LASA Fusion Autumn 2016 by Adbourne Publishing

The voice of aged care Autumn 2016 | www.lasa.asn.au

THE REAL

IMPACT OF FUNDING

REFORMS CAPITALISING ON CHINA’S AGEING POPULATION – PAGE 62 INCREASING CHOICES BILL: WHAT IT REALLY MEANS – PAGE 69 QUALITY INNOVATION LEARNINGS FROM THE US – PAGE 80

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CONTENTS The voice of aged care

5 NATIONAL CEO UPDATE

Autumn 2016 | www.lasa.asn.au

7 CHAIR UPDATE

EDITOR

OPINION 9 Sussan Ley,

Katie McKeown

LASA NATIONAL

Minister for Aged Care

Patrick Reid CEO PO Box 4774, Kingston ACT 2604 E: patrickr@lasa.asn.au

12 FOCUS ON ... FUNDING

LASA NSW/ACT

FEATURES 16 Update on the NSW

Loula Koutrodimos Acting CEO PO Box 7, Strawberry Hills NSW 2012 E: Loula.Koutrodimos@nswact.lasa.asn.au

Government inquiry into mandated RNs

LASA QLD

21 Funding constraints, agencies

Barry Ashcroft CEO PO Box 995, Indooroopilly QLD 4068 E: barry.ashcroft@qld.lasa.asn.au

driving costs

OPINION

LASA SA Paul Carberry CEO Unit 5, 259 Glen Osmond Road Frewville SA 5063

9: A word from the Minister for Aged Care

25 Codesign in practice: the Step Forward project

29 Parliamentary visit for rural delegation

34 ACFA report findings cannot

E: ceo@sa.lasa.asn.au

be ignored

LASA VIC Trevor Carr CEO Level 11 600 St Kilda Rd, Melbourne VIC 3004 E: trevorcarr@lasavictoria.asn.au

39 Ageing in CALD communities:

LASA WA

TECHNOLOGY & INNOVATION 49 Process re-engineering

Roundtable

Beth Cameron CEO Suite 6/11 Richardson Street, South Perth WA 6151 E: ceo@wa.lasa.asn.au

51 Smart Floor technology has arrived

53 Disruptive technology

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DESIGN 57 : A home first at Benetas Corowa Court apartments

BUSINESS MANAGEMENT 64 Pre-entry leave fee changes 67 Protecting your company from fraud

69 Bruce Bailey: Increasing

Administration Tarnia Hiosan (03) 9758 1431

choices – but not supply

Susan Moore Marketing susanmoore@y7mail.com

74 Why staff engagement surveys don’t work

DISCLAIMER

HEALTH & WELLNESS 76 New dementia guidelines

Fusion is the regular publication of Leading Age Services Australia (LASA). Unsolicited contributions are welcome but LASA reserves the right to edit, abridge, alter or reject material. Opinions expressed in Fusion

EVENTS 78 Tri-State 2016

are not necessarily those of LASA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Fusion may be copied in whole for distributed amongst an organisation’s staff. No part of Fusion may be reproduced in any other form without written permission from the article’s author.

BUSINESS MANAGEMENT 74: Why staff engagement surveys don’t work

80 Lessons from the US on quality innovation

84 WHAT’S NEW

NATIONAL UPDATE I

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| NATIONAL UPDATE

STABILITY AND CERTAINTY

– AN ELECTION CALL TO ARMS It may be that by the time you have received your copy of Fusion we will be clearer on when the election will be called and the increasing whispers that the Federal budget will yet again place the stability and certainty for aged care in jeopardy.

Patrick Reid Chief Executive Officer Leading Age Services Australia

n the wake of another $500 million in cuts from our industry announced in MYEFO we must apply pressure from all angles to alert your elected representatives to the long term damage this will cause and drive home the urgency of addressing our workforce, economic, quality and regulatory barriers.

might be your voice resonating in their head the next time they do so. The messages you need to convey are not complex but their meaning and impact cannot be undersold:

The next election cycle will be in three years’ time and by then pressure on age services to meet demand, presumably while receiving less support, will be even greater. So the time to act is now, while their ears are open to hear what we have to say. The provision of aged care is federally regulated, federally funded and touches the lives of all Australians.

2. Red tape reduction and simplified systems for providers and consumers.

Your local Member of Parliament (MP), as a decision maker on behalf of constituents, must be clear that ageing and age services will play an increasing role in the lives of those who vote for them, and more importantly, those who don’t. It is in this environment that you, as an aged care stakeholder, must become pro-active and seek out politicians and candidates to tell them your story and reiterate the importance of age service providers in the community. More than 1.2 million services are provided to older people, equating to approximately 1 in every 3 people over the age of 65 receiving some form of aged care. This number will increase significantly as the baby boomers begin to require age services and those in their 70s and 80s today out-live previous generations. You already know that age service providers are under pressure to meet rapidly growing demand and need stability and certainty in funding, along with policy and regulatory change to improve capacity. The power of personal contact with an MP or aspiring politician can never be underestimated. Every vote in Parliament and decision they make is on behalf of their constituents, and it

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1. Funding stability and certainty, with an agreed forecast growth rate based on evidence to ensure ongoing viability and capability.

3. Policies that support competition and investment, further driving innovation. 4. Remove existing constraints to support a robust, flexible and suitably skilled workforce Your interaction and briefing of people with influence will afford them a better understanding of the issues and challenges in age services and how this will impact their constituents. As a LASA member you can provide practical and pragmatic advice that should see them become increasingly supportive of our industry and advocate for the change we need, pressuring other politicians to do so too. LASA will shortly be seeking your support to invite politicians to your service to see what you do or seek a meeting to discuss age service issues of importance to your local area. We will provide you with support and logistics such as letter templates and collateral to assist in this process. Traditionally aged care providers have not been overly active during election campaigns but this must change if we wish to stand up for ourselves and those we care for. We cannot wait for further pain to be inflicted so it is time to act. It has to start somewhere. It has to start sometime. What better place than here, what better time than now? ■

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CHAIR

| NATIONAL UPDATE

LASA TO BECOME A NATIONAL

ORGANISATION The focus on funding in this issue of Fusion serves as a timely reminder of why LASA is transforming to a unified organisation, and I am pleased to confirm we are on track to commence as an integrated, national organisation from 1 July 2016.

e have pursued this national unified vision because we see the real benefits to us all that being a national organisation will deliver:

• stronger advocacy in a world of unprecedented change at the national level; • opportunities to share support and services to all members, without jurisdictional borders; and • enhanced value for money in the way we provide advocacy, support and services. As service providers we are deeply influenced by the way in which the sector is governed, funded, and regulated. It is critical that the sector is well positioned to present itself to policy makers and key decision makers in a way that is influential and well thought through. At its February meeting the existing national board endorsed in-principle the constitution for the nationally-integrated LASA. We have built on the strong foundation provided by the current LASA national constitution, updating it to ensure that governance arrangements support our vision of delivering stronger advocacy for members across the country and sharing support and services to all members without jurisdictional borders. We agreed to a new framework for determining member fees, which will pave the way for harmonious fee arrangements across all states, and deliver value for money for all segments of our membership base, inclusive of an optimal transitional process.

Dr Graeme Blackman OAM Chair I LASA

The Board committed to supporting current LASA members through the fee transition by way of a multi-year transition period. This will include a 1 year freeze of member fees at current levels from 1 July 2016, followed by a period of incremental adjustment toward the new rate over two years. New members joining after 1 July 2016 will commence on the new fee structure. The Board also agreed to a member voting framework, which aligns allocation of member votes to the level of fees paid. In practice, members paying a lower level of fees will be allocated a single vote, with those in the intermediate fee range allocated two votes and those in the higher fee range allocated three votes. This guarantees all LASA members an equitable voice in the direction of the organisation, whilst providing for an increasingly diverse membership mix. For our corporate sponsors, who provide critical support to LASA and the broader industry through their information, advice, services and sponsorship, the Board committed to progressing further integrated programs of work around a national service catalogue. The remainder of this financial year will see an increasingly rapid pace of activity as we finalise the transition to a unified body. The Board and I appreciate that change of this scale is not easy for anyone – members, staff and corporate partners. I commend the CEOs and staff in each LASA office for their ongoing dedication to our members and professionalism throughout the last year, and have the utmost faith in their ability to take our organisation to the next level. ■

THE DESIGNER Helen Kelleher graduated as an Occupational Therapist from Sydney in 1965. Her first appointment as an OT was at the Mount Wilga Commonwealth Rehabilitation Centre, Hornsby, in Sydney. Due to family commitments and living overseas, Helen’s career path was put on hold for several years. Upon returning to Canberra, after several years living overseas, Helen joined the Mobile Unit of The Rehabilitation Team at the Canberra Hospital in 1973. In the two years with the unit she made home assessments and arranged the supply of equipment for clients. This gave Helen a more thorough understanding the needs and difficulties faced by clients with the equipment that they had at this time. After eight years running a day care program for the aged and disabled, Helen moved back into the hospital environment working at Queanbeyan Hospital. Her duties included Home Modifications as well as working with patients on the wards and in the Day Care Centre.

THRONE ACCESSORIES It was while working in the Home Modification area that Helen identified a deficit in the design of some of the equipment. She saw that the safety aspects in accessing the toilet for many of her clients were not being adequately met by any of the equipment available. The most obvious challenge Helen identified was that other rails required patients to pull themselves up, a very difficult task for the frail, aged and those with back injuries. The Throne rails are positioned much closer to the body allowing patients to push up more like they do when sitting on a chair. Having exhausted enquiries in her search for suitable equipment, Helen set about developing her own ideas with safety and comfort high on the agenda. She was encouraged to learn that existing porcelain bowls had the strength to hold a rigid fixture that she knew was the answer for people with disabilities and physical restraints. Helen commenced designing a prototype Rail and continued to develop the Rails until the highest safety aspects were met as well as ease of transportation. The initial design was so well received that Helen set about refining the model to accommodate people with a full range of disabilities including sports injuries as well as rails and steps especially for children.

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OPINION

BRINGING AGED CARE HOME It’s been about six months since aged care came ‘home’ to the health portfolio. This was an important step, as I truly believe we can support older Australians and their carers much better with aged care in a portfolio that includes health.

ged care is not all about health and the Government has made great progress in this sector over the past three years.

We have progressively been addressing the issues and weaknesses in the system identified by the widely supported Productivity Commission 2011 report Caring for Older Australians. Our Government has landed those changes and we plan to go further. Changes to the My Aged Care Gateway are now supporting people to find their way through the aged care system and is undertaking assessments for those who need low level care at home. It is increasing its role as the one identifiable place to go for information and support to access aged care. There has also been significant work on addressing inconsistency and inequity in the pricing and consumer contributions to the cost of their care. In January this year, the Government transferred responsibility for the aged care complaints scheme from the Department of Health to the Aged Care Complaints Commissioner, creating a more independent and robust approach to complaints. We are also continuing our work on expanding flexible aged care initiatives, with the establishment of the Short-Term Restorative Care Program, to help people regain maximum independence, when they have experienced difficulties. The aim is to make it easier for people to stay independent and live in their own homes longer. Places will progressively become available, with at least 2,000 being available by 2021.

Sussan Ley, MP Minister for Health Minister for Aged Care Minister for Sport

The Aged Care Amendment Bill introduced into Parliament this month will give consumers more choice about home care packages.

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OPINION

This game changing legislation means, from February 2017, home care packages will be allocated to assessed consumers who will be able to direct Commonwealth funding to the provider of their choice.

This means aged care expenditure, as with any portfolio, must remain within its allocated but growing budget. I do however want to work with industry to ensure we have some certainty in residential aged care funding.

Perhaps more importantly, they will also have the flexibility to change their provider if they want to or, if on the move to another area or interstate, they can take their package with them.

Workforce is also an important issue and I want to take this opportunity to reconfirm the Government will assist industry with the development of a workforce strategy.

Once these changes come into effect, providers will no longer have to apply for home care places through the Aged Care Approvals Round, significantly reducing red tape for businesses. Residential care needs to be the next area of reform. It is my view that service providers should be able to make business decisions about where to build a residential care service, then allow them to attract customers through price and service. I also need to address suggestions the recent $150 million overspend in the Aged Care Funding Instrument (ACFI) occurred as a result of frailty growth. Our data shows that growth in claims is restricted to the complex health care domain, while other ACFI funded domains have not increased anywhere near the same amount, despite also being affected by increasing frailty. In December we also introduced a stronger compliance regime, including fines for repeated false claims and better targeting of funding, to start bringing expenditure back within budget.

Primary responsibility for workforce rests with providers. The rationale behind returning $1.5 billion to the Budget from the previous Governments Workforce Supplement to the industry was that providers are in the best place to determine workforce needs and manage their people. LASA is a member the Aged Care Sector Committee which has provided me with the Aged Care Roadmap to inform future policy discussions and formation. The Roadmap aligns with the government’s intention to keep moving aged care to a market based system, giving consumers choice and allowing providers to run their own services. The aged care system in Australia is world class and well respected, with high quality services that reach and meet the needs of a very diverse population. However, as people are living longer thanks to better health and better health care, the demands on our aged care system are changing. Older Australians want more choice and control over the care they receive and this demand will only increase as our ‘boomers’ and future generations require aged care services. ■

I’m sure you are aware Government is managing considerable financial pressures in the interest of our long term economic health.

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FOCUS ON I

FUNDING

FOCUS ON... FUNDING

Paul Carberry Chief Executive Officer LASA SA

Payroll Supplement removal part sector cuts pattern

adopt separate policy settings (including for subsidies and co-contributions) for the major cost components of aged care, namely care (including personal and health care), everyday living expenses and accommodation.”

It’s now more than 13 months since the Payroll Tax Supplement, a long-standing payment designed to ensure funding equality across the aged care sector, was discontinued by the Coalition Government.

The Living Longer Living Better reforms adopted this principle. They broadened the ability for non-concessional residents to pay for their accommodation and, subject to conditions, they increased the accommodation payment providers receive for concessional residents, which the government pays either fully or partially, based on the residents’ means tests.

It was a decision announced in the 2014 Federal Budget, explained at the time as the removal of a Commonwealth subsidy for a state tax, but it was simply a large funding cut.

This was done for the very good reason that the previous system provided an inadequate funding base and inadequate return on the cost of building aged care accommodation and, without these change there would be been insufficient investment to meet the future demand.

Despite its name, the Payroll Tax Supplement was a Commonwealth contribution to the cost of care, made to private providers to offset payroll tax costs which, in effect, diverted funds intended for people’s care to the states. Anyone who doubts it was a care supplement need only look at the method of calculation before it was scrapped; it was based directly on care subsidies and supplements. Its removal is part of a pattern by the Commonwealth to systematically cut the real value of spending on care and carerelated supplements. Its recent history began with freezing ACFI indexation for the 2012-13 financial year and it has continued with the removal of supplements, the continued indexation of care funding at less than increases in care costs (except in 2014-15, when funds previously grabbed were recovered), and it will continue further with the new round of ACFI changes recently announced. In both 2012 and now, the measures to reduce ACFI growth were accompanied by Government and departmental claims that providers were rorting the system. Each time widespread changes were made to the payments system in response to what turned out to be – by their own admission – a tiny rate of over-zealous claiming. One of the principles of the current funding and regulatory regime is the distinction between the cost of care and accommodation. It was a clear recommendation of the Productivity Commission in its 2011 Caring for Older Australians, which said: “The Australian Government should

The reforms to accommodation payments were introduced to ensure there would be adequate building investment in aged care. They were not introduced so the Commonwealth could cut care funding and then suggest providers should rely on the accommodation reforms to pick up the shortfall. But that is exactly what is happening. Why else would Minister Ley, in a letter responding to the sector’s concerns about the latest proposals to cut ACFI, say: “Providers have also benefited from the significant deregulation of accommodation payments for residential care, and the higher rate of accommodation supplement”? Minister Fifield made a similar comment when explaining why the Payroll Tax Supplement was on the way out. So, there it is! A pattern of cuts to care funding, accompanied by trumped-up accusations of cheating, and by suggestions that the money can be made up from the (supposedly) separate and distinct stream of accommodation payments. We all expect the Government to manage taxpayers’ money prudently. But, I doubt that Australians would expect it to be raiding the elderly’s care funds by as much and as often as it has. This would be especially so if the community understood the cost of providing care has been rising at a faster rate than care payments, which the Government now wants to cut again. The Government is always saying it is committed to ensuring that aged care residents are well cared for, and that they live in comfort and with dignity. That’s good! So, pay the bill. ■

FUNDING

Refundable Accommodation Deposit Guarantees

Barry Ashcroft Chief Executive Officer LASA QLD

In an otherwise bear market for investment in Australia and globally – the fundamentals in aged care are increasingly attractive to major investors. Rapidly escalating demand has been temporarily tempered by consumer confusion but there is an evident preference for Refundable Accommodation Deposits (RADs) while the Maximum Permissible Interest Rate sits at over six per cent.

The national RAD pool continues to grow and sits currently at over $15 billion. Market and investor interest supported by access to capital and strong recurrent income flow has driven major equity capital transactions over the past three years, but that is only one side of the coin – the other is straightforward access to capital for well-run private companies. Put together we should see unprecedented infrastructure investment in aged care for the foreseeable future. While equity funded consolidators already have highly competitive access to capital, they will look for a balance of RADs and DAPs. Not for profits able to fund growth will be less concerned about the RAD/DAP mix. Debt funded small to medium operators will be targeting RADs as a priority. Acquisition of operating stock is the focus of the larger groups, shareholder value is improved but old stock may be required to perform longer than envisaged and the investment in replacement stock to remain competitive will eventuate sooner rather than later. There is a looming problem though – the policy driven prudential requirements associated with managing a large and growing national bond pool needs to be revisited. In a market that has yet

I FOCUS ON

to experience the full force of competition, increasing infrastructure investment (including the building of new stock at inflated prices) will create tension and consumers, while satisfied with the conditional government guarantee promised would respond favourably to an underwritten national scheme to guarantee protection for their hard earned funds. Size is no guarantee of success and even for well-placed private operators who are seeing ever increasing capital flows to support their growth – the liquidity risk is ever present where an aggressive expansion strategy is adopted. The bond guarantee that was (for extra services aged care) continues for RADs. A major failure under the current regulations would mean a Government bailout and potentially a proportional levy imposed on all providers with current bond holdings – distasteful for Government and hard to accept for competent operators. While it may not seem so yet – Government is more likely to adopt a position of reduced regulation provided the consumer centric/ market based approach works in practice. Escalating demand and scarcity of supply will force the government to give certainty to investors but in so doing risk will need to be either reduced or shifted to the sector – where it belongs in a market based system. Raised in many occasions since the Productivity Commission Report Caring for Older Australians – security of bond holdings will become increasingly important. An industry based insurance product, priced according to the risk, would be one of the obvious choices. Any other approach may involve oversight by APRA and ASIC and lead to more complexity and regulation without measurably improving the security of residents deposits. APRA or ASIC cannot eliminate the risk of failure – understanding that the financial system should not be overly constricted. Rather than the Government imposing their own pooled security scheme why wouldn’t the industry encourage the establishment of a national insurance product supported by the industry for the benefit of the industry and its consumers. ■

FOCUS ON |

FUNDING

Trevor Carr Chief Executive Officer LASA VIC

The inconvenient truth of growing demand and a shrinking workforce

The paradox for service providers is that while our market is growing, workforce availability is shrinking. In an industry that is heavily reliant upon person-to-person service provision, this is a major problem.

Relatively high living standards and favourable living conditions have seen life expectancy in Australia increase lineally for well over 100 years. A boy born in the past few years can expect to live for 80.1 years and a girl can expect to live for 84.3 years. This is in stark contrast to the 47.2 and 50.8 years respectively towards the end of the 19th century.

Economics 101 tells us that if supply is limited, demand increases – and this is our quandary! As the competition and need for skills increases, we are faced with affordability and availability challenges.

While we generally rejoice in the positive aspects that living longer brings to the structure of our society, for policy makers it seems to be an inconvenient truth, constantly characterised as a ‘problem’ rather than celebrated as a social and economic benefit. To illustrate this a little further, I will explore two strategy-critical areas that have been negatively impacted by policy change in the past 18 months – investments in workforce and education, and funding for effective service provision to those with severe behaviours. The 2015 Intergenerational Report tells us that around 3.1 million Australians are currently aged 65-84, which will rise to 7 million by 2054-55. Image courtesy of Alexander Raths/ Shutterstock.com

Government refuses to accept that the indexation mechanism (ACFI) is irrelevant to our industry. At 1.3% the Commonwealth Own Purpose Outlays (COPO) will satisfy very few enterprise agreements in aged care! Thus, affordability becomes a stretch target rather than a reasonable, business-as-usual expectation. Further compounding the issue is the removal of training incentives through the 2015-16 Mid-Year Economic and Fiscal Outlook (MYEFO). The MYEFO cuts have left one of Australia’s largest workforce areas and one of the few industries creating workforce growth, sitting in a vortex of inaction from a strategic policy viewpoint. And what of the provision of care to those with severe behaviours? A consequence of living longer is that we have many more people manifesting forms of dementia. A supplement was introduced in recognition that severe behaviours create a management challenge in an environment of mixed personal dependencies. However, policy makers soon realised that the problem was much bigger than first thought, so the supplement was withdrawn and replaced with funding for the creation of severe behaviour response teams (SBRTs). SBRTs are described by policy makers as ‘a specialised team of professionals able to assist residents exhibiting very severe and extreme Behavioural and Psychological Symptoms of Dementia (BPSD), assess the causes, and assist care staff in residential aged care homes to address and deal with these behaviours’. Clearly, supplements given directly to providers to manage severe behaviours is a more enduring solution than a visiting team which provides advice. Both of the issues discussed above present deeper management challenges in a rural environment. The Aged Care Financing Authority has recently confirmed sustainability is an issue for rural providers, with many residential care services operating with negative EBITA. Like it or not, a saving to Government is an effective cut to revenue for providers. It is time that policy makers accepted this and sat down for a truly transparent conversation regarding an enduring policy framework that creates confidence in the future of our industry and timely access for those in need of care. ■

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FEATURES |

WORKFORCE

REGISTERED NURSES IN NSW RESIDENTIAL AGED CARE SERVICES As the NSW Government inquiry into mandated Registered Nurses in Nursing Homes continues, it’s important for all age service providers in Australia to understand the key issues and what it could mean for you.

n 2016 the NSW Parliament must address an outdated section of the Public Health Act 2010 which has been superseded due to Commonwealth aged care reforms.

Addressing this outdated section of the Public Health Act 2010 represents an opportunity for NSW to join all other Australian State and Territory jurisdictions and do away with duplicate legislation regarding aged care staffing and employment of registered nurses. LASA NSW-ACT has been working through a NSW Ministry of Health Steering Committee and engaging with different areas of Government to ensure that the industry’s voice is heard, and that any changes made by the NSW Government are done in the full knowledge of the benefits and impacts of change.

In repealing the NSW Nursing Homes Act 1988, a requirement was retained for a registered nurse to be on duty at all times in a ‘Nursing Home’ LASA NSW-ACT contends that registered nurses are integral to residential aged care. LASA NSW-ACT contends that registered nurses are required where the care need exists. LASA NSW-ACT contends that through the Commonwealth Aged Care Act 1997 appropriately skilled and qualified staff are mandated, sufficient to ensure that care and services are delivered according to a resident’s needs. During much of the past century, legislative duplication for residential aged care had existed between the Commonwealth and State Governments. Ultimately, a comprehensive funding and regulatory regime was established for aged care services across Australia through the Commonwealth Aged Care Act 1997. State Governments maintain legislative responsibility for public hospitals and retirement villages.

Loula Koutrodimos Acting CEO I LASA NSW-ACT

After 1997 existing State legislation for residential aged care (notably in NSW through the Nursing Homes Act 1988), acted as an additional and unnecessary layer of regulation. It was not until 30 November 2004 (some seven years after the Commonwealth Aged Care Act 1997) that the NSW Nursing Homes Act 1988 was repealed. However, in repealing the NSW Nursing Homes Act 1988, a requirement was retained for a registered nurse to be on duty at all times in a “Nursing Home”. Under the definitions in the Public Health Act 2010, a Nursing Home was given the same meaning as Hospital. The Act also defined a Nursing Home as “a facility at which that care is provided in relation to an allocated place (within the meaning of the Act [Aged Care Act 1997] that requires a high level of residential care [within the meaning of the Act]).” In June 2013, as part of the national aged care process, the Aged Care (Living Longer Living Better) Act 2013 was passed by the Federal Parliament. Included in these extensive national reforms was the removal of the delineation between ‘High Care’ and ‘Low Care’ in residential aged care services. By NSW having included (unlike all other State and Territory jurisdictions) a requirement for registered nurses in Nursing Homes in the Public Health Act 2010, there is now a mandated staff requirement which requires justification.

Residential aged care services are not hospitals, and this is confused by the inappropriate definition contained in the Public Health Act 2010. Should the NSW Parliament continue to mandate a requirement for registered nurses in residential aged care services, this will be in spite of Commonwealth legislation which outlines staffing obligations for providers of care.

WORKFORCE

Residential aged care services are not hospitals, and this is confused by the inappropriate definition contained within Section 104 of the Public Health Act 2010. The evolution of aged care in Australia over past years and decades should logically mean, and in the interest of best policy and care outcomes, any issues requiring contemporary or future legislative change be pursued through Commonwealth legislation.

Any mandatory requirement for registered nurses in all residential aged care services in NSW is an anathema to good public policy. Any mandatory requirement for registered nurses in all residential aged care services in New South Wales (including an opt-out provision for those services which cannot meet this requirement), is an anathema to good public policy. It is an unnecessary legislative duplication and will serve agendas separate to those grounded in individual care and service outcomes.

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Each day hundreds of members of LASA NSW-ACT, in communities across our state, work effectively to provide the highest standards of aged care and services to older Australians. Care and services for older Australians do not follow a linear trajectory and contemporary practice, both locally and internationally, requires that resources be aligned to needs at any moment in time. The requirement for registered nurses in residential aged care must be determined on the actual care needs of residents. LASA NSW-ACT supports repealing Section 104 of the Public Health Act 2010. This archaic piece of state based legislation, which mandates staff requirements for registered nurses in residential aged care services, provides a ‘one size fits all’ approach which does not recognise the individuality of the person and the personalisation of service delivery. The Commonwealth Aged Care Act 1997, and associated legislation and principles, already mandates the requirement for registered nurses where the care need warrants. ■

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NEW SCHOOL-BASED AGED CARE TRAINEESHIPS

A FIRST FOR AUSTRALIA IRT College has joined forces with government to trial a new approach to attract school leavers to pursue a career in aged care. HSC students will combine school work with training and paid work through IRT College

“

Aged care is one of only a few sectors with forecasts of long-term growth but to support this growth, we need to attract and retain more skilled workers, particularly in rural and regional areas,” IRT College General Manager, Dr David Rosete, said. The federal government is conducting an inquiry into the issue and has invited ideas about how to overcome workforce challenges facing the sector. With the average age of aged care employees being 49, attracting school leavers to take up carebased roles is a logical solution. Through its College, IRT Group, one of Australia’s largest community-based seniors’ lifestyle and care providers, has partnered with the NSW Department of Industry and Apprenticeship Support Australia to pilot the industry’s first School Based Apprenticeship Traineeship in a Certificate III in Individual Support.

their school studies with work and training to gain credits towards their Higher School Certificate and a nationally recognised aged care qualification,” he said. The students will complete their training at the end of the year and IRT Group Chief Executive, Nieves Murray said she hopes they will consider a career with IRT after completing their studies. “I am thrilled IRT College has partnered with government to forge a new pathway into a career in aged care for our students,” she said. “Like many care providers, less than 10 percent of our workforce is under 24 years of age, so we’re definitely keen to attract more school leavers to IRT. We can offer school leavers secure jobs in a growth industry with a bright future, and there’s more to aged care than personal care – the sky’s the limit at IRT.” ■

“We’re really excited to have 14 students from eight Illawarra schools participating in the pilot. The students will combine

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AGENCIES DRIVING UNPLANNED COSTS A new national survey of Australian healthcare directors, managers and professionals has found that agency and locum staff expenses are the highest drivers of unplanned costs in healthcare organisations.

he survey, conducted by Allocate Software, a leading provider of e-rostering software, involved 168 members of the Australian Healthcare and Hospitals Association – largely CEOs, executive directors, managers and chief nurses – across private and public hospitals, aged and community care, and primary and allied health. Participants were asked to identify which of six issues their organisation faces most concerns them: funding constraints, organisational efficiency, patient safety, staffing allocations, technology investments and personnel shortages. More than one-third identified funding constraints, ahead of staff shortages or any other issue. Funding constraints were of greatest concern in Western Australia, with 56% of respondents citing this as their biggest issue, followed by 47% of NSW respondents and 45% of Victorian respondents. Peter Croft, Allocate Software Managing Director, said the survey confirms Australia’s healthcare sector is under constant cost pressure. “There is increasing demand for services and increasing costs for delivery of more complex treatment. In the context of the increasing cost of delivery, salary and wages remains the largest single cost healthcare organisations face, with the payroll bill representing over 65% of total operating costs in many instances.”

Key factors to unplanned costs When asked about the key factors driving unplanned costs and whether these factors were being addressed, only 18% of respondents said recruitment of permanent staff due to high attrition was the main factor – even though 22% admitted to high staff turnover in their organisations. By comparison, 33% of respondents admitted that agency and locum staff were the highest driver of unplanned costs, while nearly a third attributed vacant shifts at short notice to the reason why agency and locum staff were the highest driver of unplanned costs. Despite this, only 23% said they planned to make efficiencies in agency/locum costs, while 10% admitted they weren’t addressing it at all.

“Often healthcare organisations resort to using high-cost agency staff to fill casual vacancies simply because they don’t have visibility of their casual pool of staff available to work the vacant shift. Organisations with paper- or excel-based rostering systems are the most likely to have this problem,” Mr Croft said. “Using technology for the efficient allocation of agency staff, and to identify options for use of substantive rather than agency staff, is critical to achieving system-wide cost savings.”

Victoria hardest hit by unplanned costs Findings in Victoria, Queensland and Western Australia followed those of the national findings – with agency and locum costs topping the list of drivers of unplanned costs. However, Victoria had the highest proportion of participants (44%) who admitted locum and agency costs are the biggest cause of unplanned costs while only one-third are planning efficiencies in locum and agency costs. In Queensland, 36% of participants identified agency/ locum costs at top of unplanned costs, with 23% planning efficiencies in this area, followed by 33% of WA respondents, with the same proportion planning to implement more efficient processes in this area. In NSW agency and locum staff (25%) came in second to recruitment of permanent staff due to high attrition (28% of respondents). Only 19% plan to make efficiencies in agency and locum costs. Among participants who work in the private hospital sector, 42% admitted agency/locum staff were the highest driver of unplanned costs, with just 11% planning efficiencies in costs in this area. This was followed by the aged care sector, with 40% of participants recognising agency/locum as the key driver and 29% planning efficiencies. “In general, average salaries tend to be lower in aged rather than acute care, due to the lower proportion of registered nurses in the workforce mix. In the context of lower average salaries, agency fees introduce a high and often unpredictable cost,” he said. ■

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WORKFORCE

LASA RAISES CONCERNS ABOUT

STAFF RATIOS, FUNDING CUTS IN WORKFORCE SUBMISSION The future of Australia’s aged care workforce is under review by the Senate Community Affairs Reference Committee following a call for submissions on the topic.

n behalf of members and with input from providers across all states, LASA provided a detailed response focusing on three broad areas that need to be addressed: workforce development; attraction and retention; and current workforce constraints. In particular, LASA’s submission highlighted the impact of policy changes at commonwealth and state level which have significant financial ramifications on training, development, career pathway, wages and other attraction and retention strategies age service providers need. “Age services already compete with other industries for a sustainable workforce which will only exacerbate as the pool of available workers dwindles,” LASA National CEO, Patrick Reid said. “With a competing market for workers, age services need to demonstrate attraction and retention models that provide quality training, career prospects, a supportive, safe and wellresourced workplace, job status and recognition.” “An adverse view of aged care is not helped by negative comments about the industry from the Government, and amplified by media. Such comments are upsetting to the current workforce and discourage new entrants. This is further compounded by funding cuts resulting in a workforce that feels undervalued and under resourced,” he said. In its submission LASA also called for new approaches to training and education for people in aged care, and to entice new entrants to choose a career in aged care. “Quality training and education must be made available for people interested in joining the aged care industry and for current staff to gain new skills if we are to have any chance of meeting increased demand for services over coming years.” “Standardised management skills and training packages should be developed and delivered to assist people that are interested in moving in to management roles within aged care. Professional development opportunities, as well as

remuneration and work place culture, will assist to make aged care a more desirable career of choice,” he said. In addition, LASA holds concerns about the implications of consumer directed care on workforce development, specifically the need for different skills sets that will follow changed delivery modes. “Over time, the CDC service delivery model will impact residential services and this will significantly alter care delivery models, staffing mix and numbers, skill mix, work patterns and subsequently workplace instruments,” Mr Reid said. “A more responsive, flexible workforce is needed to ensure consumers can access the type of care and services they want, including by whom the service will be delivered and when. This is easily articulated; far more difficult to implement,” he said. “LASA supports the quality delivery of services and seeks a workforce with the right attributes and attitude for working in aged care. Qualifications and specific skills can be obtained but attributes and attitude are a reflection of the person, and far more difficult to measure in a recruitment and employment phase.” “It is anticipated there will be growing need for some professionals, such as pastoral care practitioners and counsellors so the needs of the whole person are met, not just their physical needs.” “In addition to more Registered Nurses, aged care leadership requires a mixed set of skills, from financial management to leadership, as well as knowledge of regulatory and legal frameworks, health economics, governance and Information Technology, all of which is underpinned by compassion and ethics. Opportunities and support need to be available to people from other industries to assist them to upskill into aged care.” LASA raises concerns about proposed changes to the modern awards and the impact of these on labour costs and the broader industry, particularly those that require four hour minimum engagements for casual and part time staff.

WORKFORCE

“In community care, existing minimum hourly starts/payments under relevant modern award reflect both client needs and funding limitations. If a client requests, or is assessed as requiring, only one hour of home care, the government will only fund one hour of home care and/or the client will only pay for one hour of home care. The notion that an employee be paid for 4 hours, to provide one hour of home care, is not sustainable. It fails to take into account the needs of the community care industry, and the manner in which community care service delivery occurs in 2016,” Mr Reid said. “LASA, in concert with the Productivity Commission, is of the opinion that staff ratios are a blunt instrument that do not take into account the changing care needs of residents. They also do not acknowledges the broad ranging skills that the aged care workforce requires, especially those of an RN, who predominately plans, coordinates and directs care and services for aged care workers and other professionals across the spectrum of service delivery.”

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but also contributes to a high quality system that supports people to age well in Australia,” Mr Reid said. A workforce strategy should consider areas that both providers and governments can impact. This includes: • Immigration; • The Vocational, Education and Training (VET) system (ensuring graduates of age and  community service courses are work ready); • The scope of practice of workers; • Having a flexible and responsive workforce (especially in a consumer directed model of  care and service delivery) that is not impeded with historical workplace instruments that  do not reflect current practice; • Recognising that workers can practice across the industry within aged care, disability,  mental health and primary health sectors; and

The submission concludes with renewed calls for a workforce strategy to be co-designed with Government, age care providers and key stakeholders.

• Raising the ‘image’ of working in the aged care sector.   The industry has to be sustainable to ensure sufficient staff are available to enable consumers to have care and service delivery when, by whom and where they direct. ■

“This strategy would continue to develop an efficient and sustainable industry that not only supports the workforce itself

For more information go to: www.lasa.asn.au/member-services/submissions

Bett er Practice Awards 2016 Nominations for this year’s Better Practice Awards will open from 1st to 31st May.

The Quality Agency’s Better Practice Awards celebrate projects, initiatives or programs that act as exemplars for other aged care service providers and to encourage continuous improvement. They recognise and disseminate better practice and innovation in the sector. Open to all providers of aged care – home care and residential. Information on eligibility, award selection criteria and how to nominate, are available at www.aacqa.gov.au.

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CO-DESIGNING SERVICE INNOVATION

Centacare Community Services is taking a new approach to community connections its participation in the CommunityWest Step Forward – Together project.

or more than 50 years Centacare Community Services has been assisting the people of South East Queensland with child care, counselling, mental health, family and domestic violence, disability services, indigenous support and aged care. The aim of Centacare’s Enoggera aged care program is to help older people to maintain quality of life and to live independently in their own home for as long as possible through flexible services which maximise choice for older people and their families. These include domestic help, personal care, transport, respite care, social support and activities and health support. For the last nine years Centacare Community Services has worked from a person-centred approach and has developed a shared management structure where clients are part of the planning teams for the service. It saw the CommunityWest Step Forward – Together project as a platform to support service innovation. “We encourage clients to design, deliver and take ownership, every opportunity is given to people to have a voice and stay involved. One thing we say to people from the very beginning it that this is your service, it is about you, and you have an equal say,” Centacare’s Community Services Manager, Ann Donaghy, said. All 10 pilot projects in the Step Forward – Together initiative are trialling co-production with a wellness and enablement focus. The wellness philosophy is an approach to service delivery promoting social and community connections, independence, autonomy, retaining and regaining skills, and is a way of ‘doing with’, not ‘doing for.’ Centacare’s project is to run a community fair with stalls for food, craft, plants, music, poetry and entertainment for all members of the Enoggera community to attend including older people, children, carers, people with dementia and indigenous Australians. “We have this amazing hidden resource of people who can do so much, we just need to give them the opportunity and recognition. As people contribute their skills and expertise alongside us, I see the service at Centacare Enoggera becoming more diverse where people feel they genuinely

have ownership. This is what we are working to achieve through co-production,” Ms Donaghy said. Centacare is especially excited to have an Indigenous elder as part of the Steering Group who will be refreshing the garden space with local high school students to create a ‘yarning’ and dance area on the day. Indigenous health professionals and students will also attend the fair to promote the Indigenous community and intergenerational connections. “Our approach is very different for the event this time around. Previous events have been organised and run by Centacare staff, however using a coproduction approach we are working with clients and carers collaboratively and they are involved in the event planning, as well as running stalls on the day,” Project Lead, Caroline Grogan said. Caroline Grogan

Centacare has formed a Steering Group to drive their project over the eight month period, consisting of six older community members, and three staff, including a Coordinator, Community Support Worker and Service Manager. To help the group form and achieve their goals, all Steering Group members participated in CommunityWest’s training on co-production, wellness and enablement. ‘Uncle George’, a local Indigenous elder, says his motivations for being involved in the project are to actively bring about change to help people and their families by ensuring their voices are heard. “I attended the Dementia Friendly Conference and was disappointed to hear stories about people not being listened to and concerned about their families and I wanted to see if I could make a change,” he said.

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Centacare are now three months into their project with their planned event to take place in May 2016 and there have been notable changes already. “I feel there is a shift from seeing clients as vulnerable, to able and more than capable with the right support. We are beginning to see the traditional way of ‘doing for’ change to one of wellness and enablement ‘doing with.’ Furthermore co-production has provided us with a framework to encourage open dialogue to meet client needs with a collective and empowering approach. This promotes self-determination and wellbeing in a meaningful and ongoing way,” Ms Grogan said.

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Centacare hopes the Steering Group will continue after the Step Forward – Together project and is looking at forming a dementia-friendly community working group, using the coproduction philosophy and framework.

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WITH REAL PEOPLE IN MIND NovaCare Community Services is a for-purpose organisation operating in the Hunter Region of New South Wales. NovaCare provide a range of services including aged, disability and dementia care at home and in the community.

he name Milpara means ‘gathering of the community’ and the social centre offers activities for older people living in the city of Newcastle. NovaCare saw the CommunityWest Step Forward – Together project as an opportunity to improve their centre, as well as contribute to a body of knowledge around co-production for aged care providers in the future.

“Co-production was a step more than consultation and we wanted to go on the journey,” NovaCare CEO, Joseph McCarthy, said. “It’s the way things should be, these are the people who have to live with what is offered; they are the people to design services they actually want. After Joseph McCarthy all, we only exist to Chief Executive Officer, support people in the NovaCare community and we wanted to improve what we offer to people.”

the project. While its focus is on improving the wellness focus of the activities being offered at the Milpara Social Centre, Mr McCarthy has a much bigger vision for what the project will achieve. “I would love to see a service which is so good, interesting and vibrant, 99 per cent of people in the community will want to come. I want a service I will want to use myself when I’m older. There has been such a change in society in the recent years and social centres haven’t kept up with what people want and need. It’s about taking people to events and where things are happening in the community,” he said. ■

NovaCare’s pilot project under the program is to co-produce a range of activities offered at the Milpara Social Centre for residents in Newcastle. The co-produced activities will promote and improve wellness and enablement for the people accessing them by creating a place where people come to feel good. The Steering Group comprising four consumers and three staff, including the CEO and Leisure and Lifestyle Officers, is driving

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LASA has helped facilitate a series of meetings between Members of the South West Aged Care Alliance (SWACA) and key MPs from all political parties at Parliament House in Canberra, to raise awareness of the challenges faced by aged care providers in rural and remote areas and identify feasible solutions.

he CEOs of Cobden Regional Health Care, Eventide Lutheran Home in Hamilton and Edgarley Home Inc in Casterton were very clear about seeking improved ways for aged care funding to be allocated in recognition of the additional financial barriers faced by providers in rural and remote areas. Steven Toope, CEO Edgarley Home Inc said there needs to be greater equity in the current funding system. “We are simply asking for a re-targeting of existing funding for aged care to better reflect the financial burdens on rural and remote operators. This will require the development and implementation of a rural and remote funding model, together with clearer definitions for rural and remote facilities,” he said.

unviable while most residential care providers are losing up to $2,000 per resident. “The Alliance remains committed to its long standing campaign concerning the financial viability and sustainability of rural and remote operators, and was able to arrange these meetings through our industry peak body, Leading Age Services Australia,” Mr Toope said. “Several members of the Alliance travelled to Canberra to make it clear to MPs, including the Minister for Rural Health, Fiona Nash; our local member, Mr Dan Tehan; Mr Andrew Broad, the Member for Mallee; and Mr Ken Wyatt, the Assistant Minister for Aged Care, that we need action now.”

The meetings, which occurred in early March, coincided with the recent release of the Financial Issues Affecting Rural and Remote Aged Care Facilities report by the Aged Care Financing Authority, which found significant differences in expenses incurred by rural and remote providers compared to those in urban and metropolitan areas. The report identified that nearly one-third of providers in rural and remote areas are financially L to R: Jeannine Creely, CEO Cobden Regional Health Care; Tim Pitt-Lancaster, CEO Eventide Lutheran Home in Hamilton; Steven Toope, CEO Edgarley Home Inc in Casterton and Patrick Reid, National CEO – Leading Aged Services Australia.

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“The time for talk is over. We do not need another report, inquiry or further delays in addressing the needs of the aged care industry as a whole and in particular, rural and remote operators. The ACFA report speaks for itself and shows this issue must be discussed at party level as a priority for all political parties,” Mr Toope said. “Rural and remote operators are facing a difficult time. MPs need to seriously consider the impact of an ageing population and the sheer numbers of people who will require aged care into the future. We are just as important as providers based in regional and capital cities, but we need equity to be applied. There can be no doubt in the minds of those who attended what is now required.” Other issues raised by the group included: • A commitment to stability and security for aged care funding • No more reductions in funding • For ACFI (the Aged care Funding Instrument by which aged care facilities access funding for the care of residents) to reflect the true cost of care, particularly for rural and remote operators • A commitment to workforce development funding for rural and remote providers

• A commitment to act on the key findings of the Aged Care Financing Authority report. Patrick Reid, LASA National CEO, said the more that age service providers raise issues directly with their local members, the more aged care will be discussed in party rooms and elevated in national priority. “LASA is actively supporting its members to discuss the impact of funding cuts and reactive policy-making with their local MPs. Between an ageing population that is increasing demand for services, rising costs of care and severe funding cuts in successive Budgets, most aged care operators are struggling. Politicians from all electorates need to understand this and the impact it’s having on their constituents,” he said. “As part of our pre-election advocacy campaign LASA is making available a suite of resources for members to use to actively lobby their local MPs. Even something as simple as writing a letter can have an impact if everyone gets on board and participates. When calls for action from one letter are reiterated three, 10 or 15 times suddenly a politician realises how important aged care is in their community,” Mr Reid said. ■ The resources will be made available to members via the LASA state websites. For more information contact Patrick Reid on 02 6230 1676.

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niting AgeWell Board Chair, Rev Allan Thompson, says community members will have the opportunity to shape its services and the future of the aged care system through volunteering on the committee.

“While consumer advisory committees operate in hospitals and health care environments, they are unique in aged care. To my knowledge, Uniting AgeWell is one of the first to establish such a committee,” Rev Thompson said. “Our community advisory committee will be a true consumer voice driving strategy for quality of care and service delivery. This is an exciting opportunity for people to get involved and shape the future of senior services.” Rev Thompson says the role of the committee is critically important to Uniting AgeWell’s direction, enabling the organisation

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to engage with its clients and the broader community on how it delivered and improved its services and plan for the future. “We want to hear first-hand the concerns, aspirations and ideas of the community. It’s through these insights we will ensure our services continue to support people to age well and have confidence in the quality of care and services they receive,” he said. Committee member selection will aim to achieve a mix of geographic location, age, gender and social and cultural diversity. Participants don’t have to be experienced in consumer committee participation as Uniting AgeWell will provide a comprehensive induction and orientation program and free formal training through the Health Issues Centre for appointed members. The committee will meet quarterly from July 2016. ■

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Gwen Wilson and Pete Gatwood

ITâ&#x20AC;&#x2122;S A GOOD LIFE

FOR OVER 55â&#x20AC;&#x2122;S Australiaâ&#x20AC;&#x2122;s first dedicated YouTube channel for over 55s has reached over 500 subscribers to its monthly lifestyle show, The Good Life.

Since launching in October last year, The Good Life has covered a range of topics and events, from the importance of Advanced Care Planning as you get older, to a Senior Sports Carnival where the participants must be over the age of 80.

â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ve never done anything like this before, but Iâ&#x20AC;&#x2122;m really enjoying the challenge of learning new skills such as reading a teleprompter,â&#x20AC;? Mr Gatwood said.

â&#x20AC;&#x153;The beauty of a YouTube channel is that people can watch it pretty much anywhere on their smartphone or tablet, when it suits them.â&#x20AC;? â&#x2013;

â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re volunteers, and we havenâ&#x20AC;&#x2122;t been to film school... does it show?â&#x20AC;? Ms Wilson joked. â&#x20AC;&#x153;I wanted to push the boundaries and do something new, and who knows where itâ&#x20AC;&#x2122;s going to lead.â&#x20AC;?

To watch The Good Life go to: bit.do/the-good-life

he milestone coincides with the release of its fourth episode, which focuses on volunteering and the vital contribution that older Australians make to the unpaid workforce.

Hosts of The Good Life, Wollongong locals Pete Gatwood and Gwen Wilson, are volunteers themselves, as well as the showâ&#x20AC;&#x2122;s talent pool of guest presenters and correspondents from the Sunshine Coast, the NSW South Coast and the ACT.

â&#x20AC;&#x153;Over 55s is the fastest growing YouTube demographic, but thereâ&#x20AC;&#x2122;s little non-commercial Australian content available for this audience,â&#x20AC;? said IRT Foundation Manager, Toby Dawson.

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ACFA REPORT FINDINGS CANNOT BE IGNORED The latest ACFA report is all the proof Government needs that most age service providers in rural and remote areas are doing it tough and it must now take action if it is truly committed to helping rural communities.

he “Financial Issues Affecting Rural and Remote Providers” report, which was received by Government last year and made publicly available in February, shows the bottom third of providers have a negative operating EBITDA and negative average facility EBITDA. “While we draw no satisfaction from seeing a report that confirms most age service providers in rural and remote areas are in serious financial hardship, it puts to rest for once and for all any suggestion held by cynics that it’s a level playing field,” LASA National CEO, Patrick Reid said. “It is a stark reality that the average rural and remote aged care facility faces significantly higher costs in most areas of operation, resulting in a negative Operating EBITDA of -$2,004 per resident per annum compared to $8,840 in non-rural and remote areas.” “ACFA’s findings reaffirm what LASA has been telling Government for years and provide hard evidence of disparity that cannot be ignored by any political party claiming to be committed to helping rural communities, particularly not one with a Minister for Rural Health,” Mr Reid said. The report found operations costs were significantly higher for rural and remote facilities in: • Care management – nearly 4 x higher than • Registered and enrolled nurses costs – nearly double • Labour and maintenance costs – triple

• Catering, laundry and cleaning costs are higher, as are utilities and consumables. “The only expenditure item that is less for rural and remote providers is allied health professionals, and that is because they simply aren’t available,” Mr Reid said. The report found the difference in staff costs is $16,360 per resident per annum ($44.82 per resident per day) between rural and remote facilities and facilities in non-rural and remote areas. This accounts for 71 per cent of the expenditure for rural and remote facilities compared with 64 per cent for non-rural and remote facilities.

“LASA has been extremely vocal about our concerns for workforce sustainability, which is an issue in cities as well as rural areas. If we then look at the current situation in NSW where the state government wants to mandate registered nurses to be rostered on at all times, the costs for rural and remote providers would soar and likely push more facilities into the red,” Mr Reid said. While the report notes that in many cases financial performance could increase through improved organisational leadership and structure, and the adoption of innovative approaches, Government has ripped a significant amount of funding from these areas in recent years. “The workforce development fund was axed last Budget, along with tax concessions on salary-packaged entertainment benefits for staff working in age services, which serve as important employment incentives for the 64% of providers in rural areas that are not-for-profit,” Mr Reid said. “Compounding this, the Government has failed to provide reliable and affordable mobile phone and internet coverage in many parts of Australia, which simply makes it difficult for everyone.” “The report’s conclusion that much of this financial heartache would be resolved by up-skilling management staff is a flippant and insulting line that fails to recognise everything else stated throughout the document. It’s clear that Government doesn’t want to have to increase funding for rural providers, but that is what needs to happen,” he said. The story for home care providers, however, is slightly different. The report found overall the EBITDA per package per annum (pppa) does not differ greatly between rural and remote and non-rural and remote home care services, predominantly due to the fact that the majority of funding is government package funding – 81 per cent approximately for both rural and remote and non-rural and remote. On average, rural and remote home care providers: • did not show a significant difference in EBITDA ($1,712 pppa v $1,885 pppa); and

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• while the differences were not major, they had higher Government subsidies (including the Viability Supplement), lower resident fees, higher direct labour costs, lower contracted services and higher administration costs.

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Image courtesy of FiledIMAGE/Shutterstock.com

Home care services in remote and very remote areas have proportionally more Level 2 packages and fewer Level 4 packages compared with other areas. “The lessons here in the opportunity for operators to expand into home care services in rural and remote areas, which will be far easier from February 2017 when consumers will have full control over their service provider selection,” Mr Reid said. LASA is advocating for increased funding for rural and remote providers that recognise and addresses the financial challenges they face due to geographic location. “We have publicly called on the Liberal Government to take action now that it has all the evidence it needs. In early March I accompanied a delegation of rural providers to a series of meetings in Canberra with MPs from all political parties to raise awareness of these issues and discuss solutions. It was an extremely productive trip for our members and I encourage all

providers to get in touch with their elected officials while there is momentum about aged care funding and workforce issues, ” Mr Reid said. ■

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BEING LGBTI AWARE REQUIRES MORE THAN JUST TALK The aged care industry champions respecting each person and meeting their individual needs, but how well are we really doing this for Lesbian, Gay, Bi-sexual, Transgender and Intersex (LGBTI) people?

gnorance of the needs and feelings of LGBTI people can cut across the best intentions of organisations to treat them equally. Imagine being faced with a form that only offered male or female options if you don’t identify with either of them. About 11 per cent of the Australian population – some 264,000 people – identify as LGBTI. Many of these people have experienced inequitable treatment throughout their lives, suffering or fearing stigma, rejection, persecution or discrimination. A recent La Trobe University study found many older LGBTI people fear discrimination from aged care and health service providers and avoid accessing vital services. This is great cause for concern. As part of the Uniting Church, Uniting AgeWell has a long history of providing services for older people irrespective of their faith, cultural background, gender or sexual identity. We share the Church’s spirit of embracing diversity, respecting differences, being open to discuss controversial issues and what it means to be inclusive of all people. We recognise that LGBTI ageing is a unique and important experience requiring a considered, consultative and systemic approach. We celebrate the contributions LGBTI staff, volunteers and clients have made to our communities over decades. But we know we can do more to ensure members of the LGBTI community find a ready welcome at our organisation – whether they are seeking help to age well at home, looking for respite care, or exploring living in one of our retirement units or aged care communities. In 2014 we established a senior executive LGBTI Working Group and a number of Task Groups to review our approach. It was important we gained support from a wide range of staff, not just management. There is no central project leader, but staff from all areas of the organisation are involved in the groups, providing a broad range of views to help us review our practices and ensure they are inclusive. This organisation-wide journey seeks to ensure all people accessing Uniting AgeWell services feel welcome, respected and valued, within a culture where diversity is not only accepted, but celebrated.

John Clarke Director of Mission I Uniting AgeWell

We also surveyed our staff to assess their attitudes. We have run introductory staff education sessions in partnership with Transgender Victoria, senior staff have attended courses run by Gay and Lesbian Health Victoria and we are co-convenors of the LGBTI Inclusive Practice Forums in Melbourne’s southern region. We are now planning to include LGBTI training across all our induction training and ongoing education strategy. This includes educating staff about LGBTI definitions, understanding the perspectives and needs of the LGBTI community and how our own staff’s perspectives can facilitate or be a barrier to responding to these needs. In addition, we are reviewing and updating all our documents to ensure they do not exclude people from the LGBTI community. This means offering a wider variety of options people can identify with, or enable honest answers that help promote a more open conversation. For example, providing more inclusive choices for title, gender, marital status and support person, ensuring documents don’t presume heterosexual relationships or people, and enabling people to disclose information only if they wish to do so. As someone said to me – we have come out of the closet so others don’t have to. Most importantly, we have connected with members and organisations of the LGBTI community, nationally and locally, other groups in the community and in the Uniting Church, to help guide our work. The LGBTI community has been very encouraging and supportive and we are pleased to see our relationship developing. All these changes are being done through the lens of Uniting AgeWell’s core values of our organisation – Respect, Fairness, Partnership, Wisdom and Stewardship. They have also been received without issue from residents and staff, who have praised our willingness to ensure we are open and inclusive. We can all do more to offer open hearts and hands to older people from the LGBTI community. But it’s time for everyone in the aged care industry to stop talking and start doing – so that each person finds a safe place to belong and age well. ■

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ADVANCING RESEARCH INTO AGEING CALD COMMUNITIES LASA members have been represented at a National Roundtable that brought together experts to analyse the gaps and work towards a strategic agenda on advancing research around ageing in culturally and linguistically diverse (CALD) communities.

he event, held at Parliament House in Canberra on 10 March, was organised by the Federation of Ethnic Communities’ Councils of Australia (FECCA) and the National Ageing Research Institute (NARI) due to “fragmented” developments in this area.

In March 2015 FECCA released its seminal report: A Review of Australian Research on People from Culturally and Linguistically Diverse Backgrounds, which identified a range of gaps in research found by a review FECCA commissioned on the topic.

“The Roundtable provided an opportunity for collaboration between researchers, ethnic communities, the aged care sector, and policy-makers, to improve ageing experience for Australians from CALD backgrounds,” FECCA Chairperson Joe Caputo said.

It also launched its 2020 Vision for Older CALD Australians, recognising research opportunities as a support mechanism for this vision.

Collaboration across sectors and inclusion beginning from the grassroots, ensuring CALD people are at the centre of research and translating research into policy and practice were identified as key components to advancing research around ageing and aged care for CALD Australians. Given the diversity of Australia’s population, and in particular the diversity of people over the age of 65, issues affecting CALD older people need to be embraced as part of all research and service delivery. Kay Richards, LASA National Policy Manager, attended the Roundtable and discussed the importance of undertaking research to support age care workers including those from CALD backgrounds to better understand the needs of older people. “With a growing percentage of older Australians from CALD backgrounds it is important that all age care workers understand how a person’s culture may inform their values, behaviour, beliefs and basic assumptions to ensure culturally sensitive care and services are provided,” she said.

Over recent years, NARI has also undertaken research into service access and gaps for older CALD Australians, and the issues faced by community workers and health professionals about strategies to improve services. “Better policy and practice must be informed by a robust evidence-base that is gained through research, which goes to the grassroots, and can then be translated into action,” said Mr Caputo. NARI Director Associate Professor Briony Dow said of particular importance is the need for research to better understand the experiences of older CALD Australians and how they differ from those of older Anglo-Australians. “At present they are often excluded from research due to language barriers. It is time that this changed – we need better knowledge of approaches to aged care for older CALD Australians so that aged care services are accessible, culturally appropriate and timely,” she said. A strategic research agenda will be developed based on the gaps identified by FECCA’s review of Australian research into older people from CALD backgrounds and the roundtable discussion. ■

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LIFEVIEW REACHES

THE RAINBOW

Victorian aged care provider, Lifeview Residential Care, has become the first Australian private provider of residential aged care to achieve the Rainbow Tick.

ifeview is the third provider of aged services and only the ninth company in Australia to achieve the tick. A major element in achieving the tick was the specialist education and training programs undertaken by all Lifeview staff and volunteers, led by expert organisations Transgender Victoria and Val’s Cafe. “This is a fantastic achievement for all at Lifeview”, Lifeview CEO Madeline Gall said. “Staff, residents and volunteers were passionate and committed to achieving this goal, it has been a true team effort, across all levels of the organisation.” “The Rainbow Tick endorses the fact our homes are inclusive for residents, staff, volunteers and their chosen families. This

accreditation will assist us to better care for elders from all walks of life – it’s all about reducing barriers.” Lifeview Director, Peter Reilly, said it was a huge step forward in Lifeview’s vision to ensure inclusive services for all and another stepping stone in our journey towards the development of Lifeview Marigold. “LGBTI consumers now know they can access services where their sexual orientation or gender identity is valued and that Lifeview understands their needs. We are committed to ensuring older Australians are able to age with grace, dignity, choice and without fear of prejudice,” Mr Reilly said. ■

Marketing your Aged Care Organisation through Exceptional Customer Service How will customer service training assist you and your staff? Now more than ever there is a need for effective customer service and exceptional customer relations. These skills are critical to your success as an organisation. This workshop is about understanding that customer service is not an added component of your role. It should be encompassed in everything that you do each day.

This workshop is designed to provide participants with the knowledge, practical skills and strategies they can use in their workplace.

This can be done as a tailored course for your organisation or your staff can join one of our public courses. For more Information on this workshop or any of our learning and development offerings contact our team. To find out more about how we can help you make a real difference in your business, contact our office on (02) 8624 3300 or via email contact@realiseperformance.com.au

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The search begins for Australia’s best aged care professionals

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Now is the time to recognise those going above and beyond in aged care, by nominating them for the 2016 HESTA Aged Care Awards. Presented by HESTA, in partnership with the National Aged Care Alliance, the national Awards acknowledge excellence in service provision, advocacy, leadership and innovation in the aged care sector. Nominations are being sought from employers, colleagues, recipients of care and family members, and are open until 27 May. HESTA CEO, Debby Blakey, said the Awards recognise the amazing work carried out by aged care professionals, often in challenging circumstances. “Each day, aged care professionals around the country are working tirelessly to improve the quality of life of thousands of older Australians,” Ms Blakey said.

The Awards are a way of acknowledging individuals, teams and organisations that provide leadership, innovation and professionalism in aged care service delivery. ME is a longstanding Awards-supporter, with the bank generously providing the $30,000 prize pool, to be divided among the winners in three award categories — Outstanding Organisation, Team Innovation and Individual Distinction. Winners will receive $10,000 in a ME Everyday Transaction account towards further education or team development. Catholic Healthcare’s Charles O’Neill Hostel in Newcastle won the Team Innovation Award in 2015 for its unique program providing care to older Australians suffering mental illness. Residential Manager, Kristen Grainger said that the prize money would help fund the introduction of an art therapist to work with residents on a weekly basis and contribute to further staff development and education. The Outstanding Organisation Award was won by Victoria’s Southern Cross Care for Employee Development and Empowerment Program that improved the skills, health and lives of its predominantly female and culturally and linguistically diverse workforce. Paul Brophy — from the Brotherhood of St Laurence’s Sambell Lodge in Victoria — was recognised for the Individual Distinction award for staging musical events for more than 6,000 residents from 20 care homes. Proudly sponsored by:

From top: Ms Horsnell, representing Southern Cross Care; Kristen Grainger, Residential Manager of Catholic Healthcare’s Charles O’Neill Hostel; Paul Brophy from the Brotherhood of St Laurence.

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MEETING THE NEEDS OF PEOPLE

WITH LIFELONG DISABILITY A new Community for ageing people with intellectual disability and their primary carers has opened at IRT William Beach Gardens, south of Wollongong.

he development features 12 universally designed villas, a community centre, and a five-bed respite centre.

IRT Group Chief Executive Nieves Murray said the Community was founded on the unique Pathways through Partnership model, designed to keep families together in a supportive environment as they age. The innovative model was developed by IRT Group, Greenacres Disability Services, Interchange Illawarra and Community Gateway, and is supported by the University of Wollongong, which is evaluating the model as a blueprint for other service providers. “We are immensely proud of Kemira and grateful for the support we received from the NSW

IRT William Beach Gardens residents

Government, our disability service partners and the University of Wollongong,” Ms Murray said.

100 direct and indirect jobs created to service the Kemira community,” said Mr Gareth Ward MP, Parliamentary Secretary for the Illawarra and South Coast, and Member for Kiama.

“People with lifelong disability represent one of the most rapidly growing groups within Australia’s ageing population. We know there is often a crisis situation when ageing people with intellectual disability are forced to separate from their carers, who are usually family members, because their carers go into aged care.” “In this new IRT Community up to 12 people with intellectual disability will be able to rent a home of their own and live with their primary carers within a supportive community as they age,” she said. The NSW Government contributed $2.9 million in funding for the project from the $100 million Restart NSW Illawarra Infrastructure Fund, with $2 million in additional funding and in-kind support from IRT Group. “The project not only benefits people with intellectual disability and their families, but the broader community with more than

IRT Group will operate Kemira alongside its existing IRT William Beach Gardens Lifestyle & Care Community at Kanahooka, south of Wollongong. “By including a five-bed respite centre onsite, we’re also hoping to improve the lives of many other Illawarra families who are needing a break, and help them form connections with each other,” Ms Murray said. IRT will enter a tenancy contract with the person with intellectual disability, rather than their carers, which is crucial to the success of the model. “This ensures that people with disability can continue living at Kemira even if they become separated from their primary carers due to poor health or passing,” Ms Murray said. “Parents and carers are telling us that this is very important to them” ■

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QUALITY

SETTING NEW GLOBAL STANDARDS FOR

BEST PRACTICE DEMENTIA CARE In the UK, an ageing population, increasing prevalence of dementia and declining workforce are creating similar challenges to those faced by Australian aged care providers. Recognising that something had to change, Nightingale Hammerson has revolutionised its dementia care and workforce training to become a global centre of excellence.

he similarities between the ageing population and aged care workforce in the UK and Australia are stark: half of the UK’s aged care workforce are aged 50 or older, roughly the same proportion of Australia’s aged care workforce. The UK is grappling with an ageing population at similar rates to ours, and needs roughly 900,000 new entrants to aged care to handle the rise in demand for services. Likewise in Australia, there are fewer nurses entering the workforce as those retiring. Prevalence of dementia is on the rise, with an estimated 50 per cent of all residential care clients in Australia believed to have the disease. Care costs are rising and government funding is declining. It is a perfect storm that everyone is watching gathering momentum, knowing it will hit in the next five to 10 years. No longer able to ignore these facts, the Board of Nightingale Hammerson, an organisation dedicated to looking after the Jewish community, knew that something had to change, and three years ago took steps to ensure its future in an increasingly challenging and uncertain environment. “Our goal was to become a global centre of excellence for dementia care and end of life care,” Simon Pedzisi, the Director of Care Services, explained. “With funding cuts occurring left, right and centre we had to think about how to improve standards without breaking the bank.” It is this goal that attracted the attention of study tour organisers from Australia last year, and following sponsorship from Marchese Partners, Infinity Group and Commonwealth Bank, took 20 aged care executives around the UK last September. The opportunity for a complete review of its business model came for Nightingale Hammerson when the Board committed to merging Nightingale House and Hammerson House to create a single organisation operating two care homes in south west London and north west London.

“In addition to extensive renovations of Nightingale House, we knew that reaching our goal would require a complete shift in thinking by all staff. If you want to improve your standards you have to think creatively across the whole organisation from the board and executive through to the cleaners,” Mr Pedzisi said. Nightingale Hammerson offers residential aged care to 215 people. The average age of their residents is about 90, though about 13 people are over the age of 100 and the centre is seeing a steady rise in the average age that people enter its service. “In the UK about 850,000 people have dementia and roughly 80 per cent of those people are living in care homes. Dementia is now accepted as a cause of death and because of this our entire nursing model, culture and philosophy had to change,” Mr Pedzisi said.

Revolutionising the entire care model A bottom-up approach to revolutionise the care model commenced, led by Mr Pedzisi and with the full support of the Board and executive. Together with care staff and management, they created a five year plan that encompassed workforce, comorbidities, types of illness, rates of dementia, age of residents, the organisation’s internal policies and of course the external policy environment. “Our residents fall into three categories – those nearing end of life, those with dementia and those with the complicated mix of both. We need to be able to meet everyone’s needs and this starts by recognising the difference between dementia care and end of life care,” Mr Pedzisi said. “Caring for people with dementia or who are nearing end of life requires specialist skills, and not necessarily those of a trained nurse. The problem was that more people are leaving aged care than joining the profession, and new entrants don’t have these skills because they aren’t taught as specialised courses

QUALITY

anywhere. So we saw an opportunity to change this.”

Creating a skilled workforce Staff at Nightingale Hammerson contacted training providers around the UK and spoke to them about their five year plan, the type of residents they’d be looking after and the need for a new way of delivering care. “One university said they could help us by creating a knowledge transfer program. This meant classifying dementia care as a core skill, and they sent a specialist to assess the knowledge and skill application of those who were excelling in this role, and then provided a summary of what was needed to change. “Together we have developed a program with seven modules, so we can send people to do different levels of training. This program doesn’t require someone to be a qualified nurse. Using person-centred care methods you can teach anyone to look after anybody with any condition at all,” Mr Pedzisi said. Special training is offered for overseas-trained nurses that gets them accredited and new approaches to recruitment has resulted in successful job applicants from Greece and other countries with job shortages. “Our vision is to become a teaching care home and create a learning environment. Culture and staff attitudes are the most important things in any organisation, and these two factors are always improved in a learning culture. Before we made the changes we were struggling to recruit, and a secondary outcome of becoming a centre of excellence is that it’s far easier to attract staff.”

Aligning policies and procedures

| FEATURES

changed its procedures for delivering care, starting with how potential residents are assessed. “We now assess all potential residents in their own home. If we identify they might have dementia, we send a specialist to understand their life history – to get to know them as an individual. We then take that information and start planning the physical environment of their new care home to help them. For example, if someone was a teacher we create their room differently to the room of someone who was a labourer. Each person’s care plan is specific to their history and all staff know the important elements. Knowing their history enables us to better manage any angst or agitation by helping them find that important thing they are looking for or turning a moment of frustration into an activity with meaning and purpose to them,” Mr Pedzisi said. To get a full picture about someone’s life, staff engage with their family members. This assessment also helps to build trust with family members, who may be hearing the word dementia’ for the first time and may not understand the change in behaviour that has led to them requiring full time care. “Engaging with family members so they are part of the care team as opposed to just spending time with their relative is core to our care program. We run training and awareness for family members and other residents about dementia symptoms and care, so that when we have residents with challenging behaviours everyone knows things they can do to help,” Mr Pedzisi said.

Supporting staff to achieve in their roles To support these changes, the organisation has also revised shift patterns for its staff, to reduce burn out and enable staff to get the most out of their work and social lives.

The organisation has revised all its internal policies to align staff development around dementia care and end of life care, and

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TECHNOLOGY |

COMPUTER SOFTWARE

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QUALITY

“Staff need to be able to perform in their emotionally and physically demanding roles, but then have a rest and enjoy a good social life too. At the same time, for staff to really get to know residents, build relationships, and support an active care plan they need time to sit down with the resident at admission, and be involved in changes in therapy. When we began reviewing this, we realised that traditional shifts were not conducive to this, nor to staff having a good work life balance,” Mr Pedzisi said. “We also need the right environment for staff to carry out these new expectations of their roles and so we involved staff in the redevelopment of a new wing that houses 40 residents. They are the ones who know what works and what doesn’t and liaised with the builders. This wing recently won the best architectural design for a care facility!”

Namaste Program The organisation has also implemented the Namaste program into its daily care program. This program involves dedicated two-hour sessions with a range of gentle activities like hand massages and hair brushing, and then build up in stimulation so that the resident has sufficient energy to engage in a hearty meal at the end of the session. Music and memory are core elements of the program and are combined with mood lighting and scenic images on the television. Animals are also used to stimulate residents and engage residents in activities to keep their minds active. “As part of our range of stimulating and sensory activities, we include the use of small animals, including guinea pigs, hamsters and rabbits for our residents to engage with, under supervision,” Mr Pedzisi said. “Not only can interaction with animals help to relax, alleviate stress and improve motor skills in the elderly, but this type of sensory activity can also rekindle childhood memories. We have found this so beneficial that care staff and activity co-ordinators bring the animals up for residents that have difficulty in moving around independently.”

| FEATURES

“Other sensory activities our residents enjoy are outdoor activities in the easily-accessible garden, planting and growing vegetables and music therapy. This all goes back to our person-centred care approach as we learn which activities each of our residents respond well to and enjoy,” he said.

Measuring success The measure of success of these fundamental changes at Nightingale Hammerson lies with their residents’ experience, and as you might expect, significant thought has gone into creating an evidence base for this. “We formally measure behavioural patterns, moods and wellbeing of our residents as it is of paramount importance to us to understand exactly which activities suit our residents,” Mr Pedzisi explains. “To do so we have worked closely with Bradford University to create ‘care mapping’. This evaluates what is working well and what areas we can still improve on. We have specially trained staff who use this mapping system to identify the level and changes in mood of residents over a 24-hour period.” From this, staff can see when residents are bored or disengaged and when they are motivated and involved. In turn, this enables staff to increase the levels of participation in activities and decrease the times when residents have been agitated or anxious. “This helps us to build a deeper understanding of each of our residents and their likes and dislikes and really get a feel for what the resident was like before they entered our care homes,” Mr Pedzisi said. “For example, one of our residents was a mechanic in his former years so we engage with him through talking about the different parts of the Morris Minor car we have parked in our Memory Garden. It always comes back to person-centred care.” ■

New program improves data collection to improve service delivery

received an NHS health check,

information and transparency,” said

the number with depression and

George McNamara, Head of Policy at

emergency hospital admissions data.

Alzheimer’s Society.

Public Health England has launched

Its goal is to help improve dementia

“This important resource is a step

a new Dementia Profile that allows

services across the country by giving

towards tackling the postcode lottery,

comparison between local authorities

government the data is needs for

supporting commissioners to make

and Clinical Commissioning Groups in

planning purposes. This includes

evidence-based decisions about

England through a single interactive

information necessary to identify

what services are needed, while

online platform.

variation, investigate the reasons

shining a light on areas in need

for any differences, and ultimately

of improvement.”

The Profile enables sharing of key information between localities, such

improve outcomes.

as number of people with dementia

“One of the problems in preventing

and their age, the number who have

poor care has been a lack of

Original article was published by www.pharmatimes.com

INNOVATION

TECHNOLOGY & INNOVATION

PROCESS RE-ENGINEERING AND SOFTWARE SELECTION

The aged care and disability sectors have undergone significant transformation in the past two years. The current round of reforms will provide the consumer with complete control in the selection of their provider and the services they access. The consumer will increasingly select providers who have the ability to maximise services and minimise administrative burdens, resulting in a more competitive market that will benefit providers who are able to minimise their overhead.

roactive providers are responding to the change by reshaping their services, processes and structures to meet market demand in the most efficient manner possible.

As the focus moves towards consumer preferences, many of the barriers between aged care, disability care and even retirement living will dissolve. Whilst providers have traditionally focused on a single stream of care, largely as a result of the siloed funding models, we are now seeing providers examine new markets that will increase service delivery and efficiencies. Out of 2,234 providers in Australia, there are only 49 providers that have services across residential care, home care and community care.

Amber Cartwright Finance Consultant I Ansell Strategic

will require re-engineering to ensure a shift away from legacy formats, recognising that the priority should be how we deliver services, not how we spend allocated funding. By focusing on the end-point of service delivery, we can begin to identify synergies between siloed services and opportunities to integrate underlying processes. An Enterprise Resource Planning (ERP) solution can be used to match the available resources (inputs) to the service required (outputs). Organisations will have different ERP solutions because services, requirements and resources vary.

Moving from siloed services to integrated services

Providers by sub-sector at 30 June 2014

The impact on current practices should not be underestimated. Organisational systems and processes

Navigating through the various software providers and products can be overwhelming. IT solution providers will promise that their software meets your needs, or that it can be easily integrated with other software systems, or that there are new features in the pipeline. By gaining a clear understanding your client needs, service models and resourcing requirements,

TECHNOLOGY & INNOVATION

it is possible to narrow the preferred software options significantly. From a care perspective, the information system needs to be user-friendly to cater for diverse staff members (cultural, age, education, etc.), however, this needs to balance with regulatory requirements. Providers should also consider point of care documentation capabilities and compliant reporting mechanisms. Client functionality and responsiveness is central to the selection of software. The consumer based model requires a system that can provide client portals and individualised budgeting and billing. Client needs and preferences will vary, therefore the system needs to be flexible.

Consumers will increasingly select providers who have the ability to maximise service VALUE and minimise administrative burdens The primary input required to deliver our services is human resources. Staff allocation, rostering, routing, training and payroll functions need to be considered. Home, community and disability care services are inherently complex, with

The investment in process re-engineering and software selection will be essential if organisations want to deliver efficient services in our new consumer driven market staff required to be matched to clients based on location, compatibility of staff skills and client needs and preferences. Some off-the-shelf software products exist which can capture care, client and human resource requirements. However the corporate capabilities, such as finance and accounting, reporting, procurement, asset management and information technology, are often limited. Many providers find that a combination of software solutions deliver the most effective solution that addresses their needs and capacity without compromising on the quality and integrity of the system. The investment in process re-engineering and software selection will be essential for organisations that want to deliver relevant, efficient services in our new consumer driven market. Those that choose to take a back seat approach will quickly become less relevant and begin to lose their market share to proactive operators. ■ For more information contact 08 9468 7520 or email amber@ansellstrategic.com.au

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TECHNOLOGY & INNOVATION

SMART FLOOR TECHNOLOGY

ENHANCING QUALITY AND SAFETY No longer a thing of the future, smart floor technology is now available in Australia to help aged care providers set new standards of care.

he Assisi Centre Aged Care is a not-for-profit, Italianspecific 150 bed Residential Aged Care Facility located in Rosanna, Victoria. Services include a 30-bed Dementia specific unit, 30-bed high care unit as well as ageing in place.

are able to monitor resident mobility from their workstations and are able to respond to falls and other incidents more quickly.

During the planning stages of a refurbishment of its high care unit, St Francis, CEO Martin Sammut and Director of Care, Fiona Kool learned about the availability of new sensor floor technology from Finland.

“Our managers and staff who will use the system have been given training and through this they identified that the system records every event to the database and so can better analyse and assess what has occurred leading up to and after an event,” Mr Sammut said.

“Our appointed architects informed us this new technology was available in Australia that detects and monitors movement within the area which is equipped with sensors and when activated, triggers an alarm which alerts staff and records mobility patterns,” Mr Sammut said. “We are continually seeking innovative technology that is designed to improve the quality and efficiency in the care delivery to residents, including their safety and well-being, and decided now would be the time to install it since we were undergoing the refurb,” he said. The ELSI Smart Floor is developed by MariCare in Finland and installed by HLS Healthcare in Australia. The product is slowly being introduced to the Australian market and while there is a complex installation and laying process, all signs indicate the system is functioning as intended with positive readings and recording capabilities. The ELSI Smart Floor has micro sensors under the flooring and it detects when a resident gets out of bed, has a fall, enters or exits the bedroom or bathroom. There is no need for any alarm to be worn by the resident and so is not intrusive. The system can be tailored to each individual resident’s needs, ensuring that their privacy and dignity is maintained at all times. It also detects up to 4 people, including the resident and differentiates each person using colour differentiation. In essence, staff

“The changes and benefits we anticipate include efficiencies in care, establishment of improved individualised care plans that incorporate closer analysis of the resident patterns involving sleep, toileting and continence care and prevention of falls.” “Staff are extremely excited by the technology and what it has to offer, not to mention the feeling of pioneering something new as we believe we ours is the first residential aged care facility to be using this system in Victoria and by all accounts – Australia,” he said. “The Assisi Centre Aged Care is very fortunate to have the ongoing support of The Lorenzo and Pamela Galli Foundation, which has helped to fund the floor installation. We continually update residents, families and staff at quarterly meetings and everyone is keen to see it up and running, knowing it will lead to positive outcomes for resident care and the work environment,” he said. In addition to the smart floor, the organisation has installed ceiling hoist tracks to replace traditional lifting machines, catering menus are electronically displayed while the facilities auditorium is fitted with a ‘hearing loop’ to cater for residents with hearing impairment. Residents have access to iPads and enjoy visiting their country of birth or the home that they grew up in via Google Earth while many are regularly using Skype to stay in touch with family and friends. All resident rooms are fitted with electronic high/low beds and have wall mounted TVs in order to create space and to ensure a safe working environment for staff. ■

TECHNOLOGY |

COMPUTER SOFTWARE

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TECHNOLOGY & INNOVATION

DISRUPTIVE TECHNOLOGIES

AND AGED CARE

Greater support for investors and improved data collection are needed before innovation investment priorities can be determined, LASA has told the Productivity Commission.

n its response to the Commission’s Disruptive Technologies: what do governments need to do research project, LASA said that while it supports a strategic plan outlining innovation resource and investment prioritises for the industry, a baseline evaluation to determine technical competency and capability of aged care service providers will be necessary as there is insufficient infrastructure uniformly available across the age services industry to determine effective priorities. “While innovation is not necessarily reliant on technology, there is still considerable variation in the technical competency and capability of aged care service providers, with many still using paper based record systems and struggling to keep pace with emerging ICT capabilities,” LASA National CEO, Patrick Reid said.

How does health and aged care embrace innovation whilst still maintaining high levels of safety and quality? “LASA is a strong advocate of enhancing innovation in order to support the establishment of care and services that are accessible and sustainable, whilst still maintaining safeguards in quality and focuses on continuous improvement.” “New opportunities and greater investment is needed for age service providers to support older Australians population with effective and safe health and age care services and products,” he said. The Commission’s project follows its recent inquiry into Business Setup, Transfer and Closure, which highlighted that regulatory changes are required to allow the operation of, and economic benefits from, digitally disruptive new business models. It is now assessing the role of government in a range of policy areas as innovative technologies have far-reaching and interlinking impacts on the broader economy.

competition, productivity, structural adjustment and social structures – where governments are adapting well and where greater regulatory or policy attention is likely to be needed. This includes innovation, infrastructure, taxation and education. LASA has highlighted that barriers existing within current systems are often the driver for innovation, and points to limited functionality of My Aged Care and its supporting infrastructure as a classic example for aged care. “In order to embrace innovation we must consider the barriers of the existing system and assess whether they are achieving their original goals or whether they are acting to stifle innovation,” Mr Reid said. “Existing systems have the ability to impact on reforms and policy changes due to their inability to perform in a way that fully supports future initiatives. It is less than ideal when the systems and processes negatively influence significant policy change and industry reform.” “The system that exists to support consumer directed care has limited functionality and only allows one provider to be paid per consumer. As the funds start to follow the consumer, and the consumer is able to engage different providers for different services, this will present a problem. At this stage, it has been flagged with the industry that to address this system issue, one provider will be paid by the system and then that provider will have to distribute the funds to other providers as necessary. This ineffectiveness is created as a response to the limitations of an existing software program and where functionality dictates policy.” “In conjunction with the introduction of My Aged Care, the Department of Social Services has also introduced the use of the reporting system known as the Data Exchange (DEX), for which a subset of providers are required to report. However, while there is some cross over with the information reported through both systems, they are unable to share data with one another.” LASA has also highlighted tensions between innovation and quality and safety, and the extent to which regulation can have an unintended consequence of hindering innovation.

In particular, it is looking at the potential impacts and challenges of innovative and disruptive technologies for

TECHNOLOGY & INNOVATION

“Innovation is synonymous with risk, and in the context of industries that seek to avoid risk as much as possible, this inevitably creates tension between the two. Therefore how does health and aged care embrace innovation whilst still maintaining high levels of safety and quality?” Mr Reid said.

“To date, very little focus has been given to the power of big data for the aged care industry,” Mr Reid said.

Very little focus has been given to the power of big data for the aged care industry

“Furthermore, attention would have to be given to whether the existing data is of a sufficient quality to be utilised; whether continuing to collect current data is still needed; what questions are likely to be asked that will challenge the data; and whether additional safe guards may need to be implemented.”

“While regulations have been put into place to protect vulnerable people, they can have the unintended consequence of stifling innovation due to the rigidity that they can create. Careful consideration needs to be given to the impacts of regulation and how it may be possible to incorporate innovation into an existing system or whether it is necessary to look at evolving the system to support changes in services and products.” “Disruptive innovation transforms existing markets with new products or services which have the potential to redefine an industry. One of the challenges is how to create a business environment that supports innovation when there is the potential for the innovation to strongly affect the current dominant actors in the industry,” Mr Reid said. LASA also calls for improved coordination of data collection through strategies which support industry-wide initiatives.

“Any potential strategy would need to address this issue and effectively communicate the potential of large data analytics whilst also considering the possible limitations and collection requirements that may be required.”

To embrace innovation we must consider the barriers of the existing system and assess whether they are achieving their original goals “Age care has grown significantly in the last ten years and the expectations and demands placed on this industry are also evolving. Providers and those developing new services for the aged care industry, and investors in such services need to be supported to ensure the ultimate goals of meeting demand and exceeding expectation are achieved,” Mr Reid said. ■ To read LASA’s full submission go to: www.lasa.asn.au/member-services/submissions Image courtesy of Robert Kneschke/Shutterstock.com

COMPUTER SOFTWARE

| TECHNOLOGY

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DESIGN

BENETAS COROWA COURT AGED CARE APARTMENTS:

A HOME FIRST

Its commitment to a new model of care placing consumers at the centre of everything the business does, has seen leading Victorian not-for-profit aged care provider, Benetas, re-examine the role of the built form.

xhaustive research, both in Australia and abroad, has led the organisation to arrive at the new model, which will support its new direction for aged care.

A $14 million extension to and refurbishment of Benetas Corowa Court, in Mornington on Victoria’s Mornington Peninsula, will bring a hybrid-version of the new model to life, building on the existing 60 bed aged care home and increasing its capacity to 120. CEO Sandra Hills said that Benetas Corowa Court Aged Care Apartments, named to reflect the new philosophy and approach to aged care while retaining the history of the existing Corowa Court, signalled the business’ move away from an institutional, sub-acute model of care. “We wanted to support residents to have more choice and control over how they live, just as they would if they were living

in their own home, and our new model achieves this,” said Ms Hills. “This model is informed by the Benetas Commitment for residential care, which tells us that choice for residents cannot be delivered by giving attention only to one or two elements of their life. We need to consider the person’s whole life and how elements such as their relationships, clinical supports, their role in the community and their living environment contribute to their experience of ageing and life.” The Benetas model is informed by three key principles: 1. the understanding that the most appropriate way to support quality of life for older people is to deliver ‘normal’ living environments; 2. that older people should be supported by primary carers who meet their needs holistically and completely, and;

DESIGN

in their own apartment-type configuration of bedrooms, with smaller, more private living areas and fewer residents sharing their living, dining, kitchen and outdoor spaces. Staff offices and work areas, including commercial and corporate activity, are positioned ‘back of house’ contributing to more ‘usual’ and familiar domestic spaces. 3. that all service elements, such as systems, tools, staffing structures and quality processes, integrate to deliver a meaningful and responsive customer experience.

A home first To create living environments which reflect ‘normal’ life as much as possible, small clusters of residents are set to live

The work at Corowa Court Aged Care Apartments, which was first considered in 2012, has evolved as research has continued into best practice world-wide, resulting in a hybrid-model which responds to the particular nuances of the existing home. The 60-bed extension sees the development of four separate apartments, made up of 15 bedrooms, each with en-suites. Within each apartment, residents have access to a private kitchen, servery and dining facilities, where food is served but can also be prepared by residents and families, promoting independence and social inclusion. Adjacent to the dining area in each apartment is a separate living area, with direct access to an external terrace, balcony or courtyard space with sea or garden views. Private dining areas are also provided for residents to use and share with their

DESIGN

family and friends, and residents have access to an on-site café, wellbeing centre and hairdresser. The development has also been designed to support community engagement, acknowledging the importance of meaningful activities and relationships. Members of the public will be encouraged to share communal spaces, including a large garden park area, which also promotes residents’ physical activity and interaction with family, friends and the local community.

“What we’re looking for are carers who can really make a connection,” said Ms Hills. “While we’re interested in their clinical expertise and experience, we’re equally concerned with whether staff understand the importance of positive relationships with residents and how this works to deliver on client choice and control.” As part of this, carers will be rostered to work in one apartment only, giving them the opportunity to get to know the residents and provide truly individualised support.

“We’ve worked with residents and families along the way to make sure we’re best meeting their needs and delivering something they want,” said Ms Hills. “Our designs always take residents into consideration and put care at the centre of everything we do, and we wanted to allow for as much or as little social engagement as each resident wants.”

“This is a journey that we’re committed to supporting staff to take with us because we believe this model is the one that will deliver the best outcomes for older people, and staff,” she said.

The role of the carer

“The model is all about acknowledging that every function, from primary care to recruitment, and from Information Technology to Brand, needs to work together,” said Ms Hills, acknowledging that the holistic approach does not begin and end with direct service staff.

Within the new model, the relationship between resident and primary carer is identified as one of the most critical and there is an increasing focus on emotional intelligence and a working knowledge of what a person-centred approach looks like in day-to-day practice.

A whole of business commitment To make this work, a whole of business approach is required.

“Our model reflects that no one size fits all in aged care and we believe Benetas Corowa Court, more than three years in the making, delivers on this.” ■

TECHNOLOGY |

COMPUTER SOFTWARE

procurement

DESIGN

SUMMITCARE BEGINS WORK ON NEW

STATE-OF-THE-ART DEVELOPMENT Work on SummitCare’s stunning new residential aged care development is underway, which the company says will refine residential aged care.

he 180-bed project, located on 1.257 leafy hectares in Baulkham Hills, north-west Sydney, will create around 200 jobs and, when completed in mid-2017.

SummitCare has been providing top-level care and support to older people and their loved ones throughout New South Wales for the past 50 years but this Baulkham Hills development marks a major step-change in residential aged care with an exciting new approach to design and technology.

SummitCare Baulkham Hills will also offer a comprehensive activities program, allied health services, adult day centre and respite care, home care, palliative care and dementia programs, including music and movement. “As we celebrate our 50th year of operation this year, our entire team and I are excited about seeing this development come to life and being part of the Baulkham Hills community,” said CEO Cynthia Payne. ■

“Our focus has always been on creating warm, caring and welcoming environments for our residents, but Baulkham Hill will take this to a new level,” said Peter Wohl, SummitCare (Australia) Director. “Our approach to the development of this project is radically different – from the design to the use of latest technology. It has been developed based on demand for quality care in the area and what people tell us they would like to see in their home – like pet friendly spaces, a children’s play area and even a purpose-built Men’s Shed. “We’ve chosen to work with an acclaimed award winning design company, CHADA, which has vast international experience not in aged care but in the high-end hotel sector. The result will be generous room sizes and a hotel-style environment we’re confident residents and their families will love,” said Mr Wohl. Other features will include a wellness centre; hairdresser; café and shops; gardens, courtyards and a golf putting green; a gymnasium and movement room; and a media room. Technology will play a key role in both the lifestyle and care of residents with wireless connectivity, sensors, alarm call and fall-prevention systems and CCTV security to ensure a safe and connected community. Residents will also be able to catch up with family members who are interstate or overseas via video conferencing, and for those closer to home (or visiting) there will be family rooms for overnight stays.

Improving quality of life through design sym. studio is a landscape architecture and urban design practice offering a fresh approach to programming the outdoor environment. We are passionate about health & well-being; specialising in residential aged care facilities and retirement living. “sym. studio has supported Alzheimer’s Australia NSW to achieve significant steps forward in the research and development of dementia friendly garden design for its North Ryde and Port Macquarie centres.” Brendan Moore, Alzheimer’s Australia NSW

Dementia Sensitive Design

Accessibility & Connectivity

Healthy & Active Amenity Programing

Community Engagement & Focus Groups

Cultural Heritage & Identity

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BUSINESS MANAGEMENT

NEW MARKETS:

OPPORTUNITY IN CHINA Ansell Strategic Senior Consultant, Cam Ansell, attended the Australia-China International Aged Care Summit held in China late last year. In response, his firm has developed a report outlining the opportunities, risks and considerations for age service providers looking to enter the China market.

n an effort to facilitate dialogue between Australian and Chinese enterprises, the two countries organised an aged care summit in November 2015. About 600 participants from Chinese government, peak bodies and institutions and almost 150 delegates from Australia representing 75 organisations attended the summit. Although demand for aged care services is strong in China, the sector is in its infancy. There are currently 40,000 aged care institutions with approximately 5.7million beds, representing approximately 27 beds per 1,000 elderly people. By 2020, the Chinese State Council plans to reach a target of 35 to 40 aged care beds per 1,000 elderly people, representing a significant shortfall. The Council expects an aged care workforce to be in excess of 10 million by 2020. China’s five-year plan sets out the Chinese Government’s overarching strategy and targets for economic and social development over a five-year period. Its 12th plan (2011-2015) outlines a framework to support its ageing population, which aims for approximately 90 per cent of the population aged 60 years and above to age at home and be cared for their families, 6 to 7 per cent receiving support from community based care, and 3 to 4 per cent requiring residential aged care. Government-run agencies comprise of the largest operators in the market. Access to these services is difficult with entry eligibility based on care, social and financial welfare needs. Prospective residents are required to join long waitlists. Charges are generally based on an accommodation rental model and are relatively low.

result of the countries robust economic growth, resulting in higher levels of wealth and subsequently higher levels of life expectancy. At the moment policy makers are looking at a range of international aged care models used in America, Japan, Taiwan, Australia and Europe to draw from in developing a sustainable model for China. With an established and previously highly regulated aged care industry, there will be a variety of opportunities for Australian organisations to participate in China’s aged care industry. While there are plenty of opportunities for Australian organisations within the aged care market in China, there are also many challenges for early adopters (as some organisations are currently experiencing). In seizing these opportunities, we must accept that it will simply not be enough to directly duplicate our skills and models into China.

Challenges While the opportunities are clear, our observations indicate that Australian models of aged care are not easily transferable to China. Family values around filial piety and views on institutional care will gradually give way to the realities of a rapidly ageing population. The ageing population will present significant economic and social burdens to China including: • Social and cultural expectations • Market acceptance • Lack of established service models unique to China • Lack of experienced and skilled people

Most institutions provide services to residents that only require minimal assistance with daily living and who are relatively capable of living independently.

• Declining ability to support people with higher levels of dependency as the workforce ratio of workers to retirees will drop from 5:1 to 2:1.

Opportunities

• Even by Australian standards, user pay services are relatively expensive, often exacerbated by low occupancy.

Although China faces a number of challenges ahead with their ageing population, there is enormous potential and opportunity for both Chinese and Australian aged care businesses. The emergence of China’s middle class continues to grow as a

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Recommendations For companies looking to China as a potential new market, Ansell Strategic recommends the following: Do you research Research is vital. China is a large country with subtle nuances and differing social/cultural dynamics, even within each province and city. Undertaking your research will be critical in developing a service model and understanding your target market will contribute towards the overall success of the project. Offer a unique model Similar to above, developing a service model that meets the needs of the local community you are operating in is important. While the knowledge and experience gained from Australian service models will be useful, they should not be replicated identically. An open mind to service development will benefit Australian and Chinese models with shared learnings. Establish the right partnerships Finding a local partner with a sound knowledge of the local community and aged care market will ensure that you have an enhanced understanding of the operating environment and help in reducing the risk of operating in a foreign environment.

Understanding business practices and conventions will also be essential in finding the right partner. For example, many Chinese enterprises are eager to sign a contractual agreement (e.g. Memorandum of Understanding), which are usually not legally enforceable. Contract law has different connotations and working with State Owned Enterprises involves complexities that require local advice. Concentrate on your strengths Leveraging on your comparative advantage will allow you to maximise efficiencies, (particularly in a partnership) benefits and outcomes. The aged care sector in China is changing rapidly and presents significant potential. The development and knowledge of culturally specific service models will be as useful in Australia as it will be China. While there are a number of opportunities for Australian organisations in China, there will be an equal number of challenges/difficulties to navigate through. A long term commitment and investment in resources will be necessary in order to develop relationships and participate in China’s aged care market. ■ For more information or for a copy of the full report contact Daniel Lee at daniel@ansellstrategic.com.au

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BUSINESS MANAGEMENT

PRE-ENTRY LEAVE CHARGES – STILL THERE BUT ARE THEY WORTH IT?

Some approved providers are unclear as to whether they can charge residents for ‘pre-entry leave’ and if in fact the concept still exists under the Aged Care Act. Arthur Koumoukelis National Leader I Gadens Aged Care and Retirement Villages

he answer is it does but not as providers knew it. Providers can charge the daily contribution fee calculated over the pre-entry leave period and that’s all.

Prior to the reforms to the Act of 2014, an approved provider was able to be paid the residential care subsidies for a prospective resident in respect of the ‘pre entry leave’ days before the resident entered the facility. After the reforms, the concept of ‘pre-entry leave’ remained within the Act but the right to receive the residential care subsidy for that period was specifically removed. This caused approved providers to assume there was no longer any entitlement to receive funding for pre entry leave. The answer is an approved provider can but to understand why is a little confusing. Under the Act, an approved provider can enter into an accommodation agreement with a care recipient before or within 28 days after the person enters the provider’s service. A ‘resident agreement’, being the agreement under which the approved provider can charge resident fees (which includes the daily contribution, means tested care fee etc) for the provision of the care does not have a similar time obligation as accommodation agreements. Under the User Rights Principles, the information that constitutes a resident agreement must be given before or when the care recipient enters the service. The Act allows an approved provider to charge care recipients resident fees for the period prior to the entry if they are on

‘pre-entry leave’ but the maximum amount that can be charged is the standard resident contribution. However, the right to charge needs to be in the agreement and it may be not all forms of agreement address this point. Under the Act, a person can be on ‘pre entry leave’ in the same way as prior to the changes, namely during a period starting on the later of: 1. t he day on which the resident was notified that there was a vacancy in the residential care service; or 2. t he day on which the resident accepted a place in a residential care service; or 3. t he day that is seven days before the day on which the person enters the residential care service and then ending on the day before the day the person enters the residential care service. Under the Act, an approved provider must offer to enter into a resident agreement and it can be part of another agreement, such as an accommodation agreement. As a result, an approved provider could, if given enough time, such as if a care recipient is moving from another facility or from rehabilitation, provide all of the relevant information to constitute an accommodation agreement and resident agreement and within that agreement agree to charge resident fees for pre-entry leave to the maximum amount under the Act. The issue is that it needs to be in the agreement and it needs to reflect the Act. ■ For more information email arthur.koumoukelis@gadens.com

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BUSINESS MANAGEMENT

UPDATE INTERNAL CONTROLS

TO PROTECT YOURSELF FROM FRAUD During a recent catch up with a client I was told he was comfortable that there was little opportunity for fraud in his motels, due to the majority of payments now being received through card payments.

advised him not to be complacent because misappropriation of funds is often made through payment systems. A week later he dismissed a manager who had been authorising and making regular payments to a phony maintenance man who shared the manager’s bank account number. Although small, these payments amounted over time and easily flew under the radar. Internal controls – as one component of a risk management framework – are policies and procedures put in place to reduce the likelihood of an adverse event such as fraud. Large businesses rely on the segregation of duties as one key control to reduce the risk of fraud through the payment system. By having many people involved in the accounts payable process (e.g. one to enter an invoice and another to pay it), a fraudster relies on collusion with others to make fraudulent payments. But small businesses often don’t employ enough people to allow adequate segregation of duties. Where cost or other practical considerations don’t allow for the implementation of adequate key controls, we employ what are termed “compensating controls”. Rather than preventing an adverse event, compensating controls are employed to detect anomalies, hopefully allowing intervention before loss. An example of a compensating control is management undertaking a final review of all payments before they are processed and cash leaves the bank account. Other compensating controls that small businesses can employ to reduce the risk of incorrect payments and fraud include, but are not limited to: • Management review of transaction reports from the accounting system – a high level review and questioning actual transactions is more likely to uncover an anomaly than reviewing the profit and loss.

• Management review and approval of all credit notes and refunds paid to customers – refunds to customers is a high risk area for many businesses. • A review of system based audit reports – where the functionality exists, these reports show temporary changes to bank account details, suppliers and employees with the

Geoff Campbell Partner I Duesburys Nexia

same bank account numbers, deleted entries and other anomalies that should be followed up. • The use of budgets or other analytic review techniques – comparing actual expenditure to what is expected can put a spotlight on errors and anomalies. • Assigning responsibility for preparing reconciliations to someone other than the process owner – this reduces an opportunity for fraudsters to cover their own tracks. Even if a small business does not want to implement a formal internal audit program, it is advisable to periodically review the risk management framework. This is especially important because as times change and technology improves, the way of doing business changes. The risk is that internal controls remain focussed on treating risks that are no longer relevant and worse still, may not address emerging risks. This was the case with my client who was still focused on the misappropriation of cash takings, which had all but stopped. He had not addressed the fact that he had stopped signing cheques, instead instructing his bookkeepers to use accounting and banking software to pay suppliers. This change, whilst efficient, eliminated a step during which he previously reviewed all payments. A cost effective exercise we undertake with many of our clients is to have them walk us through their accounting processes and procedures. Together we identify areas of risk and discuss ways to treat it. A gap analysis is undertaken and the appropriateness and effectiveness of existing internal controls are evaluated. Once our recommendations are implemented, it makes sense that this is the ideal time to document procedures and procedures, sometimes for the first time and to update the office procedures manual. ■ For more information go to www.nexia.com.au

How Can you Optimise Patient Care to the Elderly?

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INCREASING CHOICES

– BUT NOT SUPPLY The introduction of the Increasing Consumer Choice Bill into Parliament in February provides an interesting study on the impact on demand and supply within the context of a system that ratios service provision.

Bruce Bailey Director RSM Australia National Head of Aged Care

here is no argument the ageing population means there is strong future demand for aged care services and that consumers prefer these services to be delivered in the home.

Consumer Directed Care is intended to address the “limited choice and flexibility for consumers in the current care at home arrangements including a lack of portability.”1 It will achieve this by moving the funding entitlement direct to the consumer. It is reasoned that this will empower consumers and drive productivity in the sector. Whether this occurs, time will tell, however, at this time we can examine what might occur.

there are multiple services providers to choose from those who have been prioritised will have increased choice of provider? It is through this prioritising process the Department will continue to manage supply (and cost). This change will mean the approved provider is no longer a “destination service provider” and instead they will become a “provider of choice”. What the proposals do not change is the available supply of funded home care packages.

What distinguishes “providers of choice” from “destination providers” is the need to position the service in the minds of This article considers how continuing supply management potential customers relative by the Department of Health to their competition. Typically might impact on the goal of providers of choice cast consumer choice and how their marketing net widely to What the proposals do not change is the available providers may respond to the attract all potential customers supply of funded home care packages. regulatory changes. to their offer. Under the proposed From the providers’ legislation from February perspective, notwithstanding that the overall demand for 2017 consumers will be assessed for entitlement to a home services is still tightly regulated and therefore the number care package as is the current position. Presently once of possible customers is limited, they will not be able to assessed the consumer seeks out a provider who has the plan for the quantum of services delivered in a supply relevant package (un-utilised) appropriate to their assessment constrained environment. and then engages this provider to provide the services. Under A key feature of being a provider of choice is the need to this system the approved provider of home care packages is have market position. Developing a market position will a “Destination Service Provider”. undoubtedly result in service differentiation and add costs Under the proposals, once a consumer is assessed as having to service providers. Whether the level of profitability in an entitlement to care they will need to be a “Prioritised the provision of home care services or the anticipated Home Care Recipient” before their care will be government consolidation of providers will generate the scale to cover funded. The consumer will get an ACAT assessment and these costs is yet to be seen. then – under a bureaucratic process – become prioritised to receive government funding for in home care. To the extent

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Modelling by RSM suggests that scale is going to be critical to economic sustainability in the home care sector. The following graph shows the quartile performance of home care providers (EBITDA in 2014) and the table translates this into EBITDA at certain operational sizes.

Projected EBITDA $ Places

Second quartile performance

Avg top & second quartile performance

100

$132,979

$251,347

500

$664,897

$1,256,733

750

$997,345

$1,885,099

Based on this data a provider in the first or second quartile could expect to generate less than $2,500 EBITDA per place or $250,000 from 100 packages fully delivered. Consumer choice and empowerment comes when service providers are also empowered and this occurs in an open market setting. Limiting supply to contain Government outlays is a common and legitimate feature of a publicly funded system. However, the proposed changes to the system both acknowledge and then fail to address the many potential care recipients who will not have access to home care because they have not been prioritised. Perhaps the greatest opportunity for providers once the changes are implemented is to position themselves to provide choice to those consumers who have an assessed need and because they have not been prioritised to receive government funded services have no real consumer choice. ■

References 1. Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016 Explanatory Memorandum

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THE FAMILY HOME

NO LONGER THE SACRED COW

FOR GOVERNMENT

In the Spring edition of LASA Fusion we talked about the fact that 1 January 2016 was going to bring significant changes to the way rent from the former home is treated when calculating someone’s cost of aged care and the potential benefits available to people who moved in prior to the change.

Rachel Lane Principal I Aged Care Gurus

ince then we have seen the impact of the changes – the most interesting of which was a couple where the husband had been living in care for some time and the wife moved into the same facility this year. They decided to keep and rent their home to assist in meeting the cost of care.

Beyond this we are only a hop, skip and a jump away from having some or all of the family home included in the pension assets test. Of course that’s easy to say but hard to do. The difficulty lies in the fact that house prices across the country vary so widely, both from one capital city to another and between cities and regional areas.

Here’s how their home and rent are assessed:

Let’s say the government included the value of the home in the pension assets but increased the asset test thresholds by $500,000.

The husband is paying a DAP and moved into care prior to 1 January 2016 so meets the rent exemption criteria, his half of the rent is not included when calculating the means tested care fee. Paying a DAP will also mean that rent and the asset value of the house remain exempt when calculating pension entitlement. Because his wife is no longer living in the home he has $157,987 of the house asset value included in the calculation of his means tested care fee. The wife has entered care after 1 January 2016 and so her half of the rent is included in the calculation of her means tested care fee together with the capped asset value of $157,987 for the house. As she is also paying a DAP the asset and rent will still be exempt for pension purposes. This is certainly different to the way in which assets and income of a couple have been assessed historically, but it is something we can expect to see more of as the government tighten their belt in an attempt to get the budget back in the black. In fact the next round of changes are scheduled could be less than a year away. The government’s Mid-Year Economic and Fiscal Outlook (MYEFO) included a policy decision to include rent from the former home in the calculation of pension entitlement from 1 January 2017.

In Sydney, Melbourne, Brisbane and Perth where the median house price is above $500,000 pensioners would see a reduction to their entitlement – with the most significant reduction being in Sydney where the median price is currently around $885,000. In Adelaide and Hobart where the median price is below $500,000 some people would be able to exempt the full value of their house and some of the assets outside, potentially receiving more pension than they do now – the greatest benefit would be in Hobart where the median price is $350,000. It is not an easy problem to solve, and like all changes there will inevitably be winners and losers. From an aged care perspective, removing the exemptions that apply to the family home and the rent is likely to encourage residents to pay for their cost of aged care accommodation by RAD. In fact, beds that have a higher price RAD may become the bed of choice as residents try to preserve capital and maintain their pension entitlement. ■

A change to the current policies that enable the RAD to be exempt from the asset test for the pension at the same time as the family home is exempt seems inevitable.

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BUSINESS MANAGEMENT

NEW ARRANGEMENTS

FOR ALLOCATED AND PROVISIONALLY ALLOCATED PLACES The Aged Care Amendment (Red Tape Reduction in Places Management) Act 2016 (the Act) commenced on 11 February 2016, bringing a number of changes to the way allocated and provisionally allocated places are managed and transferred between approved providers. Transfer of allocated places

he Act amends the Aged Care Act 1997 (Cth), giving effect to a new system for transfers: Transfer notice

Approved providers are no longer required to lodge an ‘application for approval to transfer places’. The transferor and the transferee now lodge a ‘transfer notice’ with the Department. Once the notice is lodged the transfer automatically takes effect on the proposed transfer day unless the Secretary of the Department requests further information or vetoes the transfer. Consider the transfer notice While the administrative process is more streamlined, the criteria which the Secretary must be satisfied of for the transfer to proceed remain largely unchanged. For example, the parties must still provide information about how the transfer will meet the objectives of the planning process, the suitability of the transferee and how the needs of any relevant care recipients will be met by the transfer. • Notice to resolve may be issued If the Secretary has any concerns about the proposed transfer or requires further information, a ‘notice to resolve’ may be issued no more than 28 days after receiving the transfer notice. The notice must detail the issues identified by the Secretary and specify which party is expected to respond to each issue. • Notice of veto may be issued If the Secretary is not satisfied that the proposed transfer meets the legislative requirements, the Secretary may issue a veto notice up to 7 days before the proposed transfer date. There is no requirement to issue a notice to resolve before issuing a veto notice. • Timeframe for veto Under the previous system the Department was required to approve or reject an application to transfer places at least 14 days before the proposed transfer date. Under the new system

Julie McStay Director Aged Care and Retirement Living Hynes Legal

the Department can veto the transfer up until just 7 days before the proposed transfer date.

Transfer of provisionally allocated places The new system provides a process for transferring provisionally allocated places which is similar to the transfer of allocated places, including power to veto the transfer or seek further information from the parties.

Changes to provisional allocation period The provisional allocation period has been increased from 2 to 4 years. The circumstances in which the Secretary is able to grant an extension to the provisional allocation period have also changed. The change to the provisional allocation period also applies retrospectively to current provisional allocations. This means that if a current provisional allocation is one year into the allocation period, it is automatically extended and now has 3 years remaining.

What this means for providers New process for transferring places: If you are considering transferring or receiving a transfer of places you will need to use the new ‘transfer notice’ that the Department is set to release shortly. We can assist you with navigating the new process and advise you on any issues that might arise in your sale or purchase transaction. Extension to the provisional allocation period: Providers currently holding a provisional allocation of places may find that the provisional allocation period has automatically been extended, depending on the date the period commenced. This sets out a broad summary of the changes in the new Act for your consideration but is not intended to be a substitute for legal advice. If you would like legal advice about the new Act and its implication for your particular circumstances please contact me on 07 3193 0503 or email Julie.mcstay@hyneslegal.com.au. ■

BUSINESS MANAGEMENT

HOW STAFF ENGAGEMENT SURVEYS

ARE HARMING YOUR CULTURE

In this third article that forms our series on culture management, Sue Jauncey challenges you to think carefully about staff engagement surveys and whether they send the right message.

ave you noticed the change in attitude in job seekers looking to join your organisation over the years? Two decades ago potential new recruits would offer you their talents and services with a long term career in mind. These days people expect to be offered services and benefits to entice them to work for the organisation and always seem to be on the lookout for the next best package available. Why is this? Over the years we have witnessed the emergence of “Entitlement Syndrome”, which is when someone thinks about what they are entitled to before they consider anyone or anything else. Entitlement syndrome has also led to a culture change in many organisations with staff having highly unreasonable expectations about their entitlements. An attitude of entitlement shows up as a lack of gratitude and personal responsibility, which leads to a lack of satisfaction and an overarching propensity to blame others when things are not going the way they would like them to or when someone is not getting their own way. Behaviours demonstrated include common use of the phrases “it’s not my job so I’m not going to do it” or “it’s not my fault, the managers don’t know what they are doing”. When such attitudes become evident in a workplace, addressing them is important. There have been numerous reports written about how to engage staff with the view that if you keep staff happy you will have a productive business.

Engagement vs opinion Almost all organisations have either heard of, or implement, some form of staff engagement survey. The objective of these surveys has been for management to understand the views and opinions of staff so that they can take action as a result of the feedback they receive in order to keep their staff happy, retain staff and provide job satisfaction. The number of staff who participate in these staff engagement surveys and what they say about the organisation and its leaders determines the engagement percentage reported back to Executive and Boards. These results are not correlated with actions taken or measurable outcomes in terms of how staff are engaged in the organisation, it simply relates to survey participation and opinion. The improvement in outcomes derived from high levels of engagement among staff are dependent on the quality

of action planning that the organisation undertakes after the results are provided. If I had a dollar for every time someone tells me that no action is ever taken when they provide feedback to these surveys or I hear a CEO ask where is the value in these surveys because they are not seeing or feeling anything different in their culture, I would be rich! In a report published last year about staff engagement surveys, Deloittes went so far as to say that the once-a-year survey has become “perilously obsolete”, while a report by McKinsey found that a continuous shorter-term process of gaining company views and opinions from staff would be more beneficial than a single annual engagement survey. Even organisations that develop and manage staff engagement surveys are now starting to reshape the model for gaining staff feedback through opinion and views, on a more regular basis with a greater focus on actionable outcomes. But herein lies the challenge. Many leaders don’t realise that staff engagement surveys are one of the very reasons that Entitlement Syndrome and a culture of entitlement exist, and continue to grow. Of even greater concern is the realisation that such surveys contribute to higher claims of bullying and harassment, larger workers compensation claims, increased sick and stress leave, and more litigation. If we look at what is typically covered in an engagement survey and the reasons behind their use, this is what we find:

Measuring engagement Measuring the key drivers of engagement within your organisation allows managers to assess whether employees are engaged or disengaged. While there are no standard drivers of engagement, commonly assessed elements include: • Opportunity for advancement • Opportunity for recognition • Pay and benefits • Position description • Opportunities for training and development • How they find their Leadership team • Are they happy with their work environment

BUSINESS MANAGEMENT

All these questions ask staff if they want more or less of something and encourage people to reflect on what’s in it for them. The questions are aimed at hearing the views and opinions of what staff want that would make them happier, or how the company can best meet their personal needs. In a culture of entitlement it is highly likely there will be more cases of: • Lower individual self-worth, which comes as a result of feeling like your needs are not being met • Higher reports of job dissatisfaction when people’s views on their own entitlements are not being realised by the company • Less personal accountability and higher incidences of blaming others The outcome? Less workplace harmony and productivity. It is essential that leaders understand the harmful impact engagement surveys can have by reinforcing entitlement rather than staff collectively achieving the vision of a company’s desired cultural state.

Alternate options to staff surveys Culture – not staff happiness – should be one of the highest strategic priorities of a board and executive management team. All too often cultures are built by default and not intentionally directed and formed, despite this ultimately being the role of a CEO. To build an intentional culture is a business process, which needs to be implemented and adhered to, a discipline that everyone is held accountable for. A culture that can be scored and measured in the same way we look to understand our organisations financial state. Instead of running staff engagement surveys, implementing a philosophy of collective achievement can return far greater results. Collective Achievement is defined as “shared or group intelligence/actions that emerges from the collective efforts from top to bottom” or, in the words of Lao Tzu, “when the best leader’s work is done the people say we did it ourselves.” Focusing staff on Collective Achievement rather than on themselves and what makes them happy, involves leaders: • Emphasising the vision and business objectives • Clearly and concisely outlining what is expected of staff • Focusing on a set of signature behaviours that all staff members from top to bottom must demonstrate • Linking these behaviours business objectives that staff have to work collectively together to achieve • Assessing the culture and quantifying individual actions so people understand the impact they having culturally on the organisation.

Image courtesy of zimmytws/Shutterstock.com

Research has found that when the focus is taken off self and what individuals think they need and is replaced with working together to achieve a shared outcome, the achievement of shared outcomes results in shared stories, feeling of belongingness, and greater job satisfaction and positive experiences. In addition, collective achievement has been proven to lead to the following positive outcomes: • Movement and momentum across an organisation when everyone is focused on key signature behaviours that are linked to the company vision and its strategic objectives • Business results accelerate and improve beyond expectations when you harness your human capability talents • It enables the organisation to celebrate together • It removes division between leaders and staff • Boards and the Executive can effectively govern and apply oversight to the organisations cultural state • Leaders can measure what people are doing, not what they are thinking. Collective Achievement provides a clear purpose for all staff, non-hierarchical to focus as one team together. Intentionally designing a culture based on Collective Achievement removes a culture of entitlement at the same time as increasing individual self-worth when staff are no longer focused on entitlements. Leaders need to understand the ramifications of engagement surveys and the harmful effects they can have on behaviour by reinforcing entitlement syndrome. ■ For more information contact Sue Jauncey, Registered Psychologist and Founder & Director of Pulse Australasia on 02 9229 6700 or 0402 435 304 or email sjauncey@pulseaustralasia.com

Collective Achievement Working collectively together to achieve a shared goal results in higher self worth for each individual staff member.

HEALTH & WELLBEING

NEW EVIDENCE-BASED GUIDELINES

FOR DEMENTIA CARE

New clinical guidelines for people with dementia emphasise the importance of training for aged care staff and discourage doctors to prescribe antipsychotic medications to people with mild-to-moderate behavioural and psychological symptoms of dementia.

he guidelines, developed by the Cognitive Decline Partnership Centre and launched in February, are the first evidence-based guidelines for dementia care. They have been written primarily for health and aged care staff (doctors, nurses, allied health and care workers) who work with people with dementia in community, residential and hospital settings.

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The detailed document addresses a number of key points within the recommendations: • T he symptoms of dementia should be investigated the first time they are reported and not dismissed as a ‘normal part of ageing’. • H ealth and aged care professionals should talk to the person with dementia and their carer(s) and family about the symptoms of dementia, treatments and services.

HEALTH & WELLBEING

Written information (such as brochures) should also be provided. • Steps should be taken to prevent, recognise and manage common behavioural and psychological symptoms of dementia such as depression and agitation. In most cases, training the carer(s) and family to provide care, forming specific strategies to address behaviours that are most upsetting,making small changes to the living environment and finding interesting and enjoyable activities for the person to do should be tried first. Medication to manage these symptoms should usually only be offered after these other strategies have been given an adequate trial. Due to the increased risk of serious adverse events, should not usually be. • Doctors, nurses, allied health and care workers should receive training in dementia care. They should be trained in how to communicate clearly with the person with dementia, their carer(s) and family and to provide personcentred care.

Additional resources for people with dementia Alzheimer’s Australia and NPS MedicineWise have developed new

• The person with dementia should be encouraged to exercise, eat well, keep doing as much for themselves as possible and stay socially connected in their local community. Staff and carer(s) should be taught how to encourage independence. • Medical practitioners should consider medication (acetylcholinesterase inhibitors or memantine) to assist in the management of the cognitive symptoms of dementia. • Carer(s) and family should be supported to care for the person with dementia. They should be offered education and training to enable them to develop skills in managing the symptoms of dementia and be offered respite when needed. Carer(s) and family should be given information about coping strategies to maintain their own wellbeing and be supported to maintain their overall health and fitness. ■ For more information go to www.sydney.edu.au/medicine/cdpc

and document their choices and

caused by unmet needs that might be

ultimately improve the quality of life

due to their health, the environment,

of the 353,800 people currently living

or difficulty verbalising pain, and

with dementia in Australia,” she said.

there are a number of medicine and

resources to support people living

NPS MedicineWise CEO Dr Lynn

with dementia and those involved

Weekes says that it can be difficult

in their care better understand their

to find reliable, evidence-based

treatment options.

information to help people make

Focusing specifically on medicines and dementia, the consumer awareness campaign will support

decisions when it comes to medicines or other treatments for symptoms associated with dementia.

non-medicine therapies available to manage these associated expressions of distress,” she said. The new resources include: • A downloadable, printable information booklet covering issues around consent, appropriate use

people with dementia and their carers

“People with dementia can be at

of medicines, and non-medicine

to make decisions with their health

particular risk of problems with

therapies including psychosocial

care providers and to communicate

medicines for a number of different

approaches to expressions

their wishes while they are able to.

reasons,” says Dr Weekes.

of distress

Alzheimer’s Australia National CEO

“They may take multiple medicines

Carol Bennett said the issues around

due to other health conditions,

medicines and dementia is something

increasing the risk of medicine-

consumers have identified as a priority

related side effects, or they may

area for improved quality of life.

experience problems with memory

“We know that people with dementia have identified the need for more information on medicines. The new resources will help people make decisions about a care plan, gain a

and communication, making it difficult to remember what their doctor or pharmacist told them about their medicines, what the medicines are for, or when to take them.

better understanding of their rights

“As dementia progresses, changes

around consent and how to discuss

in a person’s behaviour are often

• Downloadable, printable fact sheets on strategies to address distress, other conditions that commonly occur alongside dementia, and tips for good medicine management • Consumer stories told via video and sharable on social media • Information for health professionals To download the resources go to www.nps.org.au/dementia

EVENTS

LASA TRISTATE

CONFERENCE 2015 The 25th Tri-State Conference and Exhibition was held in Albury last month, with a theme ‘Your vision, your future’. The annual event is organised by LASA Victoria, LASA South Australia and LASA NSW-ACT. Minister for Aged Care, Sussan Ley, who resides in the NSW/Victoria border town, opened the event and acknowledged LASA’s contribution to the progress of our aged care system.

EVENTS

LESSONS FROM THE USA IN QUALITY INNOVATION

The recent SAGE Tour to Boston and the USA in November 2015 was curated with a special focus on quality and leadership systems in aged care and retirement facilities, with these countries chosen for their advanced approach to research and quality in aged care.

ver the 15-day program delegates were taken to a number of establishments offering retirement living, supported living and skilled nursing care, as well as state of the art research centres.

Canada’s Schlegel Centre of Excellence for Innovation in Aging was a highlight, and showed just how integrated research is in their approach to aged care. The multi-site centre for living, care, learning and innovation is designed to enhance care and living for older adults through co-location of research, training and practice. Seniors, students, educators, and researchers work alongside each other, as the centre houses both 192 long-term care residents and the Schlegel-UW Research Institute for Aging (RIA). The residential components of this project incorporate the signature architectural and design features that Schlegel Villages are known for, as well as programming and staffing models that support resident engagement, active living and quality of life. Programming features overlay the physical design to create environments where older adults thrive, while the research institute incubates new ideas through applied research, accelerates their development across the 15 Schlegel Villages, and mobilises change for everyone through practice development, training, and knowledge mobilisation. For Sam and Kay Samuel, the joint CEOs and owners of Grace Villa in Melbourne, seeing what technology other centres are using gives inspiration for what they can adapt in their 91-bed centre. “Over the course of these tours we have seen many things that were useful to adopt for our facility. We look for new technology that will change service delivery and save money, and that we can implement without too much difficulty,” Mr Samuel said. “Our new facility, which is in construction, will have the infrastructure in place to enable the use of wearable technology, and for people to communicate with family and friends around the world through interactive technology.” “Wearable technology is still in its infancy, however, once we find a product that we feel is relative for resident care then

we will adopt it. The basic infrastructure is in place for future implementation.” For Graham Dangerfield, CEO of BAPTCare, this SAGE tour was about discovering how others have developed quality control systems that translate into better quality of care for residents, and breaking down barriers. “One thing that struck me is that in Australia we are at the beginning of the journey to develop quality control to measure residents care, to develop further integrated care and to break down barriers between the health sector and aged care,” he said. “In the US, aged care providers operate with a diverse range of medically trained and untrained staff, working far more closely together than we do. They have a lot more sharing of roles and at higher levels of responsibility. They have successfully broken down barriers between health care and aged care in both countries. I would love to see reforms in that area implemented here.” Of particular note for Mr Dangerfield was the way in which the health sector contracts with the aged care sector to deliver outcomes and recognising skills in residential aged care staff. He was also impressed by the different models of care, particularly when it came to wellbeing, with gyms, swimming pools and other facilities. “They were not just static assets. Their effective use by residents was fully incorporated into care, and into the service offering. It was programmed into their lives, and with shared goals everyone was supported in their individual journeys. There were some places I saw that were so full of life and vitality even though residents were much older.” “Now I am back here in Australia I can see clearly that visual benchmarking is working well over there, better than it is here. I’ll be cherry picking from what I saw and institute the best to lift client outcomes in our organisation,” he said. Tour participant, Helen Jones is the General Manager of Strategy and Service at Australian Unity, and intends on implementing of the systems she discovered in use by

EVENTS

St Elizabeth in Toronto, Canada to measure the quality of service it provides. “I wanted to see how different organisations approached quality and quality measurement, as well as consistency and performance, in particular how multi-site organisations assess their level of service to customers, what software programs they use to inform themselves on the quantity, quality and calibre of service, and whether or not that measures up to expectations,” she said. “I have already seen how some of these businesses were operating in this sphere and wanted to see how their systems had matured and changed.” Having found what she was looking for, Ms Jones now hopes to send staff to St Elizabeth Canada to learn the system from those already working with it. “This is critical to us at Australian Unity because we want to know that everybody who chooses to either live or work with us receives the stated level of service that we say we provide. So you need an assessment tool that is robust, accurate and comprehensive to be able to measure those levels of service,” she said. ■

Image courtesy of Galiptynutz/Shutterstock.com

2016 LASA Q STATE CONFERENCE

NAVIGATING THE AGE SERVICES WATERS

13-15 April

Jupiters, Gold Coast

+61 7 3725 5555

events@qld.lasa.asn.au 81

TECHNOLOGY |

COMPUTER SOFTWARE

YOUR INDUSTRY’S REGISTERED TRAINING ORGANISATION LASA Victoria’s nationally recognised RTO has become a leading provider of accredited qualifications and workshops for the aged and community care sector. We offer accredited qualifications and short courses, workshops, CDC and SRS training.

Are you ready to take the next steps in your career? Our nationally accredited RTO will help develop your skills and qualifications, whether you’re seeking leadership and management positions, office administration roles, or want to become a more effective frontline staff member. We are a leading provider of accredited qualifications, workshops, short courses and training in Consumer Directed Care and Supported Residential Services, and Occupational Health & Safety. Our courses can be delivered as work-based training, face-to-face workshops, fully supported online learning, or in rural and regional areas via our simulation van.

LASA VICTORIA & TASMANIA

STATE CONGRESS

2016 Valued at over

$1,200

We can help employers to plan and take advantage of Commonwealth or State funding to access Aged Care qualifications.

BOOK NOW FOR OUR 2016 COURSES www.lasavictoria.asn.au/education-training E: training@lasavictoria.asn.au T: 03 9805 9412 RTO code 21826

Melbourne Park Function Centre Thursday 23 – Friday 24 June 2016

www.lasavictoria.asn.au/upcoming-events

The LASA Aged Care Health and Safety Manual is the first comprehensive set of peer reviewed template policies and procedures for residential and home care providers. Templates that can be tailored to your individual needs. Including: - policies - procedures - safe work practices - tools - checklists

“This manual is easy to use, practical & helpful” Purchase the LASA Victoria Aged Care Health and Safety Manual for $1,200 FREE TO MEMBERS 82

- residential and home care providers - 188 templates - can be tailored to your workplace - word and pdf (digital only)

This manual has been developed by the LASA Victoria OHS Committee and a working group of contributing members. The Manual content is applicable to all Australian aged care employers irrespective of operational size, approach or jurisdiction. The LASA Aged Care Health & Safety Manual is the industry’s first comprehensive Health and Safety Manual. Available in digital and hard copy. Please email membership@lasavictoria.asn.au or phone (03) 9805 9418 for further information.

EVENTS

LASA EVENTS 2016 APR

MAY

LASA Q State Conference 13-15 April 2016 – Gold Coast, QLD Osteopathic Healthcare Week 17-25 April 2016

Thyroid Awareness Month

World Asthma Day – 3 May 2016 Food Allergy week – 15-21 May 2016 Kidney Health Week – 22 May 2016 Macular degeneration week – 22-28 May 2016 National Palliative Care Week – 22-28 May 2016

LASA NSW-ACT State Congress 26-27 May 2016 – Pyrmont, NSW

JUN

Bowel cancer awareness month LASA Q National Service Integrated Housing Conference 1-3 June 2016 – Surfers Paradise, QLD World Continence Week 20-25 June 2016

LASA Victoria State Congress 23-24 June 2016 – Melbourne, VIC

SEP

JUL

Sleep Awareness Week 4-10 July 2016

National Diabetes Week 10-16 July 2016

AUG

Dental Health Week 1-8 August 2016

Be Medicinewise Week 22-28 August 2016

National Pain Week 25-31 July 2016

OCT

LASA National Congress 9-12 October 2016

Dementia Awareness Month

World Mental Health Day 10 October 2016

R U OK Day 8 September 2016

World Osteoporosis Day 20 October 2016

NOV

World Diabetes Day 14 November 2016

National Skin Cancer Action Week 20-26 November 2016

WHAT’S NEW

WHAT’S NEW Australian and New Zealand Association for Health Professional Educators

Free to attend Seminar 5 Steps to Chemical-Free Cleaning in Aged Care

The Australian and New Zealand Association for Health Professional Educators (ANZAHPE) is delighted to announce a collaboration with Australian Medicines Handbook Pty Ltd in supporting two important prizes for junior members of the association. These prizes are awarded to the pre-registration and postgraduate students who submit the most outstanding student projects related to professional or clinical education, as judged by an expert panel. Winning students are invited to present their projects at the association’s Annual Conference. Australian Medicines Handbook’s (AMH) generosity will see the recipients receive support for travel, accommodation and registration at the conference, as well as a cash award. This year the conference will be held in Perth from March 19-23, in conjunction with the international Ottawa Conference on Assessment in Medicine and the Health Care Professions.

Director of Duplex, an aged care cleaning solutions company, Murray McDonald, is travelling throughout Australia in 2016 presenting his workshop, 5 Steps to Chemical-Free Cleaning Aged Care. This training is free to attend for aged facilities and their staff. Early bookings receive a free copy of Murray McDonald’s book, 5 Steps to Chemical-Free Cleaning in Healthcare (valued at $19.95).

prizes for junior members of the assoc

Murray McDonald will be presenting on the “Duplex 5 Steps method” which is based on the following: 1. Identification: Pre-planning and cleaning product gaps 2. Assessment: Auditing and looking at your current cleaning processes 3. Planning: Developing goals, managing objections and formulating a cleaning program 4. Implementation: Practical touch point cleaning, training and consistent workflow 5. Evaluation: Auditing against benchmarks Early bookings are encouraged as there are limited spots available depending on your state. HOW TO REGISTER To register your interest, email info@duplexcleaning.com.au or call 1800 622 770 and be notified as to when Murray will be presenting in your local area.

ANZAHPE is the premier association of Health Professional Educators across Australia and New Zealand, and has a membership involved with education of many different health professions, including nursing, physiotherapy, occupational therapy, social work, paramedicine and medicine. It recognises the importance of safe prescription and use of medicines, and the nature of the relationships health PR care professionals should have with the pharmaceutical industry. 2 ANZAHPE sees Australian Medicines Handbook products as playing a critical role in assisting the next generation of health care The Australian and New Zealand Associat professionals with their education in these important matters.a collaboration with Austra to announce

Australian Medicines Handbook Pty Ltd was established in 1995 postgraduate students who submit the to develop a national formulary similar to the British National clinical education, as judged by an expert at the association’s Formulary. It was to be totally Australian and its content was to Annual Conference. recipients receive support for trave reflect contemporary Australian clinical practice. Inthejust over twenty as a cash award. This year the conference years its key product, the AMH, has become a leading evidenceinternational Ottawa Conference on Asse based, independent medicines reference preferred by thousands of ANZAHPE is the premier association of H Australian health professionals. and has a membership involved with edu

Australian Medicines Handbook Pty Ltd publishesphysiotherapy, books andoccupational therapy, social of safe prescription and use of medicine electronic reference resources aimed at improvingshould the quality use have with the pharmaceutical indu of medicines. Our editors are highly-qualified health professionals as playing a critical role in assisting the ne these important matters. and our content is extensively peer reviewed. Our inEditorial Advisory Committee and reviewers are drawn from Australia’s leading Australian Medicines Handbook Pty Ltd w the British educational and medical institutions. Our independence isNational critical,Formulary. It was to b Australian clinical practice. In just over t and as such, we accept no advertising, sponsorship or other forms evidence-based, independent medicines re of support from the pharmaceutical industry. Australian Medicines Handbook Pty Ltd

Both Australian Medicines Handbook and ANZAHPE are excited improving the quality use of medicines. content extensively about this new collaboration, and are ambitious that it is isjust the peer reviewed. Ou Australia’s leading educational and medica beginning of an enduring, fruitful relationship.

no advertising, sponsorship or other form

For further information please contact Daniel Edwards Both Australian Medicines Handbook and on 08 8229 9052 or email dan@edwardsad.com.au ambitious that it is just the beginning of an

For more information on Duplex steam cleaning equipment and aged care cleaning solutions, visit www.duplexcleaning.com.au/infectioncontrol

For further information on this press rele

PRESS RELEASE PRESS RELEASE 23rd Feb 2016 23rd Feb 2016

Daniel Edwards Managing Director - Edwards Advertising

827 South Road Clarence Gardens SA 50 000

The Australian and TheNew Australian Zealand andAssociation New Zealand for Association Health Professional for Health Educators Professional (ANZAHPE) Educatorsis(ANZAHPE) delighted is delighted p 08 8229 9052 m 0407 077 to announce a to collaboration announce awith collaboration Australian with Medicines Australian Handbook Medicines Pty Ltd Handbook in supporting Pty Ltdtwo in supporting important two important prizes for junior prizes members for junior of the members association. of the These association. prizes are These awarded prizestoare theawarded pre-registration to the pre-registration and and e dan@edwardsad.com.au postgraduate students postgraduate who submit studentsthewho most submit outstanding the most student outstanding projects student relatedprojects to professional related to orprofessional or clinical education, clinical as judged education, by anasexpert judgedpanel. by anWinning expert panel. students Winning are invited students to present are invited theirtoprojects present their projects at the association’s at the Annual association’s Conference. AnnualAustralian Conference. Medicines Australian Handbook’s Medicines (AMH) Handbook’s generosity (AMH) will generosity see will see the recipients receive the recipients supportreceive for travel, support accommodation for travel, accommodation and registrationand at registration the conference, at the as conference, well as well as a cash award.asThis a cash yearaward. the conference This year the will conference be held in Perth will be from heldMarch in Perth 19-23, fromin March conjunction 19-23,with in conjunction the with the international Ottawa international Conference Ottawa on Assessment Conference on in Medicine Assessment andinthe Medicine Health and Carethe Professions. Health Care Professions.

WHAT’S NEW

Astris Lifecare On 1st February 2016, Able Rehabilitation Equipment, Acute Healthcare and Ascot Healthcare merged into one new dynamic entity and become Astris Lifecare. This was an exciting merger of three professional, innovative and long established companies which have been in business for a total of over 50 years under their current management. Able Rehabilitation Equipment (established 1981) was a leader in the supply of mobility, home healthcare, bathroom safety and daily living aids. Acute Healthcare (established 2005) was a specialist in pressure care solutions and adjustable beds for aged care and homecare markets. Ascot Healthcare (established 2006) offered an extensive range of quality ward equipment and clinical furniture for hospitals, aged care facilities and medical clinics. This partnership further strengthens our position in the aged care, hospital, community and home healthcare markets creating a greater ability to serve you and your needs. Our extensive and innovative product range is developed and sourced locally globally and include specialised hospital, procedure, aged care and home care beds, pressure management and pain relief products, facility service equipment, medical equipment and carts, monitoring and diagnostic products, patient care equipment, patient handling solutions, bathroom safety and mobility products, healthcare furniture and orthopaedic seating, hygiene products and much more. Astris

Mary Whelan Aged care organisations face increasing challenges in light of higher expectations from stakeholders. With constant changes to regulations, the planning of a facility literally moves on a daily basis. Technological changes have had a major impact on meal, cleaning and linen services affecting delivery, administration and a strong emphasis on ensuring they meet the clients’ requirements. As well as personal and medical needs there are the practical needs to be met, i.e.; cooking, cleaning and laundry. Now is the time to question the way your current work practices are operating – ask these questions: • Does your Facility provide the level of resident or customer service that you aspire to? • Is the model you have chosen based on the optimum services that will meet the Clients needs?

Lifecare’s large stock holding ensures equipment is delivered in a prompt and efficient manner. Astris Lifecare is certified to global quality standards ISO 9001:2015, demonstrating our commitment to quality management, superior service, customer satisfaction and support. Our experienced product specialists, trained consultants and friendly customer care team provide exceptional advice, training and solutions to meet all your equipment requirements. We operate externally through seven business unit channels which allow our team to offer our clients premium service specific to the unique needs of the individual healthcare sectors: 1. Aged Care 2. Hospital Care 3. Community Care 4. Configured Care 5. Clinical Education 6. Hire Care 7. Service We look forward to meeting your needs soon!

• Does this model allow for staff to provide the services in the manner you are seeking? • Have you provided staff with the necessary tools to undertake this service? • Has the model being costed to ensure you are providing efficiencies as well as the customer and staff satisfaction? • Have your structures been aligned with your budgetary process to ensure what is sought is able to be met. Are you building a new facility or upgrading the current facility? • It is valuable to seek advice on the kitchen plan and laundry work flows, storage and include allowance for any predicted future increase in numbers or the changing clinical mix of residents – at the design stage • It is important to ensure that the Brief covers all current and future aspects of the Organisation.

For more information and a ‘health check’ assessment of your Facility, contact MAJ via: info@majconsulting.com.au Mary Whelan – 0408 039 964 John Patison – 0419 592 861

WHAT’S NEW

Sym. Studio

INVISA-BEAM Free-Standing Bed Monitor

Alzheimer’s Australia recently released their ‘dementia guide for the retirement village industry. The principles of dementia sensitive design can be applied to both new builds and existing village upgrades.

Access & aesthetics are key considerations, with residents valuing landscape above all other village amenities including the community centre rated second. (Anecdotal evidence from Uniting) Combining stakeholder engagement with dementia sensitive design is a simple and effective way to transform a village into a comfortable and desirable place to be. The most common responses during community consultation with retirement residents for what they enjoy most about the outdoors include: • Access to fresh air and sunlight • Opportunities to tender the garden • Opportunities to observe, watch & read • Amenity programming for interaction & exercise Each site has unique factors and requirements – using a registered landscape architect and retirement specialist can significantly improve user experience and village maintenance. sym. studio are passionate about health & well-being; specialising in residential aged care facilities and retirement living.

The INVISA-BEAM free-standing monitor is becoming much in demand as it is portable and adjustable in height. The recommended height for the monitor is approximately 15cm above the mattress and 15cm outside the bed perimeter. This is the optimum position to capture the first movement of exit by the resident/patient at risk of a fall. The height is easy to adjust with a simple locking nut. The stand can be neatly folded away when not in use. The free-standing model is suitable for use in nursing homes and homecare. INVISA-BEAM has a network of distributors throughout Australia and New Zealand; also UK and Ireland.

ARC Group

Features

At ARC Group we’re all about making career development easy. We are changing the way people are gaining qualifications by offering a combination of classroom based training and hands-on work experience. Australia’s ageing population will need 400,000 new aged care workers by 2050, the industry is facing exponential growth and we are aiming to help supply that demand.

• TGA listed Medical Device ARTG 173590 • Conforms to Standards – IEC 60601.1 AS/NZS 3200.1 • Free-standing and portable • INVISA-BEAM products give instant detection and continuous monitoring

Quality training doesn’t come at a cost – we’re delivering Government funded courses throughout Queensland and Sydney. These courses are designed for people looking for a rewarding career and wanting to make a real difference in the community services sector.

Professional trainers ensure the participants are equipped with the knowledge and skills to enter the industry with confidence upon completion of the qualification. Compulsory work experience and infacility training also helps prepare them for their career development.

For more information, visit arcgroup.com.au or call 1300 793 146.

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INVISA-BEAM International Pty Ltd is an Australian company. INVISA-BEAM products are manufactured in Sydney, NSW, Australia. Distributors are in all Australian states, territories and New Zealand; also UK and Ireland

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By harnessing the advanced formula intensity of Accelerated Hydrogen Peroxide (AHP), Oxivir® Tb aggressively attacks microbes whilst being safe and gentle on people and surfaces:

Simplify your cleaning and disinfection process with the one product to do the job!

• Virucidal in just 1 minute • Kills viruses, bacteria, Tb, Fungi in one step • Effective against 27 microbes including MRSA, VRE, Norovirus Pseudomonas, Klebsiella, HIV • Fast acting, realistic contact time increases the likelihood of proper use and compliance

1 wipe, 1 minute Oxivir® Tb kills microbes FAST!

For further information on Oxivir® Tb please contact Sealed Air Diversey Care: AU: 1800 647 779 NZ: 0800 803 615

COMPUTER SOFTWARE

| TECHNOLOGY

The Complete Management Solution for Aged Care. Now Managing your Consumer Directed Care (CDC) Programs. CDC ACCOUNT INCOME

• Estimate and Reconcile Government Subsidy Income

FUTURE

• Calculate accurate Home Care contributions and IT fees

• Est 1984 • Aged Care Speciﬁc • Mature yet ﬂexible

CDC ACCOUNT EXPENSES • Schedule and record service delivery • Allocate 3rd party purchases to CDC accounts • Automatically calculate admin fees & other charges

CLIENTS • Billing & Subsidies • Medicare Claiming • LLLB & CDC

REPORT WITH CONFIDENCE • Include all income & expense items on the client CDC statement • Automatic generation of CDC liability GL journals • Monitor performance of CDC programs & track unused client CDC budget

FINANCIALS • General Ledger • AP / Purchasing • Assets / Tax

HUMAN RESOURCES • Rostering • Payroll • Time & Attendance

Flexible Integrated Compliant

Sydney Melbourne Brisbane Cairns Perth

Call 1800 777 549

solutions@caresystems.com.au www.caresystems.com.au

Making the right choice for the environment is easy with Jasol.

Jasol’s EC range of cleaning and sanitising products makes it easy to be environmentally responsible. They’re made almost entirely from renewable plant resources rather than oil-based ingredients. They’re non-caustic, readily biodegradable and are certified by GECA (Good Environmental Choice Australia). This sustainable, comprehensive range is the smart environmental choice for all your cleaning needs.

For more information on the complete range call 1800 334 679 or visit jasol.com.au/environmentalchoice

JSL-2014a CPv2.2-2012 Cleaning Products

environmental choice product range