LASA Fusion Spring 2015 by Adbourne Publishing

The voice of aged care Spring 2015 | www.lasa.asn.au

co-designing tomorrowâ&#x20AC;&#x2122;s age services

CONTENTS The voice of aged care

NATIONAL UPDATE 5 CEO Report

Spring 2015 | www.lasa.asn.au

7 Chair Report

EDITOR

8 FOCUS ON... ACCESS

Katie McKeown

LASA FEDERAL

15 NEWS

Patrick Reid CEO 42 Giles street, Kingston ACT 2604 E: patrickr@lasa.asn.au

OPINION 29 Sustainable service delivery

LASA NSW/ACT

in rural & remote Aboriginal communities

Charles Wurf CEO PO Box 7, Strawberry Hills NSW 2012 E: Charles.wurf@nswact.lasa.asn.au

FEATURES 38 Home Care fee confusion?

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

LASA SA Paul Carberry CEO Unit 5, 259 Glen Osmond Road Frewville SA 5063 E: ceo@sa.lasa.asn.au

RESEARCH: DEMENTIA 23: Additional funding for dementia priority areas

LASA WA

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

51 Leadership impact on culture 59 Navigating the FBT minefield 60 Permitted Use Rules lump sum

ADBOURNE PUBLISHING

investments

Adbourne

63 Impact investments:

PUBLISHING

Advertising

Melbourne: Neil Muir (03) 9758 1433

Adelaide: Robert Spowart 0488 390 039

Production

Emily Wallis (03) 9758 1436

FUNDING 34 : It’s time to prioritise aged care

Susan Moore Marketing susanmoore@y7mail.com

Fusion is the regular publication of Leading Age

82 OSCAR hospitality finalists

welcome but LASA reserves the right to edit, abridge,

announced

alter or reject material. Opinions expressed in Fusion

or opinions expressed in signed contributions. Fusion may be copied in whole for distributed amongst an organisation’s staff. No part of Fusion may be reproduced in any other form without written permission

social media use by staff

Conference

Services Australia (LASA). Unsolicited contributions are

is accepted by the Association for statements of fact

67 Managing risks involved with

EVENTS 79 LASA Q Community Care

DISCLAIMER

are not necessarily those of LASA and no responsibility

Creating positive change

HEALTH & WELLBEING 73 Caring for our carers

Administration Robyn Fantin (03) 9758 1431

FOUNDATION PARTNERS

BUSINESS TECHNOLOGY 45 A technological approach to

BUSINESS MANAGEMENT 49 New year new rules

LASA QLD

from the article’s author.

in aged care

improving governance and meeting duty of care

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

PO Box 735, Belgrave, VIC 3160

INNOVATION 41 Co-create & co-design

BUSINESS MANAGEMENT

84 HESTA National awards

67: Managing the use of social media

90 WHAT’S NEW

CEO

| NATIONAL UPDATE

IMPROVIDUS, APTO QUOD VICTUM* In approximately 15 months (or 479 days) we will see the front edge of a major change to way consumers have accessed age services with the older Australian being able to determine how they will spend their money to receive services from a provider(s).

hen I consider the process and business models that have preceded this moment in our industry one thing is certain – the industry will need a change management approach to enable everyone involved to meet and cope with this paradigm shift. This is not only about providers and the services they provide but also anyone who interacts with the aged care system, up to and including the consumer. Most of you are probably familiar with the story of how Kodak invented the digital camera but failed to grasp the platform change required to seize upon the competitive advantage that they had invented. When an assessment of their demise was produced it showed an ignorance of keeping a company relevant and refreshed, but also a reliance on their assumption that things would remain the same. When an industry is in flux, with multiple disruptions hitting it from all sides, what’s the right way to plan for an uncertain business future? The changes that are coming will test our ability to deal with ambiguity. To ensure we are thinking ahead age service providers will need to continually ask themselves a number of key business planning questions: 1. What can age service providers do to remain competitive right now? 2. How will the age services industry shift its business planning to accommodate the new future?

3. When it’s unclear where one part of the industry ends (retirement living) and another begins (home care), how do we determine our position? 4. When the policy and process environment is unpredictable, how can we apply the traditional forecasting and analysis that are at the heart of strategic planning?

Patrick Reid Chief Executive Officer Leading Age Services Australia

5. When we’re overwhelmed with too much or constantly changing information, how can our managers pick up the right signals to understand and harness change? 6. When change is so rapid, how can a one-year — or fiveyear—planning cycle stay relevant? What we have seen since 2012 is that those who thrive are quick to read and act on the signals of change. They have worked out how to experiment rapidly, frequently, and economically —not only with their ‘static’ age services but also with their business models, processes, and strategies. Some of these providers are considered mavericks because of the models, path or choices they have made, but they continue to prosper – some of them completely outside of the Aged Care Act. These mavericks have lessons to teach about what is takes to be adaptive in our approach to planning and preparedness. Many of our colleagues are also looking outside of our industry to gather ideas and solutions that can be transplanted to the age services industry with a view to remaining relevant and competitive. Our industry has been relatively stable and predictable for a very long time. The traditional sources of competitive advantage still remain for the medium term, but our reality is that a contestable landscape is emerging where age service providers will need to be informed and dynamic in acting on the signals of change. Adaptability is no guaranteed panacea to change or competition but a mindset in your organisation of improvise, adapt and overcome will put you in good stead for what lies ahead. ■ *Improvise, adapt and overcome

CHAIR

| NATIONAL UPDATE

THE IMPORTANCE OF

LEADERSHIP The importance of strong leadership in any business or organisation cannot be overstated. A myriad of studies show correlations between improved business outcomes and sound leadership, while viewed through the prism of organisational psychology it is culture – nurtured and shaped by strong leadership – that drives results.

Dr Graeme Blackman OAM Chair I LASA

he importance of strong leadership in any business or organisation cannot be overstated. A myriad of studies show correlations between improved business outcomes and sound leadership, while viewed through the prism of organisational psychology it is culture – nurtured and shaped by strong leadership – that drives results.

on translating their vision into reality. These leaders are often adept at recognising the signals of change and adjusting their approach to incorporate a level of ambiguity that others would find unsettling or disconcerting. In his column, LASA CEO, Patrick Reid, has more to say on the issue of platform change and adaptability.

In such circumstances it is our industry leaders who will shine, who will get on with the job of ensuring the right decisions are made for the interests of providers and through them, older Australians. True leaders see through the complexities, the politics, the noise and stay focused

LASA and its members are certainly leading the industry in translating our vision – your vision – into reality. As Chairman of the board at this pivotal time I am both inspired and proud of our leadership and of our leaders. ■

LASA’s vision is for a sustainable age services industry, that How one handles complexity and change is what defines meets – and sets – best practice standards. Our vision was them as a leader. Our most recent prime minister has spent defined by you, our members, and together we are turning these few weeks (and some years prior) carefully articulating this into reality. Your voice is heard by our federal politicians, his vision for Australia. by our state politicians, Only time will tell if his by policy makers and our leadership will result in this colleagues in community vision becoming reality. As services. LASA and its members are leading the industry a country we need stability in translating our vision – your vision – into reality. The theme of this year’s in our leadership, and our National Congress, “Coindustry, like many others, designing tomorrow’s age needs it too. services” could not be more Age services is in a state of change without the added fitting for the current leadership landscape. The premise complexity of a revolving door of ministers uncertain of of co-design is that stakeholders are actively involved in whether the social services portfolio is a poison chalice designing, creating and implementing the services they or career launch pad. Major reforms are under way and in will use from the outset. It takes true leadership to ensure the case of many changes, such as the move to consumer people who use services are valued by organisations as directed care and through this consumer fund holding, partners – that they have the same influence over any there can be no turning back. decisions made about the service as the next person.

FOCUS ON I

ACCESS

FOCUS ON... ACCESS Access and Isolation – strange bedfellows Access (or lack of) and regional, rural and remote Queensland communities are long-time acquaintances; a relationship which emanates from many challenges and almost as many opportunities. As in many country communities around Australia, ageing Barry Ashcroft Queenslanders and those who support and care for them are Chief Executive Officer often deprived of the more LASA QLD commonplace and plentiful age services available to their contemporaries in larger cities and towns. Inadequate infrastructure (hospitals and accommodation), lower (and ageing) population bases, skills shortages (capacity and capability) and reduced connectivity (physical and virtual), have always been the key drivers behind the access challenges faced by these communities. There is, however, great truth in the expression ‘necessity is the mother of invention’, and this is never more evident than in the variety of solutions and innovations born from the issues brought about by the reality of inaccessibility. Rural, regional and remote Queensland communities are proven to be quick to innovate, adapt and adopt techniques and technologies to bridge the gaps created through isolation; sometimes incredibly creatively and in ways that exceed benchmarks in transformational models of service delivery in other industries. The adoption and application of telehealth services and information available to regional, rural and remote ageing Queenslanders continues to increase their ability to access safe, sustainable and appropriate care that is not only equitable and timely, but increasingly innovative. No longer the sole remit of government health departments, age services are increasingly delivered through telehealth and smart technologies to older people in residential care

facilities, retirement living communities and in their own homes (even in their Winnebagos!). Not only are these initiatives keeping senior Queenslanders healthier and more independent for longer, they are socially connecting them to their families, friends and communities, and helping them to feel comfortable and current with smart technology and the virtual way of the future. Queensland age services providers are also impacted by the tyrannies of distance, particularly when it comes to accessing timely information; accurately contextualised for their unique environments.

Telehealth services and information continues to increase people’s ability to access safe, sustainable and appropriate care in rural and remote communities. Understanding this, LASA Q remains committed to supporting our members in regional and remote areas by harnessing technologies such as webinars, telelinking and video conferencing. Through such measures we continue to ensure members are more easily able to overcome issues around timely access to information and advice. We are also mindful that it is very important for members to be able to access key LASA Q staff in their own communities, and we have developed an incredibly robust and thorough regional meeting and forum schedule that runs throughout the year. This kind of access is imperative in not only humanising our member services, but also generates real and tangible membership benefits. A single ‘touch-point’ with a LASA Q staff member can, and often does, result in individual voices being heard at the state and national levels across the LASA network, within government, and across other peak industry groups. Access will always be an issue for age services delivery in rural, regional and remote communities, but LASA Q will always endeavour to provide the conduit for inspiration, initiative and innovation.

ACCESS

Access to age services – the financial reality check In all aspects of life, access to services is ultimately a question of money and, in the aged care sector, as in other areas of social services, most of that money comes from government.

Paul Carberry Chief Executive Officer LASA SA

According to the Aged Care Financing Authority (ACFA), in 2012-13 the Commonwealth funded 88 per cent of the cost of home care packages and 71 per cent of the cost of residential care.

Over time those percentages will change as a result of the means testing and consumer payment rules which were introduced in July 2014. As the proportion of people in care who entered since July 2014 increases, the share of the cost borne by the Commonwealth will decrease. The new means tests will require more people to contribute to the cost of their care, in both the home and residential settings, and more people will contribute more towards their accommodation under the new, universally-applicable rules. These changes will bring down the Commonwealth’s overall share of the costs, but it is unclear by how much, recognising that, at the same time, the government’s higher accommodation payment and the annual and lifetime caps on care fees will move in the opposite direction.

I FOCUS ON

So, while we don’t know where the cost shares will settle, it’s clear that the Commonwealth will continue to bear the lion’s share of aged care going forward.

The greatest single financial determinant of access to aged care will be the Commonwealth’s willingness and capacity to fund the growing demand. The greatest single financial determinant of access to aged care will be the Commonwealth’s willingness and capacity to fund the growing demand. In this regard, the aged care sector will face some serious competition from other agedrelated expenditure items. According to the National Commission of Audit (the people who thought scrapping the Payroll Tax Supplement was a good idea) five of the Commonwealth’s fastest growing areas of expenditure are the age pension, Medicare benefits, hospitals, pharmaceutical benefits, and aged care itself. All of these expenditure areas are expected to grow faster than GDP, and all are impacted by the aging of the population. According to the Audit Commission, by 2023-24, these five areas combined will account for 28 per cent of all Commonwealth expenditure, compared to 25 per cent this year. When we take into account that the oldest of the babyboomers will be turning 78 that year, with their highest-cost medical and aged care years still ahead of them, we get an idea of challenge the government will face funding these programs. To ensure the future of access to quality aged care, and the other government-funded programs that support the aged, we need to encourage and support reforms which will help economic growth. We need to understand that for the government to spend adequately on aged care, we have to have a strong economy and profitable businesses to pay for it. We need to support tax reforms which are progressive, supportive of growth and which adequately fund government programs, remembering that, where individuals and organisations are exempt from tax, either less money will be available or the shortfall will have to be made up by other taxpayers.

Image courtesy of Robert Kneschke/shutterstock.com

If, as a community, Australia gets the above things right, access to quality aged care should be assured. The move to increased user payments, combined with the large growth prospects for the sector, will ensure that providers have the incentive and capacity to invest and innovate. If the government has adequate funding to support the aged, special areas of need, such as rural and remote locations, can be adequately compensated and supported.

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ACCESS

Ensuring older Australians have access to a highly skilled and qualified aged care workforce How in the future will we develop and employ our specialists in palliation? In behaviour management? In a swathe of crucial industry roles and responsibilities?

Loula Koutrodimos Acting CEO LASA NSW-ACT

Developing and securing a workforce for the future is a challenge across all industries. So how can aged care become ‘magnet’ for capable, motivated and dedicated staff, often with specialised and in-demand skills, seeking a fulfilling career?

An engaged and motivated workforce, fully committed and understanding the services being offered and delivered, will be even more crucial to the viability of an aged care provider in the future. The payment environment for the aged care industry has changed. We are working in an industry enmeshed with cocontributions, and increasingly fee for services. A dynamic workforce, both in responsibilities and outlook will be crucial to attracting residents and clients, and also like-minded staff to join a forward-looking provider. The future of quality care, as the viability of age services who deliver this care, is directly linked to the future of our workforce. This is fundamentally understood by LASA and is a key focus of our Association’s advocacy and engagement right around Australia.

Celebrating diversity through improved access

An engaged and motivated workforce, fully committed and understanding the services being offered and delivered, will be even more crucial in the future. Firstly, the industry needs to ensure that in all services ranging from residential care, to home care, to home support, and to disability care, there are dedicated pathways for both professional growth and development. While some organisations do this effectively, this must become an industryconstant rather than a stated ambition.

I FOCUS ON

Australia is a multicultural country. Australians identify with more than 300 ancestries and there are more than 260 different languages spoken in Australia today1. Australian Institute of Health and Welfare statistics have 20 per cent of older Australians born in ‘non-main English speaking countries’ with a forecast of more than 30 per cent by 2021. At LASA, we aim to facilitate an age services industry which supports and responds to the needs of all Australians regardless of culture, background, location or entry point. This includes supporting the full implementation of the National Ageing and Aged Care Strategy – which three years on is still in the early stages.

Starting with home care, and moving inexorably into residential care from 2017, consumer directed care is a reality. In this changed environment we must understand that staff autonomy will be an increasing part of delivering care, especially in the home. We must prepare, develop, and mentor our workforce to be confident and effective in working autonomously as well as with greater flexibility.

Beth Cameron Chief Executive Officer LASA WA

Across the continuum of care, be it residential care, home care, home support, or disability services, developing and maintaining our workforce will be a constant competition. This competition will be from both within and outside of the industry, and in some instances will shape the organisation delivering care.

The bureaucratic complexity that we all deal with in aged care is even more of a barrier to older Australians from culturally and linguistically diverse (CALD) backgrounds. As such, all efforts to simplify access and reduce red tape is particularly important for these older Australians.

The relationship between customer service and care will only become more profound, and each organisation’s workforce will be a key point of differentiation. Potential residents and clients will compare the quality of care and the choices available between services. They will pay close attention to compliance outcomes and will take particular note of the environment where care is delivered. They will also demand that care and services meet the expectations of their financial outlay.

CALD groups complain about a general lack of effective engagement strategies by Government; ineffective approaches to languages other than English in government websites and documentation; and insufficient use of interpreters2. Initiatives such as the Aged Care Gateway are reported as impossible to navigate for those older Australians that have difficulties with English. Statistics of 20-30 per cent indicate that access to culturally considerate care and clear, easy to navigate systems are necessary for everyone in aged care. In committing to build

FOCUS ON I

ACCESS

our capacity to ensure this is possible – governments need to provide the funding and resources required to deliver. As I mentioned at a recent Senate Committee hearing, intertwined with Australian aged care businesses being positioned to capitalise on global opportunities is the capacity to understand and support our own older Australians from CALD backgrounds. Any support given to support the sectors capacity to care for our clients identifying as culturally and linguistically diverse, through initiatives including language services and cultural sensitivity training, will have the double benefit of increasing our collective capacity to build productive working relationships across markets. The People of Australia3, a statement by the Australian Multicultural Advisory Council that catalysed the CALD strategies we have seen since, is well worth a read. The authors rightly state that, “All Australians in need of assistance from government and qualified for it are equally entitled to receive it. Culture, language and religion should in no way compromise this right. Guaranteeing this principle of fairness is helpful to both the people in need and the cause of social justice and harmony. It is the duty of government to see that all citizens are able to participate in programs and receive the services to which they are entitled, regardless of their cultural background… That is not a matter of providing an advantage not available to all Australians, but rather ensuring that all Australians are treated equally.”

References 1. National Ageing and Aged Care Strategy for People from Culturally and Linguistically Diverse (CALD) Backgrounds, Commonwealth of Australia, 2012. 2. Access & Equity for a multicultural Australia; Access and Equity Inquiry Panel, June 2012. 3. The People of Australia, Australian Multicultural Advisory Council, April 2010.

Service Access – Challenges and Opportunities Australia is widely regarded as having amongst the best systems of aged care globally. As with many advanced economies, Australia will experience a significant change in our demographic profile over the next 20 years. The Australian Bureau of Statistics estimates that Trevor Carr the proportion of our population in Chief Executive Officer the ‘aged’ 65 and over demographic will increase by 30 per cent, and in LASA VIC the ‘old’ 80 and over demographic by almost 60 per cent by 2034. In the same time period, the proportion of the population in the working age demographic decreases by 18 per cent. So what impact will these societal changes have on access to and choice of care? Let’s first explore the notion of access. The Commonwealth Home Support programme and home care packages have low barriers to entry and as a result are provided in a competitive market place by a variety of service providers. We know that most providers in this model of care are not-for-profit providers (90 per cent of home care providers are characterised in this way). We also know that from February 2017 that this part of the aged care market is to be deregulated with the consumer holding the funding package, and that from July 2018 these two programmes are to be combined. In theory, access to care for the majority of older Australians living in larger metropolitan and regional centres will be enhanced through this development, but what of the situation for those living in rural and more remote locations? One LASA Victoria member providing services into rural locations recently commented that they cannot afford to pay the cost of travel more than 10km from a regional town for level 1 and 2 home care packages. This economic reality can only be overcome through co-payment or through an enhanced funding envelope and clearly indicates an access issue for the future. And what of residential care? As a result of significant reform in the 1970s and 80s, residential care in Australia reflects a distributed model of access that has realised localised access to care for many rural and some remote communities.

Image courtesy of Diego Cervo/ shutterstock.com

Unfortunately recent reports from the Aged Care Financing Authority have indicated an increasing prevalence of service providers operating with negative or marginally sustainable financial results that are located in rural and remote locations. This reality raises an important question for policy makers in regard to the distributed model of service access that features in our world class system. Put simply, is this distributed model

ACCESS

I FOCUS ON

Image courtesy of rvlsoft/shutterstock.com

going to be supported in the future, and if so, what mechanisms will be applied to ensure that the model is sustainable. This will become more problematic should a deregulated market eventuate in the future. So once a consumer accesses the system where does the question of choice sit?

Unfortunately, in all scenarios, an active market and homogeneity is required to ensure both access and choice. It is the responsibility of all involved in policy creation to ensure that this reality is reflected in the funding models that underpin service provision. â&#x2013;

Several enhancements to choice have resulted from recent policy initiatives. The â&#x20AC;&#x2DC;My Aged Careâ&#x20AC;&#x2122; website is a significant development in affording choice to the consumer. Placing the teething issues to one side, any individual interested in determining options for care can now find the service providers operating within their locality, determine if they have places available, and review pricing structures and options. This information has not previously been accessible and is a significant development in terms of choice (and arguably, in determining access). The February 2017 reform to fund holding for recipients of home care packages will also, in theory, enable enhanced choice for the consumer. However, a risk also exists in that overhead will be driven up and the consumer may not have the same purchasing power as a package provider now represents. Challenges such as the issue of providing care more than 10kms from a regional centre may become more commonplace if consumers purchase their package of needs from multiple providers. And of course, in a reality of shrinking workforce availability, access to skilled workers will become more problematic and costly. Currently, our funding models differentiate between funding to people in the community and funding to people in aged care homes. This reality limits consumer access and choice. Future funding approaches may fund according to assessed need and not be based upon a community care/residential care differential, further enabling individuals to age in their own home by choice.

TECHNOLOGY |

COMPUTER SOFTWARE

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NEWS

NEWS Member input sought for policy submissions LASA National is currently seeking contributions for a number of up coming submissions to various organisations: • The Department of Social Services (DSS) has released a consultation paper on new aged care short-term restorative care programme policy, a copy of which is available on the DSS website. If you would like to contribute to the LASA submission please do so by COB 12 October 2015. • The Australian Aged Care Quality Agency (AACQA) is seeking feedback on its document Let’s Talk About Quality: Developing a shared understanding of quality in aged care services, further information is available on the AACQA website. The AACQA have established an online survey for which people may provide feedback through until the end of October, alternatively if you would like to contribute to the LASA submission please do so by 16 October. • The Australian Commission on Safety and Quality in Health Care are currently seeking feedback on the NSQHS Standards (Version 2), a copy of which is available on the ACSQHC website. If you would like to contribute to the LASA submission please send your comments through by 23 October. If you would like to contribute to any of the below submissions please contact either your local state office or the LASA National Policy Manager, Kay Richards at kayr@lasa.asn.au or 02 6230 1676. Recent submissions we have made on behalf of members include: • Comment on DSS Review of Commonwealth Aged Care Advocacy Services Options Paper • Comment on Collection of 2014-15 Financial Date from Home Care Providers • Comment on Limiting fringe benefits tax concessions on salary packaged entertainment benefits • Response to the SA Government’s draft guidelines for Legionella control and maintenance of drinking water distribution systems in health and aged care facilities • Response to the ACT Law Reform Advisory Council’s Reform of Guardianship Arrangements in the ACT • Comments on Legal Issues arising from the change to Consumer Directed Care in Home Care • Draft Report 2, April 2015 (Home Care Today) • Comments on Practice Guidance on Legal Issues in CDC (Home Care Today)

VCare now available in Australia Aged care providers now have access to a new software system, VCare International. VCare provides extensive care and resident management functionality with a specific focus on retirement villages and long term care facilities (nursing homes, hospitals and disability care). VCare software is smart, flexible, easy to use and already available in New Zealand, Great Britain and Ireland. It will be supplied locally through Star Business Solutions. The software can be deployed as a hosted, managed service or locally installed as per the needs of the client. This offers a variety of cost benefits including little to no capital expenditure, fixed costs, and low risk implementation. VCare and Star Business Solutions will be exhibiting at the LASA National Congress in October on Stand 91.

Be safe. Be Healthy. Because… October is Safe Work Australia Month and this year’s theme is Be safe. Be healthy. Because… There’s a range of ways you can actively participate, such as: Download the National Safe Work Month electronic information kit – designed to help you raise awareness about work health and safety within your organisation. The kit includes products such as posters, fact sheets, web banners, email templates and national safety statistics and will be available to download in early September. Enter the National Safe Work Month Workplace Participation Reward – for your chance to win. The reward will be presented to the organisation displaying the most outstanding spirit, participation, creativity and sustainable initiatives during the month, as judged by photos and stories submitted throughout October. Download the free National Safe Work Month smart phone application – find out about safety events happening near you, read national safety statistics, watch a virtual seminar and enter the Workplace Participation Reward. The app will be free to download on all mobile devices from mid-September. Watch the 2015 Virtual Seminar Series – a series of free online seminars showcasing the latest thinking and research in work health and safety. Members interested in the Virtual Seminar Series can download a copy of the program at www.safeworkaustralia.gov.au/

• Response to the ACSQHCs National consultation on the draft delirium and hip fracture care clinical care standards

NEWS

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NEWS

New workshops to support a dementiafriendly nation

senior customers who have lived in this area their whole lives. Becoming dementia-friendly is just one of the ways we can better support our community as a whole.”

Home Instead Senior Care has introduced a national public education program to assist businesses in Australia to become more dementia-friendly.

Home Instead Senior Care will be exhibiting at LASA National Congress. Visit them at booth 38.

The purpose of the program is to help businesses understand dementia through training and education and to assist in making changes that will have a positive impact on those with dementia. “Awareness, understanding and acceptance of dementia is so important but we want to take it a step further and put this understanding into practice. We assist businesses with changing their systems in regards to communication, lighting, signage and environment – all of which can have a huge impact,” said Martin Warner, owner of Home Instead Senior Care in Australia. “Many people that suffer from dementia can become isolated and unfortunately, we as Australians are implicit in this. If people living with dementia do not feel supported in their local community and face barriers to social inclusion, it is all too easy for them to shut off from society, which only exacerbates their feelings of confusion and loneliness,” said Mr Warner. The definition of a dementia-friendly community, as stated by Home Instead, is a place where people with dementia are understood, respected and supported and can continue to contribute to community life. “We want people with dementia to feel included, involved, encouraged and supported in their community. It is so vital that they can retain their independence, choice and control over their day-to-day lives,” said Mr Warner. The national public education program involves a free 30 minute training workshop with Home Instead Senior Care educators who will teach employees and employers how to maintain a dementia friendly environment. The session covers everything from how to identify someone with dementia to how to communicate with them and how to support them in their service experience. This is not a one-off session and training will be available on an on-going basis. Home Instead Senior Care awards participating businesses with a formal certificate of training to certify that the business has completed the training and is actively creating a dementia friendly Australia. Home Instead Senior Care have been running a similar program in the UK and have reached over 20,000 people. In Australia, the team hope to match and indeed surpass that number. In June 2015, Home Instead Senior Care began their pilot program in Toowong Village, Brisbane. The likes of Kmart, Wallace Bishop, Taking Shape Fashion and Brisbane City Council Library all participated in the training. This year, Home Instead are taking the program Australia-wide with workshops in Brisbane, Sydney, Melbourne, Adelaide and Perth. Toowong Village Marketing Manager Angela Green said the shopping centre has been a cornerstone of the local community for over 20 years. “Whilst we have a lot of students and young families frequent the Village, we also have a lot of

Practical palliative care information to support aged care staff Decision Assist is a Commonwealth-funded project that seeks to enhance the provision of palliative care and advance care planning services to older Australians. Aged care staff managing clients/residents with palliative care needs often require timely access to information about symptoms and medication, which can be accessed via the Decision Assist website and phone advisory line. The line, which also has an advance care planning component, provides residential aged care facility staff, people working in community care and General Practitioners with evidence-based specialist palliative care advice. Enquiries via the phone line often relate to advice about symptom management, medication management and working with caregivers and families. The advance care planning advisory line provides information about raising issues about developing a plan with care recipients and also the legal requirements for each state and territory. The Decision Assist website also provides a wealth of evidencebased information. The information most commonly sought via the website to date relates to agitation, restlessness and pain management. The site offers links to pharmacological information as well as tips for the staff that are working with people that may be experiencing these symptoms. The aim of these practical tips is to assist staff in trying to identify what may be causing the agitation and/or restlessness so that a potential solution can be found. Some examples of the information available include assessing whether the restlessness is a side effect of one of the medications being used or the possibility that the delirium is a result of urinary retention. For aged care staff wanting further information on pain, it gives access to things like the Abbey pain scale, to measure pain in people with dementia who cannot verbalise, and the Australian Pain Society’s document ‘Pain in Residential Aged Care Facilities: Management Strategies’. Support to assist the management of nausea includes information on medicines, therapeutic guidelines, and practical tips such as if the smell of food causes nausea, try switching to cold meals like salads or serve food at room temperature, and focussing on what the person enjoys, and forget about ‘healthy’ foods. To access the resources phone 1300 668 908 or visit www.decisionassist.org.au

NEWS

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QLD Day honour for Flexi Care Inc The team at Flexi Care Inc. has won the Southside Community Spirit Award at the Queensland Day ceremony. The staff and volunteers, who assist clients with daily living and to be active members of society, were recognised for their valuable contributions to the health and lifestyle of their clients. Flexi Care Inc. is a not for profit organisation has provided community-based packages of care for 23 years. They go above and beyond to enhance their clients’ lives through activities such as: • Spring Cleans • Social day trip outings every two months

“We recognise that social isolation can impact greatly on people’s lives. Through providing these extra social outings and activities we see the reality of how these outings enhance the quality of life of our clients.”

Churches of Christ win 2015 PASCOP Annual Quality in Pastoral and Spiritual Practice Awards Churches of Christ has been named the winner of the 2015 PASCOP Annual Quality in Pastoral and Spiritual Practice Awards.

• Morning teas and lunches targeting specific areas of need i.e. men’s lunch, carers group, young at heart group and life travellers group

The organisation, which cares for 1,800 aged care residents in Queensland and Victoria, won the award for its pilot dementia church service initiative.

• Weekly movie days

• Client 3 day holidays

The PASCOP Quality Practice Awards are Australia’s first national awards program dedicated to innovation and excellence in pastoral and spiritual care of older people. They recognise innovation and excellence in the spiritual care of older people.

“These projects have been delivered over and above our normal service provision,” Acting General Manager, Monika Prinsloo, said.

Since 2014, around 42 per cent of residents living with dementia have attended weekly church services that are run from Churches of Christ’s aged care facilities in south east

• iSafe 12 week program • Client Christmas Lunch

NEWS

Queensland. There are plans to expand it to the organisation’s 15 other dementia specific units. David Petty, Executive Director of PASCOP, congratulated Churches of Christ and Aged Care Chaplain, Wayne Crouch for introducing the pilot. “The introduction of a church service has made a positive, tangible difference not only to the residents but also to the staff and volunteers,” said Mr Petty. “The program highlights pastoral and spiritual care in practice for residents who are often seen as difficult to connect with.”

Australian Unity expands its Home Care operations with successful NSW tender Australian Unity has signed an agreement with the NSW Government to accept the transfer of the Home Care Service of NSW (Home Care) to Australian Unity. Home Care provides in-home care services to more than 50,000 clients across NSW and has 4000 employees. Under the agreement, staff and clients will transfer to Australian Unity and Australian Unity will continue to provide all services.

Churches of Christ receives $1,000 and the opportunity to present at a PASCOP Meaningful Ageing seminar and national conference.

Australian Unity’s Group Managing Director Rohan Mead said “This is an opportunity for Australian Unity to fulfil its vision to create Australia’s leading home care business based on a true continuum of client-directed care.”

Baptcare in Victoria was finalist in the annual awards for its Community Aged Care Chaplains program. The program has 45 pastoral visitors spending time with older people in their own homes.

The transfer will result in Home Care becoming one of the largest areas of operation within the Australian Unity Group and one of the largest home care providers nationally.

The program reaches around 100 people a month, and has now been replicated by BaptistCare in New South Wales, ACT and Western Australia.

Australian Unity is a mutual company, with a 175-year history of offering community services, with no external shareholders and with customers and staff as its members. It reinvests profits into expanding services.

David Petty said the program had shown a marked difference for clients who were isolated, housebound, and on community aged care packages. Before the program started, only 20 clients in each region of Baptcare Victoria had access to pastoral care through its Chaplains.

The Government’s key objective has been to select a provider who can deliver continuity of service and prepare Home Care for the national aged care reforms and the NDIS. The specialist area within Home Care that provides care to the Aboriginal community, Aboriginal Home Care, will retain its important and unique identity, delivering culturally appropriate services across NSW. Under the conditional agreement, Australian Unity will pay $114 million, subject to adjustments usual for a transaction of this kind. The transfer is expected to be finalised by early in 2016.

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NEWS

Elder abuse is a form of family violence, Commission told

“It happens between generations which is unlike the usual conceptualisation of family violence, where – typically – the male perpetrator is of the same generation,” she said.

Home care providers need support and training to help identify, manage and prevent instances of elder abuse, the Victorian Royal Commission into Family Violence has been told in its first week of hearings.

LASA CEO Patrick Reid said elder abuse is an aspect of family violence that is on the rise and remains under-reported, but it’s time to shine a light on this issue.

Manager of Seniors Rights Victoria, Jenny Blakey told the Commission in July that elder abuse is more common than we think and it needs to be recognised as a form of family violence.

“The key areas of concern are physical violence leading to death, neglect and financial abuse. We know this is occurring, we know it’s on the rise, and it needs greater attention from our politicians and media,” Mr Reid said.

She said home care workers are in a prime position to observe, detect, report and prevent it from happening, but they need training to become alert to or recognise elder abuse. She also believes protocols and systems that respond to the issue should be put in place. “Home and community care workers go into the home and observe older people. They are key. They have a relationship with an older person and can notice signs of abuse when they talk to them… They need to respond.” Ms Blakey acknowledged that some facilities already have training and protocols in place, but says a more holistic approach to referrals and support is needed.

It is unclear yet whether the funds announced by the Australian Government to Stop the Violence last month will stretch to measures for addressing elder abuse. The commission is due to provide its report and recommendations to the state government at the end of February 2016. ■ A panel discussion on elder abuse featuring some of the country’s leading advocates for addressing domestic and family violence, will be held at LASA National Congress at 09.25am on Tuesday 13 October.

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DEMENTIA

| RESEARCH

Additional funding for dementia priority areas Dementia research has received a $35.6 million boost in funding from the commonwealth, with six significant grants from the NHMRC announced last month. The grants will be shared across five universities – University of Melbourne, University of Newcastle, UNSW, Macquarie University and the Queensland Institute of Medical Research.

hile four of the grants are for clinical research, the other two are for research at UNSW and University of Newcastle into public health services and health promotion in the broad areas of intervention, measurement, legal issues, capacity building, prevention and healthy ageing.

Dementia is predicted to grow to over one million people in the next 40 years. Health Minister, Susan Ley, said the Dementia Research Team Grants “provide a new opportunity for Australian researchers to collaborate on priorities, rather than compete as individuals, and align with the priorities of people with dementia and their carers”. ■

RESEARCH |

DEMENTIA

The Big Questions asked:

National Dementia Research & Knowledge Translation Forum

Last month the ninth annual National Dementia Research and Knowledge Translation Forum was held in Sydney, as a joint collaboration between Dementia Collaborative Research Centres (DCRCs) and the Dementia Training Study Centres (DTSCs), in association with the Australian Journal of Dementia Care. The following selection of abstracts from the event relate to topics affecting age service providers.

Does anxiety predict cognitive decline in the elderly? Findings from the path through life study RN Arthur, ME Mortby, RA Burns, KJ Anstey Centre for Research on Ageing, Health & Wellbeing, Australian National University BACKGROUND: There is no consensus in the research literature about whether anxiety predicts cognitive decline in older adults. Conflicting results may, in part, be explained by methodological limitations in some studies, including small or biased samples, short study period, unclear empirical distinction between state and trait anxiety, and failure to account for statistical dependence between repeated observations. This study addresses these limitations and investigates the longitudinal association between trait anxiety and cognitive decline in community dwelling, older adults. METHODS: Drawing data from the PATH Through Life Study (Anstey et al 2012), associations between anxiety and cognitive function were investigated in 1590 cognitively healthy, older adults (baseline: 49%female; mean age: 62; mean education: 14 years). Observations were taken over three waves at four-yearly intervals. Measures included the Goldberg anxiety and depression scales, Symbol Digit Modalities, Digit Span Backwards (DSB), Immediate and Delayed Recall, Spot the Word, and Mini Mental State Examination (MMSE). Associations were investigated using Latent Growth Curve Modelling (LGCM), while controlling for gender, age, education, and depression. RESULTS: Trait anxiety was associated with initial cognitive performance for MMSE (β=-.126, p= .036), and

DSB (β=-.063, p=.034). In the adjusted model, trait anxiety was associated only with the intercept for MMSE (β=-.134, p= .040). Trait anxiety was not associated with the population trajectories in any of the cognitive measures. CONCLUSIONS: In an epidemiological sample of community dwelling, older adults, trait anxiety was not associated with population-level change in a range of cognitive functions. To our knowledge, this study is the first to address a number of methodological limitations associated with the investigation of the association between trait anxiety and cognitive decline using a methodologically rigorous LGCM approach.

Dementia, financial abuse and banking– a knowledge translation study for bank staff S Bhatia1; C Peisah1,2; J Macnab1; CWijeratne2; N O’Neill 1,2; H Brodaty2,3; 1 – Capacity Australia (Australian Centre for Capacity, Ethics and the Prevention of Exploitation of People with Disabilities, ACCEPD); 2 – School of Psychiatry, UNSW; 3 Dementia Collaborative Research Centres–Assessment and Better Care, UNSW. BACKGROUND: Financial abuse is the most common form of elder abuse. Banks can play an important role in preventing financial abuse of people with dementia, making it vital that frontline staff become familiar with signs and symptoms of dementia so they can spot customers who may need support. METHODS: Following guidelines modelled by the DCRC Knowledge Translation Team, our methodology comprised: (i) engaging banks in acculturating education about dementia and financial abuse into routine/mandatory training; (ii)

DEMENTIA

| RESEARCH

Image courtesy of Halfpoint/shutterstock.com

canvassing feedback from the banking industry to identify best practice approaches that could be part of a knowledge transfer process; (iii) development of a training module tailored to the industry and able to be tested; and (iv) development and implementation of a dissemination strategy. We undertook interview rounds with senior banking industry personnel representing a range of financial institutions to ascertain views about policies, practices and knowledge regarding elder financial abuse. The tool was tested on 69 banking staff across Australia from two major banks. RESULTS: Our educational tool integrated: (i) existing knowledge about dementia and financial abuse; (ii) Australian Banking Industry Guidelines on Financial Abuse Prevention and Formal Arrangements; (iii) feedback from consultations with banking staff about abuse scenarios and appropriate strategies, and supported decision-making in the banking environment. We developed an online education tool using adaptive learning developed by Smart Sparrow, an Australian eLearning technology company. It comprises a pre-test of 15 multiple choice questions, followed by a learning module tailored to the individual’s performance on pre-test, and a posttest to assess knowledge translation. A significant increase in scores was demonstrated when baseline scores were compared with post-course scores (mean score difference = 3.5; SD=1.94;t=15.1; df=68; p< 0.001).

No link between social isolation and activity participation for nursing home residents with dementia A-NCasey 1; L-F Low 2; Y-HJeon 3; H Brodaty 1; 1 – Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, UNSW; 2 – Faculty of Health Sciences, The University of Sydney, NSW; 3 – Sydney Nursing School, The University of Sydney. BACKGROUND: Perceived social isolation is associated with poorer well-being. Nursing home residents with dementia are at risk of social isolation. Positive co-resident relationships contribute to perceived social support. Structured activities provide opportunity for positive between-resident interaction. Study aims were to describe nursing home residents’ activity participation and investigate associations between participation and self reported social isolation and peer network size. METHODS: Data were collected for 27 residents with dementia aged 68-92 years (mean=82.6) in a 94-bed nursing home. Observations of activity participation were recorded in field notes. Structured activities were defined as facilitated activities involving two or more residents, not including personal care or routine meals. Residents identified relationships with coresidents and completed a measure of social isolation. Peer network size was defined as the number of relationships identified with co-residents. Relationship data were explored using social network analysis. Associations between activity

RESEARCH |

DEMENTIA

participation and social isolation and network size were investigated using Spearman’s Rank Order correlations. RESULTS: Sixteen residents completed social isolation measures. Residents participated in an average of 3.3 (SD=2.3) unique activities including large events, social groups and therapeutic programs. Peer network size ranged from 0 to 18 residents (median=0, IQR=0–2).No significant associations were found between residents’ participation in structured activities and perceived social isolation (ρ=-.33,p=.210) and peer network size (ρ=.33,p=.136). CONCLUSIONS: Residents’ participation in structured activities was not associated with their perceptions of social connectedness. The types of activities offered rarely focused on resident relationships. Understanding resident perceptions of social connectedness can guide relational approaches in dementia care practice.

Environmental and lifestyle risk factors for younger onset dementia: preliminary results from the INSPIRED study M Cations, 1,2AWithall, 1 B Draper, 2,3 FWhite, 2NDenham, 2 J Trollor, 3 P Gonski, 1ADemirkol, 1HBrodaty, 2,3,4 P Sachdev, 3,4 C Loy5 1 School of Public Health and Community Medicine, UNSW, 2 Dementia Collaborative Research Centre– Assessment and Better Care, UNSW, 3 School of Psychiatry, UNSW, 4 Centre for Healthy Brain Ageing, UNSW, 5 School of Public Health, University of Sydney BACKGROUND: Younger onset dementia (YOD) accounts for up to 9%of dementia cases, but little is known about its cause. Many environmental and lifestyle factors have been identified to increase risk of dementia in older people. It remains unknown whether these factors are also associated with its early emergence, as a vast majority of YOD epidemiological work references genetic influences alone. We aimed to investigate the risk for degenerative, non-autosomal dominant YOD associated with six potentially modifiable factors: traumatic brain injury, education, depression, cardiovascular risk factors, smoking and alcohol. METHODS: Participants with YOD were recruited via relevant health care professionals or self-referred, and their dementia diagnosis was confirmed by clinical consensus. Control participants were recruited via their GP clinic and matched by sex and five-year age group. Exposure data was collected using surveys and structured interviews with the participant and/or an informant. RESULTS: At the time of reporting, participants included 59 control participants and 72 people with degenerative YOD, including Alzheimer’s disease (61.1%), frontotemporal dementias (12.5%), vascular dementias(11.2%) and other dementias(15.3%). Control participants had significantly more years of education (M=15.4) than people with YOD (M=13.1; p=0.001). In addition, a higher proportion of people with YOD than control participants were ever smokers (65.3%vs

39.2%,OR=1.87), had a depression diagnosis in midlife or earlier(40.0%vs 30.6%,OR=1.52), and had sustained at least one stroke (11.8%vs 1.7%,OR=3.80), although these differences only approached significance. The risk of stroke remained near significance even after cases of vascular dementia were removed (OR=2.81). There were no significant differences in history of traumatic brain injury, hypertension, diabetes, hypercholesterolemia or alcohol consumption. CONCLUSIONS: Low education, depression, stroke and smoking are possible risk factors for younger onset dementia.

Facilitating culturally safe care of Aboriginal Australians living in residential aged care K Fyfe, A Stafford, S Crowe Dementia Training Study Centre (WA), School of Pharmacy, Faculty of Health Sciences, Curtin University, WA. BACKGROUND: Aboriginal people are experiencing dementia at five times the rate of other Australians. Aboriginal residents of aged care facilities have unique cultural needs often not met in these facilities. Currently being piloted, this two-stage project developed educational resources to assist residential aged care facilities (RACFs) and health professional sin providing culturally safe dementia care to Aboriginal residents. METHODS: In stage one, a film was made of an Aboriginal artist working with Aboriginal residents of the Hall & Prior RACF, Windsor Park, to produce three artworks. In stage two, an Aboriginal Advisory Committee was convened which guided the overall process plus development and validation of the resulting resources. This process included using a focus group of health professionals involved in stage one to contribute insights into the outcomes and ongoing success of the initial project. Desktop research contributed evidencebased cultural information and identified parts of validated Aboriginal culturally safe tools for incorporation into the final product. Education-focused health professionals from other WARACFs contributed to validation of the education resource. The final draft product is a half-day workshop where participants are presented with a 30-minute film showing outcomes and insights from stage one, and introduced to the Cultural Assessment Tool and Guide which will facilitate ongoing culturally safe care of the Aboriginal and Torres Strait Islander (ATSI) resident with dementia and their family. The workshop and resources will be piloted during 2015 and are planned to be available nationwide in 2016. CONCLUSIONS: A unique resource to support residential aged care organisations and health professionals to deliver culturally safe care to Aboriginal residents. The resource includes a 30-minute film, followed by a half-day workshop where a cultural assessment tool for ATSI people will be

DEMENTIA

introduced, plus a guide for using this tool with ATSI people with dementia living in RAC. The tool is yet to be piloted, but is planned to become available nationwide in 2016.

Outcomes of wandering-related boundary transgression in residential aged care M MacAndrew 1; E Beattie 1; E Fielding 1; M O’Reilly 1; A Kolanowski 2; 1 – Queensland University of Technology, Brisbane; 2 – Pennsylvania State University, Pennsylvania, US. BACKGROUND: In residential aged care (RAC) dementiarelated wandering is a common behaviour that can be disturbing for the person with dementia and challenging for family, staff and other residents. Boundary transgression (BT) is a dimension of wandering that takes the resident into out of bounds and into hazardous areas such as another resident’s bedroom. Anecdotally this behaviour is associated with loss of privacy and exiting from a safe environment; however no empirical evidence supports this contention. This descriptive study is the first to systematically observe and document the outcomes of BT in RAC. METHODS: Independently ambulant residents with severe dementia and a positive history for wandering with BT

| RESEARCH

(N=7), were observed for a minimum of 12 x 30 minute periods (total six hours per person) randomised across two days (n=92 total observation periods). A BT was classified as entry into areas considered private or hazardous and characteristics of each BT event (n=58) including location, activities observed, and outcomes of the events were collected. RESULTS: Six of the seven participants exhibited BT. The private spaces most frequently entered were other residents’ bedrooms. During the BT events, personal items were moved and/or removed from the room, food was eaten, and beds were slept in. On most occasions (54/58) no one else was present to witness the BT. When the owner of the bedroom was present, responses to the BT ranged from no response at all, to anxiety and distress. During observations, participants experienced verbal and physical altercations, as well as socially isolating behaviour from co-residents in response to their BT activities. CONCLUSIONS: Given the potentially adverse outcomes associated with witnessed BT, further investigation into interventions to reduce the incidence and negative impact of BT in RAC is warranted to ensure optimal outcomes for residents with dementia who wander and their co-residents. ■

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OPINION

Sustainable

service delivery in

rural & remote

ABORIGINAL

communities “Aged care” has a different meaning in our Aboriginal Communities. It begins at a much younger age and has complex service inputs and cultural overlays. Focused organisational capacity development and strong linkages with Australia’s primary healthcare system are required for sustainable long term service delivery.

ounger is relative term. Years are the commonly used measure either under either the Gregorian or Julian calendars and is the orbital period of the Earth moving in its orbit around the sun (365.25 days).

This common measure of ‘age’ has a different meaning when translated into an Aboriginal aged care setting. Chronic disease, increased rates of youth suicide, poor diet, and a range of other social determinates all result in lower average life expectancies for Aboriginals. According to the Australian Institute of Health and Welfare (AIHW), for the Aboriginal and Torres Strait Islander population born in 2010–2012, life expectancy was estimated to be 10.6 years lower than that of the non-Indigenous population for males (69.1 years compared with 79.7) and 9.5 years for females (73.7 compared with 83.1).

Complex service inputs and cultural overlays First and foremost is access to locally-based skilled staff. This can be challenging at the best of times across Northern Australia where many Aboriginal communities are located and arguably where culture is the strongest. The tyranny of distance, geographic isolation, work conditions all combine to make it difficult to attract the best and brightest. Understanding of western medicine and health care also impact on local employment pathways and provision of the right care at the right time. Cultural overlay cannot be underestimated. Poison cousins (an Australian Aboriginal kinship term used to describe a relation

Heath Shonhan Partner I Bentleys Qld National practice leader Bentleys Health & Ageing team

one is obligated to avoid) women’s/men’s business are both examples of customs which dictate who can and can’t deliver what services to whom. Meanwhile a distrust of western medicine impacts on timely delivery of events of care, ongoing health management, and overall community members’ views around the relevance of the service delivery. The financial inputs of service provision into Aboriginal communities are consequently significantly higher directly due to a lack of economies of scale, increased travel costs due to distances between communities and limited service providers. Cultural practices (e.g. town closure when someone has died), and increased remuneration requirements to attract, house and feed skilled staff (where fresh food costs are significantly higher than metropolitan areas) also contribute significantly to additional input costs. The healthcare data silos existing between health care service providers, hospitals, community controlled Aboriginal Medical Services, and aged /community care providers lead to fragmented health outcomes, and service fatigue (when community members received multiple visits from different agencies).

Thinking ahead Our work in recent years with community controlled healthcare providers in Aboriginal communities in far north Queensland and Cape York indicates that continual focus on improving organisational capacity definitely improves service delivery sustainability (or being ‘deadly’ as one Aboriginal Chairman of a successful Aboriginal healthcare provider asked us to task them against!).

OPINION Image courtesy of http://theconversation.com/review-pilgers-utopia-shows-usaboriginal-australia-in-2014-21965

Over and above providing ‘deadly’ levels of quality care and service provision, four areas we see leading providers work through to enable long term sustainable service deliver include: 1. Understanding and reporting key financial efficiency metrics (cost per event or episode of care) keeps an important focus on efficiency (efficacy is measured separately) and enables informed discussion around the service delivery inputs, particularly those that differ between metro vs rural such as travel costs, and business activity drivers. 2. Develop strong employment pathways for community members. This builds local jobs, creates community engagement and appreciation of western medicine, and reduces FIFO travel costs.

of where these data silos are being broken down to improve health outcomes.

3. Structure boards to add value. Community connectivity and cultural awareness is essential, and must be supplemented by traditional Western skills in areas such as finance, strategy, corporate development, and healthcare business management research and business innovation. This builds resilience and increases internal organisational Intellectual Property.

In the coming years we anticipate an increase in aged care service provision by Community Controlled Aboriginal Medical Services. This is logical given the linkages between primary care and aged care in Aboriginal communities and the need to mitigate duplication and leverage skilled staff in communities.

4. Utilise technology and data. Deploying enabling technology to improve service provision is getting easier with the influence of capital from our recent resource boom. Working collaboratively with other providers across the region to share health data can be difficult to improve care recipient outcomes, however is necessary. State health organisations can be pushed to share their data with nongovernment healthcare. Yarrabah in Qld is a good example

In the short to medium term it is unlikely rural and remote communities will have significant choice in service providers, as there just isn’t the population density compared to metropolitan areas. Interestingly, many of these Aboriginal communities are in the Northern Australia development zone. Time will tell as to whether the focus on this region for future economic development, will also lead to better health outcomes for these communities. ■

OPINION

My Health Record VS My Aged Care The decision by the Federal Government to pilot the previously titled Personally Controlled Electronic Health Record (PCEHR) as My Health Record and change the previous Government’s decision to operate the scheme as an opt in system to a universal coverage for all with an opt out arrangement to apply, is an important policy change that should be warmly welcomed.

Rod Young Government Relations Consultant IRT Group I Chair ITAC Organising Committee

ustralia has now spent well in excess of $1billion on the introduction of the PCEHR with a registration rate among the broader population after more than two years operation of approximately 1.5 million citizens. Unfortunately, due to lack of access simplicity on doctor desktops a very poor, less than 5,000 health professionals have become active participants.

In Australia there are in excess of 700,000 persons who are in receipt of some level of aged care service. This number consists of:

The aged care system has had five aged care software vendors go through the process of becoming PCEHR compliant with the following vendors undertaking the systems changes and integration work to become PCEHR compliant:

These 708,000 individuals, all of whom are over 65 years of age and older, either are or will become long term recipients of services being provided by a variety of voluntary and paid care service providers.

• LeeCare

These care service providers are often far more familiar with the clients social, familial and clinical status than any health professional as they often have contact with the client on a daily basis or more frequently.

• iCare • EOS Technologies • Autumn Care • TCM However, with My Aged Care systems continuing to operate completely separately from the My Health Record systems, there appears little incentive for aged care software vendors to engage in the final step of deploying their PCEHR compliance capability to take advantage of the health care information contained within the My Health Care integrated healthcare record. Conversely, the wealth of ‘social care’ information held by community and residential aged care providers usually does not find its way into the My Health Record. Which is unfortunate, given the enormous pool of care knowledge that carers and community nurses have about their clients.

• 180,000 residential care, care recipients • 68,000 community care, care recipients • 460,000 home support, care recipients

Consequently, there is a raft of information about a client that is recorded and accessed by the care service provider to better target and manage the care supports for a client. However, this information is not shared in any systemic and meaningful way with the appropriate health care professionals who may see the client/patient on an intermittent, ad hoc basis and who will often not have sufficient time to take a detailed history of the carer supports being accessed by the client/patient. This lack of integration between the two record systems leaves a gaping hole in the care/health record on these older long time service recipients. Which, does not, my opinion, ensure the best possible integration of care and services for this vulnerable group of older citizens. ■

OPINION

Home Care PACKAGES Much of the conversation across the industry in the past few months has been around the internal changes needed in organisations to adapt to the new Home Care Package model. The much bigger change – moving Home Care Packages into an entitlement model in February 2017 – is often overlooked. While changes to IT systems and staff training to adapt to the CDC model is important, the change to an entitlement model is fundamental.

ervices will cease to be purchased from our organisations by Government, and will be purchased by consumers. Purchasing decisions will be made for completely different reasons than they were in the past, and every dollar of revenue we earn is at risk. Recent Government announcements would tend to suggest that the Commonwealth Home Support Program will follow the Home Care Package program into this model in 2018, and the NDIS is already operating under this model as it rolls out across the country. None of these changes is surprising. The entitlement model is the most significant change our industry has encountered within the current reform program, though it’s a change that has been long anticipated: • These changes to aged care funding conditions were proposed by the Productivity Commission in its 2011 report

• Consumer Directed Care is consistent with the approach being taken with the NDIS • Aged care reforms were regularly discussed by successive ministers, and • CDC reforms specifically were flagged by Minister Fifield on several occasions during the past twelve months. So, no organisation can claim it wasn’t prepared because it wasn’t warned. Yet, judging from discussions at industry conferences recently, many organisations have done little over the past four years to prepare for this change. They haven’t invested in technologies, culture programs and leadership capabilities to help them adapt. Instead, they’ve remained focused on their relationships with Government, placing huge emphasis on compliance. But compliance won’t win customers.

Jason Howie CEO I KinCare Group

The wrong conversations about ‘Quality’ have taken up too much time at industry conferences over the past two years. The assumption seems to be that if ‘Quality’ is improved, an organisation will be successful. When clients leave KinCare they don’t tell us that they felt let down by our compliance or technical capabilities. They tell us they were motivated to leave by the mistakes on the invoices, the perception of rudeness on the phone, or an inattentive staff member that visited them. The conversations we need to be having are about culture, innovation and brand experience – and how we can make more of a difference in our customers’ lives. These things matter to consumers a lot more than they matter to Government. So we need to rebuild our organisations – which were traditionally structured around a Business to Government approach to the market – and adapt Business to consumer models instead. From February 2017 the Government will cease to be our customer, and we will all become retail businesses, whether we like it or not. The differences are profound: • Organisations will need to reorganise around the demographics they serve, rather than the contracts they hold • Cost of acquisition of customers will become a key metric along with Net Promoter Scores • More staff with marketing and sales skill-sets will be hired into the industry • Marketing campaigns will spring up, and promises made in public campaigns will need to be met • Leaders in organisations will be hired from hospitality, retail and other businesses with relevant experience

OPINION

• Infrastructure investments will prioritise communication and ease of access over compliance • Organisations will have to change their cultures to ensure clients have a great experience at every point of contact. Like any change, this one will involve winners and losers. My view is that every organisation has it within its power to be a winner from this reform. The system is workable, the industry is consolidating, and it is continuing to grow. The difference between success and failure will be leadership. CDC is not all about price. We all need to be more competitive. We all need to invest in innovation and lead cultural change in our organisations to offer better customer experiences and stronger relationships. In my view, any leader that attempts to blame change in this industry for lack of success probably hasn’t addressed the cultural change implications or has attempted to run too many business models at once without adequately resourcing them for success in an unprotected market place. My experience with diversified business models is that they cost more to run – and even with additional expenditure they can’t achieve the same quality of result as a focused model. Often they don’t gain an adequate share of capital investment or senior leadership to thrive against focused competitors.

Interestingly, smaller regional providers or special needs organisations are probably more defensible in a market environment. Many of these organisations are focused, with appropriately skilled leaders (in the context of their organisations) and are close to their staff and clients. When an organisation enjoys stronger relationships it’s in an easier position to effect cultural change, and respond more quickly to their clients’ evolving expectations. It’s also my view that organisations caught in the middle will be in trouble. They’re not specialised enough to be niche providers, nor large enough to be scale providers. They can’t offer any real differentiation or meaningful value proposition for their clients, and lack investment to change their cultures or update their infrastructure. The industry changes should be at the top of every board agenda in the Home Care Industry. Every organisation should be asking itself whether it has the clear intent to win in this environment. If you’re committed to success you’ll back yourself with the necessary resources and make major changes – even if they’re painful. Otherwise, find another area where you can create genuine value. Or sell out now before value is eroded through a declining business. ■

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FUNDING

Image courtesy of Photographee.eu/ shutterstock.com

FOCUSING ON AUSTRALIA’S

ECONOMY means prioritising age services

he Australian Government must give higher priority to age services if Prime Minister Malcolm Turnbull is serious about focusing on Australia’s economy.

“Age services is the biggest growth industry in Australia,” LASA CEO, Patrick Reid, said. “We have an ageing population. Over 2000 people turn 65 years of age each week, which is going to increase exponentially over the next decade.” “Most people will require age services at some point in their life, but access, funding and workforce policy issues plague service providers and make it unnecessarily difficult for Australians to receive the care they need.” “Hospital costs are the highest for people aged over 75 years, but many hospital beds are taken up by people who do not need acute medical care but services which could and should be provided in their homes or care facilities.” “In terms of employment, we have the jobs but not the workers. Age service providers need an additional 650

workers per month over the next 10 years to meet increasing demand.” “If Prime Minister Turnbull is serious about keeping Australia’s economy on track he will realise the opportunity that exists in bolstering our age services industry and give social services the priority it needs,” Mr Reid said. ■

FUNDING

Don’t cut FBT tax concessions for not-for-profits LASA has thrown its support behind retaining tax concessions on salary-packaged entertainment benefits for staff working in age services, proposing the current caps on living expenses be increased to support people working in the industry. In its submission to Treasury on the issue, LASA recommends the federal government consider the broader social and economic benefits of granting all organisations in high growth industries including age services, disability and community services equal opportunity in terms of accessing grants, concessions, supplements and FBT exemptions. In addition, LASA says the real value of the existing FBT allowances continues to be eroded, despite a commitment to regular adjustments when it was introduced in 2001. “The current tax concessions and exemptions are necessary to help not-for-profit age service providers maximise their charitable purpose and to enhance the social and economic fabric of Australian society,” LASA CEO, Patrick Reid said. “Workforce attraction and retention is a major challenge for all age service providers and these tax concessions are an important benefit for staff working in age services who regularly go above and beyond in their every day roles to provide the highest possible care for older Australians.”

“Recent government decisions have stripped more than $700 million from the overall fiscal position of age service providers. The combined effect of these changes is negatively impacting on all age service providers and their ability to attract, retain and remunerate staff, at a time when the demand for age services continues to escalate and operating costs are soaring,” he said. LASA has proposed two alternate ways in which the current tax exemptions can be kept in place with measures to prevent any misuse of the benefit: that either the meals and entertainment allowance cap be increased to $10,600 grossed up, which would cover 70% of industry claims under the scheme or escalate the current cap on the FBT living expenses rebate of $30,000 to at least $40,000 grossed up value per employee. “Increasing the FBT living expenses rebate to $40,000 indexed would have more impact more workers positively and provide employers who utilise the allowance with added incentives for staff. This approach would retain the value of the benefit, prevent its misuse and reduce administration and compliance costs, and it can easily be indexed each year to keep pace with consumer inflation,” Mr Reid said. LASA’s submission to Treasury can be viewed at www.lasa.asn. au/wp-content/uploads/LASA-Submission_25.8.2015.pdf

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Superannuation review must consider next stages of life

Aged care costs 3 x higher than government recognises

Any review of the retirement income system must also consider options for financing care and accommodation that meet the changing needs of older Australians, LASA has said following the Productivity Commission report about superannuation policy. The report identified a number of elements of the current retirement income system that warrant a holistic review.

The real costs of caring for older Australians are three times what the government believes and LASA maintains that funding calculations need an urgent review.

“For many Australians, accessing age services is the next natural progression in life following retirement,” LASA CEO, Patrick Reid said. “It makes sense that any review of our current retirement income system must include consideration the affordability and funding arrangements of age services.” “We are already seeing a shift towards increasing consumer contributions, which LASA supports, but the social and financial impact of these changes is yet to be realised,” he said. The real costs of caring for older Australians are increasing at three times what the government believes, as demonstrated by the miniscule indexation increase of 1.3 per cent in July. “These costs are only going to increase over time, and unless a serious review of funding for age services is carried out we are going to end up with a very skewed, inequitable situation with most Australians unable to afford and access the care they need.” If the preservation age is raised from 60 to 65 between 2035 and 2043, the first group of people affected are those who are currently in their mid 30s. “The current funding for age services is very much tied to asset ownership and this usually involves the family home. People in their mid 30s are not as wedded to property investment as baby boomers were, so right there is a significant factor that will influence aged care funding in the next few decades,” Mr Reid said. “Ensuring a sustainable age services industry that meets the needs of all older Australians is as much about today’s younger generations as it is about those who are closer to needing such services.” “As the voice of aged care, LASA members must be involved in any review of the current retirement funding policy to ensure we have an industry that is funded and structured to perform highly,” Mr Reid said.

Aged care trade summit in China Austrade will host a dedicated Aged Care Trade Mission to China, in Beijing on 16-17 November this year. Former Prime Minister Tony Abbott with Chinese President Xi Jinping at the signing of the Free Trade Agreement last year

The Summit aims to showcase Australian aged

The release of the latest fees and charges by the Department of Social Services shows an indexation rise of just 1.3 per cent, despite ABS data showing costs for healthcare alone have risen by 4.4 per cent in the last year. “As the voice of aged care, LASA urges the department to reconsider how it calculates indexation for aged care because the true costs of care are not recognised,” LASA CEO, Patrick Reid, said. “Current funding levels are one-third of what is needed for providers to keep up with rising costs, let alone expand their services to meet rapidly growing demand with 2000 Australians turning 65 years every week.” “Successive federal budgets have stripped more than $700 million from the industry, while providers continue to face increasing costs for health care, staff wages and superannuation and infrastructure.” “Although we have seen some increases to aged care funding, its value is completely outstripped by the true costs of care. The impact of this affects everyone – age service providers, staff, people receiving aged care services and their families,” Mr Reid said. The Treasurer’s own intergenerational report noted the main drivers of aged care costs were both increasing provider costs and growth in the number of people aged 70 and over. LASA has supported changes that see increased consumer contributions, but it will take time for these changes to have an impact and they are only part of the solution to ensuring sustainability within age services. “Consumer co-payments should not be an opportunity for government to starve the industry or shirk its responsibility to fund aged care properly,” Mr Reid said. “Recognising the true costs of age services through a review of indexation calculations and realistic funding is the only way we can guarantee a sustainable age services industry that meets the needs of all older Australians.”

care and healthcare capabilities and help Australian product/ service providers to understand market demands and future trends in China, share insights and experience and facilitate bilateral engagements to support potential collaborations and commercial opportunities. This Summit will be the first Australian Government initiative on aged Care and Healthcare services since the signing of the ChinaAustralia Free Trade Agreement (ChAFTA) earlier this year. ■ For more information go to www.austrade.gov.au or phone 13 28 78.

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HOME CARE

WHAT’S BEHIND THE

HOME CARE FEE CONFUSION?

Over the past few weeks, misleading allegations have surfaced around claims of consumer over-charging by home care package providers.

he confusion behind these inaccurate claims stems from recent age-service reform changes around the introduction of Consumer Directed Care (CDC), and in particular, the requirement for providers to demonstrate to clients how their care packages are being spent. While this new requirement appears perfectly reasonable, it is in fact the inflexible nature of the changes made to the prior home care fee arrangements that is creating concern and restricting consumer access to vital care services. In 2014, changes to legislation saw the introduction of new fee arrangements for all home care packages entered into from 1 July 2014 – stipulating how providers could charge clients, including the charging of a basic daily fee in a person’s care package (capped at 17.5 per cent).

State-based Level 3 and 4 Home Care Package ACAR 2015 State

Level 3

Level 4

Total

% of high level packages within total allocation

NSW

1220

865

2,245

92.8

VIC

930

615

1,662

92.96

QLD

687

104

880

89.88

403

438

92.01

300

260

590

94.92

TAS

154

90.91

ACT

100

Whilst the basic daily care fee had existed previously, not all providers had charged it. Now, however, with the move to CDC and the need for greater financial accountability, many providers are being forced to do so in order to remain viable in an increasingly competitive market. Care recipients who commenced their package from 1 July 2014 are able to apply for financial hardship consideration regarding this charge, while those who were receiving their packages prior to 1 July 2014 have always been, and continue to be, able to negotiate with their provider regarding their ability to pay. In addition, where providers had once been able to use surplus funds from one package and redirect it to another; ensuring that everyone received the care they required, this is no longer an option and is resulting in increasing numbers of clients being unable to afford the care they need. This inflexibility in policy means that where demand for level 11 and 2 packages is lower, the redirection of funds cannot be utilised to meet the growing demand for packages at levels 3 and 4 as shown in the DSS Age Care Approvals Round (ACAR) 2015 allocation table opposite. Image courtesy of Rocketclips, Inc./shutterstock.com

HOME CARE

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Image courtesy of Kristo-Gothard Hunor/ Shutterstock.com

Confusion over home care fees unfairly tarnishes providers LASA CEO, Patrick Reid has been interviewed by the ABC in response to media reports that home care providers are over-charging consumers. The program, which had not yet aired when Fusion went to print, is looking at the policy changes to home care fees and variations in provider charges. LASA believes that while age services needs greater flexibility and less regulation to meet growing demand, government policies are doing the opposite. “Confusion over provider payments has become more evident in the last month because under the changes to consumer directed care on 1 July 2015, providers must demonstrate to clients how their care package is being spent.” Breaking these figures down even further, there is increasing concern about the ability of providers to meet the needs or regional, rural and remote clients, where increasingly consumers are being assessed for higher level packages that just aren’t available. Draft guidance from DSS suggests that a person can be offered a lower level package as an interim measure until a higher level package is available, and this decision should be made by the care provider in partnership with the consumer. However, there are inherent risks involved with this proposal including the capacity of a care provider to adequately meet the care needs of a client is reduced; potentially resulting in a further decline as the client waits for appropriate care; and, the client may require a lot of extra care that they are not in a position to afford. LASA continues to advocate for home care funding to meet the actual care needs of older Australians, through the additional allocation of higher level packages and the ability to redirect unused lower level package funding toward higher level packages. ■

References

The recent move to consumer directed care in July 2015 and the need for greater financial accountability has forced many to begin charging it to stay afloat in an increasingly competitive market. “Where the policy previously attempted to ensure everyone received the care they required, and funding available for care packages was more fluid, the opposite is now occurring,” Mr Reid said. “This situation has been enabled by a lack of strategic planning and communication by government to consumers. At a time when age services needs greater flexibility and less regulation in order to meet growing demand, government policies are doing the opposite.” “The government and the department need to realise that there are not enough level 3 and level 4 packages available to meet people’s needs, and action must be taken immediately as many people cannot afford the care they need,” Mr Reid said.

1. Data contained within the Operations of the Aged Care Act 2013-14 detailed occupancy rates for Level 1 packages at 48.7%

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INNOVATION

CO-CREATE & CO-DESIGN IN AGED CARE When we have input into a decision, we feel pride in – and support – the outcome. Older people know what is best for their own health and well-being. Rhod Ellis-Jones Principal I Ellis-Jones

roviders that lead excellence in care involve the older person, their families and loved-ones in the decision-making processes. They help them to care for themselves to the greatest extent possible.

Family and friends not only know that their loved one is being cared for, but that they are being cared for in exactly the way that they want to be cared for. We are all aware that, in July, the government introduced a model for Consumer Directed Care (CDC). This initiative signals the desire of the government to empower the older person to have greater decision making power over their quality of life, health and well-being. At every point along the research, service and accommodation design, delivery and measurement process we need to address this. Traditionally, a service organisation has provided a particular solution for the client. The problem is identified and the organisation deploys its assets, resources and skills to provide a solution for or to the client. Greater levels of communication and engagement enable the organisation to better understand the predicament facing clients and tailor a solution to meet their needs. If we introduce the notions and practice of co-creation and co-design in aged care we can go even further. And, in the process, differentiate services and organisations while developing services that are likely to succeed on market entry and into the future. That means certainty over revenue and growth.

The fundamental aspects of co-creation and co-design As defined by the Centre for Social Impact, the terms cocreation and co-design can be defined in the following way:

• Co-creation: The systematic process of creating new solutions with people not for them; involving citizens and communities in policy and service development • Co-design: The process of designing with people that will use or deliver a product or service Broadly, co-creation and co-design involves the working together with the client to help the client reach a solution to the problem through collaborative, cooperative and communitycentred approaches. The organisation empowers the client through the provision of assets, skills, resources and more, which the client can use to address the issues they face. Involving the client in the decision making process leads to higher levels of participation, belonging, trust and enables the organisation to provide innovative services, ultimately leading to business returns and greater social impact.

Co-creating aged care Co-creation in aged care is connecting local councils, community leaders and aged care experts in setting a vision for aged care for community. In our experience it is a inspiring, rewarding and unifying experience, in which aged care providers are able to apply their experience and expertise across the full spectrum of ageing considerations. Not-for-profit or private provider, it recasts the relationship with community and overcomes the ‘keypad factor’ in residential aged care where thinking and outcomes are locked from view behind a security door. Co-creation encourages family members to work with residents at a peer-to-peer level to come forward with ideas for improving aspects of services, communication and, potentially, building design. Once areas in which value can be created have been define, the process continues to tailor existing and create new fee-

INNOVATION

Image courtesy of alice-photo/Shutterstock.com

for-service options or better funded services for a specific community. At an employee level, co-creation is building staff competencies across disciplines and facilitating employee forums to identify community needs and scope service options.

Ultimately, using co-creation and co-design principles, you create a market for new services as you design them, reducing risk of failure and establishing clear differentiation between your organisation and competitors.

Before entering into co-design initiatives, or facilitating, developing or designing and executing initiatives, the organisation needs to understand the extent of its competencies, assets and mission or purpose in order to provide a framework for design activities. There needs to be an acknowledgement that, although all ideas can be considered, there are clear and communicated constraints for what can be implemented.

Marketing becomes less ‘what we can offer you’ and much more ‘look what we have created together’. ■ For more information go to www.ellisjones.com.au or phone 03 9416 0046 Don’t miss Rhod Ellis-Jones on the breakfast session panel, “Unleashing innovation in the CDC era – Redefining community partnerships to co-create services, grow revenue and improve outcomes in a CDC market”, on Monday 12 October at LASA National Congress. *This article was originally published as a blog post at www.ellisjones.com.au/ disciplines/marketing-pr/co-creation-and-co-design-in-aged-care

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INNOVATION

EXPANDING HORIZONS FOR INNOVATION IN AGE SERVICES Two leading industry events are putting age services on the radar of some of Australia’s brightest innovators.

n a typical autumn morning in Canberra in March, a group of people gathered at the University of Canberra early one morning to learn more about the needs of aged care providers. They ranged in age from under 10 years old to over 60, and shared a common purpose of pitching ideas for potential development to improve the lives of older Australians. InnovAGE 2015 was Australia’s first ever innovation event for aged care to bring together innovators from a variety of backgrounds including IT, design and age service providers. It was the brain-child of the team at LASA National and sought to highlight opportunity in age services for entrepreneurial thinking across a range of areas. “The aim of InnovAGE was to stimulate new thinking and ideas that can be rolled out in age services or the community, and provide context about our industry to innovators who may not have thought about ageing as a growth area,” LASA National CEO, Patrick Reid said. “The audience isn’t people who are already working in age services; most participants were non industry professionals in their own fields which is what’s needed to bring new ideas and new approaches to the industry. Fresh eyes on our issues may lead to breakthroughs we otherwise may not have considered.” InnovAGE came to fruition thanks to partnerships and support from providers who saw the potential benefits to their clients. Isobar, the University of Canberra, Lighthouse and the Aged Care Industry IT Council (ACIITC) backed the inaugural event, which will become a calendar fixture following its huge success. Some of the ideas from the event are expected to be launched on the open market including dementia-specific items around memory such as personalised memory walls that can be curated by the family and are triggered as the client approaches them. The winning team of a father and his two sons have spent a lot of time further developing their idea with the help of other

experts. Their product uses a Microsoft Kinect sensor to stimulate rehabilitation exercise into normal television viewing, particularly game shows. It was designed with their grandfather in mind, who enjoys watching television but wasn’t doing his prescribed rehabilitation exercises. The two sons have since organised an innovation day at their school in Canberra, encouraging other students to think about inventions that can help their grandparents or others in the community with needs. The nutrition industry was struggling with how to ensure all health professionals involved with the care of a client are aware of their nutritional requirements. A solution created at InnovAGE tracks their daily requirements online in a centralised place, again curating the information in a client focused way. ITAC is another shining example of opportunity for innovators and entrepreneurs to connect with age service providers over shared goals to improve the lives of older Australians. The keynote speaker at this year’s event, which is being held at the Gold Coast from 24-25 November, is Holly Ransom, CEO of Emergent Solutions and chair of the 2014 G20 Youth Summit. Holly has impressed many audiences, industry and global leaders with her skills in creating innovative solutions to complex multi-stakeholder problems for corporations, governments and non-profit organisations. “Einstein famously said, we can’t solve our problems with the same thinking that created them, but entrenched ways of thinking, working and leading often mean organisations need an objective set of eyes,” Holly says of the importance of innovation and new ideas. And it is new ideas and innovation that events like InnovAGE and ITAC are leading to. “These real opportunities for people to work together to create products and services that will positively impact the lives of older Australians,” Mr Reid said. “This is co-design and co-production in practice. LASA is proud to be taking a leadership approach to innovation in a way that is being adapted in similar markets around the world.

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Tel: (03) 9408 3644

BUSINESS TECHNOLOGY

A TECHNOLOGICAL APPROACH TO

IMPROVING GOVERNANCE

AND MEETING DUTY OF CARE In the face of major changes occurring across the aged care industry, with mergers and acquisitions on the rise, ACAR places in decline and consumer directed care creating increased competition for service providers, the quality of corporate governance has never been more important.

he role of good governance in relation to the global financial crisis has been discussed at length in recent years, with many reports published on the key governance failings in some major global financial institutions during the GFC. John F Laker, Chairman of the Australian Prudential Regulation Authority (APRA), gave a speech to the Australian British Chamber of Commerce on this very topic two years ago, which draws stark similarities to aged care providers today. “Why, within many individual jurisdictions, where the regulatory framework was uniform and the supervisory approach common, did some financial institutions fail or need public rescue, some come close to the brink but many others weather the storm and continue to operate profitably? Part of the answer is differences in business models. But a significant part, surely, must be differences between institutions in the quality of their corporate governance,” he said. On a different scale, the same lessons apply to aged care providers. In his speech Laker identified four key elements of good governance: • Professionalism of the board including the empowerment and involvement of non-executive directors; • Risk governance, in terms of being able to accurately identify and understand the risks inherent in their business and the company’s risk appetite as well as skilled and authoritative risk committees; • Flow of information which resulted in potentially fatal “wood for the trees” problems; and • Values and risk culture. “While values and culture are more amorphous concepts they are a fundamental aspect of a governance framework,” he said. “Values and culture drive people to do the right thing even

when no one is looking … Although value and culture cannot always be measured quantitatively, they impact governance in powerful ways.” But what does this mean for aged care providers? “People get confused about governance and risk management. They are two different things, but good governance will include risk management strategies,” said Sonja Bernhardt OAM, secretary of the Aged Care IT Vendors Association and CEO of i.on my care. “At the ultimate level governance is about frameworks and structures that are clearly defined and can demonstrate the workflow of how everything occurs in your organisation.” “Policies and processes should support these frameworks, but it all needs to be captured, not just generally accepted that ‘this is the way things are done around here’,” she said. This is particularly important for organisations seeking investment or takeover in what is fast becoming a bullish mergers and acquisitions market. Larger chains don’t just pick up any small business. They want to see the business and be able to tag transparency and the auditability of what they are purchasing. “Ultimately, this means adding another layer of governance and transparency around what you do and how you do it,” Ms Bernhardt said.

Demonstrating duty of care Good governance also ties in with duty of care, which is now a legal obligation of companies and officer bearers with criminal penalties for businesses and individuals for failing to fulfil duty of care to staff. Where duty of care was previously regarded as a moral compass, it is now clearly defined by legislation and

Keeping up with legislation changes?

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BUSINESS TECHNOLOGY

demonstrated and assessed through clear policies and processes. In 2013 the workplace health and safety laws were updated to include clearer definitions of duty of care, but also harsher penalties for companies and individuals who failed to meet their duty to staff. “It has always been hard for organisations to demonstrate they are fulfilling duty of care obligations irrespective of what sector they’re in,” Ms Bernhardt said. “The onus is now very much on boards and office bearers, regardless of their business model or charity status, to demonstrate that managers and directors have fulfilled their duty of care obligations.” The easiest and most efficient way for businesses to demonstrate duty of care, particularly if an incident has occurred and is being legally challenged, is through technology. “There are many new products that make it easy to look at what you do, why you do it and how you do it,” Ms Bernhardt said. “Reviewing processes and systems in this way can help to identify areas for efficiency and improvement, and more importantly capture and document what is being done.” One of the challenges facing aged care providers is the absence of integrated processes and systems that span every aspect of an aged care business – from governance through to compliance, regulation and staff performance, contractors, training, credentials, infections, purchasing, projects, maintenance, audit and quality control, billing and clinical facets.

What to consider before looking at new software 1. Before you even look at new software, do a comprehensive review of your processes, current KPIs and the systems you already have in place.

Image courtesy of dizain/Shutterstock.com

“The day to day focus of operational staff is not governance or demonstrating that processes have been properly carried out. Staff working in aged care are already over burdened with paperwork, compliance and regulation, which takes them away from providing care.” “There are plenty of bandaid solutions that might help address either clinical care, billing or risk management, or talk to one another via web services, but very few – if any – that truly integrate all aspects of business and care delivery,” Ms Bernhardt said. “With increased competition and mergers and acquisitions in the aged care industry, we are going to see an increase in software available to providers that does integrate business and clinical governance. Already we are seeing new technology that can put vendors through a compliance review before they are granted a tender, greatly improving efficiency and compliance,” she said. ■

moves at a fast pace and there’s a lot out there that is marketed as ‘new’ but is in fact quite dated. “It’s never a good idea to invest significantly in old technology,” Bernhardt warns. 5. When you’re ready to go to market or tender for new

Understanding the benefits you will obtain through

software, make your decision, don’t delay it. You are

a proper cost benefit analysis will make it an easy

better off using the best available system at the time

decision. Weight off the purchase investment against

than holding off for something newer and delaying the

your benefits, and not just those in dollar terms.

improvements to your business.

2. It can be worthwhile outsourcing this step to a

6. Regardless of how big or small your company is,

consultancy that knows what to look for and isn’t

consider cloud options, which are making it more

close to the current set up.

feasible to expand technology use into other areas,

3. Understand what your existing software does and can do. 4. Do due diligence on the technology platforms of any new software solution you are looking at. Technology

even for companies that have their own servers. 7. Until the market has one integrated system, make sure your new software has web services capabilities so it can talk to other systems.

Off the back of their very successful book, â&#x20AC;&#x153;Aged Care, Who Cares?â&#x20AC;? Rachel Lane and Noel Whittaker have teamed up again to pen The Retirement Living Handbook. The Retirement Living Handbook covers all of the important aspects of moving to a retirement community from selling your home and finding the right retirement community to the different forms of legal contract and financial arrangements and puts them into context with lots of case studies from real retirement communities. Combined with a directory of over 1,000 retirement communities The Retirement Living Handbook is your complete guide to retirement living in Australia. The Retirement Living Handbook is available in all good book stores and at at www.retirementhandbook.com.au for $24.99.

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BUSINESS MANAGEMENT

NEW YEAR

NEW RULES A wise person once said “Change is inevitable, except from a vending machine”… which is funny because it’s true! While the Aged Care Reforms in 2014 gave us significant changes that doesn’t mean we should expect things to now stay the same. In fact the next change will be here in a couple of months and many prospective aged care residents are completely unaware of it.

rom 1 January 2016 there will be a change to the way that rent received from the former home is treated. At the moment aged care residents who choose to rent their former home and contribute towards the cost of their accommodation by daily payment don’t have the rent included in the calculation of their means tested care fee. The value of their former home and the rent is also exempt from the calculation of their pension entitlement. For residents who enter care after 1 January 2016, the pension exemptions will remain but the net rent will be included as income for calculating the means tested care fee. The government has called this a way of “improving the fairness and equity of aged care means testing arrangements.” On the surface the change seems fair. But it’s important to bear in mind that the market price arrangements have effectively capped the amount someone can pay to an aged care facility, making it hard to exchange an exempt asset (their home) for an exempt asset (their refundable accommodation deposit). The amount someone pays into the RAD is included in the calculation of the means tested care fee and any money “left over” causes the cost of care to increase and reduces their pension entitlement.

Rachel Lane Principal I Aged Care Gurus

Let’s assume that Shirley is going to pay $100,000 by RAD, $58.97p.d by DAP and rent her home. Then under the current rules Shirley’s means tested care fee would be $5.63p.d and she would have a small cash flow surplus of around $600p.a But if Shirley moved into care from 1 January 2016 her means tested care fee would be $31.88p.d and she would have a cash flow shortfall of around $9,000p.a. The alternative is selling her house to fund her RAD. Shirley would see her pension entitlement reduce by $376 per fortnight and her means tested care fee would increase to $49.82p.d. Her cash flow shortfall would be $14,570p.a. As you can see if Shirley decides to rent her home and enters aged care from 1 January next year her means tested care fee is going to be more than 5 times what it would be if she enters prior to 1 January. There is no doubt that the decisions people face when looking to fund aged care are becoming more complex, with implications on pension entitlement, the cost of care, tax, the ability to afford care in the longer term and estate planning consequences all needing to be considered. There is no substitute for specialist financial advice. ■

Those hit hardest of all will be people with few assets outside the home and limited income sources, in other words, pensioners. For many, the decision to sell the home and pay a RAD won’t be simple either, as the resulting loss in pension and increased cost of care will mean that their cash flow is still unable to meet their living expenses. Let’s look at an example. Shirley is a pensioner. She has a house worth $850,000 that could be rented for $400p.w (net). She also has $200,000 in the bank and $5,000 in personal effects. The facility she is moving to has a market price of $450,000 RAD or $75.82p.d DAP.

TECHNOLOGY |

COMPUTER SOFTWARE

BUSINESS MANAGEMENT

Leadership impact on culture In this second part of a four-part series that looks at the impact of culture, Sue Jauncey, registered psychologist and Founder of Pulse, looks at the role of the board and CEO in driving a company’s culture.

n the winter issue of Fusion, we explored the nature of culture and its importance to business success. Studies have shown time and again that there may be no more critical element to business success or failure than a company’s culture. As Drucker puts it, “culture eats strategy for breakfast.”

Dinesh’s first step was to rebuild his entire leadership team from scratch. This took 18 months but produced significant changes. The 16,000 employees began to engage and focus on becoming a dynamic culture, committed to excellence and innovation.

In 2014, Harman achieved record revenue of $5.3 billion (up 24 per cent over the previous year) and record profits of $555 million (up 35 per cent over the previous year). It was the staff, aligned and under strong leadership, worked together to achieve this result. There were no to human resources wholesale cost cuts or managers, who are not able to do it alone and mergers, the results were Culture is more do not always link the people outcomes with achieved on the back of than values business outcomes. motivated staff who were Culture is more than encouraged to innovate and identifying a set of strategic excel. New products were launched successfully and record values, producing glossy posters and then going back to profits were made. business-as-usual expecting staff to somehow demonstrate the behaviour associated with the identified values. Who owns a company’s culture? One of the most recent and famous culture studies was When approaching the subject of business culture, the conducted around the behaviours at Enron, the US energy debate continues around who owns culture? Is it the Board, and commodities company that collapsed and resulted the CEO, Human Resources? Culture seldom features as a in ongoing litigation in 2000. Integrity was one of Enron’s key performance indicator, let alone a strategic initiative in company values, yet leadership behaviours included hiding many business plans. So who is responsible for shaping documents, lying and covering up (on multiple occasions) and measuring a business culture? less-than-honest transactions. Identifying a set of company That is not to say that strategy doesn’t matter. Rather, the particular strategy a company employs will succeed only if it is supported by the appropriate cultural attributes (Booz and Co 2011). Culture is often deferred

values does not mean that you will have a positive culture. To mean anything, values require expression through behaviours. The sum of our behaviours, as an expression of our company values, gives rise to our business culture: the way we do things around here. Dinesh Paliwal, CEO of Harmon International, was a leader who fully understood the power of people and culture. He put his belief in people into action when he accepted the position to lead Harman International Industries (HII) in 2007. At this time, the company was declining in sales; people were not engaged with the company.

In the absence of any intentional direction, culture (being the way we do things around here) is owned and shaped by everyone in the organisation. Often culture is deferred to human resources managers, who are not able to do it alone and do not always link the people outcomes with business outcomes. As a result, a business culture can be unfocused, unproductive and generate a number of unintended consequences arising from inappropriate behaviours. However, the reality remains that without people, we have no business culture and no business success.

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BUSINESS MANAGEMENT

Many executive leadership groups invest more in systems and processes than business culture. It is reasonable to suggest that systems and processes provide tangible assets or products that are relatively easy to buy and manage. However, the successful execution of any system or process, and the subsequent delivery of its intent, will be greatly influenced by how the people in the organisation behave. Training provides many of the technical skills required but training alone does not influence individual or collective behaviour.

• Are technical skills considered more important than leadership and behaviour? • Are we prepared to hire and fire based on a demonstrated leadership capability to competently lead people to an intentionally directed culture? • Are the CEO and executive team committed to learning and understanding how to intentionally direct a desired cultural state or more concerned about maintaining the status quo and power in the current business?

• Is the CEO and executive team prepared to lead and role To achieve a performance culture, the desired organisational model a culture program or are we likely to delegate it to behaviours must first link back to the company’s strategic HR and continue with business as usual? challenges, which are in turn supported by systems and An ability to honestly answer the above questions will help processes. Therefore, culture transformation must be you to determine the type of leadership required and the defined and led by the CEO as a strategic priority. The depth of the executive team’s resolve to undertake a cultural desired behaviours need to transformation program. be agreed and role modelled by the Board, and executed First transform your and role-modelled The primary role of the Board and CEO is leadership then operationally through the to develop the culture of the organisation – CEO, executive management McKinsey 2015 your culture and human resources. It goes without saying that capable leadership drives Change requires leadership and resolve culture change: how leaders behave, what they say, and In most businesses, executive management espouse the what they value. It is the factor that most highly correlates importance of their staff, yet many have little belief or with an individual’s recommendation of their company confidence that their staff can really make a difference. as a place to work (Deloitte, 2015). The leadership of an Executive management is often reluctant to invest time, organisation will determine whether or not the company will energy and money in culture programs, especially if they develop a performance culture. Leading is about aligning have not seen it work before. Many have invested heavily people’s behaviours so they work well together as a team. in engagement and leadership programs promising No matter how big or small the company, aligned behaviours breakthrough performance but which have not delivered will help drive increases in services and profits. any real change in how staff demonstrate behaviours Companies that focus on building great leaders invest that support business success. substantially in leadership development. This development In the absence of a business culture providing right the is often targeted around harnessing the capability of their behavioural framework, we often observe executive people and the attributes and traits of a good leader. management reinforcing unwanted or destructive To be effective, leaders must first genuinely believe that behaviours. In any situation, executives must hold people can make a difference and be willing to hold both themselves accountable for their behaviours. Failing to be themselves and staff accountable for the collective delivery accountable at any level of the organisation reinforces that of business success. inappropriate behaviours are acceptable. When faced with challenges in the workplace, there are Before any organisation considers a culture transformation two ways that a leader may behave: program, a few questions must first be discussed and 1. Personalisation – reacting to situations based on the answered by the Board, CEO and executive management: primacy of their ego. • Are people our greatest asset? How is this evidenced? 2. De-personalisation – responding to situations based • Where should the majority of the strategic focus be on collective achievement. spent? ‘Wisdom in the Workplace’ is a behavioural approach to • Is culture transformation considered a key strategic leadership development that encourages the participant objective? to explore the underlying preconceptions that drive their • What are the effects of the current culture on business decisions and actions. It enables leaders to understand performance and the bottom line? the impact of their behaviour on whole of business. It is • What will be the lead and lag effects of changing the based on a long history of psychological research into the culture be on business performance and the bottom line? impact of ego (self) on behaviour and more recent studies

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BUSINESS MANAGEMENT

Image courtesy of Stuart Miles/Shutterstock.com

relating to wisdom (higher self) and its impact on collective achievement. Essentially, leaders are required to reflect on, explore and change their behaviours against: Ego Characteristics • Focused on self-achievement • Seeks advantage from situation • Accepts preconceptions as insight • Reacts to protect self interest • Uses blame to shift accountability • Satisfies ego by victory over others Typified by: What’s in it for me Wisdom Characteristics • Focused on collective achievement • Seeks insight into situation • Explores preconceptions for validity • Identifies preconditions for success

• Visioning: providing a meaningful purpose, knowing what success looks like and shaping your services to meet evolving needs. • Removing complexity: simplifying responses to issues and opportunities so staff can clearly understand their role in achieving success. • Effective communication: the right communication for the right situation. In many cases, stories convey more meaning than facts alone. • Individual and team accountability: empowering people to act within their roles without complex process. • Behavioural alignment: recruit for behaviours that align to company values and objectives. Build required skills with focused training. • Rewards and incentives: celebrating success, innovation and going the extra mile.

Culture in aged care

• Satisfies ego by building success

Across the aged care sector there has been a long standing victim and blame culture within the workforce. This is demonstrated by:

Typified by: When the team wins, we all win

• Staff not show up for their rostered shift without notice

Leadership development needs to shift from skills-based to behaviour-based development focusing on understanding individual and collective behaviours that support success. When the modern leader understands their preconceptions, they can then effectively respond to the unique nature of a given situation. This will change the way leaders both see and approach the requirements of the business. The key focus areas for this change in behaviour are:

• complaints of being overworked when required to backfill short notice sick leave,

• Is accountable for their response

• a lack of accountability in the workplace driving staff anger and frustration • the high number of bullying and harassment behaviours and claims between staff • the blaming of managers and executives for poor workplace conditions.

BUSINESS MANAGEMENT

With sector reforms currently underway, the primary objective for executive management is to ensure services are customer focused and that clients receive the best services (not just care) possible. Executives are beginning to understand that the culture of their organisations has to change if they are to survive the changing market environment and remain viable into the future.

Changing an organisation’s culture is one of the most difficult leadership challenges – Steve Denning, Leadership Expert, Forbes Magazine To begin culture transformation, CEOs must first recognise the role they and their leadership teams have played in defining the current cultural state. Many leaders have turned a blind eye to destructive unacceptable behaviours not knowing how to address these behaviours or are fearful of industrial responses when attempting to hold staff to account. Image courtesy of Ivan Smuk/Shutterstock.com

Aged Care Leadership Capability Framework To support the transition to the new aged care market, the Leadership Development Project has produced an online Aged Care Leadership Capability Framework. The project is a partnership between LASA, ACSA and the Community Services and Health Industry Skills Council (CS&HISC). The framework development involved over 450 leaders across the industry and was launched earlier in 2015. The Framework is designed to assist providers in developing the leadership that is needed to navigate through the changes brought about by reforms in Aged Care. LASA CEO, Patrick Reid, says “facilitating a place where leaders can come together to share ideas and access resources and tools that can be applied personally and to their businesses, is critical to the development of leaders in our sector. Helping each other is vital and key to our survival.” It is now imperative that CEOs and Boards commit to investing in executive and management by developing their leadership capability. In turn, these leaders will learn how to lead and intentionally build a performance culture. For the intent of the framework to be realised, executives and managers need to measure their demonstration of leadership capabilities on a regular basis. This will provide a greater understanding of the impact and quantum of the change occurring in leadership capability and the positive impact this will have on key performance measures across the business. Each executive and manager should have a personal Aged Care Leadership Score (ACLS) as a

benchmark for all executive and managers to understand how well they are demonstrating their leadership capabilities. From this score, executives and managers will be provided direction as to where they need to develop their leadership capability and increase their ACLS.

Achieving a performance culture Performance culture has a positive impact on business outcomes but capable leadership is required to deliver a performance culture. Repeated measurement and reinforcement of both the business culture and leadership capability can be delivered through the Net Culture Score (NCS) and the Aged Care Leadership Score (ACLS) respectively, discussed in depth in our previous article in Fusion. A higher ACLS should correlate positively with a higher Net Culture Score (NCS). Cultural transformation is required across the aged care sector to ensure its sustainability going forward. Boards and CEOs have access to both a system and supporting measures that will enable them to navigate the changing industry and ensure future sustainability. ■ For further information about leading culture change go to www.pulseaustralasia.com.au or contact 02 9229 6700.

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BUSINESS MANAGEMENT

Navigating the

FBT minefield We recently completed a review of a salary packaging arrangement for one of our clients. An employee queried the amount being deducted from her salary in relation to a motor vehicle. The arrangement was managed by the finance team without the assistance of their accountant.

e uncovered that due to a misunderstanding, post-tax contributions made by the employee towards the cost of the vehicle had not been taken into account when calculating the salary sacrifice amount deducted from her salary. In addition, a lack of knowledge about the interaction between FBT and the GST led to an undisclosed GST liability and FBT returns had not been lodged. Although the motor vehicle cost less than $30,000, more than $5,000 was incorrectly deducted from the employee’s salary package over the course of a year. As employees are taxed in the year they receive salary payments, reimbursing the employee the following year put her in the next tax bracket costing her an additional 10% in income tax. Needless to say, the employee was not impressed. Motor vehicles are one of the most commonly salary packaged items and are often provided through the use of a novated lease agreement. These agreements allow the employer to provide a fully maintained motor vehicle by paying the lease payments and usually the car’s running costs. The employee compensates the employer through a combination of a reduction to their pre-tax salary and post-tax contributions to eliminate the FBT liability. The employer is protected because the obligation to guarantee the residual at the end of the lease rests with the employee. If the employee ceases employment for any reason, they are the one responsible for the remaining lease payments. The employee benefits because the arrangement allows them to use pre-tax dollars to own and operate a private motor vehicle and effectively claim a credit for the GST, something that is not allowed if they purchase the motor vehicle themselves. Sometimes employees benefit from dealer discounts offered to their employer. Managed correctly, salary sacrificing arrangements can be used by employers to attract and reward employees. However, not following the complex FBT rules administered by the

Geoff Campbell Partner I Duesburys Nexia

ATO could leave employers with substantial FBT liabilities. In some cases, employees could be the ones out of pocket, as illustrated in our example. The importance of record keeping can’t be understated. Time and time again taxpayers are unable to mount sustainable objections to ATO assessments simply because they cannot provide sufficient evidence to support their claims. For example, exemptions that can reduce FBT on meal entertainment entirely, rely on accurate record keeping. It is essential that motor vehicles are financed correctly. Making repayments on an employee’s car loan is an expense payment fringe benefit, rather than a motor vehicle fringe benefit and is not concessionally taxed. Employers are often unaware that a simple loan or advance provided to an employee will result in a loan fringe benefit if a market rate of interest is not charged. It is critical that both FBT exempt and rebatable employers understand the capping thresholds that apply to the concessions. The thresholds apply to the grossed up taxable value of payments made on behalf of employees, not the amount paid. In the 2015-16 budget a new cap was announced for salary sacrificed meal entertainment and entertainment facility leasing expenses provided by exempt and rebatable employers. This is currently uncapped and if the proposed amendments are made, affected employers will need to amend their remuneration policies at the start of the 2017 FBT year. Employees also need to be aware of the superannuation contributions cap when instructing their employers to make superannuation contributions on their behalf. It is critical to consider all payments to all of your superannuation funds, including funds you may have joined simply to obtain insurance cover. Payments to these funds are often incorrectly thought of as insurance payments, but are instead superannuation contributions. ■ For further information visit www.nexia.com.au

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Permitted Use Rules

lump sum investments The Aged Care Financing Authority (ACFA) has found that accommodation liabilities rose by 9 per cent during 2014 to $15.6bn. In its most recent report on the impact of financial reforms ACFA found that refundable accommodation deposits remain the preferred method of making accommodation payments with the overall level of liabilities growing by 7 per cent in the six months to December 2014.

odelling done by RSM prior to accommodation charges changes beginning in 2014 also predicted the increasing use of lump sums to meet accommodation payments. All indications are that operators of residential aged care can be confident that liquidity will continue to grow well into the future. In its 2015 annual report ACFA referred to research that found higher performing providers have lower liquidity. This environment of increasing levels of lump sums and the need for strong liquidity management poses two issues for providers: â&#x20AC;˘ what is strong liquidity management? â&#x20AC;˘ where should or can providers invest the increasing levels of lump sums?

Strong liquidity management This is a relative term. In a recent study we undertook for ACFA we found that target liquidity levels (the proportion of lump sum funds held in cash or cash equivalents) varied from less than 15 per cent to more than 50 per cent. We also found that providers with higher financial performance tended to have 20 per cent liquidity (less for for-profit operators) while providers with lower financial performance tended to have more than 40 per cent liquidity. While achieving a liquidity percentage does not of itself guarantee higher financial performance it stands to reason that if an operator is sacrificing a daily accommodation payment that is calculated at 6.15 per cent of the equivalent lump sum and then invests the lump sum at 3 per cent then this will have a negative impact on the operating outcome of the facility. In this environment operators are likely to look for alternative investments for these funds.

Bruce Bailey National lead of aged care and retirement living practice RSM Bird Cameron

Multi entity structures Many providers operate multi-entity structures but these can create issues within the context of permitted use rules. Often there are loans between related parties. The rules require these loans to be documented and on commercial terms. Without care you can end up with unintended consequences, for example you might have an operating entity that makes a loss because of interest and or rent charges to a related property owning entity. This could in turn impact on you capacity to demonstrate viability in applications for new approved places. This is where organisational restructuring can be helpful. While investment in aged care at $1.5bn increased by 69 per cent in 2014 it is still well short of the forecast $3bn+ annual requirement to meet demand. The permitted use of lump sum accommodation funds has and will continue to be a significant source of funds to build the places required.

Where to invest lump sums As a general principle, using income to repay debt is expensive, particularly if you are a for-profit operator, so considering using lump sums to repay any debt should be high on the agenda. Both the 2015 ACFA report and RSM research found the sector does not use high levels of bank debt so clearly this is occurring. Another general principle for for-profit providers is that minimising equity maximises the return on equity. Ordinarily this might lead operators to look to pass excess liquidity to shareholders. Given the rationale behind lump sum accommodation payments is to provide capital to create more accommodation stock it should be no surprise the permitted use rules in Division 52N of the Aged Care Act 1997 limit the opportunity to do this.

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In short, the rules promote two uses for lump sums: 1. Invest in more aged care assets

Image courtesy of Devrim PINAR/ Shutterstock.com

2. Invest in other arms-length investments As a general principle, if you’re looking to expand your involvement in the industry then lump sums and consumers’ preference to pay accommodation by lump sums are a great mechanism to do this.

Things you can do • Create land banks, provided the intention is to use the land for residential aged care • Acquire other existing aged care operations • Use lump sum funds to facilitate organisational restructures • Undertake major refurbishments including replacing plant and equipment • Shares (securities) in listed and private companies

Things to avoid The following uses of lump sum payments would most likely constitute a breach of permitted use rules and should be avoided:

• Venturing into independent living units or other accommodation styles. This is a trap for many companies that have joint retirement village and residential aged care facilities, as you cannot use bond money for these purposes. • Venturing into home care and using lump sums to support these activities • Merely replace plant and equipment • Direct investments in non-aged care related assets ■ For more information email Bruce Bailey at bruce.bailey@rsmi.com.au or phone 02 8226 4500.

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Impact investments: Creating positive change

One might not get this impression from some of the behaviours that are frequently demonstrated by its participants, but the financial system was never meant to be an end in itself.

t should be, in fact, an enabler that brings together capital and productive enterprise to create growth and change.

The superannuation system is now much larger in size than our GDP, and the decisions to allocate capital within the system are going to have increasingly profound implications for our economy and our future. Super funds are now a fundamental part of our financial system: impacting it and being impacted by it in return. The responsibility to be mindful of the implications of the capital allocation decision is more and more significant.

Richard Brandweiner Chief Investment Officer First State Super

Rosemary Addis Co-Founder and Chair Impact Investing Australia

Increasingly, there is recognition by economic commentators that future economic growth depends on solving difficult social issues. For example, Professor Michael Porter argues that “the strongest businesses of the future will be those that align making profit with creating social progress,” and points out, “there is nothing soft about the concept of shared value... [it represents] the next stage in our understanding of markets, competition and business management” (Porter and Kramer, 2011).

Aged care has and will make an enormous contribution to this given the growing needs to cater for an ageing population, provide affordable housing, and meet growing demand for health services.

In developed nations like Australia, social services are overtaking other industries as growth drivers and require different forms of innovation to those that supported manufacturing and technology in the past. This is occurring in the context of contracting fiscal environments, rising demand for social services and changing citizen expectations of delivery. Leaders internationally are highlighting that this also means we need our financial systems to work effectively and efficiently for the social sector.

This, in turn, is prompting more innovative thinking. Consideration of the longer term environmental, social and governance risks embedded in investments has already become mainstream. Ethical investing has gone further to exclude certain types of investments based on a set of values (such as tobacco, or gaming). Now, however, investors are increasingly seeking to take a more pro-active stance and think about using their investments to create positive change.

Impact investing is already ‘catalysing’ new markets: encouraging entrepreneurship and innovation; resourcing communities; creating jobs, and financing initiatives across aged care, health, social housing, education, clean water and sanitation, microfinance, and sustainable agriculture and development. This finance can be targeted in a range of ways, including: developing enterprises with a social purpose; investing in real assets (such as housing); and financing delivery of social programs.

Investments that deliver a financial return, while achieving a targeted social or environmental outcome, are known as impact investments.

Impact investing is gaining momentum and focus in international markets and is projected to reach between US$400 billion and $1 trillion globally in the coming decade (Monitor Institute, 2009; JP Morgan, 2010). The field is developing in Australia. A range of market players are

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becoming increasingly active and developments here mirror international patterns. There is significant potential, and with the right policies in place, Australiaâ&#x20AC;&#x2122;s impact investment market is forecast to grow at around the international benchmark of over 30 per cent. That would see the domestic market reach $32 billion in the next decade (IMPACT-Australia, 2013). Australia has a history of cooperatives and local enterprise, as well as a growing body of activity and interest in new forms of enterprise that deliver social benefit. Australia has a notfor-profit sector that is economically significant (Productivity Commission, 2010), as well as dynamic small and medium enterprises, that created the largest number of new jobs over the last decade (Place Based Impact Investment in Australia, 2012; Senate Economics References Committee, 2010). Agedcare has and will make an enormous contribution to this given the growing needs to cater for an ageing population, provide affordable housing, and meet growing demand for health services. All of these areas present opportunities for impact investment, particularly in areas where the needs are not being met effectively within the existing system. Developing the field to reach this potential remains a strategic challenge. It will require leadership and focus from a range of market participants, including governments and policy makers. In the UK the sector is more advanced, receiving strong support from Prime Minister Cameron and his government. To see some of the innovations related to aged-care, go to www.careplaces.co.uk and www.oomph-wellness.org â&#x2013;

Image courtesy of www.BillionPhotos.com/Shutterstock.com

About the authors: Richard Brandweiner is Chief Investment Officer of First State Super, one of Australiaâ&#x20AC;&#x2122;s largest profit-to-member superfunds. The majority of First State Super members work in education, health and service-based vocations, including law enforcement, emergency services and other organisations that care for the community, including aged care. www. firststatesuper.com.au Rosemary Addis is a leading strategist and recognised global thought leader in social innovation and investment. She is the Co-Founder and Chair of Impact Investing Australia an organisation that fosters the market for investments that intentionally create positive social or environmental impact as well as a financial return. www.impactinvestingaustralia.com

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for Business for Health 65

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Sarah Walters Senior Associate I Minter Ellison

Victoria Hepburn Partner I Minter Ellison

MANAGING THE USE OF SOCIAL MEDIA –

A Guide for Aged Care Providers The use of the internet and social media among Australians, including the majority of older Australians (65+), has become increasingly prominent.1 This presents both opportunities and challenges for Aged Care providers within their relationships with employees and clients. Despite this, many employers only consider introducing policies and procedure regarding social media after issues have already been raised. Recent decisions by the Fair Work Commission (the Commission) emphasise the importance of addressing these matters proactively.

Spotlight on Bullying Provisions

ocial media policies are particularly important in the anti-bullying jurisdiction of the Commission. Under the anti-bullying provisions, a worker can apply for orders to stop bullying at work. Providers should be aware that a claim can be made not only by one employee about the behaviour of another, but also about the actions of clients, contractors, union officials, client’s family members etc. towards them. The Commission has recently determined that:2 • using social media to repeatedly behave unreasonably towards a worker constitutes bullying behaviour; • comments accessed at work (regardless of when they were posted) could constitute bullying at work. Bullies do

not need to be ‘at work’ at the time they engage in the relevant behaviour; • bullying continues as long as the comments remain online. Such behaviour can and should be restricted in a social media policy.

Customer Feedback via Twitter In another case, the Commission upheld the termination of a tram driver who was dismissed for behaviour brought to the attention of the employer as a result of a Twitter post by a commuter who had witnessed the driver using his phone while operating a tram.3 This provides a timely reminder that social media can be used by clients to provide feedback to, and about, entities, including

BUSINESS MANAGEMENT

raising concerns about the behaviour of employees. Further, even where workers are away from the traditional workplace (including when working in the community, driving company vehicles etc) workers are likely to be considered by the public to be representing the provider. Where comments are made by clients and others on social media, providers should ensure: • an appropriate and considered response is made to the individual; • if allegations are raised, these are investigated in a thorough way; • policies and procedures are complied with for both the use of social media and any resulting investigation or disciplinary process.

Social Media Policies The Commission has said: • it is ‘not sufficient’ in this electronic age for an employer not to have a social media policy and simply rely on induction training and general conduct policies.4 • ‘in an employment context the establishment of a social media policy is clearly a legitimate exercise in acting to protect the reputation and security of a business…’5

Having a clear and enforceable social media policy is key to managing the online behaviour of both employees and clients. A good social media policy will: • apply broadly to work and personal platforms; • clearly set out what is expected of all users (clients, employees and the general public); • in relation to employees, be reasonable and ensure that the regulated behaviour ‘has the requisite connection’ with employment;6 • in relation to clients, restrict use only to the extent required to meet legislative obligations and protect the interests of the provider; • explain whether employees can make statements on behalf of the provider and, if so, in what circumstances; • require employees to comply with professional obligations, duties of care, AHPRA policies, ethical obligations etc. • require users to meet legislative obligations including in relation to privacy, confidentiality, anti-discrimination, safety, harassment, defamation, employment, intellectual property etc; • prohibit inappropriate behaviour including harassment, bullying and discrimination; • protect the provider’s reputation, confidential information and intellectual property; • include non-exhaustive examples of appropriate and inappropriate behaviour; • specify the potential consequences of breach; • provide that the policy does not form part of the contract (resident or employment) and the provider may review and amend the policy. Where an account, forum or website is held in a provider’s business name, some additional matters should be covered including: • who can access and make comments on behalf of the provider; • what topics can and cannot be covered; • processes to address comments and complaints from clients, suppliers, employees and the public; • training for users to ensure they are aware of the risks of defamation, corporate reputation, misleading and deceptive conduct, discrimination etc. Like all policies, a social media policy should be reviewed regularly and be supported by the provision of training and information to all users about the requirements of the policy.

Consequences of Breach The online conduct of individuals regularly comes before the courts. Often the conduct relates to:

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• Comments, images and conduct which criticises an entity or damages its reputation. • Inappropriate conduct towards employees, clients and suppliers (including discriminatory or harassing comments, images etc).

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• Inappropriate behaviour such as where employees have called in sick to the employer but made comments on their social media accounts indicating they have ‘taken a sickie’ to engage in other activities. For employees, whether conduct is sufficient to amount to grounds for discipline and dismissal will involve a consideration of a number of factors including the:

• the circumstances and terms of use (as above for employees); • the agreement between the client (or their representative) and the provider; • other avenues available for remedy (defamation etc). ■

References 1. Sensis Social Media Report May 2015 How Australian people and businesses

• circumstances – what was said or done, who could see or access the comments/images etc; • terms of use – terms and conditions that users agree to comply with when they post on the forum, website etc; • policies and procedures in place; • training provided to the employee.

are using social media, including at pages 11-13. 2. Bowker [2014] FWCFB 9227 3. G abriel Soares v KDR Victoria Pty Ltd t/a Yarra Trams [2015] FWC 4472 4. Stutsel v Linfox Australia Pty Ltd [2011] FWA 8444. 5. P earson v Linfox Australia Pty Ltd [2014] FWCFB 1870 at [46].

While all cases will turn on the facts, the courts have found that comments made on social media outside of work hours and on personal devices can amount to misconduct and may be grounds for dismissal.7 Where clients and/or their families have made detrimental or inappropriate comments about the provider or its workers, whether action can be taken by the provider will depend on factors such as:

6. J udith Wilkinson-Reed v Launtoy Pty Ltd T/A Launceston Toyota [2014] FWC 644. 7. S ee for example Damien O’Keefe v Williams Muir’s Pty Ltd t/a Troy Williams The Good Guys [2011] FWA 5311; Linfox Australia Pty Ltd v Glen Stutsel [2012] FWAFB 7097; Cameron Little v Credit Corp Group Limited t/as Credit Corp Group [2013] FWC 9642 etc.

LASA NSW-ACT Business Services CLAIMS AND BILLING SERVICE LASA NSW-ACT has over 20 years’ experience in all claims and billing procedures. We have a fully integrated billing system, tailored to meet aged care facilities’ needs in compliance with both pre and post 1 July 2014 legislation. LASA NSW-ACT offers clients the assurance that: • Payment statements are reconciled to ensure all reclaims are made to Medicare • All fees are accurately reflected on the resident statement • All DAPs are calculated correctly – specialising in complex processing issues such as draw downs and top ups • Updating on line claims occurs within 3 days to ensure cash flow • Generation of expected funding allows financial forecasting • Quarterly Quality Review Meetings • Free advice to facilitate compliance with legislation fusion ad - claims and billing.indd 1

• Reconciliation of Accounts Receivable Reports, Product Reports and Sales Reports on a monthly basis • Analysis of payment statement to maximise funding • Advice on reassessment of residents to maintain and/or increase funding • Production of Bond and RAD reports to prudential compliance • Resident payment can be processed through direct debit facility • Notification of fee changes is passed on to relevant members of the organisation • Provision of internal control procedures to satisfy audit requirements • Overdue accounts are managed and controlled

For further information regarding this service please contact us: Postal Address: PO Box 7, Strawberry Hills, NSW 2012 Street Address: Level 8, 418A Elizabeth Street Surry Hills, NSW 2010 Phone: (02) 9212 6922

Fax: (02) 9212 3488

Email: accounts@nswact.lasa.asn.au www.nswact.lasa.asn.au

Free education sessions For a limited time we are offering free education sessions of your choice when you engage us to provide Claims and Billing Services (6 free sessions). Contact us today

8/09/2015 1:41:55 PM

Electrical Safety may not be your core business…. but it is ours.

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We make electrical safety as easy as abc: Aﬀordable Beneﬁcial Compliant

Our focus is on reducing: Energy consumption Environmental impact Overall maintenance costs

Swift Electrical • Uses Licensed Electricians and testing is performed to Australian Standards • Provides detailed reports to meet legislative requirements • Cares about the residents’ health and respond quickly • Provides organisations with comfort and security Servicing: • Aged Care residences • Community Service organisations • Health service providers • Schools and pre-schools

Specialising in: • Electrical compliance services • Electrical safety gap analysis • Lighting recommendations and installations • General electrical works with rapid response • Falls prevention systems (Bedside Guardian)

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The impact of the ACFI

on physiotherapists in aged care Since the Aged Care Funding Instrument (ACFI) was introduced in 2008, there have been a number of concerns about issues such as the types of physiotherapy interventions allowed under the funding model.

rior to its implementation, residential aged care facilities received no funding for direct physiotherapy or other allied health services. Physiotherapists were limited to prescribing exercise programs and had little or no opportunity to provide hands-on treatment to residents. Consequently, working in this sector was frustrating, un-gratifying and the skills that a physiotherapist could offer older people were only accessed where individual residents sought private interventions (at their expense). These exercise programs, for which the facility received funding for, were not implemented by a physiotherapist. This traditionally meant limited engagement for the physiotherapy profession in terms of frequency, duration and scope (4 hours per week for a 60-bed facility was common practice).

Incentive to improve resident outcomes The implementation of the ACFI led to a situation where if a resident has an assessed need for pain management, and this is being performed by a physiotherapist (or other suitably qualified allied health professional), in most circumstances the facility may receive funding that covers the cost of this service. Unlike the Resident Classification Scale (RCS) the ACFI does not dictate an annual mandatory appraisal, which encourages the active re-enablement or rehabilitation of a resident as a facility does not lose funding in the following year if a residents’ mobility, function, and quality of life improves.

More than pain management The ACFI User Guide states that complex pain management interventions must involve therapeutic massage and/ or technical equipment specifically designed for pain management. Although this creates limitations to the number

Michael Peachey CEO I W&L Aged Care Services

of residents the facility may make an ACFI claim for, it doesn’t necessarily limit the treatments provided. Therapists providing treatment options based on the residents’ needs can routinely include a range of treatment and rehabilitation modalities such as: • Concurrently performing other techniques to improve limb function • Mobility rehabilitation • Falls prevention and balance improvement • Exercises during pain management sessions

Concerns about over-servicing, under-treatment All physiotherapists must abide by a code of conduct. When physiotherapy providers have little understanding of their impact on the ACFI, over-servicing issues may arise, such as the blanket prescription of “Directive-4b” interventions. The decision to place someone on a treatment should be based on clinical needs. Physiotherapists should use their clinical reasoning and judgment to assess residents’ needs and implement a tailored approach to their care delivery. Otherwise, this is a misallocation of resources that simply creates additional costs with no more financial impact for the facility then providing the less-frequent interventions which are actually clinically indicated. The industry standard for providing treatments multiple days per week is 15 minutes per sessions. A consequence of over-servicing can be a physiotherapist attempting to see more residents in less time (e.g. six or more per hour). Productivity rates such as this, especially when invoicingper-treatment is occurring, make it hard to justify that resident outcomes are the focus.

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Facility managers are aware of the clinical benefits of physiotherapy. Concerns are frequently raised, however, that although they’re aware that the ACFI funding is likely covering the cost, there’s little transparency regarding the overall impact on their budget. This makes it hard to justify continuing the larger number of hours being provided. One simple solution to this is a transparent reporting system whereby physiotherapists maintain a real-time list of which residents are being seen, how often they’re being seen, and the overall budgetary impact of the service. For a copy of the complete ‘Report into the Impact of the ACFI on Resident Care’ or further information about physiotherapy services that improve resident pain management and mobility outcomes contact 08 8363 1344 or email contact@wellnesslifestyles.com.au. ■

Image courtesy of Belushi/Shutterstock.com

▪

HEALTH & WELLBEING

CARING FOR OUR CARERS On the back of another successful R U OK? Day, Fusion looks at the importance of recognising workplace stress and supporting staff in the often physical and emotionally demanding roles of caring for others. “If you wanted to create the optimum environment for the manufacture of stress, many of the factors you would include would be clearly recognised by nursing staff as events which they encounter in their daily routine. These include an enclosed atmosphere, time pressures, excessive

effective intervention, development and implementation of prevention strategies,” the Council states in a fact sheet about occupational stress for nurses. There are several factors that make caring for residents in aged care facilities unique to the duties of other nurses and carers.

noise or undue quiet, sudden swings from intense to

• Residents often have multiple and complex needs

mundane tasks, no second chance, unpleasant sights

• Care staff may ‘know’ and care for residents for several years

and sounds, and standing for long hours.” –

International Council of Nurses

ob stress is cited as the biggest cause of absenteeism in Australia, and it’s costing us all in one way or another. According to Work Safe Australia, occupational stress costs Australian businesses an estimated $10 billion per year through absenteeism, reduced productivity and health care costs. In the UK it’s estimated to be US$64.8-66.1 billion and in the US it’s US$200-250 billion. Workplace stress in aged care has been the topic of a number of studies in recent years. Last year the Victoria University conducted an ‘exploratory study of stress in regional aged care nurses’, which investigated aged care nurses’ experiences of occupational stress. It also explored the coping strategies employed by nurses to assist in the management of stress. The study found two overarching themes around perceived powerlessness and industry culture. Other sources of stress included, organisational culture factors – low staffing levels and inadequate resources; work role factors such as role overload, time constraints, too much autonomy and interpersonal stressors such as dealing with violent and aggressive behaviour from residents and families, and coping with the death of residents. These findings are in line with International Nurses Council’s concerns that nurses are exposed to a great number of stressors in their working environment, such as a heavy workload and dealing with death and dying patients. “These aspects can have serious consequences not only for nurses but for the patients, as well. The knowledge and the estimation of stressors in nursing can provide a basis for

• Care staff are exposed to continual death and dying • Personal carers, cleaners, administration and activity staff often spend significant time with residents • Caring for cognitively impaired residents can be challenging and extremely stressful • Care staff are often asked to assist with palliative care decision-making by relatives

R U OK? Initiatives like R U OK? Day aim to get people having regular, meaningful conversations throughout the year to help anyone who might be struggling with life. The not-for-profit organisation was inspired by Gavin Larkin, whose father committed suicide in 1995. Gavin Larkin chose to champion just one question to honour his father and to try and protect other families from the pain his endured: Are you ok? This has led to a national suicide prevention movement seeking to change behaviour across Australia. Now in its seventh year, R U OK? Day has become an information hub with practical, useful resources for to support workplaces and individuals. For more information go to www.ruok.org.au

HEALTH & WELLBEING

The complexities around palliative care further compound workplace stress for staff who are untrained or not confident in their skills in this space, as noted by Decision Assist. Untrained staff are less likely to have education about palliative care and how to cope with death, dying, loss and grief than registered nurses. Care staff often face complex ethical challenges, for example, staff views about prognosis and end-of-life care goals are often in conflict with the views and expectations of families. Care staff are often concerned about the quality of care they are able to provide. They express frustration with a lack of ability to provide the kind of care they feel is appropriate. Others have noted that lack of time to spend with residents and unrealistic work demands contribute to their frustrations, as do negative interactions with colleagues, residents and families and a lack of support and debriefing following a residents death is not available, leaving carers fearful of the death experience. Staff tend to get most frustrated when their care values are at odds with those of their employer. They cite unsupportive management as the most common reason for dissatisfaction with care work. Low staff to resident ratios combined with low salary and status as well as a lack of training, are some of the reasons why registered nurses decide to leave aged care.

The impact of stress Occupational stress is known to produce physical and psychological impacts, which can present as: • Backache • Headache • Eye strain (e.g. inflammation and an increased pain sensitivity) • Sleep disturbance based on hormonal imbalance • Dizziness • Fatigue • Gastrointestinal problems (e.g. nausea, acid indigestion, heartburn and abdominal and stomach cramps) • Change in appetite • Irritability • Burnout • Inability to concentrate/forgetfulness • Anxiety • Depression

Additional stress sources in nursing relate to the physical, psychological and social environment: • Work load, including stressful situations due to nurses’ staffing and scheduling problems • Dealing with death and dying and performing painful procedures on patients • Inadequate preparation to deal with emotional needs of patients and their families • Lack of staff support and negative feelings of anger and frustration • Uncertainty concerning treatment due to inadequate communication • Conflicts with colleagues including supervisors especially in the case of criticism • Organisation of work and financial issues (e.g. unexpected situations) • Public criticism including patients’ unrealistic expectations • Hazards at the workplace such as Cytotoxics and infections • Shift work especially working at night or overtime.

HEALTH & WELLBEING

Stress and workplace culture More generally, low morale has also been identified as a leading cause of workplace stress, with one-third of claims due to low moral, though often they are treated as “adjustment disorder”, according to clinical and organisational psychologist Peter Cotton. Dr Cotton told the Australian Psychological Society conference that morale-related psychological injuries were usually driven by conflicts with bosses or co-workers and work dissatisfaction issues rather than an increase in mental health symptoms. He said staff need early access to guidance, better conflict resolution and human resources interventions. “Psychological injury claims are damaging to businesses because they caused longer absences from work,” he said. But issues relating to low morale could be fixed by improving culture. According to the APS’s psychologically healthy workplace program, employees benefit from having a supportive leader, clearly defined goals and expectations and opportunities for development and growth. In turn, businesses benefit from higher employee performance, and employee job satisfaction that leads to fewer conflicts, compensation claims and absences.

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COMPUTER SOFTWARE

ALEXYS.COM.AU

The next generation of integrated solutions for the healthcare industry Alexys Australia is committed to design, supply, installation and support of industry leading technology for Healthcare. Our systems are built on proven technology and based upon industry standards. With todayâ&#x20AC;&#x2122;s solutions being highly integrated and the requirement of seamless operation, the Alexys team can provide consultation, information and decision making assistance to reassure all stakeholders throughout the procurement process. Our consultative process ensures that appropriate technology is delivered on time and on budget. Let Alexys provide you the complete package, the way it is meant to be. With 24/7/365 support, we are leading the industry on system readiness and uptime. Remote access to monitor and support sites removes the tyranny of distance and guarantees availability of technical assistance. Our nationwide support network ensures sites are never too far away if a site visit is required. You can be assured that we meet or exceed the industry standards for availability. Our SLA program can be tailored to your needs, working together to provide the best service possible. We support a range of systems including legacy nurse call. Our maintenance agreements include an annual health check, providing you a detailed report of your systems condition giving you confidence that all systems are tested and are on the latest version of software. By keeping your software current you are always receiving any system improvements and feature upgrades, including new time saving features. At Alexys we understand the critical nature of the systems we supply and support, we are committed to providing industry leading products, knowledge and support for Aged Care.

Nurse Call Systems

Aptus CMS

Wifi

Access Control

Duress

For more information contact us on 1300 ALEXYS â&#x20AC;&#x201C; 1300 253 997 or +61 2 8294 2699 www.alexys.com.au

Real time location services [RTLS]

CCTV

Telephony

Paging

HEALTH & WELLBEING

emphasised the importance of social support in being able to cope with work-related stress. Its recommendations included: • Regular staff meetings, such as debriefing sessions, allow staff to discuss concerns and support each other to solve encountered problems. • Time should be allowed and budgeted for staff handovers at the conclusion of shifts, to allow staff to exchange important information about resident care. • In order to foster the emotional wellbeing of aged care nurses, they should have access to grief counsellors (off site) to help cope with experiences of grief and loss. • Adequate breaks and sufficient rests between shifts, in order to create a culture of wellbeing and to maintain individual health.

Putting employee happiness at the centre of business strategies is one of the approaches that Sir Richard Branson has implemented across his different ventures, and attributes to their success. The founder of the Virgin Group is widely recognised for his approach to workplace culture and doing things differently. “Beyond creating good policies, you need to think about what makes your company different, and help your employees to celebrate that. If it’s the sense of mission, then give them the tools they need to keep in touch with how your business is progressing toward its goals. If it’s engagement with customers, then empower your people to take the lead as they help your clients. If you need clues about where to begin, pay attention to where the happiest employees are in your business, since this can indicate that something is working very well – something that can be replicated elsewhere,” he told Entrepreneur magazine in an interview last year. “Celebrate your achievements and those of your employees, because each one is a step on the road to your business’ success. If you’ve been working on a project that has required people to work long hours, when it’s done, let loose a little and give people a chance to reconnect outside the office,” he said.

Prevention and Protection Stress management strategies aren’t a new concept, but integrating them into every day processes and workplace culture can go a long way in helping individuals and businesses to manage stress burdens. In the Victoria University study, nurses reported the use of both problem-focused and emotional-focused coping strategies to manage the effects of these stressors. In particular, participants

Other ways employers can help staff to manage their stress levels is through supporting managers to improve their communications skills, offer regular training and education programs to update employees’ skills and knowledge, involve staff in any redesigns or restructures, and provide immediate debriefing and psychological support after particularly traumatic events. For staff involved in palliative care, carers and nurses have reported the following strategies as being helpful in dealing with continuous exposure to death and dying: • having clear boundaries between work and home and being able to leave work behind • family and leisure activities • connecting with nature • talking to other people about their experiences and emotions, and • offering debriefing or counselling. ■

Becoming a mentally healthy business – virtual seminar 6 October 2015 As part of Safe Work Australia month, which runs throughout October, a series of virtual seminars will be held to support businesses to look after their staff. The series kicks off on Tuesday 6 October with a live panel discussion, “Becoming a mentally healthy small business” at 11am. Panellists include Carolyn Davis, Australian Chamber of Commerce and Industry (Introductory speaker); Ann Sherry AO, Chair Safe Work Australia; Georgie Harman, beyondblue; and Leanne Faulkner, Entrepreneur. For more information go to www.safeworkaustralia.gov.au/sites/swa/australianstrategy/vss/pages/vss

TECHNOLOGY |

COMPUTER SOFTWARE

EVENTS

LASA Q

COMMUNITY CARE CONFERENCE SURFERS’ PARADISE 7-8 SEPTEMBER 2015

With an of environment of change, challenge and opportunity as its backdrop, this year’s LASA Q Community Care Conference saw an unprecedented number of delegates and exhibitors come together to engage on current and emerging community care issues that really matter.

hrough a comprehensive and insightful conference program developed by industry and delivered by industry professionals, participants spent two days immersed in the past, present and future world of community care. We kicked off with the Department of Social Services (DSS) updating delegates on the ongoing reforms, Carer Gateway and operations of My Aged Care. Providers were reminded that with increased choice for consumers comes competition; requiring all involved to challenge traditional service models and sell their uniqueness.

Presentations on the practicalities of being a Regional Assessment Service (RAS) Assessor in rural and remote Queensland followed, with insights into how a consortia RAS model works.

2016 International Program South Africa February/March ••••••••••

Switzerland May

••••••••••

New Zealand July

••••••••••

Netherlands/France September

2016 program NOW OPEN. Register your interest today! For more information visit: sagetours.com.au or Contact Program Manager Judy Martin: judy.martin@thomsonadsett.com

mobile: 0437 649 672 Studying and Advancing Global Eldercare

Celebrating 10 years in 2016

EVENTS

Consumer Directed Care (CDC) was a significant topic on the program, with several speakers sharing their journeys with the audience. Topics including internal barriers and learnings, infrastructure, culture, skill groups, regulations and governance requirements were thoroughly explored and work-shopped. FOWLER chaiR pOsitiOn

powder-coating provides antimicrobial surface protection

Alison Hill, mind mechanic extraordinaire, concluded the day’s program with a brilliant and interactive conversation about change overload. Asking the audience to consider where they sat in the checked out, burnt out, freaked out or standing out matrix, it was unsurprising that many found themselves across all four… sometimes in the space of a day!

FULL and REvERsE tREndELEnbURg

dEsignEd FOR cOmFORt & EFFiciEnt OpERatiOn Height travel range: 178mm to 762mm

“nEW WidE gLidE” ZEnith 9000 aps

intUitivE tWO-pEdaL LOcking systEm

built in expandable King Single sleep deck

WaRm-tO-thE-tOUch haLFLEngth assist dEvicE WidE dEck kit Optional wide kit adjusts the bed sleep deck to 990mm or 1066mm width for greater resident comfort

FOR FURTHER INFORMATION sOULaRch agEd caRE sUppLiEs JOhn maRkaRian m: 0418 634 534 E: soularch@bigpond.com www.soularchagedcare.com.au abn 94 159 417 535

nOvitatEc 491910

With its obvious synergies, the National Disability Insurance Scheme (NDIS) was also a key point of reference for delegates, made all the more relevant through the Queensland Government Department of Communities presentation on what’s happening in this space in Queensland, with particular focus on NDIS readiness and the availability of resources for individuals who aren’t NDIS eligible.

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An absolute conference highlight was dinner with the Sea World dolphins. These truly beautiful animals had diners spellbound, and conversation the following morning was all about how privileged people felt to have been afforded such an experience. The next day focused on marketing, communication and change management, with fabulous presentations encouraging providers to identify their point of difference, and communicate and manage their brand through the application of imagination, creativity, empathy and innovation. Several presenters shared strategies and mechanisms they had employed in embracing change, facing challenge and making the most of opportunities. It is not surprising that empowering people (staff and clients) with authority, knowledge, skills and tools (often through technology) was central to the growth and vitality of successful organisational transformation. Critical aspects of HR, IR, regulation, legislation and duty of care in community care service delivery were also covered in depth. The conference concluded with a reminder that challenges around change may at times seem daunting but opportunities for growth and innovation are available in abundance. ■

EVENTS

OSCAR 3CP

OSCAR 3CP is cloud software that supports the hospitality management of your Aged Care facility to deliver clinically appropriate, nutritious, safe, cost effective, resident focused restaurant-quality food to every resident simultaneously. It mitigates risk while meeting legislative and regulatory compliance. Minimises administration time and improves efficiency.

Hospitality Software for Aged Care CATERING CARE PROGRAM

EXPENDITURE ANALYSIS

Resident dietary and menu/recipe management software that includes food medication

Track live per resident per day spend across all commodity groups

interactions

FOOD FOR THOUGHT CALENDAR History, recipes and activities for annual theme days and events

FOOD SAFETY PROGRAM Identify and manage food safety hazards and documentation with in-built email alerts and automated industry legislative updates

SURVEY

TRAINING

Survey residents and family members electronically providing immediate collation and reporting

Industry specific training videos and fact sheets

&ROODERUDWH

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OSCAR 3CP

linked to individual staff training matrix

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1300 4 OSCAR info@oscar3cp.com www.oscarhospitality.com.au 81

EVENTS

OSCAR HOSPITALITY

AGED CARE AWARD FINALISTS 2015 The OSCAR Hospitality Aged Care Hospitality Awards (ACHA), now in its fifth year, aims to create a five star culture in the hospitality industry within Aged Care. The ACHA recognises and rewards outstanding staff members, initiatives and facilities in the betterment of aged care catering, cleaning and laundry services.

he extraordinary individuals and organisations nominated exceeded expectations and demonstrate an ongoing commitment to providing outstanding service, contribution and initiatives within aged care catering, cleaning and laundry.

Chef/Cook of the Year

The following are national finalists in the 2015 awards, which will be announced at the Aged Care Hospitality National Awards Gala Dinner on Friday 30 October.

• Barry Dawson, The Whiddon Group Bourke, NSW

Facility Catering Service of the Year

• Radhya Khadka, Bupa Care Mosman, NSW

• The Whiddon Group Easton Park, NSW

• Ann Haigh, Bupa Care South Hobart, TAS

• BlueCross Chelsea Manor, VIC

• Deepthi Domingo, BlueCross Hawthorn East, VIC

• Evergreen Lifecare Yallambee Lodge, NSW

• Sarah Bender, Bupa Care Woodend, VIC

Catering Innovation of the Year • Baptistcare Maranoa, NSW • BlueCross Chelsea Manor & Riverlea, VIC • BlueCross Hawthorn East, VIC • ACSAG George Vowell Mount Eliza, VIC • Estia Health, VIC • Lyndoch Living Inc. Warrnambool, VIC

Chef Manager of the Year • Kay Steele, RSL Care Bolton Point, NSW • Ashley Thomson, Lansdowne Gardens, NSW • Sindhy Ladegourdie, BlueCross Hawthorn East, VIC • Tibor Paller, Tabulam & Templer Homes for the Aged Bayswater, VIC • Chris Mann, Bupa Care Narre Warren North, VIC

• Dedza Parsons, Bupa Care Sydney, NSW • Alison Milsom, Bupa Care Pottsville, NSW • June Ellem, The Whiddon Group Grafton, NSW • Teresa Costelloe, Salvation Army Barrington Lodge, TAS

Food Service Assistant of the Year

• Alison Alder, BlueCross Hawthorn East, VIC

EVENTS

Facility Cleaner of the Year • Kerrie Heffernan, Royal Freemason’s Benevolent Institution Hawkins Masonic Village, NSW • Mandy Pitkin, The Whiddon Group Grafton, NSW • Maria Smith, Bupa Care Mt Sheridan, QLD • Kymberly Meehl, RSL Care Adelaide, SA • Joy Norman, Southern Cross Care Shepparton, VIC

Laundry Services Individual of the Year • Louise Damen, Baptistcare Alstonvill, NSW • Narelle Lewry, Opal Aged Care Bossley Park, NSW • Liz Priddle, The Whiddon Group Kelso, NSW • Nancy Farrell Bupa Care Mt Sheridan, QLD • Glenda Jackson Noosa Nursing Home, QLD The ACHA is an industry event and in 2015 are proudly supported by Bidvest Foodservice, Unilever, Heinz, and SAJ Fruit & Vegetables, Robot Coupe, Sunny Queen Meal Solutions, Jaymak, Reward Distribution, Comcater, Textured Concept Foods, Nestle Health Science and OSCAR Hospitality. ■ Image courtesy of Monkey Business Images/Shutterstock.com

18-19 MAY 2016 MELBOURNE SHOWGROUNDS Epsom Road, Ascot Vale, Victoria

YOUR CHOICE, YOUR CONTROL Supporting inclusion and independence with Australia’s foremost exhibition of aids, equipment & allied services. On display will be the latest in aids, equipment and assistive technology, as well as options for mobility, services and lifestyles. The event is open to visitors of all ages, including those with a disability, seniors and their families, friends and carers.

For more information phone 1300 789 845 or visit www.atsaindependentlivingexpo.com.au Media Partner

ATSA Independent Living Expo

Victoria & NSW shine in national awards for aged care excellence A Victorian aged care organisation innovating to empower its predominantly female workforce, a Newcastle hostel providing aged care services to those with mental illness, and a Melbourne hostel manager staging musical events for thousands of older Australians, have received top honours at the 2015 HESTA Aged Care Awards. The winners were recognised for their exceptional contribution to improving the quality of life of older Australians in three categories: Outstanding Organisation, Team Innovation, and Individual Distinction. HESTA CEO, Debby Blakey, said the three winners reflected the important work of aged care professionals in meeting the challenge of providing high-quality care and support to the growing number of older people in our community. “Our winners are making a real difference, ensuring Australians age well in a variety of residential settings,” Ms Blakey said.

We are proud to acknowledge their achievements and give them the recognition they deserve.

The 2015 winners are: Outstanding Organisation Award: Southern Cross Care (Vic) for its Employee Development and Empowerment Program that has improved the skills, health and lives of its predominantly female and culturally and linguistically diverse workforce. The program includes almost 20 initiatives including formal education opportunities in aged care, leadership, pastoral care and computer literacy, as well as a Women’s Health Program and a Money-Minded Program to increase financial literacy among staff. Team Innovation Award: ‘A Safe Place to Call Home’ program team — from Catholic Healthcare’s Charles O’Neill Hostel in Newcastle — for its unique program providing care to older Australians suffering from mental illness. The team provides specialist care for people with mental health disorders such as schizophrenia, bipolar disorder, post-traumatic stress disorder, personality disorder and depression, who are often turned away from other aged care facilities. Individual Distinction Award: Paul Brophy — from the Brotherhood of St Laurence’s Sambell Lodge in Victoria — for staging musical events for more than 6,000 residents from 20 care homes. Many residents attending the events are from disadvantaged backgrounds with little family contact, so the events provide them with an opportunity to interact with other people and enjoy themselves. The winners were announced at an awards dinner in Canberra on 27 August 2015. They share in a $30,000 prize pool, generously provided by proud sponsor, industry super funds’ owned bank, ME. The Outstanding Organisation and Team Innovation Award winners each received a $10,000 development grant. The Individual Distinction Award winner received a $5,000 ME EveryDay transaction account and $5,000 towards further education. Learn more about the awards at hestaagedcareawards.com.au Proudly sponsored by:

Proudly presented by:

hestaawards.com.au Facebook “f ” Logo

@HESTAACawards

CMYK / .eps

Facebook “f ” Logo

CMYK / .eps

/HESTAAgedCareAwards

H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No.235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.

LASA Victoria & LASA NSW-ACT HESTA Awards 85

TASKI Jonmaster

™

Microfibre Cleaning Solution for Healthcare TASKI Jonmaster combines an ergonomically designed workstation with the effective use of unique microfibre cloths, mops and associated tools for daily cleaning. Break the chain of Infection – one mop, one cloth per resident / patient room. Increased productivity1 – 26% less time to clean than traditional cleaning methods Ergonomic – no filling or emptying of buckets, less physical effort required Superior cleaning results – removes 99% of bacteria2 Environmentally responsible – up to 30% less chemical and water use Improved Infection Control and Operational Efficiency References 1. ATIR Report Hospital Cleaning, July 2003 2. TNO Independent Laboratory Report, Cloths 1, Mar 2010, Mops 14, Feb 2012

Oxivir® Tb Kills viruses in just 60 seconds

OXIVIR® Tb is a powerful one step Hospital Grade Disinfectant cleaner that is FAST, EFFECTIVE and SAFE.

Fast, powerful disinfectant. Kills Influenza A, Norovirus, HIV, Hepatitis C in 60 seconds. Effective against 27 pathogens including MRSA and VRE. Safe for patients, staff, and on surfaces. Low odour, non-irritant, non-corrosive.

For more information contact 1800 647 779 www.diversey.com

16511-ADV-05/13-EN

EVENTS

COMMUNITY HEALTHCARE CHAMPION NAMED IN 100 WOMEN OF INFLUENCE Anna Shepherd, CEO of Regal Home Health and Adjunct Associate Professor at The University of Sydney Nursing School, has been announced as a winner in The Australian Financial Review and Westpac 100 Women of Influence Awards for 2015 in the Business Enterprise category.

ver the past 32 years Ms Shepherd has worked as a passionate advocate for primary health nursing in the community. She has persisted in keeping community nursing on the national agenda and has driven the delivery of high-quality clinical services in the home.

work of her mother, Patricia R Shepherd RMN, FACN. Established in the 1960s, Regal Home Health developed an innovative nurse-led model of care that allows nurses to take control of their practice. Ms Shepherd joined her mother at Regal Home Health in 1984 and took on the role of CEO in 2000. ■

She also drove Regal Home Health to become the first private home healthcare organisation in Australia to be accredited by the Australian Council on Healthcare Standards (ACHS), and it has been endorsed for excellence from 1994 to 2018.

24 & 25 November 2015 Jupiter’s Hotel Gold Coast

“It’s an absolute honour to be included in this list of remarkable women, and it has been an honour to advocate on behalf of Community Nurses, who make it possible for people to stay in their own homes, connected and happy,” Ms Shepherd commented. “I strongly believe that clinical healthcare in the home is a progressive response to our changing 21st century health needs, and I’m committed to ensuring that multidisciplinary home healthcare and community nurses continue to have a voice and are recognised for the sustainable quality outcomes achieved within our health system.” “It’s fitting that this week is Community and Primary Health Nursing Week, promoted by the Australian College of Nursing, and I’m thrilled that the timing of this award allows me to highlight the phenomenal work Community Nurses do for their patients in all weather, every day of the year, around the country.” “It’s also International Suicide Prevention Month, and I’d particularly like to draw attention to the vital role community healthcare can play in addressing social isolation and supporting people with mental health challenges to live independently and successfully within their own homes. It’s my ambition that this award will help me to continue progressing community-based primary care, which I know has the power to transform people’s lives and offer much needed holistic support to diverse communities.”

LIVING THE AGE

www.itacconference.com.au

REVOLUTION: IT DRIVING CHANGE

All enquiries to: Conference Secretariat Corporate Vision Events T: 08 8981 5119 E: itac@itacconference.com.au

by the Aged Care Industry Information Technology Council (Aciitc) supported by Leading Age Services Australia and Aged and Community Services Australia.

Ms Shepherd’s work on behalf of Community Nursing and home healthcare is informed and inspired by the

documents by HYNES LEGAL

Simply Legal provides access to high quality, editable legal documents tailored to the aged care industry. It is a simple, cost effective, online method for accessing customisable legal documents. Be confident in the knowledge that Simply Legal is supported by one of Australiaâ&#x20AC;&#x2122;s leading aged care legal firms, Hynes Legal.

Benefits for subscribers include: z Immediate access to a range of legal documents. z Efficiently produce customisable Resident Agreements. z Immediate access to your documents. z Safe and secure storage of all your downloaded documents. z Cost effective annual subscription fee for unlimited Resident Agreements to be produced.

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EVENTS

UPCOMING EVENTS

& HEALTH WEEKS OCT NOV Breast Cancer Awareness Month www.bcna.org.au

Lung Health Awareness Month www.lungfoundation.com.au

Mental health week 4-11 October – www.wahm.org.au

48th AAG National Conference 4-6 November – Alice Springs Convention Centre

LASA National Congress 2015 11-14 October – Melbourne Convention and Exhibition Centre

FECCA 2015 National Biennial Conference 5-6 November – Sheraton on the Park, Sydney

National Nutrition Week 11-17 October – www.nutritionaustralia.org Be medicinewise week 12-18 October – www.nps.org.au Australian IBD Day 22 October – www.gutfoundation.com National Housing Conference 2015 28-30 October – Perth Convention Centre OSCAR Hospitality Aged Care Hospitality National Awards (ACHA) Dinner 30 October – Pullman on the Park, Melbourne

Food safety Week 8-14 November – www.foodsafety.asn.au National hat day 9 November – www.australianrotaryhealth.org.au National skin cancer action week 15-21 November – www.cancer.org.au LASA Victoria Community & Home Care Seminar 16 November – Leonda by the Yarra, Hawthorn VIC Antibiotic awareness week 16-22 November – www.safetyandquality.gov.au, www.nps.org.au ITAC 2015 Conference 24-25 November – Jupiter’s Hotel Gold Coast

LASA EVENTS 2016 Tri-State Conference & Exhibition 21-23 February 2016 – Albury, NSW

LASA Q National Service Integrated Housing Conference 1-3 June 2016 – Surfers Paradise, QLD

LASA Q State Conference 13-15 April 2016 – Gold Coast, NSW

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

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

LASA National Congress 9-12 October 2016 – Gold Coast, QLD

WHAT’S NEW

WHAT’S NEW Retirement village regrets inspire new book

SAFE T GUARD

The stories of people moving to a retirement community and then suffering buyer regret years later when they, or their estate, realise what they get back again, showcased recently in the media. The interviewees said that they knew about the deferred management fee of 1% per quarter but only realised what that meant in terms of the cost when it came time to sell. It’s an all too common story.

For over 80 years Jasol has a trusted reputation for providing best in class products (for value and effectiveness) on all our cleaning and hygiene solutions (chemical manufacture plus equipment supply) and in line with this tradition, we’re pleased to announce Safe T Guard; our new innovative instant hand sanitiser joining our Personal Care Range soon.

Such stories also contribute to the other type of buyer regret, that they didn’t make the move sooner. Both Noel and Rachel heard the stories of both kinds for years. Rachel says “The biggest problem with both types of regret is that it is too late to do anything about it, you can’t wind back the clock and move into the village sooner and if you are at the point of leaving the village it is too late to negotiate a different financial arrangement”, Noel adds “What they needed was someone to help identify the village or villages that would meet their lifestyle needs and explain the legal and financial aspects to them well before they chose a village”. Off the back of their very successful book “Aged Care, Who Cares?”, finance gurus Rachel Lane and Noel Whittaker have penned The Retirement Living Handbook. The book is aimed at people considering making the move to a retirement community or as they like to refer to them “the tree change, sea change and downsize seekers of Australia” with a view to preventing both types of regret. The book covers all of the important aspects of moving to a retirement community from selling your home to finding the retirement community that’s right for you, the different forms of legal contract and financial arrangements and the impacts on pension entitlement and eligibility for rent assistance. To put all of the concepts into a real life context the authors provide more than a dozen case studies from Australian retirement communities. At the back of the book is a directory of over 1,000 retirement communities broken down by lifestyle with a lexicon of key features to help readers identify the retirement communities that may best suit them.

For more information contact Rachel Lane 03 9016 9722.

We understand the constant need for hygienically clean hands in the health & aged care industries. Where washing of hands is not always practical, the use of Sanitiser’s is now a quick, reliable sanitation method to eradicate and stop the spreading of harmful bacteria. Whilst in the past, the most traditional hand Image used for sanitisers contained up to 60% alcohol promotional purposes (which can be very efficient ingredient to only reduce germs but leaves the skin dry, sticky with probable skin irritation problems and poor aroma) Jasol’s Safe T Guard is an alcohol free, instant hand sanitiser, containing unique ingredient’s that reduces the spread of germs. Delivered via a touchless dispensing system as a foam (or via pump bottle) onto the surface of the skin and quickly evaporates when hands are rubbed together. This unique moisturising formula is also perfume free which also makes it ideal for use in food processing environments, leaving hands soft, smooth with no lasting stickiness, odour or residue.

For more information visit our site www.jasol.com.au or call our Customer Service Team on: 1 800 334 679 JASOL EXHIBITING AT THE LASA CONGRESS OCT 11-14, 2015 (MELBOURNE CONVENTION & EXHIBITION CENTRE)

Confoil The Pack and Seal System from Confoil has been tried and tested in the hospital, aged care, Meals On Wheels and prison systems. Using a sealing machine, which creates an air-tight plastic seal over the tray (this lidding can also be frozen, microwaved and ovened to 220C), is beneficial for customers who may normally have food accessibility issues. These machines are installed and serviced by Confoil and many organisations have found that being supplied the entire packaging solution from one source has led to increased packaging, warehousing & logistical savings. The machines themselves are easy to use and clean and can seal from 4 to 34 packs per minute. Another feature of the system is the availability of compartmentalised trays, which can segregate different foods. These trays are microwavable, ovenable to 220C and freezable to -40C. Other benefits of these trays include: recyclability, aesthetically pleasing and are also strong enough to cope with long transportation.

For more information visit www.confoil.com.au

COMPUTER SOFTWARE

| TECHNOLOGY

Put your hands together for the revolutionary dispenser range from Jasol.

You’ll applaud our stylish and durable, easy to operate dispenser range that suits every hygiene point. NEW TOUCH FREE & MANUAL DISPENSERS LIQUID OR FOAM SOAP COMPATIBLE Jasol’s wall mounted soap dispenser comes in both a touch free and manual option and is the latest innovation with a 100% disposable inner mechanism for both, which ensures full hygiene integrity. Highly versatile, both units are made with the same unique mechanism with interchangeable pumps and soap pods that can be switched between both the touch free and manual models easily and hassle free. Once the soap pods are popped into the unit they will only need replacing when the container is empty. The chemical is never in contact with air or germs, hence its integrity is never compromised.

NEW WET WIPE DISPENSER Solid and clever, the modular dispenser has been designed to dispense one wet wipe at a time while keeping the remaining stock as fresh as new. Wall mounted, this static cleaning station also keeps the workplace tidy and locks away the stock of wet wipes.

NEW AUTOMATIC DRYER Jasol’s automatic hand dryer offers the highest level of performance. Its small size helps to reduce the amount of water spread by the blast, resulting in a cleaner and more hygienic environment. Speak to your Jasol Account Manager or contact our customer service team on 1 800 334 679. www.jasol.com.au

Providing hygiene service solutions since 1934

MedSig: the paperless signing of choice ®

Your best practice in medication management Complete, accurate and auditable records Paperless signing and efciency improvements Account for all medications at each dosage time Flexibility and safety with administration round Unique and inbuilt medication administration ‘reason’ codes and alerts Immediate access to concise medication information during

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administration Ability to measure and track staff performance