LASA Fusion by Adbourne Publishing

The voice of all aged services Spring 2012 | www.lasa.asn.au

Aged Care Workforce – ATTRACTING YOUNGER STAFF – GROWING YOUR WORKFORCE

TEAM LASA 2012 AND ON

ACFI CHANGES INDUSTRY RESPONSES

ACIITC WILL I.T CHANGE OUR WORLD?

COMMUNITY CARE CHALLENGES

INTERESTING TIMES AHEAD

The voice of all aged services Spring 2012 | www.lasa.asn.au

70 NATIONAL UPDATE

TECHNOLOGY

GENERAL

3 6 9 10 11 12 14

29 The Rising Tide of eHealth 30 ACIITC Report 40 ACIVA Report 43 Aged Care IT Path Finders

61 Community care challenges 63 Media and crisis management 65 Retirement Villages 68 Changing corporate structure 69 Better Practice Awards 2012 71 Medication is there another answer? 72 Will China grow old 74 Life Care Award – young people with onset dementia 76 If the shoe fits – falls prevention 77 Calendar of Events

CEO Report SA Report NSW Report VIC Report QLD Report WA Report Inaugural LASA Congress

PROFILES 17 Team LASA

ACFI 20 QPS 23 Overview of the ACFI Changes 24 Estimated impact 26 Thought Leadership EDITOR PRODUCTION

Gerard Mansour Jane Murray

LASA Federal Gerard Mansour CEO, Unit 4, 21 Torrens Street Braddon ACT 2612 Tel: (02) 6230 1676 Fax: (02) 6230 7085 Mobile: 0417 518 103 E: gerardm@lasa.asn.au LASA New South Wales/ACT Charles Wurf CEO PO Box 7 Strawberry Hills NSW 2012 Tel: (02) 9212 6922 Fax: (02) 9212 3488 Mobile: 0419 231 056 E: Charles.wurf@nswact.lasa.asn.au

WORKFORCE 49 Presidential Card 50 The secrets of success in attracting young staff 53 CSIHCS – Growing your own workforce

SPONSORS 57 Incorrect energy bills cost thousands LASA Victoria Peter Begg CEO Level 7, 71 Queens Road Melbourne VIC 3004 Tel: (03) 9805-9400 Fax: (03) 9805 9455 Mobile: 0417 562 579 E: peterb@vic.lasa.asn.au

LASA WA Anne Marie Archer CEO Suite 6, 11 Richardson Street, SOUTH PERTH WA 6151 Tel: (08) 9474 9200 Fax: (08) 9474 9300 Mobile: 0437 488 364 E: amarcher@wa.lasa.asn.au

LASA SA Paul Carberry CEO Unit 5, 259 Glen Osmond Road Frewville SA 5063 Tel: (08) 8338 6500 Fax: (08) 8338 6511 Mobile: 0403 809 713 E: ceo@sa.lasa.asn.au

LASA QLD Nick Ryan CEO PO Box 995 Indooroopilly QLD 4068 Tel: (07) 3725 5555 Fax: (07) 3715-8166 Mobile: 0418 881 538 Email: nick.ryan@qld.lasa.asn.au

Adbourne PUBLISHING

Adbourne Publishing PO Box 735 Belgrave, VIC 3160

ADVERTISING Melbourne: Neil Muir (03) 9758 1433 Adelaide: Robert Spowart 0488 390 039 PRODUCTION Sonya Murphy (03) 9758 1436 ADMINISTRATION Robyn Fantin (03) 9758 1431

DISCLAIMER Fusion is the regular publication of Leading Age Services Australia. Unsolicited contributions are welcome but LASA reserves the right to edit, abridge, alter or reject any material. Opinions expressed in Fusion 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 distribution among an organisation’s staff. No part of Fusion may be reproduced in any form without written permission from the article’s author.

National Update | 3

CEO REPORT The long and winding road …

Gerard Mansour Chief Executive Officer | Leading Age Services Australia

Leading Age Services Australia – it’s just the beginning It is evident there has never been a more important time for our new national industry association to actively represent our members’ interests. Leading Age Services Australia (LASA) is destined to re-shape the nature and structure of industry association representation for our aged and community care industry. Why you may ask? Leading Age Services Australia is the only national peak body committed to speak for all age care service providers - all age services speaking as one.

I am delighted to be the inaugural national CEO of the largest national industry association for aged and community care, and the privilege of speaking on behalf of aged care providers who are dedicated to serve to those in our care. The membership of Leading Age Services Australia is broad and representative. We have approximately equal numbers of members from not for-profit and private organizations, providing the full spectrum of services. This spans large multi-state providers, church and charitable and community organisations, to private businesses both small and large, bush nursing, and rural and remote providers as well as those who care for those with special needs including as indigenous Australians, the homeless, those from a CALD background or GLBTI.

LASA is ideally placed to actively represent our members in the myriad of policy and funding opportunities and challenges that lie ahead. As we move into a decade of reform the collective voice of aged care providers has never been more important. There can be no doubt whatsoever that what unites us as an industry LASA’s role is clear, a unified voice and is far more compelling than inclusive approach to maximize effectiveness our points of difference. and success in advocating the needs of the Aged care providers are whole industry to government. genuinely united in their commitment to meet the needs of older Australians we support. Age Care Reform

‘‘ ’’

After the honour of representing the Victorian industry for six years, it is clear to me that each and every organisation has their own particular approach to serving the older people in their care, be that in residential care, in-home care or various housing options. Diversity is essential – these differences ensure our industry provides a rich tapestry of services, approaches and options for the Australian community. However, in the end, we know there is a national aged and community care system, one national policy framework and common regulatory and compliance obligations. LASA’s role is clear, a unified voice and inclusive approach to maximize effectiveness and success in advocating the needs of the whole industry to government. We must take the time as an industry to actively contribute to policy solutions. LASA is uniquely placed to test and refine policy and funding decisions to ensure they work appropriately in all settings and for all older Australians in our care. Nothing less is acceptable.

What does this mean for Government and others? Talk to, or interact with, Leading Age Services Australia and you are interacting with the depth and breadth and the height of our industry.

From the outset, Leading Age Services Australia has been committed to a longer term period of aged care reform. The building blocks of our current system were indeed designed in the 1990s - if not earlier. And yet in the next 20 years our industry will double in size as the result of our ageing population. One of the most stark figures that point to the challenges ahead came in the Productivity Commission’s final aged care report, when considering the workforce implications. Some forty years ago for every person in retirement there were about 7 workers, today for every person in retirement we have about 5 workers and by 2050 this will have declined to about 2.7 workers for every person in retirement. Thus key elements in the recent reform such as a shift towards greater consumer contributions from those who can afford to pay are strongly supported and essential in order for our aged and community care industry to be viable and flourish.

National Update | 5

The release of the long awaited Government response to the Productivity Commission report into aged care, provides both important opportunities and challenges.

What are some short term priorities?

Since the announcement of the Aged Care reform package it is clear that we have commenced a journey that I can best describe at this point as a long and winding road. As we embrace the reform process I assure you LASA is genuinely committed to build an industry capable of meeting future demands.

•

Funding that better matches the needs of older Australians in aged care homes and in their own homes

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Additional Government Funding provided for LLLB aged care reform package to avert the need for redirecting money away from residential aged care

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Annual funding adjustments to meet increasing costs

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Government to work with Leading Age Services Australia to address the sequencing of the LLLB aged care reform package initiatives, this includes bringing forward elements such as the ability to provide additional hotel and lifestyle services

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Key LLLB aged care reform package initiatives in areas such as in home care, dementia care, a new Gateway, a new system of providing quality information to consumers and a key focus on all special needs groups such as rural and remote, indigenous, the homeless, those from a CALD background, mental health, disability and LGTBI.

The initial national member survey, undertaken by LASA Australia, has in many ways set the policy agenda focus over recent months. The Survey gave hundreds of members from across Australia the opportunity to provide early feedback on key industry issues. While there was support for various elements of the aged care reform package, there were two most decisive findings which captured the views of our members. The first was in relation to the uncertainty which surrounded the capital raising issues, and the second was the level of concern about changes to ACFI. From 1 July 2012 we have seen reduced revenue for certain resident ‘profiles’ and a loss of an annual funding increase for providers despite ever rising costs. Leading Age Services Australia has called for the ACFI policy changes to be addressed in next years budget – that is, reinstate the annual funding increase and go back to the core principle – funding matches care needs rather than be limited by budget constraints.

While there are many key longer term policy issues, some of the more immediate priorities include:

As I said at the outset, we have just started on the journey over the long and winding road called aged care reform… ■

These changes to ACFI will now be overseen by the Minister’s ACFI Monitoring Group. Importantly, one of the two new independent bodies created by the Government, the Aged Care Financing Authority (ACFA) has a critical role to play in providing independent and transparent advice to government on key funding issues including the relativity between lump sum and accommodation periodic payments. The creation of ACFA was welcomed by LASA. This is an important policy decision as it ensures government will receive independent and transparent advice on key industry financing issues. LASA will continue to be at the forefront of representing member interests through this key period of aged care reform.

Consumer Directed Care While it has been necessary that key issues such as ACFI and accommodation payments have dominated the early focus of the LLLB package, there are a number of other key areas of aged care reform which will gain increasing prominence in coming months. One of these is the strong move towards consumer direction within the community care setting and later to also be considered within residential aged care. The consumer directed care pilots, reviewed by KPMG, provided critical insights into key policy and practical implementation issues which need to be addressed as part of a move to re-shape the current model of home care in a decisive shift towards consumer direction. All of the new home care packages to be rolled out as part of the 2012 ACAR will be based on the consumer directed care model and include two new package levels, one below the existing CACP and a new package between CACP and EACH.

· Virtual Design Information Centre · Dementia Design Workshops · Library Resources · Adapting the Home For advice, information and resources on how to create a dementia enabling environment please visit: www.enablingenvironments.com.au

6 | National Update

SOUTH AUSTRALIA REPORT Annual Dinner Paul Carberry Chief Executive Officer | LASA South Australia

ur annual dinner is one of the highlights of our calendar, and this year we equalled our best-ever attendance, with over 250 people filing the largest room at the Adelaide National Wine Centre on 24 September.

We plan our dinner with two important objectives, firstly it’s the Association’s big social event of the year and we want providers and staff to have fun, to have an opportunity to network and to simply enjoy a big night out. Even more important though, is the fact that the annual dinner is the occasion at which we present the Association’s Excellence Awards. These are presented to staff who have performed outstandingly and have achieved exceptional outcomes for residents and families.

Earlier in the year providers nominate staff who they feel are deserving of an award. The nominations can be proposed by their manager or supervisor, another staff member or a resident or relative, however they must be signed off by management and they must provide an overview of the nominee’s accomplishments which addresses the criteria we have set. Nominations are then de-identified and sent to our judges, who are experienced and respected aged care practitioners, e.g. retired directors of nursing, and are independent of the Association. The judges score each nomination against the judging criteria and the total scores produce four finalists and a winner. This year the finalists were: • Erlinda Barogo from Ananda Hope Valley Residential Care, operated by Dr Prabhash Goel and his family; • Robyn Caruso from BUPA Care at Morphetville; • Mary Craig from Burnleigh Private Nursing Home, operated by Padman Healthcare; and • Sharon Henderson from Trevu House, operated by Whelan Care. Each of the nominations described truly inspirational efforts by the finalists. The winner for 2012 was Robyn Caruso, who has set up and run a fantastic program in conjunction with a local primary school. It involves regular weekly visits by the children to the home, which has resulted in the formation of special relationships between children and residents. It has greatly enhanced the lives of residents and produced great benefits for the children, including, as reported by their teachers, increased self-confidence and self-esteem. The program has received recognition through awards and through the media, which has enabled Robyn to increase the community’s awareness and understanding of dementia. Each of the finalists received a certificate and a $300 gift voucher, and the winner received a winner’s certificate and a $1,000 travel voucher. The Excellence Awards are a tangible and public way of recognizing the great work of aged care staff and letting them know how much their efforts are valued.

Robyn Caruso from BUPU Care receives her Excellence Award from CEO, Paul Carberry

Such things are only possible through the generous support of sponsors and this year our major sponsors for the dinner were Bankwest, Guild Insurance, HESTA Super Fund and Zenith Insurance Services. ■

National Update | 9

NEW SOUTH WALES REPORT Mandatory Installation of Sprinklers in Residential Aged Care Facilities in New South Wales Charles Wurf Chief Executive Officer | LASA New South Wales

ll members of LASA across Australia are trying to meet the challenges that have arisen out of Living Longer. Living Better. In New South Wales providers are now also facing the requirement for fire sprinklers to be installed in residential aged care facilities. Although legislative responsibility for aged care falls principally to the Federal Government, regulations and responsibility in some areas, including fire protection, is the responsibility of state governments. While the states of Victoria and Queensland have enacted different rules requiring the installation of sprinklers in existing residential aged care facilities, in New South Wales the best evidence for fire protection did not require sprinklers in buildings constructed before 2002. The impetus to re-examine fire protection standards, and in particular to understand whether sprinklers should be mandatory for all residential aged care facilities, followed the terrible tragedy at Quakers Hill Nursing Home. The industry has, in general, appreciated the process undertaken by the New South Wales Government.

The process has been consultative with industry and other key stakeholders. The process has been conducted in a time frame that has allowed differing points of view to be considered and industry concerns, including how any retrofitting of sprinklers would be funded, to at least be heard and acknowledged. This process, according to some aged care providers and industry representatives, is in contrast to the Federal Government’s ‘rushed’ approach to significant policy change following the Living Longer. Living Better. announcement.

The best evidence now for fire protection is that sprinklers should be installed in all residential aged care facilities. While the legislation and the details are still being finalised (at time of writing this article) a general transition timetable is as follows: January 2013 Commencement date; June 2013

Progress Report to be submitted by aged care providers;

June 2014

Target date for work to be completed;

June 2014

Business Plan to be submitted before this date if work is not able to be completed, with 6 monthly reports to be submitted;

January 2016 All work to be completed; January 2016 Exceptional circumstances extension for up to 12 months. Consultation with the Department of Planning and Infrastructure is continuing. While some providers might seek to immediately undertake a retrofitting of sprinklers, there should be a note of caution to wait until a complete understanding of the requirements and legislative changes are known. For some providers, their need to retrofit sprinklers will be an enormous challenge and pressure will continue to be applied on the both the New South Wales and Federal Government for funding support. At present both levels of Government are deflecting the obligation to fund retrofitting. We will have a clearer idea in coming months to the true extent of the cost on providers, particularly those who operate smaller and older facilities in regional and remote areas. ■

10 | National Update

VICTORIA REPORT LASA Victoria Training: how far we have come Kate Hough Acting Chief Executive Officer | Victoria

remarkable success story for LASA Victoria is the growth in the breadth and scope of the training services we provide, which includes accredited training, workshops and seminars.

LASA Victoria operates as a Registered Training Organisational (RTO) in order to access various government payments for skills acquisitions, as well as offering members discounted fee based courses. The strongest growth has been in the area of accredited training where the student numbers have increased from 90 two years ago to a current enrolment of 460 students. The success we have had is a reflection of the clear strategic focus that LASA Victoria has on assisting members to build both the capacity and capability of

existing staff, as well as contributing to the development of future aged care workforce. This expansion has been made possible through a collaborative approach to working with members to identify training needs combined with active environmental scanning to identify sources of funding that can help to offset training costs. On site workshops have also increased threefold over the past three years, while the public offer workshops and seminars have maintained a constant level of strong support. Members training needs are identified through an annual training needs analysis. The rigor taken in ensuring the ongoing relevance of the workshops and seminars helps to maintain strong membership support. The LASA Victoria graduate and under graduate nurse programs are also great examples of innovative training practice to assist in addressing concerns about the future registered nurse workforce. In 2012, LASA Victoria was successful in obtaining funding for 70 newly registered nurses to complete a nurse graduate program in aged care, and will continue the program into 2013. In partnership with Monash University we are able to offer an undergraduate nurse clinical placement program that will see 150 undergraduates undertake aged care placements in 2012 and 2013.

Occupational health and Safety Aged Care Stakeholder Forum LASA Victoria, in partnership with WorkSafe Victoria, has established an OH&S Aged Care Stakeholder Forum. The stakeholder forum is a vital start in our ongoing engagement strategy for our members to address both current and emerging OH&S issues and challenges. The forum will provide opportunities to share best practice OH&S management processes and provide a key communication channel for stakeholders to liaise with regulatory bodies. At the first meeting of this group Bernie Dean, General Manager of WorkSafeâ&#x20AC;&#x2122;s Prevention Strategy Division discussed the need for creating sustainable partnerships with industry stakeholders to develop programs based on shared vision and experiences. Some of the emerging issues in the aged care industry which have been identified and will be addressed in this forum include workplace aggression, managing bariatric residents, workplace cultural issues and the ageing workforce. â&#x2013;

National Update | 11

QUEENSLAND REPORT Nick Ryan Chief Executive Officer | LASA Queensland

n the national stage, LASA Q and our member organisations have been actively contributing to ongoing, collaborative, consultation and lobbying around the Australian Government’s Living Longer Living Better (LLLB) reform package, and in particular: • concerns around the ACFI changes • development of the Aged Care Workforce Compact • definitions around ‘significant refurbishment’ • review of prescribed services • design of the new Community Care Packages and Consumer Directed Care framework • development of a LGBTI Ageing and Aged Care Strategy Charged with chairing and facilitating the Retirement Living and Housing Committee in 2012-13, LASA Q has also recently called for membership nominations from each state. It is our intention to report on the activities of the Committee, once established, in future editions of LASA Fusion. Closer to home now and much of our attention has been focused on the review and amendment of legislation governing various aspects of age services provision in Queensland. This has seen collaborative submissions developed for parliamentary inquiries into the Operation of Queensland’s Workers’ Compensation Scheme, Palliative Care and Home and Community Care Services and Dementia. The LASA Q Retirement Living Committee is also in the midst of preparing a submission in response to a review of the Retirement Villages Act, an activity we know many of our national colleagues are also undertaking, or have undertaken in recent times. With a government focus on reducing ‘red tape’ to facilitate the ongoing viability and expansion of the industry, we are highly appreciative of the invaluable assistance provided by our legal expert members including Robin Lyons, Partner at Minters Ellison. LASA Q has also successfully initiated and facilitated several member forums and workshops, designed to develop and enhance member and/or industry capability and capacity. A snapshot of these activities include our: •

Disaster Management in Community Care Breakfast Forum – designed to explore how business continuity can be successfully achieved when working collaboratively with other local Community Care service providers

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Social Media Workshop – aimed at addressing the use of social media in the workplace; what it is, how it’s used, how its use can be managed, and how it can be used to effectively engage clients

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Inaugural Industry Forum - where industry members were given practical and informative insights into the age services

sector, assisting them to better understand the sector and more effectively market their products and services. On our radar for November, is a Regional Invitation Series to be delivered in partnership with our sponsors’ Paynter Dixon, BDO and Hynes Lawyers. By invitation only, CEO’s/CFO’s, Board Members DON’s and other senior executives, will have access to strategic level information on the legal, financial and design and construction futures facing the sector in regional Queensland, and advice on capitalising on future challenges and optimising future business opportunities. As a sector experiencing a climate of development and delivery… in overdrive, there has never been a more important time for us to foster and draw on our strong sector connections and extensive networks. Working smarter to ensure coordinated and collegiate responses to some of the most important aspects of age services reform in decades can only work to our advantage, both now and into the future. ■

12 | National Update

WESTERN AUSTRALIA REPORT Anne-Marie Archer Chief Executive Officer | Western Australia

t is anything but quiet on the western front, as we prepare for the Inaugural LASA Congress to be hosted in Perth at the end of October.

Although your first instinct will be to review the content of the program for its array of interesting and informative presenters, but I also encourage you to take advantage of the travel opportunity to stay longer to explore our fine State. The obvious pre & post congress trip would have to be Margaret River – where the foodies will have their culinary palate delighted and the wine buffs will be able to sample many of our fine wares… but there is considerably more to see and do if you have the time. My personal recommendation would be to also visit the many caves that pit the southern wine region. However, if you don’t have that much time up your sleeve - a day trip to the Swan Valley will certainly provide you with just as many wonderful wines and produce to savour. Other day trip adventures from Perth include the Pinnacles, Wave Rock & York, Valley of the Giants & tree top walk, the Fremantle Prison, just to name a few and don’t forget Rottnest Island, but I would suggest staying the night to relax after a bike ride, walk or some fantastic snorkelling.

For the water babies you can arrange to swim with dolphins in Rockingham and those wanting to explore our underwater offshore wrecks, you are welcome to join us on a HMAS Swan Wreck dive from Busselton and be back in time for the Sunday official opening. If a dive does tickle your fancy contact me directly at the Perth office. Some have indicated that they will be heading north to the place of all things pearl in Broome and others not so far up the coast to Monkey Mia for some much deserved R&R. The golf enthusiast heading West won’t be disappointed with a huge choice of courses available for a round or two during your stay. Even though some of you will have to head straight home, I am sure you will find much to see and do in Perth and Fremantle, as well as along our surfside suburbs where you are guaranteed to see some sensational sunsets. We look forward to seeing you in the wonderful west in October.

PS Don’t forget to bring your Halloween costume for the gala dinner! ■

14 | National Update

t is an exciting time to be in the business of aged care, it is also a critical time to keep abreast of the changes in your industry by attending the first national LASA Conference (replacing the previous ACAA Congress). LASA Congress bigger and better, representing a broader cross section of the aged care sector, with a commitment to represent all participants, (both for profit and not for profit) regardless of their service offering or ownership status. Come to this year’s LASA Conference in Perth and share with colleagues from across Australia. Build your personal network; discover exciting new technology, innovation because this conference promises to address the issues that you, as an aged care provider, owner, staff member, community care provider have to deal with every day.

A message from inaugural Leading Age Services Australia Chair, Peter Cosgrove, regarding the ﬁrst LASA Congress. We need to hear from our members from right around Australia about the issues and challenges in caring for older Australians 24 hours a day, every day. We need our members to share their thoughts and experiences about the impact of the Living Longer. Living Better. package. And we need to build on the platform established by LASA, a platform to engage with Government and lead to positive reform in age services. How will aged care organisations adapt to what promises to be a decade of change ahead? How can we ensure appropriate income and funding; keep up with IT developments; workforce retention and other issues that confront you as an owner, CEO or senior manager? Our congress has the highly regarded futurist, Morris Miselowski, as a plenary Speaker. Morris helps his clients unravel complex situations and implement practical and profitable

solutions every day; Morris’ presentation is a must for the savvy provider. There is a resolve throughout Leading Age Services Australia that older Australians must be assured of a viable and sustainable aged care industry now and in years to come. But achieving this requires the engagement, experience, and enthusiasm of our members. At Congress I am looking forward to hearing the thoughts of members from right around Australia. I am also looking forward to speaking at Congress and sharing my own thoughts about a viable and sustainable industry. At Congress we will garner the experience, goodwill, and the energy of our membership to advance our industry into 2013 and beyond. I encourage those who have not yet committed to attend, to recognise the opportunity that Congress is providing our industry and join us in Perth in late October.

Social Program The social program will provide delegates with plenty of time to network and have some fun. The first official social function will be the Welcome Reception in the trade exhibition on Sunday 28 October. There will be an Exhibitors’ Reception for all Congress attendees at Frasers State Reception Centre, Frasers Park on Monday 29 October, and then the Gala Dinner, the social highlight of the Congress, will be held on Tuesday 30 October – this year’s theme is Halloween, so get your thinking caps on, dress up and have a great night.

Exhibitors Listing Abbott Nutrition AE Smith Aged Care Channel Aged Care Guru’s Aged Care Online AirLiquide Healthcare Alchemy Technology Alzheimers Australia APHS ArjoHuntleigh Aspire Learning Resources Atama Furniture Austco Autumn Care Blair Architects Bunzl Outsourcing Services

Campana Systems Pty Ltd – Gold Care Capital Guardians Care Systems Cater Care Australia Choice One Recruitment Commonwealth Bank Community Services & Health Industry Skills Council Creek Solutions Department of Human Services DPS Publishing Ebos Healthcare EnergyAction Epicor e-Tools Software Foxtel Gow Gates

Health Metrics Health Super Health Training Australia (Inc) Healthcare Australia HealthStrong HealthX HESTA Higgins Coatings Hills Healthcare HIP (Health Industry Plan) Human Technologies iCare Solutions ifolio IMB Treasury Invacare Kimberly-Clark Lappset Laundry Solutions

leecare Solutions Medirest Mercury Group of Companies Mirus Australia Moving ON Audits NAB Health National Relay Service Nationwide Health & Aged Care Services NEC Nestle Health Science Pharmatex Presidential Card Provider Assist Provider Assist QPS Benchmarking Questek Rhima Roche Diagnostics

Royale Corp Safety Link Personal Response Service Sarah Aged Care Sari-Med Pty Ltd Sebel Furniture Simavita Sodexo Seniors St George Corporate & Business Bank Surgical House The Essence Consulting Group TimeTarget Veeco Laundry Systems Webstercare Wellness & Lifestyles Westpac Zenith Insurance Services

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TEAM LASA 2012 and on Mike Swinson

“We need people that have ‘get up and go’ and that’s what we have in this team,” said Gerard Mansour the new CEO of the new national aged care organisation, Leading Aged Services Australia (LASA)

erard says LASA’s focus and activities have been expanded and it’s now the only national organisation that seeks to represent the views of all the players in the aged care industry regardless of their service offering or ownership status. The birth of this new organisation is not simply an end to an era and welcome to a new. We are starting with the combined wealth of expertise and knowledge from the three founding members; Aged Care Association Australia (ACAA), Aged and Community Care Victoria (ACCV) and Aged Care Queensland (ACQ). It’s expected that this new peak body will keep growing its role and expanding its membership across the industry over the years ahead. “To start when there is so much interest and focus on aged care is very exciting. As an Association, we are mapping out our priorities with members, setting directions, reviewing our progress and then changing things where necessary. It won’t be an easy road ahead by any means given the challenges facing our members who will play a critical role in every step along the way. For me, it’s both a challenge and an exciting opportunity,” he said. Gerard’s new team includes two new management positions to be based in the Canberra national office. They are Kay Richards as the National Policy Manager, and Justine Caines (OAM) as the National Government Relations & Communications Manager. When he first announced the appointments he said there has never been a more important time for the aged and community care industry, adding that it was a great moment to strengthen the LASA national office with the appointment of two highly skilled, passionate and dedicated professionals. “These two new positions will contribute most significantly to the continuing growth of Leading Age Services Australia – All age services, speaking as one. The new roles, filled by highly competent professionals in Kay and Justine, will enable LASA to continue to grow as the national peak body for all providers of care, services and accommodation for older Australians.”

Gerard said he has an enormous respect for what aged care organisations do in the sector, even though they operate in vastly different ways. It gives choice to older Australians and that’s something he embraces. He wants to make sure that LASA maintains an industry with diversity and flexibility that provides choice and options for consumers. “That’s our mandate“says Gerard, “that’s our purpose and what unites us now is far greater than what divides us!” Gerard Mansour comes to this role at a critical time in the changing nature of aged care and how it is funded by government and the community. He will be guiding his members as they plot a path through the myriad of changes in the way funds are allocated and the industry is run, particularly with the advent of the ‘Living Longer, Living Better’ announcement. He brings with him a wealth of experience as the former CEO of Victoria’s only aged care representative body, with members across all sectors of the industry. He also brings a breadth of experience and a diversity of skills from his time as a youth worker, community education and the trade union movement. “I have gone from youth worker, dealing with teenagers, to kindergartens and now to the other end of life in aged care! After ten years of working in an industry body within children’s’ services, I saw an ad wanting someone to bring together for profit and not for profit aged care into one body in Victoria, the same role is now ahead of me nationally,” he said. “I found being the voice of all organisations that provide services to older Australians in Victoria an inspiring role and still do. Now my role is a national one, with a much larger national focus, even though most of the issues remain the same. So in a sense my new role is totally different, in another sense it is the same.” Growing up Gerard was part of a close working class family with five children. His parents were dedicated to making sure the children had every opportunity they could afford. His father died

18 | Profile

some years ago and now his mother is in her mid eighties and is someone who is already accessing aged care services.

While Kay admits that public policy in aged care is a minefield with all its inherent dangers, she loves working in the sector.

“That’s one of the critical things for me,” said Gerard, ‘we must always make sure that we see the world through the eyes of the consumer; older Australian’s, vulnerable Australians. If we can’t transfer our ideas into language and concepts that ordinary people can understand then we simply cannot be successful.”

“It’s exhilarating. One thing I do know is that no matter if you are a politician, a bureaucrat or a policy maker or lobbyist, we all share the same goal, to make sure that older Australians are properly looked after, respected, valued and safe. The challenge is how we do that so that aged care providers are sustainable, while at the same time balance the national budgets within available finite resources. I am looking forward to advocating on behalf of providers to make sure they can provide the care levels that are needed,” she said.

So what qualities, skills and life experiences do Kay Richards as the National Policy Manager and Justine Caines as the National Government Relations & Communications Manager bring to the LASA team? Kay Richards, National Policy Manager. “I have enormous respect for older Australians and what they have sacrificed to build what we enjoy now,” says Kay. “LASA is an organisation covering residential and community based care, care in all its shapes and sizes. Some of those services are helping people maintain their independence and dignity while in their own home and also supporting and assisting those who go to residential care. I want to do my bit to make sure that providers of aged care are well supported by government, so they are in a sustainable business or service so that they can provide quality care to older Australians.” She adds with some passion in her voice “for me it’s about caring for people; that’s why I became a nurse, I wanted to make a positive difference in people’s lives and I still do, it’s in my blood.

If you wanted to choose someone to advocate on your behalf, you couldn’t ignore Kay Richards. Nine years working in aged care advocacy at a state level; combined with her personality and the standards she sets herself all point to a remarkable and effective individual. In a moment of reflective honesty she says “some people think I am forthright and upfront, but that’s not how I see myself. My role is to advocate on member’s behalf so naturally I will be strongly representing the members of LASA, that’s my focus. You cannot be a shrinking violet in this job! I hope when people are describing me they say that ‘she is a caring person because that’s at the core of my existence; I am also a wife, a mother and now a grandmother so my family life is also very important to me.”

profile | 19

While her early family life was tough at times she said her mother taught her the importance of being caring and compassionate, while her father taught her to stand up for herself and the things she believed in. Kay brings with her years of experience in the aged care and health sectors as General Manager of RSL LifeCare, Manager of Member Services with ACAA-NSW and as a Board Director for the Australian College of Nursing.

Justine Caines, (OAM) National Government Relations & Communications Manager. Well if Kay Richards describes herself as ‘no shrinking violet’ then Justine Caines is a mirror image! Justine is a self made crusader, an activist; she has led the campaign to reform maternity services that resulted in Medicare access for midwives. She formed and led the ‘What Women Want’ political party and she has an Order of Australia for her services to women and the community. “Crusades can become all encompassing, they can swallow you. Today I know how to pull back, I still have the interest, the ‘get up and go’ I still have the fire in my belly but I do know when to pull back.” Like Gerard and Kay, Justine is on message about the issues facing aged care. “One of my prime tasks that I see in these early days is to help position LASA as the leading aged care organisation, to give it

a strong position. My life and work experiences strongly support that endeavour. It’s now about strengthening key relationships and assisting the reform process in a positive manner. To draw out areas of commonality with key stakeholders, I want to use my skills in networking to the industries best advantage,” she said. “I have a 93 year old Grandmother who is yo-yoing through various aged care services, has been in community based care, respite care and is now looking at residential care and yet wants to stay at home, but cannot look after herself. It’s the same situation faced by tens of thousands of other Australians, so I know first hand what they go through.” “I guess I can see real parallels with how we enter the world and how we leave it. Not everyone in aged care is leaving it quickly I might add! I have a particular interest in this area because as a society how we treat the more vulnerable is a measure of how compassionate and caring we are. I also have a strong interest in reform processes and aged care is in the midst of one of the biggest reforms to the system for decades.” I see some of the biggest issues in aged care for providers as sustainability, choice, continuity and knowing that you have been listened to, that your opinions and ideas are valued. ‘So who was the defining person in your life?’ I asked. “My Dad, he taught me to be inquisitive, to question the status quo and that there is nothing wrong about being passionate on the issues that matter.” ■

20 | ACFI

QPS Benchmarking ACFI Changes Review: Residential Aged Care On Thursday the 24th June 2012, it was announced by DOHA that from the 1st July 2012, ACFI funding would be changed as follows: 1. A change to the scores in question 3 of the Activities of Daily Living (ADL) domain; 2. A change to the Complex Health Care (CHC) matrix; Changes to ADL and CHC components will take effect for all new appraisals and reappraisals from 1st July 2012 onwards

The team at QPS initially performed a requirements analysis. It was apparent that in order to successfully collect data from a large range of unknown sites in an extremely short time frame, the simplest method would provide the best solution. For this reason, QPS developed a specialised Microsoft Excel sheet which collected ACFI data for further analysis and also gave participating organisations an instant view of how their residents and facilities would be affected.

3. A subsidy reduction of 1.6% (COPO shortfall) resulting in a loss of the annual funding increase.

275 residential aged care facilities returned ACFI data on a total of 18,348 residents assessed for ACFI funding. This data was collated and reviewed for funding levels prior and post changes to ACFI scoring and funding.

QPS Benchmarking (QPS) and Leading Age Services (LASA) conducted a survey of residential aged care facilities in order to understand and model the potential impacts of DOHA’s recently introduced reductions to ACFI scoring and funding.

The study identified the following: • ACFI Loss; • COPO Shortfall and; • Overall Loss. (Note: Overall Loss is the combination of the ACFI Loss and the COPO Shortfall). ■

Table 1 provides the results of the ACFI Loss, COPO Shortfall and Overall Loss for the total aggregated data and averaged per facility, within the study. (i.e. 275 residential aged care facilities, 18,348 residents) ACFI Loss

COPO Shortfall

Overall Loss

1.1

Total $ loss

-$21,232,692.40

-$13,181,766.34

-$34,414,458.74

1.2

Total % loss

2.6%

1.6%

4.2%

1.3

Total $ loss per facility

-$77,209.79

-$47,933.70

-$125,143.49

Table 2 provides the results of the ACFI Dollar Loss for ADL’s and CHC’s, COPO Shortfall and Overall Loss averaged per resident affected by the changes and total residents population within the study.

Number of Residents Affected By Changes

Percentage of Residents Affected By Changes

Average Dollar Loss Per Resident Affected by Changes

Average Dollar Loss Per Resident per total study population (N=18,348)

2.1

ADL $ Loss

692

3.8%

-$13,047.20

-$492.08

2.2

CHC $ Loss

1301

7.1%

-$9,380.50

-$665.14

2.3

TOTAL ACFI $ Loss

1924

10.5%

-$11,035.70

-$1,157.22

(note: those residents affected by both domain losses are counted once only)

2.4

COPO $ Shortfall

18,348

100%

-$718.43

2.5

Overall $ Loss

18,348

100%

$1,875.65

(ACFI & COPO)

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ACFI | 23

Overview of the ACFI Changes from July Jacqui Banham | ACFI and Clinical Services Director | Provider Assist

From Provider Assist’s perspective the recalibration in July 2012 of the ACFI has had the following outcomes: changes in 2 care domains namely the Activities of Daily Living (ADL) domain and Complex Health Care domain and the freezing of the CPI increase (1.6%) of ACFI dollars.

aving had numerous discussions with our clients from both for profit and church and charitable sectors, their feedback, our modelling and our experience working with the ACFI reveals the consistent outcomes detailed below: •

In relation to the ADL domain changes we have witnessed very little impact in sustaining or achieving a high or low level claim. However, impact is being felt in sustaining or achieving a medium level claim. We have noted, from client feedback and our own experience, that as residents are reappraised if their claiming profile is CCDCA, BCDCB or CCDBB these profiles will now result in a low level claim. The resulting financial loss is $36.38 per day or $13,278.70 per annum.

•

The Complex Health Care domain has only had a small impact affecting those residents who have previously only claimed a D claim in Question 11 (medication) and where there has been no claim made in Question 12 (complex health care procedures). In this scenario the claim has dropped from a medium to a low level causing a financial loss of $25.70 per day or $9,380.50 per annum.

An interesting finding from the impact of the change that the industry believed took effect from 1 July 2012 was found in Provider Notes on the Payment Summary for June Claim which stated that any ACFI submitted on or after 21 June 2012 will be affected by the changes. To quote: “Please Note: Some applications for classifications received by DHS in June 2012 were not classified in accordance with the ACFI classification changes announced by Minister Butler on 21 June 2012. On 28 June 2012 a system release was implemented to apply to the classification changes and reclassify affected ACFIs. As a result, the classification will not match the previous classification information provided for these applications. All payment amounts for July will reflect the ACFI changes announced on 21 June”.

Overall we believe the freezing of the ACFI dollars payment and the calibration of the instrument appears to be having about a 2% reduction in overall funding. We await further detail as to the impact of the changes expected towards the end of 2012. Please contact Provider Assist for any further comments, information, ACFI training, ACFI education or advice at providerassist.com.au or 1300 419 119. ■

24 | ACFI

Estimated impact of changes to the ACFI Sarina Fisher | Director, Health Economics and Policy | The CIE Group

Key points •

Changes to the Aged Care Funding Instrument generate substantial and ongoing losses of revenue for providers of residential aged care.

•

Cumulative revenue losses due to the new funding rules and changes to indexation arrangements for the four year period 2012–13 to 2015–16 are estimated to be in excess of $1.1 billion over four years.

•

The estimated annual revenue loss is $224 million for 2012–2013, $273 million for 2013–2014, $281 million for 2014–2015, and $334 million for 2015–2016. Annual losses would continue to rise in the following years as more residents are progressively assessed under the new funding rules.

•

Annual ACFI losses are over $20 000 per affected resident (or more than $60 per day) when allocating all revenue losses for those residents experiencing a scoring change.

Study outcomes

• •

$281 million for 2014–15; and $334 million for 2015–16.

In August this year the CIE was commissioned by Leading Age Services Australia to estimate the expected revenue loss A breakdown on the total revenue losses by year is shown below. associated with the changes to the ACFI that were implemented Annual ACFI losses are over $20 000 per affected resident (or on 1 July 2012, including: more than $60 per day) when allocating all revenue losses for • the change to the scores in question 3 of the Activities of Daily those residents experiencing a scoring change. Living (ADL) domain; The revenue loss per permanent resident, irrespective of whether • the change to the Complex Health Care (CHC) matrix (both of they are affected by scoring changes or not, range from $1 300 to which will take effect for all new appraisals and reappraisals $1 800 per resident. from 1 July 2012 onwards); and • the one-off reduction in the amount paid under the ACFI at all care levels from 2012–13 2013–14 2014–15 2015–16 1 July 2012, which after indexation is $m $m $m $m Summary of total revenue losses applied from 1 July 2012, means that Reduction in scores due to ADL ACFI subsidy rates will remain at their -33.7 -52.1 -53.2 -74.0 reappraisal 30 June 2012 level. Sector-wide modelling based on a detailed model of forecast residents and expected revised score outcomes attributable to the new funding rules found total cumulative losses to be in excess of $1.1 billion the four year period 2012–13 to 2015–16, and approximately $200 million — $300 million per annum. In particular, the estimated losses were: • $224 million for 2012–13 due primarily to the loss of indexation on ACFI care subsidies across all care levels and the reduction in daily subsidies for new residents or residents reappraised for the ACFI after 1 July 2012; • $273 million for 2013–14 as residents are progressively assessed under the post July 2012 appraisal criteria and when the ongoing impacts of the reduction in FY2013 indexation are felt;

Reduction in scores due to CHC reappraisal

-46.8

-72.2

-73.8

-102.7

Loss of indexation at all care levels

-143.7

-148.3

-154.0

-157.7

Total revenue loss

-224.2

-272.6

-281.0

-334.4

Data source: The CIE.

2012–13

2013–14

2014–15

2015–16

Total revenue losses per resident affected by changes in ACFI scores (incl. all indexation losses)

-$32 240

-$25 370

-$25 600

-$21 900

Scoring related revenue losses per resident affected by scoring changes

-$11 570

-$1 300

-$1 550

-$1 560

-$1 820

Revenue losses per permanent resident

Average revenue losses per permanent resident Results have been subject to rounding. Data source: The CIE.

ACFI | 25

The most significant change to the ACFI in terms of reductions in ACFI revenue relate to changes in indexation. The total annual revenue loss was found to be $144 million for 2012–13 rising to $158 million in 2015–16. This reflects the loss in revenue when indexation is not applied in 2012–13 and the ongoing annual losses related to changes in base rates. The chart below highlights how the ‘one off’ change in 2012–13 indexation affects future funding outcomes in subsequent years. The proportion of residents that are likely to receive a different score in question three of the ADL domain and with respect

Effect of the ‘one off’ change in 2012–13 indexation

Data source: The CIE.

to the CHC matrix, and the size of the change in funding per day, were based on the results of a survey undertaken by QPS Benchmarking. The QPS Benchmarking surveyed covered 275 facilities across Australia and 18 348 residents. This analysis demonstrates that changes to the ACFI are expected to generate substantial and ongoing losses of revenue for providers of residential aged care, compared to funding that would have otherwise been received without the changes to indexation or changes to scores in the ADL domain and the CHC matrix. ■

26 | ACFI

Thought Leadership on the ACFI Reforms

The whitepaper also rebukes the criticism on ACFI’s ‘over claiming’ argument by referencing the positive care outcome aspects of the instrument. “It’s costing more, because the industry is doing more and thus achieving better care outcomes”. For most businesses the care subsidy can amount to as much as 80% of total revenues. Recent reforms mean that certain refinements to the optimisation paradigm must be taken into account for providers to stay ahead of the curve. The eCase optimiser by Health Metrics provides a mechanism by which a provider can ensure congruence and optimisation per claim. Diagrams A and B illustrate the ongoing value of the eCase optimizer to individual ACFI criteria changes; at introduction this effect can be multiplied by a substantial proportion of the population database. Health Metrics has also modelled the “typical” residential care journey as it shows in diagram C on page 28. Reducing the subsidy values during the subsidy growth period despite the corresponding physical and cognitive decline has the potential for critical financial and thus operational impact, which will most likely happen between seven and ten quarters to achieve its highest probability of peak effect. Thus, the financial pain is predicted to have the greatest impact approximately two years after its

Diagram A

Diagram B

ACFI Subsidy

F No. of Residents

espite the industry-wide concerns about ACFI, Health Metrics voices the opinion that the change to ACFI is a great step forward which should always have been embraced. Although it seemed that the disruptive nature of the change was at first, clouding the benefits, Health Metrics pointed out the benefits of ACFI in its white paper of 2007. This earlier paper showed that ACFI’s diagnosis driven nature makes for better care outcomes and a win-win-win-win scenario for Residents-Families-Staff-Providers. The current whitepaper further acknowledges that a considerable “retooling” cost was associated with the 2008 paradigm shift from RCS to ACFI, which remains something that certain parties have chosen to ignore.

No. of Residents

A recent whitepaper published by Health Metrics outlines a strategic view for providers facing an altered ACFI future. Steven Strange, the CEO of Health Metrics argues that there has never been a more important time to harness electronic subsidy manage systems in his paper.

ACFI Subsidy

28 | ACFI

$Subsidy Vs. $Cost

Shallow $ growth despite Physical & Cognitive decline

HHH or HMH

ADL: L - > M Spike

Time Diagram C

154 Weeks

National Average Expectation

implementation (ie. post July 1, 2012). Providers need to model their own scenario to understand the negative cash impact. Understanding your probability based cash impact model is critical. Health Metrics modelling points to an extrapolated industry impact of between $250m and $300m (approximately 3.4%) for year one. The one off reduction of any inflationary adjustment could cost approximately 3%. EBA arrangements this year could add cost to the tune of 3%+. Providers could be facing a

combined 9%+ shortfall. The current ACFI reforms may equate to the difference between a profit and a loss for some or the difference between solvency and insolvency for others. Health Metrics has coined the term “subsidy architecture” as a label to its methodology for care funding management and optimisation. More recipes for crafting and managing your subsidy architecture can be found in the full whitepaper from Health Metrics website: www.healthmetrics.com.au ■

Technology | 29

Moving from talk to action – embracing the future through the PCEHR system Leigh Donoghue Accenture Health Lead (Australia New Zealand), Accenture – Health & Public Service

Jackie1 has been working in a residential aged care facility for 10 years. Frequently involved in transferring residents to and from hospitals, she sees first-hand the difficulties of sharing information across care se ings and professionals. She also sees the consequences of this in terms of resident care, with clients sometimes returning dehydrated or malnourished due to hospital staff not recognising their feeding difficulties, and hours tied up chasing clinical information, such as discharge summaries, specialist le ers, and medications lists. Jackie thinks that there must be a be er way to share and store medical information across the health system. The good news is that now there is.

ged Care professionals need the right information at the right time to deliver high-quality, client-centric care. Yet Carers and GPs operating within the sector are struggling to manage the care of their patients effectively, particularly where patients move between services, locations and agencies. And the demands are growing. Australia’s population is aging at a rapid rate; with three million older Australians, one million of which are in aged care. Of these, around 170,000 people live in aged care facilities and 800,000 are supported in the Community. Aged care health providers are facing increasing pressures to manage the delivery of care to service these residents, many with long-term and complex needs. The problem is that client information is gathered by a wide range of care professionals, but is then held under separate, isolated records that are difficult to share. For clients this means the details of their care, treatment and even basic personal demographics have to be repeated regularly to various health professionals. This is further complicated where the client has dementia. Time and effort is duplicated across health and aged care facilities, and important information is not quickly available to the people who most need it. Good news. This is changing. The Personally Controlled eHealth Record (PCEHR) system enjoyed a ‘soft launch’ on the 1st July 2012. This meant that the system went into live production across Australia. This system

is specifically designed to enable health professionals to record, access and share sensitive client information in a secure way, thereby making possible a vastly improved service to clients and authorised carers. Information stored in the record can be accessed by the client and their carer(s) along with authorised healthcare providers in a simple and effective way. Through this information, care professionals will be able to make better, timelier decisions about the health and treatment of their clients. Such a transformation won’t happen overnight. Inevitably, a change of this scope and complexity takes time to establish and prove itself. This is the lesson from similar overseas and local programs, including the Northern Territory, arguably the most advanced example of a shared electronic health record in Australia. This took more than five years to ‘take root’ but has now become integral to how care is delivered across remote and rural communities. Slow start-ups typically raise questions and draw criticism in the media: when will it happen, and even will it happen? This is already emerging with the PCEHR system, despite the fact that almost 10,000 Australians have registered in the first two months of operation. This is a solid start by global measures, a reasonable base to build upon. A slow start-up for the PCEHR system is likely, but it’s not inevitable. Nor is it desirable. 1 Jackie is a hypothetical example of an aged care worker

30 | Technology

‘‘ ’’ The Aged Care sector has a unique opportunity to play a pioneering role in Health by registering both themselves and their clients, and demonstrating the benefits of shared electronic records. Older Australians have already been recognised as a priority cohort by the Federal Government. The challenge is now with the sector to respond: to integrate to the PCEHR and make adoption a priority, and to leverage the new national system to deliver a higher standard of care to clients and their carers.

Older Australians shouldn’t have to wait five to seven years for better information sharing and better care. Nor should committed staff who work in and around the Aged Care system have to struggle with incomplete records. The potential of a system like the PCEHR to improve and connect the healthcare of Australians means the discussion must move from debating the project’s future to recognising that “the future is here”. The Aged Care sector has a unique opportunity to play a pioneering role in Health by registering both themselves and their clients, and demonstrating the benefits of shared electronic records. Older Australians have already been recognised as a priority cohort by the Federal Government. The challenge is now

with the sector to respond: to integrate to the PCEHR and make adoption a priority, and to leverage the new national system to deliver a higher standard of care to clients and their carers. One of the first ways to engage with the system is for consumers to register for an eHealth record. This can be completed online, by phone or in person at a DHS Medicare office, or in writing by completing a paper registration form. To register online, visit: www.ehealth.gov.au, and then follow these three steps: 1. Register – for an Australia.gov.au account 2. Verify – your identity with Medicare 3. Create – an eHealth Record Over time, eHealth records will gradually be populated with clinical data as clinicians and provider systems are connected. One of the data types currently available for a consumer’s record is Medicare information. This may include Medicare Benefits Scheme (MBS) information, Pharmaceutical Benefits Scheme (PBS) information, and other relevant information. Over time, a richer variety of clinical information will be uploaded to the record, including Shared Health Summaries, Event Summaries, eDischarge Summaries, and Specialist Letters. The consumer may also choose to upload data via a Personal Health Summary, record the location of an Advanced Care Directive, and a variety of other features. Not only will registration establish your care record, but it will also provide an opportunity to become familiar with the system, to understand the capabilities and benefits, and form the basis for discussing the eHealth system with your clients. A next step is to register your dependents, encourage your families to join, and assist your clients and residents in your care to join. More information can be found on the eHealth Learning Centre website - http://publiclearning.ehealth.gov.au/hcp/ This resource provides details about preparing for and using the eHealth record system, and examples of how the system will support different clinical scenarios, including those in Aged Care: http://publiclearning.ehealth.gov.au/hcp/what-will-it-mean/patientjourneys/older-australians/ http://publiclearning.ehealth.gov.au/ hcp/how-do-we-use-it/clinical-scenarios/discharge-from-hospital/ This is a call to action – support the registration process for your clients, register yourself, and register your family whilst you’re at it. Over time, the PCEHR system will change the way that care is delivered. The Aged Care sector needs to be at the forefront of this. ■

32 | Technology

Aged Care Industry IT Council â&#x20AC;&#x201C; Will IT change our world? Rod Young

The Aged Care Industry IT Council (ACIITC) met in Canberra 17th September with a focus on the future directions of IT in the aged services sector. The Council is a broad cross section of industry representatives and strives to use technology especially information technology to support systemic reform and improved quality outcomes for our clients/care participants and providers. The following article is an outline of the areas of interest the ACIITC wishes to explore in the future

2.8 million Australians are over 65 today. By 2040, thirty years time that number will rise to 7.2 million. Today 400,000 Australians are over 65 years of age by 2040 there will be 1.8 million over 85 year olds. Today there are 5 taxpayers for every person over 65. In 2040 there will be 2.7 taxpayers for every Australian over 65. Australians clearly wish to remain independent and in their own home environment for all of their lives. Quite simply, if Australia is to maintain a quality aged care system and to satisfy the wishes of an ageing population to have choice around the services they can secure and the location in which those services will be provided then the aged care system must become much smarter at how it delivers services and how it maximizes the capacity of a severely stretched workforce. In essence the Australian Aged Care system must use every technological solution that will assist care recipients. More importantly these solutions need to focus on making the care recipient the centerpiece of the care continuum. The care recipient must be enabled, as far as practical to manage their own health status to become the expert of first resort in the management of their care and health needs. This is not diminishing the role and responsibility of carers and health professionals. It is simply recognizing the reality of our future world. We simply will not have sufficient human resources to do what we do today, in the future. Unless we engage the consumer of care more actively in managing their health and care status then the whole health and care system is in jeopardy and could fail.

So what does all this mean? Quite simply we need to plan for the exciting technologies that are already available and which will be developed over coming years and ensure we can maximize the benefit that these technologies can provide to our future care service provision. Some of the opportunities that immediately spring to mind are: 1. HOME BASED MONITORING Community Care Providers service 670,000 Australians in their homes. Services can range from simple garden maintenance to daily nursing support for wound management or medication administration. These service providers are uniquely placed to deploy a range of home based monitoring devices for frail older care recipients. These devices can be alert systems, fall monitors, movement monitors, bed exit monitors and a range of other devices all of which are currently available. The services need to have access to a 24/7 call centre service so that the client has faith that a response will be initiated no matter the time of day. 2. TWENTY FOUR HOUR SERVICE SUPPORT Home based services are considerably enhanced by the deployment of 24/7 call centre support. To ensure these benefits are realized Australia needs to invest in the development or engagement of existing call centre service providers to ensure all community care providers can

34 | Technology

carers in care status and being better informed therefore able to seek interventions much earlier and hence avoid more expensive service needs such as a hospital admission;

have access to a comprehensive call centre/back of office support system that will underpin a range of home based technology deployments. This capacity to assist all community care providers to access a comprehensive back of office call centre support is crucial in the long term deployment of home based technologies. A small number of providers have already made the considerable investment in the development of an in-house service and several commercial call centre operators are acting as a back up service. Small community care providers need contracting and service development support in extending their service offering to their clients to maximize the benefits of deployed technology solutions. 3. DIGITIZED DIAGNOSTICS

(b)

care service providers have a much clearer understanding of service need and can target their workforce to more acutely service the needs of the individual client.

Several aged care providers are already deploying digitized devices, so far in a limited context. They are: (1)

Silverchain, a WA based major community care provider with approximately 200 home based deployments

(2)

RDNS Vic, the largest home care provider in that state

(3)

Feros Care, a medium sized residential/community care provider in NSW/QLD

4. COMMUNICATIONS INTEGRATION

There are a range of technologies already capable of being deployed in a care recipientâ&#x20AC;&#x2122;s home that can provide enhanced care and support got care recipients in two ways:

When discussing home based care technologies it is often assumed that deployments must begin from scratch and that new communication systems will be required.

(a)

In fact one of the largest pieces of infrastructure in the Australian telecommunications space is the home based television set with over 99% of all households having one or more units.

the care recipient becomes fully engaged, where possible, in the management of their care therefore ensuring greater efficiency of resources and more direct engagement by the care recipient and their voluntary

Technology | 35

With the conversion of the Australian television network to digital the opportunities for convergence emerge very rapidly. Digital TV connectivity to the internet is rapidly occurring. With this conversion comes the capability to deliver a range of care related services not able to be delivered through existing channels. The next development will be the capability to interface with the digital television through voice recognition technology. This capability already exists, however broad deployment over coming years will break down a barrier many older people feel when trying to access the internet and that is the necessary keyboard skills. Integrating the internet and television will enable the average home based care recipient to deploy a range of digitized devices to a monitor which they use on a daily basis as well as linking that source to health and care related databases which are providing the data management and data analysis capability that will fully support the care recipient to understand their health/care status as well as provide the health/care recipient with enhanced care and service knowledge to better target services to the individual.

5. TELEHEALTH Telehealth is a critical component of future home based care delivery. The three aged care providers mentioned above are all keen to utilize the NBN to deliver improved telehealth capability. Telehealth can include several different formats: (1)

Video Conference Using business grade broadband to deliver remote consultation capability between various health professionals in a variety of locations,

(2)

Remote Monitoring Using community care providers to deploy and monitor a range of home based devices targeted at more accurately managing a personâ&#x20AC;&#x2122;s health and care needs

(3)

Hospital Avoidance Strategies Empowering GPs and Community Care Providers to operate virtual nurses stations underpinned by business grade broadband to enable quality service delivery in a personâ&#x20AC;&#x2122;s home.

Well monitored home based care also underpins early hospital discharge with short term home based maintenance and support. To safely do this requires 24/7 monitoring and call centre support integrated with a service provider who can provide emergency home based services when required.

Technology | 37

in a person’s home to collect a range of health and care data which will be highly reliable and which can then be shared with health professionals especially treating GPs.

6. CARE INTEGRATION One of the substantial holes in the current care regime is the lack of communication between home based nursing and care services and local GP medical service providers. The profile of the usual person in receipt of home care or home nursing is usually someone suffering a chronic disease or frail aged requiring an escalating suite of services.

7. HOSPITAL AVOIDANCE As stated above, one of the opportunities flowing from an integrated care and health data collection from a persons home is the ability to avoid unnecessary hospital admissions.

These factors if not monitored effectively and managed appropriately are likely to lead to poor health outcomes or avoidable hospital admissions. It is essential therefore that community care providers who are often in a person’s home on a daily basis if not more frequently are supported to collect a range of data about the client. The essential components of this data collection should be shared with the treating GP so there is a much better understanding of the care plan as well as the medical plan of care.

If the care and health professionals are able to support a person through remote monitoring, virtual consultations, virtual nurses’ station and the better link this information to the GP to assist better clinical decision making it is a given that a high level of existing presentations at hospital emergency departments could be avoided. This would be a considerable benefit to the broader health system and to the individual and their families and carers. 8

If this interaction and exchange of care/health information is not present then it is likely that the care and medical decision making may be in conflict or at least not at their optimum. Reform of the Australian health and care systems must include the empowerment of care professionals operating

EHEALTH RECORD SOLUTION The decision by the Australian Government to move to a Personally Controlled Electronic Health Record (PCeHR) was timely and recognized the capability of a range of support technologies that will be needed to make such a plan capable of being delivered.

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tomi@jamix.com.au

38 | Technology

To take full effect of the PCeHR concept however will require recognition that much of the care and health system occurs outside of the mainstream health professionals framework. Yes, all the health professionals are key to ensuring that an individual receives quality care and services in the health system however community carers and community nurses usually spend much more time with the chronic disease, frail aged and long term care recipients than the mainstream health system other then in high activity events such as hospital admissions or medical service visits. The care of the group rests far more with voluntary carers and community based professional nurses and carers. Yet this group of care recipients consumes a disproportionately large portion of the overall health budget. It is therefore essential that the health and care data available to home based carers of all types is collected in such a fashion that is capable of being shared with other health professionals and vice versa. 9. VOLUNTARY CARERS The voluntary carers in the Australian health system are crucial for long term sustainability. Maintaining a person in their home

environment is often not possible unless there is a voluntary carer able to support the care regime. In the health service world this person is often forgotten or ignored especially the impact on aspects of their lives. In addition, often family and friends are keen to help or need to be assured of the safety and wellbeing of their loved one. With the introduction of business grade broadband capability this group even though they live separately from the care recipient can have much greater input into the management of the care and support of the home based care recipient through remote monitoring and video conferencing capability. ■

ER D ER 79 EA F e R OF pag ee

How do you manage your funding? Prioritise your reassessments? Track your results over time? Based on its extensive Advisory experience, Mirus Australia has developed an intuitive reporting and analytics solution for the Aged Care market. Aged Care Metrics is a cloud based solution that provides information at your ﬁngertips on mobile devices such as the iPad. The solution includes: • Executive management reporting of key ﬁnancial and operational metrics to enable site to site comparison and monitoring of leading key performance indicators. • Facility reporting that presents raw Medicare data into easy to understand information allowing a targeted improvement plan. • Resident reporting showing key medical diagnoses and existing ACFI assessment scores.

MIRUS – mir•us adj. – wonderful, remarkable, amazing, surprising, extraordinary (Latin derivative)

To ﬁnd out more and for your no obligation evaluation, please visit us at LASA stand 17

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40 | Technology

ACIVA Report John Perkins CEO Ethan Group and Caroline Lee – CEO Leecare Solutions

ACIVA wishes the industry to know that so ware vendors were not consulted regarding ACFI and Subsidy changes

espite ACIVA being involved in numerous Government working groups, ACIVA was not consulted by DoHA on its ACFI and indexation changes, which were announced by DoHA on 21st June. ACIVA has subsequently criticised DoHA’s handling of the introduction of changes in the Government’s Living Longer, Living Better Reforms with their disregard of the ICT industry requirements. Without any consultation with ACIVA members, the minister stated that the changes would only take software developers “2 hours”, a statement out rightly rejected by ACIVA. ACIVA members have been flooded with calls from their clients, the aged care operators, wanting to know when their software will be compliant with the new changes so they can provide the care and manage their businesses under these still-confused new business rules, and that is without consideration of the development costs involved with such changes. Due to the efficient and professional development capabilities of the vendors involved, clients were upgraded to include the ACFI changes in most if not all systems by mid to late July. Members have also strongly criticised the timeliness of the release of changes to Aged Care Fees and Subsidies. Prudent and error free developments require significant time to update software, test it and release it to clients prior to the new rates coming into effect.

Subsidies were only released to some in the industry on Friday 21st September yet came into effect on Thursday 20th September and were only updated on the Departments website over the weekend. We do not criticise the staff in the Department of Health and Ageing as they have also expressed their stress to members regarding the lack of notice. It is the entire aged care industry, who now rely more than ever on ICT solutions to be efficient, accurate and meet regulatory requirements, that is impacted negatively by this lack of consultation. We call on the Department again, to provide a “draft” copy of changes ahead of time to allow for software to be a step ahead of the release dates – as making slight changes to an eventual final drafted development will serve the industry far better than no development plans. ACIVA continues involvement in a number of working groups ACIVA are actively involved in a number of Government Panels and Working Groups, including •

Medicare – National Residential Medication Chart to be issued at some point in near future – will be used for prescribing medications as well as administration.

•

NEHTA and DoHA- ACIVA continues their support for the ongoing working groups

•

ACIVA is still heavily involved around PCEHR workgroups and testing ■

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The Aged Care IT Pathﬁnders Mike Swinson

“We are going to make sure that when the PCEHR (Personally Controlled Electronic Health Record) is up and running that it is as easy to use as possible, that it works for the people who use it on a daily basis, that it is secure and that it looks a er our consumers, the old, frail and vulnerable people who are in the aged care system!”

hat’s the commitment from the Chair of the Aged Care IT Industry Council, and the leader of the council’s pathfinder group, Suri Ramanathan.

“We want to make sure that everything the nurse, the GP, the specialist, the pharmacy or the hospital needs to know about any of the people in our care, be it residential or community care, is electronically and instantly available to them.” The Pathfinder Project is a unique initiative which brings together healthcare providers and software vendors in the aged and community care sector, in a partnership to make sure that when the PCEHR is up and running that it works for everyone in the aged care sector; consumers, facility operators, community care providers and healthcare providers.

A Pathfinder is defined as a person or group who goes ahead and discovers or shows others a path or way. So it is with this group of Pathfinders, leading from the front by example, being active participants in the development of new and effective technology for the delivery of services, showing the way for others to follow. The PCEHR project was announced back in 2010.

“Australians will be able to check their medical history online through the introduction of personally controlled electronic health records, which will boost patient safety, improve health care delivery, and cut waste and duplication. The $466.7 million investment over the next two years will revolutionise the delivery of healthcare in Australia.”

The Pathfinder group was formed after NEHTA announced that in association with then ACAA, (now LASA) it would execute contracts with five aged care software vendors to form a vendor panel that will support and encourage the introduction of personally controlled electronic health records (PCEHR) across the aged care sector. The software vendors are AutumnCare, iCare, Leecare, EOS Technologies (part of the Silver Chain group) and Database Consultants Australia. Three of these vendors have combined with providers, Silverchain, RSL Life Care and Montefiore to work together, to make sure that the software the industry has access to will work seamlessly within the PCEHR. In a recent article, one of the key players in the Pathfinder project, Silverchain explained it this way.

“The purpose of the Pathfinder Project is to demonstrate to healthcare policy makers that the aged care sector, characterised by very close working relationships between healthcare providers and software vendors, is ideally positioned to play a leading role in the adoption of the eHealth standards developed by the National eHealth Transition Authority (NEHTA). These standards allow vendors to integrate their software products with the PCEHR. This will allow clinicians to upload and access PCEHR content from the software package they are already using – without the need to use the PCEHR system directly. “ Just so there is no misunderstanding of what the PCEHR is, let me explain. For me, an average health consumer, not yet in the aged

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care sector this advance in technology cannot come soon enough. I want to be able to access my detailed medical records anytime, anywhere, no matter if I am on a cruise ship near the Antarctic, living the high life in Paris, or joining the grey nomads in outback Australia. Once the PCEHR is up and working it will mean that if required, a specialist doctor in Melbourne can instantly access all my health records, even though I might be in a Royal Flying Doctor aircraft being airlifted from somewhere up bush to a Melbourne hospital. The specialist will almost never have to ring my GP to get background information about my general health status and the moment I arrive he/she and the hospital staff will know everything about me that is available. (I do have to decide to opt into the system and I control who has access to my health information) A member of the Pathfinder project, Carolyn Lee from software vendor Leecare and a member of the Pathfinder group explains the benefits better than I can. “The disparate medical records that are out there now, stored with medical practitioners that never see the light of day from one medico to the other should be and soon will be a thing of the past. Technology will allow us to not only live longer but also better!” Carolyn Lee has elderly parents who suffer from a range of medical conditions, including Parkinson’s and cardiac problems. She worries about them, so for her the implementation of the PCEHR cannot come soon enough. “When I think that this project will combine all their medical records so that anyone at any time can access their latest medical history and treatments will make me breathe a lot easier,” says Carolyn. “They go from hospitals to specialists to other medical practitioners and all the details of the various treatments end up stored all over the place, not in a single repository where anyone can access them. That’s why I am so excited about this Pathfinder project. This will make sure that our aged care clients can

access the benefits of the PCEHR system, using their existing software.” Carolyn says she remembers a story a friend of hers told her when one of her friends parents went to hospital recently. The hospital lost the medical records, so the lady went without critical drugs for three days! Caroline said “one of the nurses came up to my friend while she was visiting her Mum and said ‘gosh isn’t it amazing your Mum isn’t on any drugs at her age!’ My friend replied, ‘what do you mean, she is on a bucket full of drugs, where are they and why hasn’t she been taking them?’ Finally the truth was revealed about the lost charts. That should never happen once the PCEHR is up and running.” For IT Council chair and leader of the Pathfinder group, Suri Ramanathan, it is critical that the aged care sector make the PCEHR work for them.

Technology | 45

“The software vendors we have chosen have accelerated the work, modified the software and then got feedback from providers to make sure that the modification and enhancements are working, including identifying what is missing from their perspective.” Suri says “it is not acceptable to make old, frail and vulnerable people responsible for remembering all the details of the medicines they take and why, nor should it be the responsibility of the nurses or carers to have to tell hospitals and/or medical practitioners everything from the patient’s medical records, given that those records are stored in repositories that might be miles apart. It’s just not right; it’s no longer up to the ageing consumer to remember” Again quoting from the Silverchain article:

“While developing software products, the vendor participants in the Pathfinder Project have been collaborating on a document which summarises the ‘lessons learned,’ along with recommendations on how to improve the working relationship between the standards-setting bodies and software vendors. The document will be passed to senior policy makers at the Department of Health and Aging as well as NEHTA, in the hope that when other (non-Pathfinder) software vendors embark on their NEHTA-compliance work, their path will be much smoother than that experienced by the Pathfinder vendors. This will help the whole aged and community care sector by allowing more vendors to produce NEHTA compliant software quicker and cheaper than would otherwise be the case. For their part, the healthcare provider members of the Pathfinder project are collaborating together to come up with the best way this new technology can be applied to improving clinical practice and client care. In most technology-related projects, the greatest barrier to success is not the technology itself, but the change management around business processes. Having a forum where providers can compare notes not only benefits the Pathfinder members but the whole aged and community care sector. One criticism levelled at NEHTA is that their agenda is dominated by the acute care sector, and that there is comparatively less understanding of the unique requirements of the aged and community sector. The Pathfinder providers are identifying these gaps so that the IT Council can champion the sector’s cause to senior policy makers. For example, a very clear need has been identified for a new type of document that NEHTA hadn’t previously considered: the Transfer Document, sent with clients whenever they are transferred out of a residential care facility. Another area overlooked by NEHTA is the need for care plans – which are critical in aged and community care. Suri Ramanathan says the people who are in residential care are traditionally high end users of the acute care sector. They end up needing hospital care much more than the rest of the community.

46 | Technology

“So the question we in the Pathfinder group are investigating is, ‘how can we use the PCEHR to their advantage and to the advantage of the organisations that provide that care?’ The PCEHR is a bridge between aged care facilities, hospitals, GP’s and other medical specialists, not to mention ancillary health providers. It’s an information bridge that allows instant transfer and availability of all medical records of the person who is the centre of attention,” he said. “It’s person centric!” I’m sure Clive James would roll his eyes and mutter profound verbal profanities if he was forced to utter those words ‘person centric!’ Suri says “we have been trialling this model with the three providers, testing it, training the people who work in the facility to use it. Take as an example our argument that each provider should have nominated individuals, not necessarily GP’s, who would be able to enter ‘shared information’ into a resident’s PCEHR. In aged care it is essential that registered nurses be allowed to enter that shared information, that it not be restricted to GP’s.” Suri went on to say that these nominated individuals could also upload what is called an ‘event summary.’

“We have also come up with a new format that is called a ‘transfer summary,’ that is designed to help when an individual moves from community care to residential aged care or from a facility to hospital, anything that sees the person move,” he said. Yet the reality is that not many Australians are signing up. This report from the Sydney Morning Herald reports that;

“Only 320 people signed up for an electronic health record five days after the Federal Government’s much anticipated July 1 e-health launch. With numbers like this, the Personally Controlled Electronic Health Record project, which aims to streamline patient medical records to facilitate treatment, is unlikely to meet its own target of registering 500,000 users by July 1 next year.” The article went on to say ‘a spokesman for the Royal Australian College of General Practitioners (RACGP) said the College supported the slow rollout. “From a clinical perspective, it is really important that this system is rigorously tested every step of the way. The PCEHR is an exceptionally complex system and rather than rush to an artificial timeline of July 1, we would prefer that if there are issues, they are ironed out first.” However the Deputy CEO of RSL Life Care, Carolyn Kwok, one of the providers involved in the Pathfinder group says “this is a fantastic idea that we cannot afford to let wither on the vine, its way too important.” “When it’s up and working properly it will save time, money and could even save lives. The ability to electronically transfer critical information, particularly when residents are going in and out of hospital will be a godsend. No longer should we face situations where paperwork is late, lost or non-existent. Nor will we face the current situation that when we do get a discharge summary from a hospital we get the sixth or seventh carbon copy that is almost always impossible to read,” she said. Carolyn says that the electronic information will be easy to read, easy to understand and should be accurate and will work even better for aged care providers when the e-pharmacy part is up and running. Just in conclusion I want to once again quote from the Silverchain article, because the author has hit the nail fairly and squarely on the head. To paraphrase Winston Churchill the launch of the PCEHR is “not the end. It is not even the beginning to the end. But it is, perhaps, the end of the beginning.” All those involved in the Pathfinder group say much more work is to be done, lessons learned, software adapted, so that when the PCEHR is ready for widespread adoption that the path for all vendors and providers in the aged care sector will be as smooth as possible. ■

Congratulations to Electrolux Laundry Systems Best in Test – Uses less power and water than other Washer Extractors The Danish Energy Association invited 5 leading suppliers Electrolux, Ipso, Meile, Primus and Schutless to participate in the consumption data study. The Association then staged the independent testing of commercial Washer Extractors from the five suppliers in accordance with established industry standards and these are the results: The Electrolux machine uses: t MFTT QPXFS DPOTVNQUJPO UIBO UIF BWFSBHF t MFTT XBUFS DPOTVNQUJPO UIBU UIF BWFSBHF The test examined independently verified and uniform consumption and performance data in accordance with EN IEC 60445 – the basis for European energy marking systems for domestic washing machines. The Electrolux machine tested was the W465H Economy Washer Extractor, examined on two program settings Wash (3A03) and Economy (3A01). All other suppliers submitted a like sized machine for testing. Its official – the Electrolux machines consume less water and power than other leading brands.

Measuring water consumption

Energy Consumption test

Water consumption per kilo was measured at various different wash temperatures form 30oC to 60oC without a pre-wash, these are the test results*

Denmark is one of the countries that have taken the lead in energy savings and addressing the issue of CO2 emissions. The Danish Government has adopted a long term vision in order to meet their set targets.

Test results Average water consumption Ipso 16.4 per kg clothing.

Test results Average energy consumption in kWh per kg of clothing.

Ipso 0.264

The Energy consumption test was conducted in a similar fashion as the water consumption test, i.e.: washing cotton fabric at various temperatures from 30oC to 60oC without a pre-wash, the results speak for themselves* Electrolux environmental considerations don’t stop with water and energy efﬁcient machines ….. All Electrolux commercial laundry products are manufactured to ISO14001 Environmental Management Standard that incorporates materials composition, environmental impact during manufacturing process, recycling, packaging, distribution and environmental safety.

Electrolux (Performance) 14.3

Primus 13.5

Schulthess 12.3

AVERAGE

Miele 11.8

AVERAGE Primus 0.178 Schulthess 0.176 Electrolux (Performance) 0.169

BEST IN B TEST BEST IN TEST

Miele 0.149 Electrolux (Economy) 0.145

Electrolux (Economy) 8.3

*The factors are based on an analysis contained in the “Energy Saving in the Public Sector Project” (Nov 2007).(– small font, italic)

*These test results can all be found at www.faellesvaskeri.dk

Electrolux Laundry Systems can not only provide you with the most efﬁcient, user-friendly and environmentally friendly machines but with 6 full time technicians and a large network of associated services agents they can maintain and support your investment. The service line is open for business 24/7, 365 days a year. Along with professional service and support is a huge local spare parts holding, free design and consultancy service, accreditation advice and all the ancillaries necessary to ensure your laundry works to its optimum and is OH&S compliant. All this and the conﬁdence that you are dealing with a recognised global company not a Distributor.

With Utility prices on the rise talk to the leading manufacturer of easy to use, innovative, energy and water eﬃcient laundry systems.

888 or visit on www.electrolux.com/professional CallCall for 1300 a free550 consultation on 1300 546 Australia wide to ﬁnd948 out more orour visitwebsite our website at www.electrolux.com/laundrysystems .

Feeling Hungry ??? We are all familiar with Dining Programs that offer discounts at selected restaurants…....they are a great way to turn an evening out into something that doesn’t hurt the hip pocket so much. The only problem is that if you find a really good restaurant, after one visit the discount stops. We are pleased to announce the addition of another 600 restaurants to our Program, which allow you to visit as many times as you want! For many Aged Care employees, this now means the difference between being able to dine out, and not. • Up to 50% discount • Visit as many times in a year as you like • More than 1,000 restaurants across Australia and New Zealand In addition to our restaurants, we have over 8,000 retailers offering discounts and in excess of 20,000 household products online, there is something in the Program for everyone. To make it more valuable to your employees, and hence your organisation, we have also made the Card usable by family members. I often meet resistance from organisations to implement an organisational funded Program, with the perception that “We don’t think our employees would use the Card”. I don’t know any Aged Care employee that could afford to pass up hundreds of dollars in savings annually, let alone thousands. So….how much can the average family of three save in a year by using the Program? Food & Fuel Insurance Dining Health Insurance Movie Tickets Clothing Holidays Household Items Car Servicing

$ $ $ $ $ $ $ $ $

910 720 300 280 270 200 140 100 77

$2,997 At the equivalent cost of a 1 cent / hour pay rise, the LASA Employee Benefits Program is a fantastic opportunity to offer a substantial benefit to your employees at a minimal cost. Whilst each website is co-branded with your organisation’s logo and welcome message, our generic website can be viewed using the following login details: www.presidentialcard.com.au/lasa LOGIN: LASA00000 PASSWORD: LASA Brad King Manager Business Development, Presidential Card, 0413 839 999, BKing@PresidentialCard.com.au

50 | Workforce

The Secrets of Success in A racting Young Staﬀ By Mike Swinson

’I just love seeing the kids become successful and happy, seeing them achieve, that is reward enough for me. But it’s more than that, this is about keeping communities going, adding to them, caring about what happens to young people and not dismissing them.’

his is a wonderful story of caring, of taking a risk and giving some kids a chance, of putting in and as Napoleon Hill said, ‘Of going the extra mile,’ not because you have to, but because you want to.

Meet Jenny Knight, the HR Manager of Whyalla Care Incorporated, the only aged care facility in the South Australian mining town. ‘We are community owned, our town has about 22,000 people and we are the only aged care provider. We have 141 beds residential and around 50 community packages, employing over 260 staff,’ says Jenny. She told me that just before the new CEO, Juanita Walker was appointed, one of the facilities was sanctioned, and that some staff had been expecting something like that to happen one day. ‘I think it’s safe to say that the management philosophy was a bit old fashioned, so things had to change or we would have been in big trouble. I started working here soon after Juanita started and I have to say that the management team have turned this place upside down. We were faced with an ageing workforce, we had retention problems and the staff were pretty set in their ways, nobody liked anything changing,’ Jenny said. But change they did and results have been quite remarkable. In July this year Whyalla Aged Care Incorporated boasted 64 employees under the age of 44! And that number is expected to grow. Jenny Wright told me that they looked at how they could do employment and retention better, forge stronger links to the local schools, TAFE and workplace service providers. ‘We were going out there and selling aged care as a great career option to the schools, no-one had done that before, so many of the kids didn’t know about us or just dismissed us as a possible employer.’ Jenny also told me that while many girls in years 10, 11 and 12 thought about a career in child care that could lead to teaching,

Left: Jenny Knight, the HR Manager; Right: Director of Nursing/Chief Executive Officer, Juanita Walker. very few of them knew about starting in aged care, doing a Certificate 3, then into nursing as a career move. She said ‘aged care did not have that attraction to the younger ones, so we went out there to change kids and teachers perceptions. There are career pathways and there are jobs in aged care that can earn you a significant income if you study and get qualifications.’ But when I asked Jenny why she does what she does, why she takes the time to support and encourage some kids that most thought would be useless, she said ‘it’s madness! No, honestly I’ve never thought much about it, I suppose I get a huge reward every time a youngster turns out OK, who comes here on work experience, then into part time casual work, then a full time job, I get a huge kick out of that.’ There are numerous examples Jenny shared with me, of the first kitchen work experience youngster. Many of the staff initially were not too keen, then going full circle, so that when this young trainee had to travel to Adelaide to get basic kitchen training the staff all kicked in to help her buy a set of knives and other things she

Workforce | 51

needed. Of the overweight kid who turned up on day one of work experience, dressed in an old track suit, looking pretty sloppy! He is now working part time, losing weight, loving the work and the relationships he is building with the residents and is about to be offered his first full time job. He is in his mid twenties! ‘We have put through school based training youngsters in our kitchens, one left and is now working in a hotel. We have a school based trainee in our administration section; she has completed her Certificate 3 and will continue to grow in capacity. I see her as a future leader, with the potential to do well; she is also a finalist in the school based trainee awards this year.’ Jenny said ‘We have another young girl who started as a school based trainee; she will finish her year 12 and certificate 3 at the same time. She does a lot of extra shifts and wants to do enrolled nursing then registered nursing, which luckily is something they can do here in Whyalla, they don’t have to travel to Adelaide to do that. We have a lad who works in our gardens, some are successful, others are not but we keep on going because overall it is working really well.’ When Jenny first started she was told “we don’t employ anyone under 17,” well she said ‘we are now employing school based apprentices at 15. We are picking them up as they approach the end of year 10. They do a week’s work experience, and then if they are still keen, we say come in for 1 day a week. It opens their

eyes to career possibilities. We work closely with the school; we work flexibly so they can fit it in with school work. It takes time and effort but it’s worth it.’ Whyalla is an industrial based centre where unemployment rates are rising. The unemployment rate for the Port Augusta-WhyallaPort Pirie region was 6.4 per cent at September 2011, an increase of 1.0 percentage point over the preceding 12 months. Jenny said that when she attended a recent skills workshop she was told that businesses had to start the engagement process with young people well before year 12; otherwise it is almost too late. If kids have not had experience with industry or training that has been positive, particularly for those kids without good parental or family role models then by the time they are 18 it’s almost too late. ‘Many young people when they come here are surprised that there is such a wide variety of careers, they are well treated, they work in a uniform and they love it when they pick up an extra Saturday or Sunday shift! It means a substantial increase in their take home pay and gives them independence. We have 5 youngsters at the moment who are under 18 and I want that to go up to 15.’ ‘When I started three years ago, we had six people less than 24 years of age, now we have up around 30 and it’s climbing. One thing that comes with that is we have 5 staff members who are

52 | Workforce

pregnant. But it’s all family, so when the babies arrive they come in and share them with the residents who just love it,’ said Jenny. ‘I read your article on attracting young people into aged care in the ACAA Winter 2012 edition with great interest. We are an aged care provider in regional South Australia and recognised several years ago that our future needed to include younger staff. I have included the details that Jenny sent me in her email, because I am sure it will be of interest to almost every aged care facility manager who is also trying to attract younger staff into their workforce. The strategies include: •

School Based Apprenticeships in the following areas:- Cert II in Aged Care, Administration, Kitchen, IT, Maintenance and Garden

•

Employment of Supported Wage Employees (Young employees with disabilities or disadvantaged)

•

Work placement for Cert III& IV students, enrolled nurses and registered nurses and allied health students

•

Support of Work Experience for High School students

•

Support of placement for Community Service Hours for students

•

Introduction of Career Pathways for existing staff (including Cert IV in Leisure and Lifestyle, Allied Health, Frontline Management and Nursing)

Jenny says all these strategies are reasonably new but she is starting to see outcomes already and last year Whyalla Aged Care were finalists in the State Training Awards, won the local award for Employer of the Year (training) and this year one of the young staff members has been nominated as a finalist in the State Training Awards. It obviously pays to ‘go the extra mile!’ We currently employ 249 Staff and I have attached a couple of reports that show the change in our workforce profile over the past 5 years with the adoption of all of the above strategies. We believe the future of our organisation and our community (particularly as we are regional) rests with the younger generation and these strategies support this philosophy. ■

For further details contact: Jenny Knight, HR Manager, Whyalla Aged Care Incorporated, 25 Newton Street, Whyalla SA 5600 Telephone: 08 8645 5588 Facsimile: 08 8645 5596 E-mail: jknight@whyallaagedcare.com.au http://www.whyallaagedcare.com.au

Workforce | 53

Growing your own workforce Workforce Development isn’t a catch-phrase; it is a business decision that could be the diﬀerence between a sustainability and closing down according to Rod Cooke, CEO, of Community Services and Health Industry Skills Council (CS&HISC).

S&HISC is the body responsible for developing the national Vocational Education and Training (VET) qualifications for the community services and health industries. By consulting with industry advisers, peak bodies, employers and unions, CS&HISC ensures the 160 VET qualifications for the care industries reflect the 500 vocationallybased job roles. The 65 sectors in these industries range from aged care, mental health, disability services right through to allied health and children’s services. “Developing the qualifications is only part of our role, we also work to ensure that the competencies and skills within the qualifications are used by workplaces to strengthen their workforce and their service delivery,” said Rod. “Because we know that organisations which invest in their workers development now will be the ones that deliver the best service in the most productive ways. We also know that investment in current workers, and support of trainees, has been shown to improve retention and recruitment rates, respectively; and with Government estimates indicating 272% more workers will be required in aged care alone by 2025, investing in workers now is going to place you ahead of the curve when demand outstrips workforce supply,” Rod stated. However, Rod cautions there is training and then there is quality training. “CS&HISC has clear ideas about what constitutes quality training, and who plays a role in ensuring everyone gets the greatest benefit from up-skilling,” he said. “For our sectors, we advocate several actions for improving quality in training that requires involvement by VET regulators, employers and workplaces, RTOs, trainees, and CS&HISC itself. 1. The Australian Skills Quality Authority (ASQA), Victorian and WA regulators

and sector regulators need to use clear indicators when reviewing and authorising licenses to RTOs with care industries on their scope. CS&HISC is working with both agencies to help define these indicators, which we feel would assist in identifying both poorer and better practice by RTOs particularly in the aged care sector. This wouldn’t necessarily mean making any changes to the regulatory process, but would support both authorities in managing risk and building industry engagement. 2. As the Industry Skills Council we need to ensure that the qualifications and competency standards within the training packages are enhanced to specify and strengthen the inclusion of workplace experience in training and assessment. We have already started our work on this by reviewing all 160 qualifications and 1,198 competency standards covered by the Community Services Training Package and the Health Training Package.

544 | Se S Section e ect ct tion io on

Workforce | 55

3. Employers need to open workplaces to trainees to provide work experience. They also need to develop strong induction programs to support new staff and support work-based development, and establish a supervision and assessment schedule that includes an in-house training plan. 4. Registered Training Organisations need to ensure their staff are suitably qualified, and that their industry currency is being maintained to improve curricula development and relevant delivery CS&HISC will work with state and territory training authorities and industry training advisory bodies to seek their support for professional development for RTOs to improve quality and improve their engagement with employers. 6. If you’re a worker or learner about to undertake training – choose carefully. This is a message we give to all trainees who approach CS&HISC either through our website, at career expos or in conversations. We encourage all leaners to investigate the employment outcomes and compare the cost and duration of a course with others on the market. Employers seeking training for their workforce need to be vigilant as well, and make sure you are getting the qualifications and skills your organisation needs, delivered in a way that works best for you and your staff. “We have been refining this ‘must have’ list for a few months now, but would really welcome any comments you have to make,” said Rod

Workforce Development Case Study Innovative employee engagement at Braemar Presbyterian Care Braemar Presbyterian Care is a Western Australia based not-forprofit residential aged care organisation providing various levels of accommodation and care to almost 200 residents across three facilities. The organisation is known for innovative programs to attract staff, mentor new employees and encourage young people to consider careers in aged care. In 2008, Braemar knew it needed a long term strategy to attract and retain care staff, so it developed a workforce plan based on ongoing career development to foster new and existing staff. Braemar management planned holistically and developed a five year training plan to address much more than what the name implies. They thought broadly about recruitment, retention and employee satisfaction which led to a coordinated training and development program that specifies targeted learning experiences for identified staff. This systematic

approach enabled Braemar to align the needs of the business with the personal goals of employees, to create a program that is meaningful and effective. Getting the right skill mix was an important part of the plan to ensure sustainability. Through funding from the Australian Government within the Enterprise Based Productivity Places Program (EBPPP), Braemar has been able to address this issue by training existing carers in the Diploma of Nursing (Enrolled/ Division 2 Nursing) as part of the ‘advancing care’ element of its training plan. Braemar encourage commitment to the training program by supporting the participants and promoting flexibility. By negotiating with the partner registered training organisation, Central Institute of Technology (CIT), Braemar hosted the first block of training sessions on site to make it easier for staff to attend and to gradually introduce them to learning by holding it in a familiar place. Once comfortable with the structure of the program, most of the training moved to the CIT campus, returning to Braemar for a monthly training day. Trainees have been supported in-house by ‘Braemar Mentors’ who have been a pivotal group as part of Braemar’s workforce development plan; and personal support from the CEO though attendance at some of the training days and internally and community promotion. Braemar is committed to placing training in the bigger picture, so from the outset, participants were not only congratulated on their awarded training enrolment, but welcomed to a broader personal development program by the CEO. In terms of developing a workforce, the plan seems to be working. One example is of a worker attracted to the organisation following a careers expo Braemar held on site at a local smallgoods factory that was closing down. Today, she is an employee who has followed a career pathway from Certificate III in Aged Care to being midway through the Diploma of Nursing.

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Another innovative program was launched in March this year called: ‘Leading the Way’. Still a pilot program, it is a projectbased training model whereby participants complete the Advanced Diploma in Community Sector Management. Developed by a consortium of four aged care providers, it was inspired by a training needs analysis undertaken at Braemar for administration and management employees. Taking the opportunity of monies made available through the National Workforce Development Fund (NWDF) the program aims to build essential skills at managerial level, encourage innovation, develop interagency networks and build a skills ecosystem for participating agencies. There are 20 participants, and Central Institute of Technology is again providing the training. Assessment includes project-based team assessment, individual assessment and reflective journals. All workshop activities feed directly into project based assessments and additional support has been provided by an experienced mentor/coach. With the vision to develop a comprehensive leadership program and commitment to the ongoing support and flexibility of current programs, it seems Braemar is well on the way to achieving one of its key strategic objectives – Shaping a workforce of competent and passionate people who love being connected with the clients and wider community. ■

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Incorrect energy bills cost Australian businesses thousands Energy Action leading the charge to help businesses understand energy costs

ith all their jargon, technical information and complex calculations, energy bills can be confusing and difficult to understand for Australian businesses. Because of this many discrepancies between what organisations should be paying and what they’re actually paying go undetected. Sometimes the difference may only be a few dollars, but in many cases it can be hundreds or even thousands of dollars. Furthermore, more than half of Australian businesses (55 per cent) wrongly believe their energy contracts are not “contestable” (or able to be negotiated). Many businesses sit back and remain on the same contract, and some may not even be aware they are on high default rates. It is therefore more vital than ever for Australian businesses to understand the content of their bills. Correcting overcharges can save Australian businesses a significant amount on their energy bills. Likewise those being undercharged can identify the discrepancies early in their contract and rectify them, avoiding hefty surprise additions to bills later down the line. Energy Action analysed bills submitted for bill validation via their contract management and monitoring services over a 3 month period. They found that: •

1 in 5 bills (21 per cent) were incorrect in some way

•

on average, 13 per cent of users are overcharged and 8 per cent undercharged

•

overcharges amounted to more than $74,000

•

the most common reason for an overcharge was incorrect ‘line loss’ charges (loss factors represent energy lost in the electricity network during transport).

Valerie Duncan, CEO of Energy Action said: “Many businesses are worried about the rising cost in energy and the introduction of the carbon tax. But there are many other charges that could potentially be reduced if actively monitored. Having an independent energy management company assess that you are on the right network tariff for example can, in some cases, result in significant savings. “Businesses wouldn’t pay a phone bill without checking its accuracy, and energy bills should be no different. But the reality is that a lot of energy bills are paid without ever being validated. Checking an energy bill is virtually impossible without expert help however. Energy Action’s Activ8 service provides energy monitoring and bill validation services to help Australian businesses check they are not being charged incorrectly as

unlocking these savings is not a simple task for a business to tackle on their own.”

What makes up energy charges on a bill? An energy bill is made up of several different charges. Energy itself makes up just under half (around 45 per cent) of the total. The charges that make up the remainder of an energy bill include: network, market, environmental and service related charges. •

Network charges cover costs involved in the transporting of electricity from generators, across the transmission and distribution networks to a site. These charges are reviewed and adjusted annually.

•

Market charges are fees which are paid to the Australian Energy Market Operator (AEMO) to operate and maintain the National Electricity Market (NEM).

•

Environmental charges are costs associated with complying with State and Federal schemes which are aimed at promoting efficient use of energy, reducing greenhouse gas and funding renewable energy generation.

•

Other service related charges are fixed fees which typically cover costs associated with electricity retailing such as service charges and retailer fees. This section may also include additional metering fees that may be associated with metering or monitoring services.

What should businesses be doing? 1. Get to know your bill: To help Australian businesses better understand their energy bills Energy Action has launched an online guide: http://www.energyaction.com.au/australian-energy-market/ get-to-know-your-bill.html 2. Check your charges Get an expert to check bills. It can be difficult to know whether bills are correct without understanding how charges are calculated. Often you may require additional information and consumption data related to time of use from a metering agent. Many bill issues therefore cannot be rectified directly with your energy supplier and will need the expert help of a reputable energy management company who can independently check charges are correct and advise on where savings could be made. 3. Review network tariffs An energy management company can advise if you’re eligible for a better value network tariff. As network charges make up

a sizable part of an organisation’s energy bills, switching tariffs can, in some cases, result in significant savings. Energy Action highlighted potential savings for its Activ8 customers in Victoria of more than $1.2 million, with average savings of $5,800 and several being well in excess of $20,000 per annum. 4. Think about use Using electricity in the off peak period is not necessarily the best way to save money. Electricity companies look at peak usage and keep enough energy back to cover this level at all times (so there is always enough energy available). Using large amounts of energy in a short period of time means the electricity company will need to supply the highest amount you use all day – resulting in much higher demand and capacity charges. It is often better to spread use across the day. 5. Identify opportunities for energy efficiency Ultimately, the best way to reduce bill costs is to reduce consumption. Educating staff on ways to reduce electricity use and creating an energy policy are good ways to lower a business’s energy footprint. Upgrading lights can also be a cost effective option to reduce consumption. Some businesses may even be able to produce their own energy with expert guidance. Cogeneration can reduce organisations carbon footprint by up to 30 per cent. There are also many schemes and grants available to help businesses implement energy efficient improvements. Valerie Duncan added: “Checking your bill is just the first step in making cost savings. Most organisations can also find other quickwin efficiencies and organisations spending more than $20,000 per annum should consider securing future energy rates by negotiating a forward contract. Businesses should also be looking at ways they can become more energy efficient in the long-term to bring down costs and help the environment.” To discuss this opportunity further and have a free electricity (or gas) bill health check, contact Peter Naylor at Energy Action today! As a special offer to LASA members, we have waived the registration fee (usually $450.00) for use of the Australian Energy Exchange. This means your aged care facility has no fees to pay, only savings to be made! Even if your contract isn’t due to expire, we can still help! Phone: (03) 98225244 (ext 2002) Mobile: 0451 039 350 Email: peternaylor@energyaction.com.au or go online: www.energyaction.com.au ■ ABOUT ENERGY ACTION Energy Action is Australia’s leading independent energy management Company, offering comprehensive buying and management services aimed at reducing energy usage and saving businesses money. The company’s flagship service, the Australian Energy Exchange, allows energy suppliers to competitively bid against one another to supply an organisation’s energy – with a best fit contract secured in around 15 minutes. This unique platform has secured energy contracts in excess of $5 billion and delivered millions of dollars’ worth of savings for Australian organisations.

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Community Care Challenges Judy Gregurke Community Living & Policy Manager LASA Victoria

hese are indeed highly interesting times for the community aged care sector. The release of the Gillard Government’s Living Longer. Living Better aged care reform in April 2012 has raised the profile of care provided to assist older people stay at home. This increased focus on ‘in home care’ was one of the outcomes of the ‘conversations on ageing’ undertaken by Minister Mark Butler, and provided an improved understanding of the choices and preferences of older people.

•

the reform of four key programs over three years with Home and Community Care (HACC), National Respite for Carers Program (NRCP), Day Therapy centres (DTC) and Assistance with Care and Housing for the Aged (ACHA) to be rolled into the Home Support Program from July 2015

This focus on consumer directed or consumer led care is based on an aspirational change to provide greater opportunities for consumers to exercise more choice in how they receive care services. In the context of the Productivity Commission’s recommendations in the ‘Caring for Older Australians’ report released in August 2011, consumer direction was one part of a broader concept of moving to an entitlement model of aged care. It included a focus on care leading to reablement, in which older people would be able to request and receive services and care to meet their needs and improve their functioning. While the LLLB reform package falls short of this entitlement approach, the Government response to the PC Report committed to a greater focus on ‘consumer direction’ where consumers “have more choice in how they use the subsidies they are entitled to”. The major changes for the community care sector involve: •

an expansion of packaged care in both numbers and range of packages available

•

the creation of two additional home care packages, one as a new entry point below the current community aged care (CACP) package and one as a mid-point between the current CACP and EACH packages. This will result in four levels of home care packages

•

the offering of all new packages from the next Aged Care Approvals Round (ACAR) as consumer directed, with all existing packages to transfer to consumer directed models by July 2015

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Nearly six months since the release of the LLLB reform package, the Department of Health and Ageing (DoHA) and the government are focussing their attention on the shape and structure of these new â&#x20AC;&#x2DC;consumer directedâ&#x20AC;&#x2122; in home care packages. This is a priority so that the new home care packages, based on principles of consumer direction, can be part of the ACAR in 2012. The National Aged Care Alliance (NACA) is assisting in providing advice about the nature and structure of these packages through the Home Care Packages/CDC Working Group.

Australia in two stages from July 2010 to June 2012. The â&#x20AC;&#x2DC;KPMG evaluation of the consumer-directed care initiative â&#x20AC;&#x201C; Final Reportâ&#x20AC;&#x2122; (125 pages without appendices) can be found on the Department of Health and Ageing website under community care.

As part of the Working Group processes, LASA is actively engaging with members from the community care sector in identifying opportunities as well as barriers to reform and seeking solutions that lead to an ongoing viable community care sector with capacity to meet consumer needs and preferences.

LASA believes that in coming months, a critical priority is for key stakeholders to develop a shared understanding of how we can ensure a robust and viable community aged care sector that can enable older people to choose a variety of care and supports. Inevitably there will be many opportunities and challenges as we set in place a system which enables older Australians to choose the level of control they wish to have over the delivery of their home care.

Consumer directed care (CDC) is defined as a philosophy or approach to service delivery that allows older people and their carers to make choices and have greater control over their care and services, ideally on the â&#x20AC;&#x2DC;what, who, where and whenâ&#x20AC;&#x2122; services are delivered. The mainstreaming of CDC follows an evaluation of the CDC initiative, a pilot of CDC packages and carer respite across

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General | 63

Aged Care Industry Media and Crisis Management By Mike Swinson Media and Crisis Management Consultant to the aged care sector.

‘Now more than ever, you, as the CEO of an aged care facility or organisation need to be prepared for the worst. You need to have crisis and media management plans in place, well researched, well rehearsed with key staﬀ aware of their respective roles and responsibilities when everything goes pear shaped for whatever reason. You need to protect your brand, your business reputation, who your local community think you are!’

“A crisis can destroy the public’s trust or belief in an organisation, its reputation and/or its image.” (The Essential Guide to Managing Corporate Crisis.)

hat to do in a crisis and how to make use of defensive public relations methods are aspects not often considered by management until it is too late to avert or control the problem. Consumerism is becoming stronger, helped by open, unfettered and uncontrolled access to the web and encouraged and supported by a story hungry and largely time poor media. There is also increasing government interest and interference and a need to be ‘seen to be doing something,’ particularly in the aged care sector that is largely publicly funded. “It is far better to plan for the worst, be prepared for any eventuality that may never happen, than to have to face an unforgiving media, hungry for someone to blame, someone they can blame and publicly shame!”

Latest statistics suggest that there are around 3,000 organisations providing aged care services to older Australians. They range in size from small (30 to 50 beds) to large. (Over 1000 beds) Many of these same organisations also provide care to those who live in their own homes in the community. Aged care is provided by not-for-profit (religious, charitable and community groups), private sector operators and governments. The not-for-profit sector provides approximately 65% of the county’s residential aged care services, with the balance provided by the private sector and governments. Over recent years, there has been a gradual move away from residential care, in line with the preferences of older people and increasing government support for the provision of home-based care. As you are all aware, you work in a highly regulated sector of the economy, with successive governments quick to shift blame for misadventures back to the industry.

There is no better example of this than the recent Seven Thirty Report story on ‘Rorting in Aged Care.’ Minister Butler was quick to suggest he would be ‘looking into this’ even though the program suggested that it was his department that was at the heart of the problem, apart from ‘a few unnamed and unidentified greedy’ aged care providers! The Aged Care Standards and Accreditation Agency can be contacted by prospective residents and carers in relation to a facility’s accreditation status. It can and is contacted by existing residents, family members or employees in the industries, any

64 | General

of whom can and do lodge complaints or allegations of abuse, bullying, harassment or illegality of any form. At the same time as this evolution of care has been occurring, the media and information industry has also been undergoing huge change. Now, more than ever people can access information from uncontrolled and unregulated sources, mostly via the World Wide Web. The current younger generations (Gen X and Y) are media and tech savvy, more so than any previous generation and when their parents start moving into care, (the Baby Boomers) providers will have to be more media aware and prepared for any eventuality than ever before. So, how prepared are you for a crisis in whatever form it manifests itself? Check this list and see how well you perform: •

What is the worst thing that could happen to you as the CEO/ DON or your organisation?

•

When is the worst time for it to happen?

•

Do you have a plan to deal with it?

•

Who will lead the response team?

•

Do you have pre-prepared responses for the most serious situations?

•

Can you contact your key people quickly?

•

Where will you manage your response from?

•

How will the business run while this is happening?

•

What are your recovery goals?

If you answered ‘Yes’ to all those questions then you are remarkable and obviously well prepared for a crisis when it hits. If you did not get a perfect score than there is much work to be done to ensure that if and when a crisis happens, you are well prepared and rehearsed for any eventuality. There are a myriad of situations that can engulf you and your organisation almost instantaneously if you are not prepared. Incidents can happen without warning such as building fires, power failures, violence, food poisoning or a bus crash. How would you handle a stabbing incident of a resident, a report of allegations of bullying and harassment of staff in the local newspaper, the death of a resident in questionable circumstances? The list is endless. The one piece of good news is that there are professionals out there who can guide you through the media minefield, supporting you and your organisation. Sometimes it doesn’t hurt to raise your hand and say, ‘I need help here!’ By the way, the crisis communications team’s job is not complete once the fire is out or the bus crash scene has been cleared, in fact the bulk of the work has just begun. ■ Mike Swinson, Managing Partner, Corporate Image Matters, E: mike@cimatters.com.au M: 0407485649 www.corporateimagematters.com.au Mike Swinson runs Media and Crisis Management workshops in Victoria and New South Wales run by the state based LASA office.

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When is a retirement village not a retirement village? Rachel Lane | Principal | Aged Care Gurus

Part 2 In the last edition of Aged Care Australia Magazine we examined Demountable Homes Parks (o en referred to as Over 55’s communities) as the second instalment of our four part series examining the diﬀerent legal and ﬁnancial arrangements that people enter into to provide companionship and aged care services. In this edition we are going to look at Retirement Villages.

here are a number of factors that motivate people to make the move from their own home to a retirement village; maintaining the family home may be becoming difficult, not to mention expensive, a health scare or the loss of a spouse may bring social isolation and the desire to take part in sports or social activities with a community of like-minded people can be motivating factors. Retirement villages operate under the relevant state or territory legislation which typically sets a minimum age of 55. This legislation generally provides a definition of what is and isn’t considered to be a retirement village, sets out what legal documents (including disclosures) are required to be provided to residents by the village operator, regulates some (not all) financial arrangements and provides framework for the resolution of disputes. There are many different forms of ownership models with Retirement Villages, including freehold or strata title, company title, leasehold, licence and some operate under a rental model. The most common of the ownership models is 99year (or Lifetime) Leasehold or Licence. The level of care that can be provided to you in a Retirement Village will vary from one to another. Traditional retirement villages focus on the lifestyle and activities and want to attract residents that are sociable and physically active. These villages may require that you leave if your health deteriorates, as too many people unable to participate or remaining in their units can have a detrimental effect on the experience of the other residents as well as the ability to sell units to new residents. In some circumstances the village operator will allow you to have care provided to you in your unit. If the retirement village cannot organise this for you will need to arrange for the services to be provided just as you would in your own home; through government funded community aged care packages or private services or a combination of the two. At the other end of the scale there are retirement villages that are purpose built to deliver aged care. It can be difficult to tell the

difference between these and an aged care facility. The rooms are often single rooms or small apartments with an ensuite bathroom and they are often built to the same specifications as an aged care facility; wide doorways, bathrooms with handrails and showers without a recess to enable staff to assist with showering, call buttons to request assistance as well as the provision of meals, domestic services and some nursing services. These services may

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be delivered to you as your care needs increase or it may be a condition of entry that you already require some or all of these to be provided. Where it is a condition of entry that you require care the retirement village operator will generally assess your needs prior to you moving in to ensure that they can provide the services you need. They will generally co-ordinate the package of services for you and provide you with a price table to help you understand what the cost will be now and what you can expect if your care needs increase. In many cases the care being provided will be through a government funded community care package with the retirement village delivering any “top up” services themselves or through private contractors. Financially, retirement villages are very different to aged care facilities so let’s examine the costs. There are four main categories of costs: 1. Entry cost. This is the price you pay to gain possession of the unit. This will be either the purchase price if it is strata title or company title, or the amount of the interest-free loan you make to the developer if it is a lease or licence arrangement. The amount you pay determines if Centrelink/DVA consider you to be a homeowner, whether the amount is considered an assessable asset and your entitlement to rent assistance, consideration also needs to be given to the impact on pension entitlement itself.

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2. Service charges. Irrespective of the method of title held, residents are responsible for the ongoing costs of the village. These include insurance, water rates, general lighting, staff wages, and repairs and maintenance. As these are reimbursable items, the management is not allowed to make a profit on them but can claim only the actual costs. The manager prepares a budget of expenditure for the year and each resident is levied for a proportion of that expenditure. 3. Internal maintenance. Naturally residents are responsible for the internal maintenance of their own units and are required to pay for all damage apart from “fair wear and tear”. They are also liable for their own electricity and telephone costs as well as insurance of their personal effects. Where you are accessing care or other personal services such as meals, assistance with laundry cleaning or nursing services you will generally need to meet the cost of these services on a “user pays” basis depending on the type and amount of services you use. Many villages require outgoing residents to pay the cost of repainting the interior while others will require a complete refurbishment of the unit at the resident’s expense and this will be part of the calculation of the departure fee. 4. Deferred management fee. This is the cost that causes the most confusion. The deferred management fee (DMF) in simple terms may be regarded as part of the developer’s profit. Many people seem to regard deferred management

fees as a “rip-off” but the developers can make no profit from the service levies or the internal maintenance fees, and often make no profit on the development until they reach the later stages. There are a number of different ways in which the DMF can be calculated, and in some cases the retirement village operator may give you a choice of models. In looking at the models it is important to understand if the DMF will be calculated using the purchase price or the sale price and whether it will be before or after any capital gain sharing. There is no doubt that retirement village living is fast becoming an attractive option for many retirees and it will be one of Australia’s major growth industries as the number of people over 65 increases. The diversity of interests, demand for privacy and space, expectations in terms of additional services, desire for flexible financial arrangements and potential care needs in this age group will make catering to the baby boomers’ wants and needs challenging for village operators. ■

68 | General

Is it the right time for your not for proﬁt organization to change their corporate structure?

hen is the right time for an incorporated association to transition to a company limited by guarantee?

company limited by guarantee, as it will then be entitled to operate in any part of Australia. •

A not-for-profit organisation starting out in Australia has two obvious choices when it comes to establishing itself as a legal entity: •

register as an incorporated association under its State of operation and the relevant incorporated associations legislation; or

•

It is understandable why many start-up not-for-profits will commence operations as an incorporated association. There may be no real or practical alternative due to limited availability of personnel and financial resources at the time of establishment. There is also the perception that an incorporated association is quicker, cheaper and easier (although that may not always be true). If the organisation is uncertain about its future success, an incorporated association may seem less risky or complicated. If your organisation has taken the incorporated association path, it will be important to evaluate your activities on a regular basis to make sure your chosen structure remains the most effective. Are you experiencing growth in your organisation, seeking external funding and/or conducting significant business activities? Any one of these factors may be a good indication that you have outgrown, or are outgrowing, your original structure. Did you know: •

Incorporated associations are not permitted to conduct business outside of their State of registration, unless registered as a registered Australian body. Any organisation wishing to extend its operations outside its State of registration should consider converting to a

•

Organisations that carry on significant business activities, such as regular provision of goods or services to the public, are likely to benefit from a company structure for a number of reasons including: o

An organisation that carries on business activities that are government funded, or that requires external funding or loans, will be expected to comply with a higher level of transparency and accountability that is more consistent with the increased level of accountability in a public company.

A company structure requires the establishment of a board of directors, separate to the persons involved in day to day operation. This separation allows the board to focus on strategic direction and oversight for the organisation, leaving the operational aspects to management. The Management Committee in an incorporated association is required to fulfil both these roles, and the strategic direction will often suffer as a result.

It is now much more affordable for an incorporated association to transition to a company limited by guarantee. Recent legislative changes have provided for a simplified transition process that avoids the need for a transfer of assets and the winding up of the incorporated association.

If you think your association may be ready for a change or if you would like to find out more information regarding the transition process, please contact Carly Richardson or Julie McStay at Hynes Lawyers. carly.richardson@hyneslawyers.com.au or julie.mcstay@hyneslawyers.com.au ■

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Be er Practice Awards 2012

he annual Better Practice Awards recognise quality improvement and better practice in aged care and serve as exemplars to encourage improvement and innovation and recognise the aged care industry’s high achievers.

This year, there were 51 winners across the five categories. The Accreditation Agency’s Chairman Dr Andrew Refshauge congratulates the Better Practice Award winners. “We received almost 200 nominations - more than double last year - and the calibre and quality of programs was outstanding,” Dr Refshauge said. “The people behind these Award-winning programs are the aged care industry leaders who are driving quality, driving improvement. Their efforts are deserving of recognition,” Dr Refshauge said. “Whether the program is about staff development, addressing living environment or environment management, the ultimate goal is improved resident care.”

AND THE WINNERS ARE … Ballroom dancing as a falls management strategy, sensory towels which improve appetite and cooking classes to beat depression are among 51 Better Practice Award winners announced recently by Aged Care Standards and Accreditation Agency. At St Michael’s Aged Care Facility, Murrumbeena, a supper dance proved so popular it led to a ballroom dancing program which has reduced falls, improved resident posture and behavioural outcomes. At Bupa Thomastown, they found use of warm face-washers with essential oils, distributed to residents 30 minutes before their lunchtime meal, stimulated their interest in eating and appetite. Pathways Aged Care Killara Gardens identified that up to 60 per cent of new residents had a history or symptoms of depression and anxiety and many had difficulty socialising in large groups and were self-isolating. So they developed a program around small-group activities including reminiscing, gentle exercise, Tai Chi, a men’s group,

70 | General

and “Cooking with Barry” – an interactive cooking class with the home’s chef each week for six residents at a time where they help prepare and are served a special menu in the private dining room. Garden City Retirement Home at Upper Mount Gravatt also addressed social isolation through activity programs in response to resident preferences. The gender differences were stark: men wanted a shed and beer, and women wanted shopping and coffee. Resident lifestyle initiatives featured strongly among the Better Practice Award winners. Aged care organisations were also recognised for programs to attract and retain staff, including ‘employer of choice’ initiatives, recruitment programs to grow the talent pool of front-line care workers, and a graduate nurse program to make aged care a more attractive career option for graduate nurses. The Accreditation Agency’s annual Better Practice Awards recognise innovation, quality improvement and better practice in aged care across five award categories: • Environmental management/living environment • Health and personal care • Innovation • Resident lifestyle • Staff development and retention The Accreditation Agency’s Chair, Dr Andrew Refshauge, congratulated the Better Practice Award winners. “We received almost 200 nominations – more than double last year – and the calibre and quality of the programs were outstanding,” Dr Refshauge said.

The judging panel had a challenging task, and decided to award 51 programs to 38 approved providers representing 110 homes. “The people behind these Award-winning programs are the aged care industry leaders who are driving quality, driving improvement. Their efforts are deserving of recognition,” Dr Refshauge said. “Whether the program is about staff development, addressing living environment or environment management, the ultimate goal is improved resident care.” The full list of Better Practice Award winners and profiles are available on the agency’s website, www.accreditation.org.au A distinguished panel of aged care experts reviewed the 186 applications and made 51 awards. The panel convenor was Accreditation Agency Director Dr June Heinrich AM (former Chief Executive Officer Baptist Community Services NSW), and panel members were Dr Lyn Arnold (former CEO Anglicare SA); Rev Don Bain (former CEO Seventh Day Adventist Aged Care South Queensland Limited); Mr Ken Barber (former CEO Anglican Retirement Villages NSW); Mr Wayne Belcher OAM (former Chief Executive Officer Bethanie Group WA); Mr Richard Gray (Director, Aged Care Services, Catholic Health Australia ); Mr Robert Hillier (former CEO The Frank Whiddon Masonic Homes of New South Wales); Mr John Ireland (former CEO Southern Cross Care NSW and ACT); Mr John Millar, (former CEO Dubbo RSL Aged Care Association); Mr Doug Strain (CEO Masonic Homes Limited); Ms Malda Tobin (former CEO Hardi Group); and Mr Ian Wilson OAM (former Chief Executive Officer Warrigal Care NSW). ■

General | 71

he issue of overuse of antipsychotics and other psychotropic drugs in people living with dementia has become a hot topic in the media and political circles in recent months.

One of the many ways that the Spark of Life Approach works is by going behind the labels of difficult behaviours connected with dementia to the root cause; finding the unmet need behind such behaviours.

‘Approaches such as the award-winning Spark of Life from Dementia Care Australia are improving the lives of people with dementia far more than any pill that is likely to come on the market in the foreseeable future.’ G. Allen Power MD, FACP, St John’s, Rochester, New York A common difficult behaviour that many may already have encountered is the accusation of stealing. A person with dementia accuses either a family member or a professional carer of stealing their money or belongings. This behaviour naturally cause concern and distress for everyone involved. A typical reaction may be to resort to a medical intervention; using psychotropic medication to address the difficult behaviour. This often results in the person with dementia becoming withdrawn with diminished sensory experiences, slurred speech, and at an increased risk of having a fall or becoming incontinent. These devastating side effects may result in the person sitting defocused, disengaged, and staring into space. Medication is often resorted to because carers are at their wits end and do not know any other way to resolve a particular problem. There is no doubt that medication has a place however, it should always be the very last resort after every other avenue has been trialled. Medication remains a band-aid solution that

does not deal with the underlying cause of the behaviour. So, what can we do that will constructively and respectfully dissolve such a difficult situations? The Spark of Life Approach to a person with dementia making an accusation of stealing is to understand that, in the majority of situations, the person is experiencing an unmet need. Unmet needs can be physical such as a medical illness, hunger or thirst, or pain. These conditions can increase confusion and affect the person’s perception of what is happening around them. Unmet environmental needs can be anything from the experience of home, peace and quiet, pleasant sounds and smells, daylight, or a personally chosen chair. However, when a person makes accusations of stealing, they are most likely to be experiencing an unmet emotional need. Always work from the assumption that a statement such as, ‘The staff are stealing my clothes!’ shows the state of the person’s spirit. It represents a social, emotional, or spiritual need that is not being met either now or in the past. While the person is definitely experiencing a need, they do not know how to express it exactly in words and therefore convey the meaning embedded in symbolic language. The Spark of Life Approach enables you to understand the special symbolic language that people with dementia often use to communicate. Accusing someone of stealing is exactly one of these symbolic ways. The idea that people with dementia communicate via symbols makes sense. This belief is important and integral in enabling us to tap into the meanings behind their special language of spoken and gestured symbols. By focusing on the messages conveyed through rich symbolism, we can move towards a deeper understanding of the individual person. ■

The Big Question, will China Grow Old before it can grow Rich? By Mike Swinson.

icture a standard IKEA store in Australia; every time I go to one, which isn’t often, it’s usually crammed full of people and its always busy at the checkout. Yet that’s not the scene in the huge and modern IKEA store in the equally ultra-modern Shanghai, a city that is one of the fastest growing in the world.

According to Mukul Devichand from the BBC, this IKEA store is full of grey haired elderly Chinese, whose main interest is not the flat pack furniture, but the restaurant where cheap food and good company is available. Mukul says that under protest, IKEA Management have set aside special areas for the elderly, not to shop but to flirt and find love! China is rapidly ageing, faster than Japan and Korea and the trend looks like it’s getting worse, so the big question is, will China grow old, before it can grow rich?

General | 73

China’s welfare system is struggling to cope, estimates are that ten million carers will be needed to look after the ageing population; so far 100,000 have been trained. To make matters worse, the one child policy means there aren’t family members available to look after ageing parents. 77 year old Mrs Zhang looks after her husband who is partly crippled and suffering from dementia. The couple live together in a tiny one-room apartment. “I have to take care of him all by myself,” says Zhang. “We cannot afford private care.” Mr and Mrs Zhang’s only daughter lives with her in-laws and visits when she can. The glitz of Shanghai’s main drag is an avenue of skyscrapers, but in the teeming lanes behind the skyscrapers are hundreds of cramped and fading blocks of units, crammed with the elderly and the poor. China’s decision makers and policy planners face a quandary, low levels of pensions, make pensioners a vulnerable group, falling quickly below the working population, for the government that view economic growth as its main goal, the daunting challenge is how to raise the spending on aged care without undermining its capacity to sustain economic growth. Take 84 year old He Daxing, on the eve of the Chinese New Year, he was left alone, sitting on the doorstep of his daughter’s home. Local officials offered to help him sue his family, but his situation reveals a changing attitude to older people.

China will soon have many more He Daxing’s, it faces a soaring number of old people and a shrinking number of young adults to look after them. In 2009 there were 167 million Chinese over 60; by 2050 there will be 480 million. In the year 2000 there were 6 workers for every person over 60, by 2030 there will be just 2. China is unique, she is getting older before she get’s rich, says Wang Dewen of the World Bank. So the one child policy may have to be expanded to two or even more. “I have one daughter and there is no way she will be able to take care of me” says Lui Zhongli. Lui is unusual, and she is in the unique position of being the director of Evergreen, state owned old people’s home near Beijing. She says kids still love their parents - her facility is inundated with visitors on the weekends – but the pressures of modern life are sometimes overwhelming. Increased life expectancy means children need care as well, take the 88 year old son of the home’s oldest resident who just turned 109! Evergreen costs about $800.00/week, it has 600 beds and a waiting list of 1300. There is no easy answer to the ageing question, not here in Australia nor in China, both countries with growing economies, both interdependent on one another. This article has been drawn from numerous sources, including the BBC report by Mukul Devichand, a story researched by Han Cheng and other web based media publications. ■

74 | General

Life Care is a global leader in support of people with younger onset dementia

outh Australian aged care provider Life Care has been internationally acclaimed for a unique program supporting people with younger onset dementia and their families.

Life Care is celebrating success in the International Dementia Excellence Awards (IDEAs) for its pioneering Side By Side project. The IDEAs, organised by the University of Stirling UK Dementia Services Development Centre, were presented in Sydney as part of an international dementia conference in late June.

Life Care’s Side By Side project was among 23 nominations shortlisted in the prestigious awards. It was selected by an international panel of judges as the winner in the category of Life Engagement. Younger onset dementia is a condition that can have a devastating effect on individuals who in many cases find themselves suddenly unemployed with families to support. It can leave individuals in their forties and fifties isolated from their families and society with crumbling self-esteem, fading memories and a slow neurological decline. However, Life Care’s Side By Side project is providing an opportunity for people with the condition to re-engage with the community to maintain skills and retain self-confidence. Accepting the award in Sydney, Life Care’s Chief Executive Officer, Allen Candy, said the project worked by allowing people with younger onset dementia to spend time in a working environment and to meaningfully interact with others in everyday activities while allowing their regular carers to have some muchneeded respite. Bunnings is the first company in Adelaide to support the project by welcoming individuals with younger onset dementia from Life Care’s Norman House specialist respite care facility to work with team members at its Mile End store. “Each participant is partnered with a “buddy” from Bunnings to undertake a range of different tasks. It is a socialisation process through which the participants are developing new task skills while having a valued workplace role. “There have been some outstanding outcomes for participants and their families from the Side By Side project. Mr Candy congratulated Jacinta Robertson, Life Care’s Community Coordinator of Respite Programs, and staff at Norman House for their contribution to the outstanding Side by Side project and he thanked Bunnings for its support. The Side By Side project initially was supported by the Australian Federal Government through the Dementia Community Support Grants program. The University of South Australia is working with Life Care to evaluate the impact of the Side By Side project on participants and their regular carers. Interview: Allen Candy, CEO, Life Care on 8239 9800 or 0402 482 798 ■

Section | 75

76 | General

If the Shoe Fits – Falls Prevention by Katrina Taylor Director/Senior Podiatrist Senior Foot Care

alls are a common and complex problem amongst the ageing population, causing considerable mortality, morbidity, reduced functioning and premature nursing home admissions. In fact, falls are the leading cause of injury and deaths in people aged 65 years and over. Further, one in three people aged 65 years and over, fall each year. Medical conditions such as peripheral neuropathy, vestibular dysfunction, muscle weakness, vision impairment and dementia have a detrimental effect on postural stability by effecting balance and a person’s awareness of their feet in relation to their body, making it difficult to adjust to changes in environment and knowing where their placement of foot is. When these medical conditions are combined with environmental hazards and poor footwear the risk of falls increases. Podiatrists can a play a role in the prevention of falls as they are skilled in the assessment of feet and footwear. A footwear assessment by a podiatrist should be implemented upon admission into an aged care facility and continually reviewed on a regular basis. Specifically, safe footwear can potentially improve postural stability, mobility in residents and therefore reduce falls risk and damage to feet.

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Preferably laces to hold the foot firmly in place or with straps or velcro fastening to adjust for variations in swelling

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Is preferably made of leather (but not patent which is too hard). Leather is a natural material that breathes preventing feet from becoming hot and sweaty.

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Has a smooth lining (stitching may rub causing irritation)

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Has a thick bouncy synthetic sole for cushioning (leather soled shoes are hard to walk on) that will help absorb shock and reduces pressure on the feet

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There should be a gap of 1cm from the tip of the longest toe to the shoe to allow the toes to spread during toe off

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The ideal styles are trainers, lace-ups, sandals, moccasins and boots as they each have a mechanism for holding the foot back in the heel of the shoe. Without this fixation the foot is allowed to slip forward into the toe box causing trauma to the toes

Senior Foot Care has developed a safe footwear checklist. Some of the key features to look for in a safe shoe are: •

Footwear should have a firm heel counter. The heel counter stabilises the foot preventing excessive movement of the heel

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Flexion at the forefoot to allow for adequate toe off

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The widest part of the foot should fit the widest part of the shoe

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Low, wide heel for stability (less than 2.5 cm in height). High heels increase pressure on the ball of the foot which can result in bunions, hammertoes, corns and calluses. Prolonged wear can result in shortening of the calf muscles making barefoot walking uncomfortable.

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A deep, wide toe box to allow the toes to spread as you weight bear.

For more information on falls prevention visit our website www.seniorfootcare.com.au ■

2012 Calendar of Events 28-31 October

12â&#x20AC;&#x201C;14 November

20-23 November 2012

LASA Inaugural Congress Consec â&#x20AC;&#x201C; Conference Management

RVA National Conference

Australian Association of Gerontology

Hilton Hotel, Sydney W: www.rva.com.au

Brisbane Convention and Exhibition Centre E: aag@eastcoastconferences.com.au W: www.eastcoastconferences.com.au

T: 02 6251 0675 F: 02 6251 0672 E: lasa@consec.com.au W: www.lasacongress2012.asn.au

2013 Calendar of Events 24-26 February

1 & 2 May

30 & 31 May

22nd Annual Tri-State Conference

ITAC 2013

LASA NSW-ACT Congress

Crown Towers, Crown Conference Centre Melbourne Contact: Jane Murray T: 08-8981 5119 E: itac2013@jayscorpevents.com.au

The Westin, Sydney E: cynthia.oyoung@nswact.lasa.asn.au W: www.nswact.lasa.asn.au/events/congress

Albury Entertainment Centre T: 03-9805 9400 E: events@vic.lasa.asn.au

Getting old is easy...... having fun at it is thee real trick. I celebrated my birthday this year by buying an all-terrain 4-wheeler. This is a picture of me playing with it in the back yard. Life is fleeting by. Enjoy it while you can!!

78 | Product News

Aqua Joy bath lift supplied by Freedom Bath Lift Company

The ease of access in and out of the tub enhances the ability of people with disabilities to bathe independently. However if desired the bath-lift can be used by any member of the household, carer or attendant.

Aids mobility impaired people of all ages

Aqua Joy Bath-lifts are both portable and versatile. They are suitable for deep baths, (having a maximum seat height of 460 mm); as well as for shallow baths (with a minimum seat height of 88 mm). The maximum lifting weight limit is 170 kg (26.5 Stone).

There are many expenses and limits involved in building a home catering for people with disabilities. Often the design process can be costly, time consuming and unsightly. Considering this, Freedom Bath Lift Australasia has introduced to Australia the ‘Aqua Joy’ bathlift to provide for people with disabilities and reduce their renovating costs substantially. Instead of renovating or building an entirely new bathroom, a ‘Freedom Bath Aqua Joy’ is merely placed inside one’s existing bath and – by a simple push of a button – the bather moves downwards and upwards allowing access into and egress out of the bath. “At the touch of a button you can be lowered into or raised from your bathtub to ease the effort and risks involved in the process for many people. The Aqua Joy with effort enhances comfortable independent and safe use of the existing bathtub,” says Freedom Bath Australia Director James Lloyd. ‘Aqua Joy Bath Lift’ is ideal for people who use wheelchairs, scooters and walkers. “Transferring from a wheelchair to a Aqua Joy Bath Lift is unproblematic because the transfer is made at the same level from one to the other, the lifting and lowering are done for you,” says Mr Lloyd.

“Aqua Joy Bath Lift” can fit into almost any style of bath. Not only are people with disability able to enjoy this comfort at home, they are also able apply this comfort when travelling,” says Mr Lloyd the unit is totally transportable. The Aqua Joy Bath Lift separates easily into two compact sections, saving storage space and enabling portable use in instances when people are travelling. Being able to take your ‘Aqua Joy Bath Lift ‘ to hotels or to a relative’s accommodation eliminates the need of finding accommodation with specialised facilities provided in-house. With the seat positioned as far back in the bath as possible, the design provides maximum legroom to optimise comfort in the bath. A luxury ‘slip over cover’ attached to the Aqua Joy Bath Lift also enhances comfort. A range of accessories are available such as Vertical detachable side flaps, Lap belts, Chest restraints, Head Rests and Pommels enabling children and adults suffering Cerebral Palsy, Parkinson’s and other debilitating illnesses to

at last enjoy a bath in safety without fear of injury or drowning. Simplicity of use extends to the charging process, which includes an indicator light showing when the battery is charging. One charge generally lasts for 15 lifts however as with all chargeable batteries the more they are charged the longer the life in some cases up to six years. The bath lift has a unique inbuilt safety feature of not lowering unless there is sufficient charge to raise the client back to the top of the bath. The quality control in the manufacture and assembly of the Aqua Joy Bath Lift is second to none in fact the units are cycle tested ten thousand times on a regular basis that is the equivalent of two baths a week for almost one hundred years, every component is individually tested before assembly. “Aqua Joy Bath Lift is designed to be safe and simple to use, so as to assist people of all ages with disabilities to improve their mobility hence become more independent”. For customised package deals especially designed to fit individual needs, please call TOLL FREE 1800 505 712

National Product Update News | 79

Monitoring your funding can improve your care It is common for up to 70% of an aged care facility’s funding to come from government sources, but do you know how many of your funding claims are accurate relative to the care you provide? Mirus Australia helps aged care organisations to more accurately monitor their funding to ensure residents are able to receive the level of care appropriate to their needs. Mirus adopted best practice from other industries to build a custom solution for aged care homes in Australia to monitor and track their Medicare data. The system, Aged Care Metrics Mobile can be up and running within 24 hours without the need for IT investment or financial analyst support and can be accessed through an iPad. Mirus Aged Care Metrics provides you with interactive dashboards for: • Executive management Key financial and operational metrics with site comparison provides tracking of trends over time to allow timely and effective decision making. • Facility analysis Presents Medicare data as easy to understand graphs and visuals allowing you to run a prioritised improvement plan. The tool is easy to use so your staff spend less time wading through paperwork and more time dealing with the day to day activities of running your facility. • Individual residents Highlight actions based on key dates, and review medical diagnoses and existing ACFI scores. Your staff can quickly access prioritised assessment data at the point of care.

Simon Wilson, Director at Mirus says: “We have now worked with over 150 aged care facilities and we have observed how the most successful providers manage their resident level data. By making this best in class reporting solution available to the wider industry, we take the headache of repetitive analysis away from your executives and clinical staff allowing them to focus on what’s important – the care of your residents.“ SPECIAL READER OFFER Simply mention this article when booking your evaluation of Aged Care Metrics before 31 December 2012 and you will receive a FREE iPad for each facility signed up. Visit us at the LASA Congress at stand 17 or call Simon Wilson on 02 8823 3140.

Manage your funding | Prioritise your reviews and reassessments | Track your results over time Mirus Aged Care Metrics can help www.mirusaustralia.com

Surgical House is uniquely placed in the West Australian market as a full service provider to the Aged Care market. For over 30 years the company has assisted hospitals, medical practitioners, allied health professionals and aged care providers with their medical supply needs. The company has established a strong reputation based on their customer service, reliability and willingness to work individually with their clients. In 2012, recognising the developments and changes in the burgeoning aged and community care markets, the business opened its retail showroom allowing their customers to talk directly with sales staff, seek individual attention and see products prior to purchasing. By constantly connecting with their customers, Surgical House recognised that there was still more that it could do to support its customers, and recently appointed a Patient Care Equipment Specialist. By engaging with a number of preferred suppliers Surgical House has access to a comprehensive range of community and aged care equipment. By partnering with suppliers like Ausmedic Australia, the company can now offer a range of products that meet the equipment needs of aged care providers, community care providers, carers and families alike. The organisation is committed to providing quality products with exceptional customer service at a reasonable price.

This proudly West Australian family owned business is the only one-stop-shop that not only has all the products you need but also understands the needs of all stakeholders involved in the care of facility residents and clients; medical professionals, aged care providers, carers, family members and the resident or client themselves. Phone (08) 9381 4199 www.surgicalhouse.com.au

80 | Product NationalNews Update

Manad Plus Manad Plus is a leading aged care software solution that ticks all the boxes.

increased entitlements. We’ve already released the 1 July ACFI changes

• Easy to use: Changing from paper-based or existing software is easy for clinical and administrative staff with simple navigation and intuitive screens

• Stay on top of accreditation: Continuous quality improvement plans and audits will assist with compliance

• Complete care management: Document all your residents clinical care needs in assessments, care plans, progress notes and charts • Get the best from ACFI: Our unique ACFI ‘in-progress’ feature constantly tracks changing care needs to highlight

• Plan and track tasks: Organise your home by scheduling all the tasks that need to be completed, allocate it to someone and track its progress and completion • Billing and bond management: Easily generate all your residents invoices each period and manage their bonds and your prudential requirements

• Powerful reporting: Analytical reporting tools, more than meeting the needs of management • Support: the help desk is supported by senior nursing staff and IT professionals to get assistance when you need it

Call us now on 1300 62 62 32 for a Manad Plus demonstration or visit manad.com.au for more information.

Are your residents and staff at risk? Over the past 10 years a multitude of electric bed failures in the homecare and aged care sectors has increased significantly due to improper or non existent preventative maintenance structures, therefore placing residents and staff at risk of serious injury.

According to the Department of health and ageing standards and guidelines manual Section 1.7 Inventory and Equipment, Part B “that equipment is maintained in a fit state through preventative and corrective maintenance programs”

preventive maintenance. Without preventive maintenance, for example, costs for lost down time from unscheduled equipment breakdown will be incurred. Also, preventive maintenance will result in savings due to an increase of effective system service life.

Preventive maintenance is a schedule of planned maintenance actions aimed at the prevention of breakdowns and failures. Our primary goal of preventive maintenance is to prevent the failure of equipment before it actually occurs. It is designed to preserve and enhance equipment reliability by replacing worn components before they actually fail. Preventive maintenance activities include equipment checks, lubrication of moving parts, replacement of worn components etc.

Value of Preventive Maintenance

Long-term benefits of preventive maintenance include:

There are multiple misconceptions about preventive maintenance. One such misconception is that preventive maintenance is unduly costly. This logic dictates that it would cost more for regularly scheduled downtime and maintenance than it would normally cost to operate equipment until repair is absolutely necessary. This may be true for some components; however, one should compare not only the costs but the longterm benefits and savings associated with

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Reduction of resident or staff injury

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Improved system reliability.

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Decreased cost of replacement.

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Decreased system downtime.

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Better spare parts inventory management For more information call us on 0410 771 029 or email us at info@mrbedmechanic.com.au

Sarah Aged Care Management is a privately owned Australian company that specialises in the development of Aged Care Management Software to support the aged care industry. Sarah was designed by an aged care facility manager for use in the aged care industry to provide effective data management for all facility requirements. The first facility to use Sarah was awarded a commendable for standard one, specifically for module 1.8 (Information Management). The accreditation report also stated that the database (Sarah) covered all four standards a claim that no other product can make. Our Mission is to assist our clients in their provision of quality of care for residents by improving the productivity of staff through the use of an effective user friendly system.

Sarah was founded in 2002 and has grown steadily over the years. The company is located in Springwood close to Brisbane and has a staff of 10. Sarah is used throughout Australia to assist in the effective management of over 4000 beds. Our clients range in size from the smallest facility of 15 beds to the largest of 600 plus beds. We provide 24/7 phone support and our call response is considered superior when compared to other vendors. Remote access is used to install updates and carry out support work when necessary. Onsite support visits are also conducted when required.

What is Sarah? Sarah is made up of several modules to provide a complete information management system to enable effective facility management.

What does Sarah do? Sarah automates many processes and significantly reduces repetitive data input. One facility analysed Sarah usage during their first year and reports showed that Sarah enabled them to put 18,000 hours back into resident care during their first year of Sarah use. Another facility advised that they had reduced the number of forms in use by 180. Sarah also provides instant reports on all day to day activities. What does Sarah stand for? A question asked by many. Sarah is named after the designer’s daughter. Phone: (07) 3290 1161

Product Section News | 81

Haddad Pharmacy Group is a leader in the provision of pharmacy related services to Residential Care Facilities. The pharmacy was established in 1959. Over this time, it has built a name and reputation for quality of service provision and professionalism. The pharmacy offers numerous medication packing systems such as a state of the art machine packed medication sachet system as well as numerous Webster ™ packing systems including a seven day multi dose system , a single dose 7 day unit dose system as well as a 35 day single item Webster™ system pack. This enables Haddad Pharmacy Group to cater for every medication packing need that a Residential Care Facility has. Haddad Pharmacy Group has grown to a critical mass that has allowed us to invest in three sachet packing machines. This allows us to offer to all our clients, a quality of service unique in South Australia, by ensuring that minor interruptions or mechanical breakdowns do not compromise the timeliness and accuracy of our medication supply service. We are at the forefront of new technology having recently acquired a Vizen™ machine which takes a digital photograph of every sachet that is packed and is an enormous advancement in quality control.

We currently employ eight Pharmacists to ensure all medication that leaves the pharmacy is checked for accuracy and appropriateness. Haddad Pharmacy Group delivers to forty Residential Care Facilities throughout the state of South Australia, both metropolitan and regional, utilising 4 internal couriers as well as Courier companies for regional deliveries. We offer a 24 hour/7 day a week Pharmacist on call to service the after- hours requirements of the Residential Care Facilities we service. The pharmacy also offers additional Quality Use of Medicines activities and support through Accreditation and through our extensive involvement in the Medication Advisory Committees. The residents of the facilities are provided with delivery and packing free of charge and we are incredibly competitive on pricing. We welcome anyone who may be interested in discussing our services further to come and see us in action at 160 Unley Rd, Unley SA 5061 or to ring Greg, Toan or Nicola on 08 8271 2343.

Engage your workforce and boost service delivery Achieving optimal service delivery in aged care relies on a fully engaged workforce to deliver best practices. According to consulting group Deloitte, “engaged employees are prepared to put discretionary effort into achieving organisational goals, become strong advocates for the company’s values and stick with a company for a long time”. Key contributors to positive engagement are professional development opportunities, career advancement, performance feedback and recognition. On the other hand, diminishing engagement can often be attributed to onerous and unnecessary processes getting in the way of improved patient care. A well implemented Human Resources Management Information System (HRMIS) can address each of these factors in a simple format suitable for the typical aged care worker. The Aurion HRMIS is well utilised in aged care across the country as a fully integrated HR and payroll solution that simplifies important processes for workforce

management. Aurion ensures accurate and timely payroll and leave processing as well as managing the recruitment, learning and development and career management of staff. All of which contribute to staff engagement. Ensuring your staff engagement activities are not hindered by overwhelming processes, Aurion delivers an easy to use Employee Self-Service portal and Business Process Automation (BPA) to take out the manual processing of common and laborious activities. Critical functions such as occupational health and safety, immunisation monitoring and qualification tracking are also integrated into the Aurion HRMIS to ease the governance burden in aged care. In a recent whitepaper released by HR consulting firm, Chandler Macleod,

business leaders identified process improvements, staff training and increasing of employee engagement as the three most important activities being employed to improve productivity. Aurion addresses each of these activities and more to help you power your performance and optimise your service delivery in aged care.

For more information visit www.aurion.com.au

82 | Product News

Bethsalem Care Bethsalem Care is an aged care facility operated by the Christadelphians in South Australia and is based on the principles and values of Bible truth. After 50 years operating as a low care facility at Glynde, our new home at Happy Valley was opened in August 2004. ‘Bethsalem’ means “A House of Peace” and this is clearly reflected in a spacious, beautifully appointed and care focussed design. As a home ‘where life matters’ Bethsalem Care provides appropriate quality care for resident’s need giving families and friends peace of mind, whilst encouraging independence. Bethsalem Care is a 90 bed, fully accredited stand alone facility committed to pursuing continuous improvement and implementation of evidence based best practice. A decision was made to implement the Clintel CareRight package as the application of choice for clinical care. This decision was made after extensive evaluation of industry standard clinical care packages for the following reasons • Good support of the ACFI and accreditation processes • Excellent capability for the design of assessments and forms and the ability to configure assessments to populate information on the resident care plan • The ability to integrate functionally with existing accounting software and other IT packages in use and proposed for future implementation • Strong local presence and support in South Australia

• It offered a cost effective solution to our requirement for an IT based clinical administration system As with any new technology implementation, early adoption by staff was a significant consideration, especially moving to an IT based system requiring everyday input from a largely mature aged work-force not quite so familiar with IT concepts. To address this a survey of employee’s computer skills was undertaken and whilst the majority of staff were competent with email and internet use it was necessary to run training sessions for all staff on the CareRight web based interface. Our initial concept was to go live in one section of the home, however on later analysis it was agreed that an “all inclusive” implementation would provide a better solution and improve staff take up and commitment to change. Bethsalem Care migrated from a paper based clinical system to CareRight in September 2011 and after a few teething problems has settled well into our usual daily operations. Staff were actively supported during the implementation phase. CareRight has been operational for over nine months and some of the benefits we have experienced are: • A user friendly and easy to navigate webbased interface • Resident information can be accessed from the all networked computers. As Care Manager I am able to access residents’ information and review resident needs and outcomes easily • The Clinical record application has features which support good documentation such as spell check and

Safety Link is a national ISO accredited 24-hour Personal Alarm Call Response Service that links clients with family, friends or emergency services in times of need. The service is designed for people who may be at risk due to age, ill-health or a disability and comprises of a pendant button, an alarm connected to the existing telephone system, and the highly trained staff at the Safety Link Monitoring Centre. When the personal pendant is pressed, it sends a radio signal to the alarm unit, which in turn rings the response centre. When an alarm call is received at the response centre, one of Safety Link’s fully trained monitoring staff will attempt to make telephone contact with the client to establish the appropriate action to take. If contact cannot be made with the client, the monitor will telephone the client’s nominated ‘contacts’ who may be a family member or neighbour to check on the client’s wellbeing. Should a contact not be available a 24-hour emergency service will be called.

other Microsoft applications that many of our staff are familiar with • Capabilities for the design of forms/ assessments. We have developed our own assessments and are able to configure them to automatically populate relevant information to the resident care plan. Whilst this is still a work in process the first assessment/care plan design implemented and trialled was the resident interim care plan. An initial assessment is conducted when the resident is admitted to the facility covering all the basic care needs to ensure continuity of care. Once the assessment is completed the registered nurse prints the interim care plan and implements it on the floor for the delivery of resident care by the personal care staff • Through integration with our resident accounting package, resident data is entered once and this information then populates Care Right. Updates also populate CareRight automatically • It is our intention to integrate Clintel with our electronic medication management system to facilitate flow of information from our medication system to the resident clinical record • The global dash-board and user private messaging has improved communication with care staff in the facility, many of whom do not have access to company email • An easily accessible product based helpdesk can be used to log issues and make requests

Safety Link prides itself on helping maintain clients’ independence and recognises its successes are due to the dedicated friendly employees who provide a personal and caring service to its clients. Safety Link is now pleased to offer assistance to Carers looking after people who may be at risk of self- harm or injury (for example people with dementia or a disability). Safety Link offers affordable wireless and easy to use solutions giving peace of mind for Carers yet with the utmost care for safety. Carers in their own home or in a residential support service choose the best equipment for their situation. Carers or families will be able to safely monitor the movement of the person via doors, floor and chair sensors and GPS monitoring to minimise risk. Safety Link can also provide seizure sensors ideal for monitoring someone with epilepsy (ideal for sleeping or sitting) so Carers or family members can feel reassured about the persons safety. 1800 813 617 http://www.safetylink.org.au

Product News | 83

Software food service solutions for aged care kitchens: Sundale A new innovation in catering management for the aged care industry has reached Australian shores and is taking kitchens by storm – one recipe card at a time. Sundale is a local community based not for profit residential aged care organisation focusing on the needs of the community by providing innovative high-tech solutions for its aged care customers across many sites. Sundale’s focus is independence and well being. Jamix is working with aged care in Australia and Finland with software systems to teach food service operations how to cost effectively deliver food with nutrition and online stock management to track

their business for cook fresh, satellite and production kitchens. In addition to Jamix reducing costs, waste and administration, Jamix through ingredients, recipes, menus and stock cards can improve productivity in the kitchen by documenting processes and food safety requirements. Gavin Tomlins, Sundale’s Chief Information Officer, found the Jamix Food program as a versatile tool, quick to install and simple to use. The clever software makes browsing and maintaining recipe, menu and resident dietary data efficient and quick so that a range of vital information is readily available. This software provides the answer.

The revolutionary Jamix system assists kitchens with what they call the “Food Cycle”, from the basics of planning and managing ingredients, individual meals and menus, to major inventory control, online supplier orders, wastage and nutrition planning. Catering operations can utilise the system to cut costs and enhance efficiency in every area of their operation. For more information, see www.jamix.com.au or contact Tomi Hamalainen, on mobile 0438 637 187 or email tomi@jamix.com.au

SARI-MED Pty Ltd SARI-MED distributes products for infection control and hygiene monitoring. Our sales focus is the health, nursing and dental market as well as the food and beverage processing industries. Aerosol disinfection with the DioProtectionTM system achieves the highest level of hygienic safety and: • Provides increased protection against dangerous pathogens such as MRSA • Safe, easy to operate & eco-friendly technology based on hydrogen peroxide

The system consists of a handheld light reading unit (SystemSure Plus Luminometer) and a sample testing device(Ultrasnap) which enables customers to: • Instantly assess the cleanliness of surfaces, allowing immediate corrective action to be taken • Reduce the use of conventional microbiological testing methods that are slow, labour intensive and costly • Enhance sanitation training, as well as verify efforts of santation personnel

• Cost efficient & disinfecting room sizes up to 450m3

• Record and track test results to identify problem areas, make improvements and show due diligence and compliance with HACCP, Sanitation Standard Operating Procedures(SSOPs) and industry regulations

• Reaches even the most inaccessible areas

• Optimize the use of sanitation chemicals

• Various testimonials & independent reports show efficacy

Get in contact with us now to protect your teams, residents and visitors welfare!

• Works automatically within 90 minutes without leaving any damp residues

The system is composed of the aerosol generator DiosolGenerator and the antimicrobial disinfectant (6% hydrogen peroxide with silver cations). The SystemSURE Plus ATP Detection system offers a state-of-the-art solution for organisations looking to monitor and advance the hygienic conditions in their facilities.

Tel: 08-8362 5291 Email: js@sari-med.com.au Web: www.sari-med.com.au

84 | Product News

TECO Australia introduces Bar Fridges to its Range Following its successes in supplying Split System and Window Wall Air Conditioners, and LED/LCD TV’s to Mining Camp Accommodation and Common Area Portable Building Units, Student Accommodation areas and Hotel/Motel Rooms, TECO have introduced a range of Bar Fridges specifically designed to cater for the hospitality industry. Engineered to Perform with Super Quiet operation, Stylish Design, Internal Light, Glass Shelving and handy Drink Can Dispenser in the 117Ltr Freestanding or Under Bench Bar Fridge is suitable for medium

to large rooms, and to cater for Student Accommodation and smaller Hotel/Motel Rooms, that require a small fridge for guest convenience, TECO have also introduced a 50Ltr Bench Top Bar Fridge. To complement this range, TECO Australia will introduce over the coming months, Vertical Freezers, Chest Freezers and Frost free Refrigerators with Multi Flow Control ranging from 215Ltr to 410Ltr.

For more information visit www.teco.com.au

A toilet seat that changed my life Barbara Nash simply dreaded going to the toilet, the combination of arthritis and a bad back made what is a simple thing for most people almost impossible for her. Usually she had to have a shower after going to the toilet; it was a secret she kept to herself for years.

the wash button on the remote control and the Bidet cleans me with a stream of warm water, the in-built fan then dries me off with warm air and I haven’t used toilet paper since. It’s the best thing since sliced bread!”

Her doctor had said a Bidet would solve her problem but the cost for installation and space required for the traditional stand alone BIDET to be installed in her home was just too expensive.

Well Barbara hesitantly went in to the toilet and used the COWAY Bidet, she pressed the large button on the remote control and she was clean. She cried tears of joy and relief now that her toileting problems were solved.

Barbara says her luck changed when visiting her friend Norma in the next suburb. While she was there she had to go to the toilet - a thing she dreaded most while she was out. Well she was amazed by what was on her friend’s toilet! She asked Norma what it was and Norma explained that she had a COWAY Bidet toilet seat installed only a few weeks ago by The BIDET SHOP®. “The chap was so nice and helpful; he had the Bidet installed in a jiff y.” She went on to say, “it has a heated seat and soft closing lid but the best thing is, once I have finished going to the LOO I simply press

Equipment 4 Life

understands the need for the elderly, the physically challenged and their carers to obtain assisted living products that are designed for comfort and ease of use. For 17 years we have been offering an extensive range of products that are reliable and of the quality and dependability expected by our customers. Our products maximise the independent living potential of the elderly, the physically challenged and improve carer productivity and client/resident lifestyle. As technology progresses, we have always expanded and improved our product range to enable us to provide products that are affordable, unique, innovative and manufactured to the highest quality and standards. We sell directly to individuals, home carers, Aged Care Communities, Community Care Services, Hospitals and Pharmacies and pride ourselves on providing what we think is an unrivalled service which includes staff training in facilities. Our friendly staff is always available to discuss any queries and help you decide what product is right for you or your loved ones. So whether you just need a set of cutlery to make eating easier or you need to fit out a whole facility, we can help!

http://www.equipment4life.com.au/

She rang The BIDET SHOP® straight away and ordered one. They installed it later that week. Since then Barbara has introduced 4 of her other friends to this life changing machine. She said “I just didn’t know how many other people out there were having trouble going to the toilet. My advice to everyone is get a COWAY Bidet put on your toilet, I did and it changed my life.” For more info or to purchase call The BIDET SHOP® on 1800 243 387 (free call) or visit us at www.thebidetshop.com.au (OTs visit: www.otbidets.com.au)

Health Metrics Health Metrics Pty Ltd purchased the assets of WeCare Australia Pty Ltd. The acquisition adds dozens of customers and thousands of residential care beds to the Health Metrics stable. This transaction extends Health Metrics’ market share within the aged care vertical. “This acquisition is a key part of our multi-pronged strategy”, said Steven Strange, CEO of Health Metrics. “This is good for our bottom line and our growth but more importantly it’s very good for the WeCare customers and staff. The customers now have a road map that will future proof their current investments. We will continue to support and enhance the WeCare system”, added Steven. All existing WeCare customers will be contacted individually as part of the integration process. For any further enquiries regarding this press release please contact Steven Strange directly at sstrange@healthmetrics.com.au