will determine the degree of flood protection that you need to install,” says Hancock. “While these sources can act collectively, one or two will usually represent the greatest threat to your property. “Development has increased the risk of flooding from rivers and streams in many areas by reducing the natural capacity of floodplains and increasing the rate of overland surface water run-off by up to six times.”
Identifying the potential operational impacts After identifying your aged care facility’s flood risks, you then need to work out what the main impacts of this event are likely to be on your operation. These can include: • personal injury or death of staff • personal injury or death of residents • exposure to hazardous materials • loss of operating records • damage to plant/equipment, furniture, floor coverings and fittings • damage to reputation • temporary rehousing of residents • time taken to resume operations • cost of clean-up • visitors unable to physically access premises • employees unable to come to work. Putting in place a contingency plan to help mitigate these risks is an important next step. Likewise, Hancock recommends that aged care facility owners check their
insurance policies to make sure that flood is not a listed exclusion. “Flood cover was difficult to get in Australia until fairly recently,” says Hancock. “Last September, Zurich became the first insurer in Australia to automatically include flood cover in its base wordings for all eligible new commercial customers, as well as eligible existing policies on renewal. This initiative had very little if any impact on the premium for the majority of clients.”
Flood-proofing techniques Numerous options are now available to help make an existing building more resistant to flood damage. Permanent/ automatic measures, which require no human intervention, can include things like installing back-pressure reflux valves on drains or locating hard-to-move equipment and critical machinery, stock and spares to elevated areas. Meanwhile, contingent flood-proofing measures (i.e. activated when there’s a threat of flooding) can include putting in place movable floodwalls and freestanding barriers. To find out more about Zurich’s Risk Engineering services and flood cover, contact your local insurance broker. n * “Current Issues Brief: Australian Catastrophe Information”, ICA
2009 Calendar of Events 20 – 22 July
30 – 31 July
4-7 August
IAHSA’s 8th International Conference
Nurses in Management Aged Care Conference and Trade Exhibition 2009
ACHSE 2009 National Congress
‘Leadership Beyond Borders’
Conrad Jupiters, Gold Coast
Queen Elizabeth II Centre London, England
Contact: ACQ Conference + Event Management
W: http://www.iahsa.net/london/
P: 07-3725 5588 E: events@acqi.org.au W: www.acqi.org.au
Building our Healthcare System around People and their Needs Surfers Paradise Marriott Resort & Spa, Gold Coast Contact: Mike Knowles, Executive Officer, ACHSE (Qld Branch) Phone: 07 3229 3170 Email: mike@achseqld.org.au
25 – 26 August
13 – 16 September
24 – 25 September
ACS Community Care Conference
ACSA 2009 National Conference
National Dementia Research Forum
Sydney Convention and Exhibition Centre
‘Get up, stand up!’
Wesley Conference Centre - Sydney www.dementia.unsw.edu.au
www.agedservices.asn.au
Perth Convention Exhibition Centre Conference Secretariat: EECW Pty Ltd T: 08-9389 1488 F: 08-9389 1499 E: info@eecw.com.au
22 – 23rd October
15 – 17 November
4th International Conference On Creative Expression Communication and Dementia
ACAA 28th Annual Congress
Darling Harbour
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
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product news
National IT in Aged Care Awards (ITAC) 2009
Best Implementation of the Year Over 150 Places/Clients – Winner Barwon Health Service At the recent National IT in Aged Care awards, Barwon Health’s use of the leetotalcare® software program won the award for the best software implementation for a facility of over 150 beds.
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he awards were announced in Sydney at a gala dinner and recognise excellence and achievement in aged care providers and software suppliers. The adoption of new technology in the Barwon Health region of South West Victoria has been recognised nationally for the way it has transformed health care delivery in the region, putting it at the forefront of healthcare delivery in Australia. Sue De Gilio, CEO of Barwon Health says that the benefit to staff and patients from the adoption of the new technology is far reaching. “For the first time the regions healthcare facilities, including hospitals, outpatients and aged care providers have instant access to electronic patient health records. The [leetotalcare®] system not only ensures that clinicians can access patient records anywhere, anytime; it also protects the patient’s medical history.” The leading aged care leetotalcare® technology has also slashed thousands of hours off the time staff spent entering and storing resident and patient health records. Another aged care provider, utilising the leetotalcare® package was one of this year’s finalists in the annual ITAC Awards.
Best Implementation of the Year Under 150 Places/Clients – finalist Grant Lodge Djerriwarrh Health Service Grant Lodge were selected for this nomination as a finalist for their comprehensive and targeted leetotalcare® implementation process which enabled all staff of this 30 bed facility to have daily involvement in quality resident data collection, transforming the way care is delivered in this small facility. ‘This demonstrates the flexibility of leetotalcare® supporting community and aged care facilities of all sizes, budgets and needs,’ said Caroline Lee.
Caroline Lee said ‘we are so proud to have two of our clients achieve such National recognition for their implementation of the lee total care® program, which not only recognizes staff and management’s considerable efforts BUT provides the residents and families of these communities reassurance that their care teams are committed and knowledgeable regarding their care needs.’
Background Information on Barwon Health Sue De Gilio, CEO of Barwon Health says that the benefit to staff and patients from the adoption of the new technology is far reaching. “We have numerous sites scattered across the region, which presents problems with accessing patient’s records,’ says Sue De Gilio. “By having all a patients details in one location, care planning is made so much easier and staff are not tied down with administrative tasks, freeing them up to spend more time actively caring for patients,” she said. The leading aged care leetotalcare® technology has also slashed thousands of hours off the time staff spent entering and storing resident and patient health records. Sue De Gilio said the project has reduced the need for vast amounts of storage for hard copy patient records. “Racks and racks of paper records are fast disappearing as more and more areas are digitized, helping to reduce our carbon footprint,” she said. The leetotalcare® Project commenced in July 2006 and concluded in June 2008. The team, based at Barwon Health’s McKellar Centre, was led by Anne Shirley and enlisted advice from Lee Consulting and the South West Alliance of Rural Health (SWARH) in developing a solution. “We were finding that there was a diverse range of forms being used across the service which created problems. The volume of repetition in terms of information being written on forms was slowing the admission process and taking up vast amounts of staff time, that could be better spent caring for patients” Anne said. “All Aged Care resident files are now electronic and can be easily accessed by the staff in real time providing a better level of care.” CEO of leetotalcare®, Caroline Lee said ‘aged care providers are increasingly recognising that IT can be a powerful tool to offset some of the difficulties in securing the right staff with the right skills; in coping with the complexities of the Federal Governments Aged Care Funding requirements and in slashing time staff spend on paper based record keeping’. ‘Our Congratulations to Barwon Health and Grant Lodge!!!’ Contacts Caroline Lee CEO of leetotalcare®, Ph: 03 93396888 Sue De Gilio CEO of Barwon Health. Kate Nelson, Director, Communications, Marketing & Community Engagement. Barwon Health. Ph: 03 5226 7707
The Implementation of the Year category recognises Aged and Community Care Providers and their implementation partners that have effectively used ICT to improve business outcomes in the Australian Aged and Community Care environment. The awards are run under the auspices of ACAA, ACSA (Aged & Community Services Australia) and HISA (The Health Informatics Society of Australia.)
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product news
Melbourne Based – Australia Wide
EXPERTS IN AGED CARE SALES FOR OVER 50 YEARS
Market Overview to May 2009 Recession? What recession? Over the past five months to May 30, we have negotiated the sale of; • Four freehold RACF’s with a value of $37.75 million
Poorly managed Facilities or any with underlying problems are saleable at prices reflecting their true value. Soundly run facilities with solid trading histories are still sought after by an increasing number of buyers who are appreciating that quality is not discounted. One negative impacting on the Industry is that funding for many remains a challenge. We are certainly positive as to the strong long term viability of the Industry and have a number of Freehold and Leasehold opportunities to offer in South Australia, Victoria, NSW and Queensland, plus a number of groups of relocatable beds. Your enquiry is welcomed and we also welcome the opportunity to discuss without any obligation, any aspect of the Aged care industry. n
•
Four leasehold RACF’s with a value of $19.5 million
Change of Address:
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104 relocatable bed licences,
Please note that we are now operating from our newly acquired offices.
and negotiations are in hand with several others in all categories. To the question have values or prices fallen, the answer is “yes, marginally but not across the board”. Boom time premium prices are gone along with easy credit, which has opened the market to the Institutions and Charitables along with private buyers seeking sound long term assets.
BED BUGS ARE BACK!
Unit 33, 41-49 Norcal Road Nunawading Vic 3131 PO Box 132 Nunawading 3131 Phone: (03) 9264 8700 Fax : (03) 9872 3708 E-mail: sales@ecclesrealty.com.au
pest control methods and bed bugs developing an immunity to many insecticides.
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Infestations can be found in residential areas, hotels, hospitals, nursing homes, and university dorms – in fact any location which has beds and soft furnishings. Bed bugs are well adapted to living with humans. As a successful parasite they prefer to sleep near their next meal; close to where people sleep or lounge.
Reasons for their resurgence include; increased international travel, changing
Bed bugs are flat, allowing them to get in or behind anything. When first infesting a location, bed bugs will migrate to areas of least exposure, such as mattresses and bed bases, making them very hard to detect. It only takes 3-4 months for a home to be fully infested and this is only when the bugs become visible.
Protect-A-Bed® AllerZip® – the Proven & Permanent Solution. ince the late 90’s bed bugs have made a comeback. In fact, between 2000 and 2006, bed bug infestations in Australia increased by an extraordinary 4,600%!1 Protect-A-Bed® is recognized as the premier provider of mattress and bed base encasement products worldwide. Product-A-Bed®’s innovation AllerZip® is the tried, tested and proven solution to prevent and control bed bugs.
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Bed bugs eat at night and exclusively feed on blood. Their bites feel and look similar to mosquito bites. Often they are painless and result in small, red, itchy bumps along the body. Dark spotting and staining on sheets, mattresses, pillows and clothing are visible signs that they have taken up residence. The staining is from excrement and blood left by crushed bed bugs. In severe cases, bed bugs leave an offensive sweet, musty odour produced by their scent glands.
ProtectA-Bed’s AllerZip® with patentpending BugLock™ is certified to be bed bug entry, escape and bite proof and is renowned as a highly effective tool in helping to manage and prevent bed bug infestations in both residential homes and outlets within the hospitality and healthcare industry. AllerZip® has a patent pending enclosure system; Buglock™ that incorporates a safety sealed trench with micro-zipper teeth for an extra tight seal. Secure Seal™ attaches to the zipper as an added tie down point on the encasement. This means that under no condition will the zipper pull away from the clasp.
Jomor Healthcare
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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
®
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Richard Cooper, leading US entomologist and Director of Cooper Pest Solutions, New Jersey, USA, is quoted as saying; “In my opinion, the best encasements designed are by Protect-A-Bed®. These mattress and bed base encasements were developed specifically for use with bed bugs. They have been tested extensively by an independent research laboratory using scientific methodology, to demonstrate that they are completely bite-proof and escape-proof”. AllerZip® with Protect-A-Bed®’s Miracle Membrane® also provides bedding solutions for general hygiene, allergies, eczema and bedwetting. AllerZip®’s waterproof barrier is air vapour porous so breathable and cool and comfortable to sleep on.
For information on AllerZip®, your local Protect-A-Bed distributor or an associated Pest Management company, please call 1300 857 123. References:
1. The resurgence of bed bugs, Stephen L Doggett amd Richard Russell, Westmead Hospital, Australia, Proceedings of the Sixth International Conference on Urban Pests.
AllerZip® is a total solution in bedding hygiene and the perfect tool to combat bed bugs infestations.
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
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.
Experts in Occupational Hand Hygiene
eb has recently released a new skin care range dedicated to the Aged care sector.
The range consists of a mild foaming hand soap, Alcohol Foam hand sanitiser, moisturising cream and a complete 3 in 1 shampoo, conditioner and body wash.
All products are designed to be used in easy to use dispensers. Deb Australia & New Zealand Tel: (02) 9794 7700 Website: www.deb.com.au
Aged Care A U S T R A L I A | Winter 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.
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• •
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
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:
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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
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ow often do you see something and think, “Wow, what a great idea! Wish I’d thought of it”?
That’s what many people are saying about the flashID Emergency Identification System, where key medical and personal information is stored on a USB device in a simple Word document. Coloured the internationally recognised emergency green with a white cross, the flashID device is immediately identifiable by emergency services and hospital staff. Accidents don’t always happen to “other people” so if you are involved in an accident or for any reason collapse in the street, vital minutes can be saved if you have flashID, which comes in three inexpensive models. The Classic flashID device can be carried on a keyring or lanyard around the neck or attached to a mobile phone and is priced at just $49.50. There is also the flashID Card ($55 RRP) which is the same size as a credit card, though a little thicker and may be kept in your wallet
Winter 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
It’s a Great Idea…
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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.
or purse. In this model, the USB key folds out to plug into the computer. Finally, the flashID watch is a smart wristwatch with the USB key built into the watchband. The watch face carries the distinctive flashID logo so it is easily recognisable. The watch is normally priced at $75 plus postage but is now available for a limited time as an internet super special at just $59.50 including postage. For more details, visit www.flashID.org See our ad on page 37 of this issue!