LASA Fusion Summer 16/17 by Adbourne Publishing

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

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HOME CARE REFORMS EXPLAINED ADVANCED CARE PLANNING & TALKING ABOUT THE END OF LIFE WHY ENGAGE IN ENTERPRISE BARGAINING?

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

OPINION 5 CEO National Update

CONGRESS 45 Congress 2016: Imagining

7 Chair National Update

age services – No borders, no boundaries

8 Delivering better services 11 What’s so good about good governance?

NATIONAL UPDATE 13 Residential aged care funding update

14 Aged care complaints commissioner releases first annual report

17 Home Care changes 18 Future of the aged care workforce

EDITOR

19 Funding and financing the

Lyn Larkin Corporate Affairs Manager, Leading Age Services Australia Ltd E: editor@lasa.asn.au

aged care industry

21 Meet our new State Managers 22 The value of a person’s assets

LASA NATIONAL

25 Aged care indexation

Sean Rooney CEO E: seanr@lasa.asn.au

OUT AND ABOUT 28 Out and about in NSW

ADDRESS First Floor Andrew Arcade 42 Giles Street Kingston ACT 2604

31 Qld’s Regional Forums… part of our commitment to delivering on the promise

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Victorian members

35 Out and about in WA

50 Advanced Care Planning 53 Linkages Project encourages collaboration on end-of-life care

54 Communication around death and dying

AROUND THE SECTOR 56 CareerAbility – Enabling careers in aged care

59 Meeting staff and customer needs: Evidence for a win-win strategy

61 Bringing everyone along, supporting remote and indigenous communities in aged care reform

DISCLAIMER Fusion is the regular publication of Leading Age Services Australia (LASA). Unsolicited contributions are welcome but LASA reserves the right to edit, abridge, alter or reject material. Opinions expressed in Fusion are not necessarily those of LASA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Fusion may be copied in whole for distributed amongst an organisation’s staff. No part of Fusion may be reproduced in any other form without written permission

AGE SERVICES MANAGEMENT 65 Back-up generator grant offers secure power for more Victorians

66 Privacy laws and homecare 69 Aged Care, Who Cares?

YOUR MEMBERSHIP 37 Our LASA Membership offer

Where, How and How Much?

71 SAGE Tours – Trends and learnings

EMPLOYMENT RELATIONS 40 Modern Award Review Process

72 Utilising additional services to maximise sustainability

– Where are we up to?

43 Enterprise Bargaining – What

from the article’s author.

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32 Out and about with ADBOURNE PUBLISHING

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76 WHAT’S NEW

NATIONAL UPDATE I

CEO

OPINION

CEO NATIONAL UPDATE As the temperatures climb and our thoughts turn to the summer holiday break, I thought Iâ&#x20AC;&#x2122;d take a moment to reflect on my first six months at the helm of our newly unified organisation and share some of my Sean Rooney thoughts about the opportunities and challenges I see ahead for Chief Executive Officer LASA in 2017. Leading Age Services Australia

s you would be aware, 1 July 2016 was the date Leading Aged Services Australia merged its previous state-based industry associations into a single unified Membership organisation and peak body.

LASAâ&#x20AC;&#x2122;s Members and our state boards agreed that a national organisation would be best placed to support the industry as it responds to a dynamic, changing and complex environment. Building on the past achievements, rich history and legacy of our state organisations, they determined that through unification LASA would be better able to provide national reach and impact and serve Member needs. The promise made to LASA Members was that a unified LASA would be best placed to lead the sector in debates on policy reform, technological changes, the pressures of a growing population, and the complex needs and changing expectations of consumers. Since July, we have been working hard to deliver this new unified organisation providing stronger advocacy in a world of unprecedented change; access to support and services to all Members anywhere in Australia; and enhanced value for money in the way deliver for Members. With our new strategic plan, structures and processes in place, we have been focusing our efforts on getting on with the job of talking to our Members, improving our services to them and stepping up our advocacy activities on their behalf. Over the past few months, LASA has been actively lobbying politicians on all sides on the need to halt proposed aged care funding cuts while the Government undertakes its review of the Living Longer, Living Better reforms, rolls out new Home Care

changes and consults with industry on new models for aged care funding. We have also been very active in working with the Department of Human Services to help resolve issues for our Members with the beleaguered aged care payment system. We have also been calling for continued improvements to My Aged Care. LASA has also worked with the Department to ensure provider concerns were taken into account in the design of the new Home Care reform package. We have also proposed new approaches to the Senate Inquiry into the Future of Australiaâ&#x20AC;&#x2122;s Aged Care Sector Workforce on the challenges and opportunities that confront our future aged care workforce. LASA has been engaging with our Members in pulling together our submission to the Living Longer Living Better Review. We believe this review will be critical for both industry and Government as an opportunity to reflect on the progress of aged care reforms and to test whether consumers are, in fact, getting more choice. The Review will tell us what is working, what is not, and what needs to change further in order to meet the growing needs and expectations of our ageing population. LASA remains optimistic that the review will address the issue of funding sustainability and will consider the true and full cost of aged care service provision in all its forms. In the New Year we will be working hard to help our Members understand and navigate the significant reforms that are being rolled out across the Home Care sector.

OPINION

We will also be rolling out a strong and dynamic calendar of events, workshops, conferences and training, including our flagship National Congress in October on the Gold Coast. LASA will also be setting up a new Members Advisory Committee to provide advice to the Board on how Member advocacy can be enhanced, and how to improve, expand and evaluate LASA Member products, services and activities. The Committee will be the formal mechanism for Member feedback to the Board on issues of importance including: policy issues/positions, Member Services and other issues Members wish to raise. New state-based Member Advisory Committees will also be put in place to mirror the national Committee and streamlined national advisory groups will inform the focus of our services and advocacy activities.

As we go into 2017, we will be taking a robust role in discussions and negotiations with Government, politicians from all sides, and the bureaucracy, on aged care funding, payment and information systems. We need to ensure the right decisions are made for the interests of age service providers and older Australians and we will be looking for opportunities to work together with other like-minded organisations in the sector to ensure the conditions are created for a strong and united industry. LASA believes in the value of a strong national organisation that represents the entire industry – including for profits, not for profits, residential care, community care and retirement living – supported by members from across Australia. Thank you for your support in 2016. We look forward to working with you and for you in 2017. ■

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OPINION

CHAIR NATIONAL UPDATE In our Spring issue of Fusion I was projecting forward to the decisions confronting our first Annual General Meeting (AGM) as a unified LASA and the election of new Board members to be held at our National Congress in October.

ur first gathering as a united Membership was historic and long-awaited for most participants and I am pleased to report that the meeting endorsed significant changes to our LASA Constitution and held a successful election for one vacant Board position. Our AGM overwhelmingly passed significant amendments to LASA’s constitution to open the door to multi-state aged care providers to seek directorship on LASA’s Board. This constitutional change is significant because it allows large providers to contribute their expertise and experience to our organisation. This change effectively completes the transformation of a federated organisation into a single national membership peak body representing all providers of age services across residential care, home care and retirement living. Our Members also participated in the voting process for a Victorian and Tasmanian directorship of a unified LASA, resulting in the re-election of Ingrid Williams a representative from a small rural regional aged care facility to the Leading Age Services Australia (LASA) Board. Ms Williams is the Director and CEO of Elm Aged Living that has facilities in Safety Beach on the Mornington Peninsula and Flora Hill in Bendigo and her re-election ensures our board will continue to have unique insights into the challenges and opportunities of providing age services in regional Australia.

Dr Graeme Blackman OAM Chair I LASA

Ms Williams’ appointment is a clear demonstration that our organisation can cater for all age service providers across the sector from the very small to the very large. LASA also welcomes the appointment of independent Director Saranne Cook to our Board for a term of three years. Saranne holds a number of non-executive director and board posts, including with the Western Health Alliance Ltd (Western NSW Primary Health Network) and Racing NSW. At an operational level, the Board has been working to ensure a seamless transition to operational unification. With the recruitment process now finalised for all our state manager appointments and a new organisational structure now in place, I believe LASA now has a strong presence and a strong voice nationally as well as an aged care advocate across every state in Australia. As the unification process draws to a close this year, our organisation is well placed to deal with our Member’s frontline jurisdictional concerns while at the same time ensuring their interests and voices are heard on the National stage. I take this opportunity to thank you for choosing LASA as your peak body. We are here to work with you, and for you, in the interests of our members. I call on you to get engaged and be part of further shaping our services and advocacy to better meet your needs. ■

OPINION

DELIVERING BETTER SERVICES Ingrid Williams Managing Director/CEO, Elm Aged Living I Board Member, LASA Ltd

Elm Aged Living is a small private organisation that has two residential aged care services, both in regional Victoria. There are a total of 171 beds and approximately 230 staff are employed across a range of areas including nursing, care, lifestyle, catering, cleaning, maintenance and gardening, as well as administration..

hen reflecting on the pressing issues facing aged care providers, it is hard to go past financial sustainability and workforce challenges, as well as concerns that Government does not appreciate the need for aged care providers to be profitable to ensure their sustainability. The aged care sector needs to grow itself and needs an incentive to do so. Consolidation within the sector is inevitable, however, consumers do need and want choice. I have heard prospective residents comment on their desire to live in a home that is part of a small group in which the owners are close and in touch with their client base. With increasing expectations of consumers comes an increase in the need for a more versatile and highly skilled workforce. Providers such as Elm are looking to create a more flexible workforce to ensure maximum productivity as well as ensuring the workforce is committed and focused on ensuring the best quality service. To address the financial pressures and workforce issues alike, Elm has embraced a ‘bring in and take control’ approach. As such, a number of previously outsourced functions have been brought in-house. This in itself is not unique, but has reinforced the importance of taking ‘control of that which is important to you’. The view has very much been one of taking control of the things that are most important to the business. Why would one let someone else provide a service which is critical to our success? What does that say to others? It can say that if it is not considered it’s not important, so we get someone else to do it. Bluntly put, Elm can’t afford to pay for other organisations’ profit margin! By bringing services in-house such as cleaning, catering and Allied Health we have a closer connection to ensuring that we recruit the right people, provide the best service and can respond to issues quickly and more effectively. Great customer service is easier to provide when you can respond quickly and not via a third party. The other issue regarding financial sustainability relates to ACFI. Now I know everyone is talking about it but there is a specific issue that needs to be highlighted and that relates to

Ingrid Williams with some of the Elm average ACFI subsidies team, Kate Dellar and Margo Matthews. within regional services. Given the reduced access to community services such as Home Care within regional locations, residents come into aged care homes often with lower acuity. As such the average ACFI is significantly lower. Consider this in the setting of staff being paid the same as in metropolitan areas. Elm’s service in Bendigo has average ACFI subsidies that are $20/day lower than that of the service in Mount Martha. It is important to consider this in the context of ensuring that there are services available for everyone, wherever they live.

Having given you an overview of Elm’s position, it is important to also consider how LASA can assist and what role do they play in supporting other members such as Elm Aged Living. I have been a strong supporter of a unified LASA and it is an honour to again have the opportunity to service Members as a representative on the LASA Board. Every sector has a range of challenges, however, aged care is unique given the breadth of services which make up the sector and the responsibility we are entrusted with to care for older Australians. Only through a unified sector will we be at our most effective in our advocacy to Government. Our unified LASA is providing a voice and benefits for Members which have not previously been available. What we do each day as providers of care matters in the life of thousands of older Australians and their families right around Australia. I look forward to working with and for Members during the coming year. I hope that this brief overview of some of the things Elm has done to ensure its ongoing viability is something other providers can relate to and consider when reviewing their services and how they deliver them for the betterment of all the residents who live in aged care homes. ■

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OPINION

WHAT’S SO GOOD ABOUT

GOOD GOVERNANCE? Good governance enables effective boards to make good decisions that are in the best interest of the organisation. A well governed organisation uses various policies, processes and practices that enable them to operate effectively, clearly outlining responsibilities. Good governance involves having strong relationships between the members and stakeholders and very importantly it helps make sure that the day-to-day work of the organisation aligns with the purpose of the organisation.

y personal interest in governance has been developed during my time on boards across various industries, and in seeing the benefits good governance brings to organisations. It basically enables a sound framework upon which boards and executives can really just get on with the job. In some respects governance is one of those things that you notice more when it isn’t there, rather than when it is working well. Once boards and executives have a clear understanding of roles and responsibilities and a sound system of decision making processes, the actual decision making gets a whole lot easier. To have the oldest and wisest Australians in your care is a privilege. Our Members have been entrusted with one of the most important roles, and with this comes a duty of care. And this is where good governance plays its part. This is not different for LASA, your membership organisation. Both our Members, and the end customers (our elderly Australians) need us to be a strong membership organisation, with quality services and a clear voice to government in these changing times. With a new national organisation, a clear voice and good governance, and that is exactly what we intend to be. My passion and understanding for good governance has been enhanced in my current PhD studies in board governance, looking at the ASX200 companies. As for my interest in the Aged Care sector, I am fortunate enough to have my four grandparents (all in their nineties) as happy elderly Australians residing in some wonderful facilities. Their wonderful active lives spent being cared for in fabulous facilities is a reminder to all of their descendants as to the importance of the roles played by those in whom we have entrusted their care. And good governance I have no doubts has played a foundational role in those wonderful organisations. ■

Saranne Cooke is an independent director on the Board of LASA, having been recently appointed. She is also on the Board of Charles Sturt University, Racing NSW, Western NSW

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Primary Health Network and General Practice Registrars Australia. She is also the Chair of the NSW Western Region Committee of the Australian Institute of Company Directors, has a Master of Commercial Law, is a Fellow CPA and is studying a PhD in Board Governance.

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NATIONAL UPDATE

RESIDENTIAL AGED CARE FUNDING UPDATE With $1.2 billion in cuts to the Aged Care Funding Instrument due to come into effect on 1 January 2017, LASA and its Membership have stepped up their advocacy efforts to halt the Minister’s decision.

ASA Members began 2016 galvanised into action by Federal Government cuts to aged care funding released just before Christmas. Those cuts, announced in the December 2015 Mid-Year Economic and Fiscal Outlook stripped $472 million from the Aged Care Funding Instrument. It wasn’t long before Member anger turned to outrage when an additional $1.3 billion in cuts to ACFI were announced in the May 2016 Budget. As your peak body, LASA hit the ground running, directing significant energy and resources on behalf of Members to campaigning against these cuts. LASA ran a strong social media and media campaign against the cuts during the Federal Election, including a petition signed by over 4000 people. The cuts were the focal point of much of our advocacy work with politicians across the political spectrum before, during, and after the election. LASA has been pushing the case that no funding cuts should be implemented while the Government undertakes its review of the Living Longer, Living Better reforms, rolls out new Home Care changes and consults with industry on new models for aged care funding. To do so is short-sighted and poor policy. The Living Longer, Living Better Review and the work being done on new aged care funding models will no doubt herald significant changes for aged care funding. With increasing demand for age services, significant shortcomings in the Government’s current payment system, and unresolved issues with the My Aged Care portal, it is extraordinary that the Government would withdraw funding from the sector when the sector is clearly in need of greater investment.

Kay Richards LASA National Policy Manager

LASA has continued to advocate to politicians and the bureaucracy in recent months, meeting with Members of Parliament from across the political spectrum, include Senate cross-benchers, the Australian Greens and the Australian Labor Party, as well as with Government backbenchers and Ministers. There is significant support from cross-bench Senators and the Greens for our arguments and to blocking the ACFI cuts. But while the ALP is sympathetic to our argument, they did not support a recent motion in the Senate to disallow the regulations that give effect to the MYEFO cuts. A decision on the final size and make-up of the ACFI cuts is expected to be made by the Minister for Health and Aged Care, Sussan Ley, prior to Christmas 2016 for potential implementation as early as 1 January 2017. If the cuts are implemented as originally outlined, or with minimal change, LASA will continue to lobby all sides to block them as they go through Parliament – most likely in the new year. LASA will also be stepping up our advocacy activities in the New Year to engage the Australian public in a discussion about the future of aged care funding. We believe the issue of ageing and aged care in Australia is not just an issue for older Australians, or for providers of age services, or for Government, it is an issue of national importance for all Australians. Australia needs an aged care funding strategy that addresses the fiscal constraints of Government, but also ensures the growing demand for services is adequately met, and aligned to the innovation and productivity intent of the consumer-centred aged care reform agenda currently underway. ■

NATIONAL UPDATE

AGED CARE COMPLAINTS

COMMISSIONER RELEASES FIRST ANNUAL REPORT

Rae Lamb Aged Care Complaints Commissioner

The Aged Care Complaints Commissioner Rae Lamb’s first Annual Report was recently released.

t’s the first time in many years that there has been a standalone report providing so much information about aged care complaints. The report includes common complaint issues and case studies. It also highlights the work the Complaints Commissioner and staff are doing to educate service users and aged care providers about the best ways to handle complaints. “Although this report only captures the first six months of my new role, my staff and I have hit the ground running and we are excited to share the progress we’ve made. You will see in the report we are already beginning to see positive outcomes from the new independent complaints handling arrangements. In many cases we have seen the service provider learn from the complaint and act on opportunities to improve care for others,” Ms Lamb said.

Overview of complaints received The Complaints Commissioner received 2,153 in-scope complaints from 1 January to 30 June 2016. Family members or representatives of people receiving care accounted for 1,272 (59 per cent) of complaints and 347 (16 per cent) were from care recipients. The remaining 534 (25 per cent) were from

anonymous complainants, other interested people (such as a friend of the care recipient) and referrals from other agencies. Compared to the corresponding six month period in 2015, the number of complaints has increased by 11 per cent (from 1,938 to 2,153). This may be due to the transition to an independent Commissioner and the public becoming more aware of the office and the support we can offer. Most complaints, 1,746 (81 per cent), were about residential aged care, 276 (13 per cent) were about home care packages, 114 (five per cent) were about Commonwealth Home Support Programme and 17 (one per cent) were about flexible and community care services.

NATIONAL UPDATE

Complaints about home care packages and the Commonwealth Home Support Programme accounted for 18 per cent of all complaints in 2016. This compares to 12 per cent in the corresponding period in 2015.

The most common complaint issues for flexible care services were about the conduct or behaviour of service staff (four), infections and infection control (three) and lack of training, skills and adequate qualifications of the staff (three).

The most common issues complained about for residential care related to clinical care (267), the administration of medication (200), continence management (178) and the choice and dignity of the person receiving care (163).

Education

For home care services, the most commonly complained about issues related to fees (94) and other financial concerns (55) and communication between the service and person receiving care (66). Commonwealth Home Support Programme complaint issues were very similar, with fees (14), lack of communication (13) and other financial concerns (eight) being the most common.

The Complaints Commissioner also has an important role in educating service providers and service users about good complaints handling and using complaints to improve care. If you would like to arrange for Commissioner staff to present an information session or workshop for your serviceâ&#x20AC;&#x2122;s management team or staff responsible for complaints handling, please contact the Commissionerâ&#x20AC;&#x2122;s office at enquiries@agedcarecomplaints.gov.au. â&#x2013; You can view and download the Aged Care Complaints Commissioner Annual Report at www.agedcarecomplaints.gov.au

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NATIONAL UPDATE

HOME CARE CHANGES The Home Care Increasing Choice Reforms to be rolled out on 27 February, 2017 herald significant change for both providers and consumers.

hese changes, announced in the 2015-16 Federal Budget, are designed to deliver consumer-directed care and improve the way home care services are delivered to older Australians giving them greater choice and more control over who provides their care. Consumers can now choose their service provider and change provider if they wish to. Home care package funding will follow the consumer, enabling them to direct package funding to the provider of their choice. A new consistent national approach is being rolled out to prioritise access to home care based on urgency/need and length of time a consumer has been waiting. Streamlined processes will be introduced for organisations seeking to become approved providers, whereby providers of residential care and flexible care will be able to ‘opt-in’ to providing home care rather than going through a full application process. LASA was concerned that there would be issues for providers in calculating unspent funds under the new Home Care reforms. The Government has listened to our concerns and has introduced an ‘exit amount’ that will compensate providers for the administrative costs associated with enabling consumers to switch provider. With such a short period of time to go before these changes come into effect, LASA has entered into a contract with the Department of Health to deliver information to Members and their staff on the reforms. We will continue to keep Members updated through our fortnightly LASA eNews and our website with new information from the Department, as well as our plans for delivering these information modules as the work progresses. The following information is designed to provide a high level overview of the key changes. For providers, the key changes are: • There will be no further allocation of home care places via Aged Care Approval Rounds. (ACAR will continue for residential and flexible places.)

• Providers can expand services, including accepting clients from other regions. • Funding will now follow the consumer, it moves with them if they change providers. • Packages cannot be re-assigned to another client if a current care recipient leaves home care, instead a cessation date is to be submitted to DHS and the package will be released back into the national pool. • There are new requirements about how unspent funding needs to be reported and treated by the provider. • A new prioritisation system to manage eligible consumers access to packages within My Aged Care is being introduced. • The total number of home care packages at each level continues to be capped. • Prioritisation will take into account the needs and circumstances of consumers and the time they have been waiting for care. For consumers, the key changes are: • Consumers assessed and approved for home care will be placed in a national queue. • Priority for service will be determined by ACAT assessment and include physical, medical, social and psychological factors as well as other considerations. • Consumers should start researching available providers once they anticipate they will need aged care services so they can make an informed and considered choice rather than choose during a period of crisis. • Once consumers receive an approval letter they can approach the providers they want to provide services for them. • Consumers will receive a letter when they reach the top of the queue, including details of their package, a referral code and the date they need to enter into a home care agreement by – or their package will be withdrawn. Factsheets on these changes are available on the Department of Health website at: https://agedcare.health.gov.au/programs/ home-care/introduction-to-home-care-changes. ■

NATIONAL UPDATE

FUTURE OF THE AGED CARE WORKFORCE

Sean Rooney, LASA CEO I Kay Richards, National Policy Manager I Emma Patton, National Manager Employment Relations Manager

Our aged care workforce – its viability and future – is something aged care providers think about every day - from challenges in attracting and retaining staff, to contemplating the ageing profile of our workers.

he future of our aged care workforce has been the focus of a long-running Senate Inquiry that kicked off before the July Federal Election and is due to hand down its report on 28 April 2017. LASA made a submission to the Inquiry earlier this year and gave evidence at the Future Aged Care Workforce Inquiry in Canberra at the start of November. In our presentation to the Inquiry LASA attempted to lay out some of the key workforce challenges our LASA Members – and the broader industry – face. Specifically, LASA identified three big drivers of change in the aged care sector that all impact on the future of our workforce: population, expectation and innovation. Population – we have reached a new normal now in terms of the number of people in our population who are over the age of 65, indeed, over the age of 85, and this will continue for some decades. Expectation – older Australians have greater needs and wants in terms of the types of care they want and services they require, how and where those services are delivered, by whom and when. Innovation – in terms of new technologies, models of care and new service offerings. In response to these drivers we strongly argued that Australia’s aged care workforce will need to have the following attributes if it is to meet the challenges of increased demand, consumer choice, a rapidly changing marketplace and the integration of new technologies. Firstly, the existing workforce needs to be renewed as the latest statistics tell us that an estimated 60% of the existing workforce will reach retirement age over the next 15 years. These workers not only need to be replaced, but our aged care workforce needs to rapidly increase to meet the growing demand for different types of services. The workforce will need to be responsive, knowing that we have a new cohort of older

Australians with broader expectations of how, where and by whom their care is delivered. Workers will also need to be adaptive, with technology likely to significantly impact on the type of care and services that are delivered and the training and skills required of the workforce. To meet these challenges, our future workforce will also need appropriate and flexible industrial arrangements with workers needing to be able to work across residential, home and community based settings. They will also have to embrace new care models and service offerings. Our future workforce will also need to deliver an appropriately high quality of care, with workers able to meet professional and legislated standards as well as the duty of care and consumer expectations. At the Senate Inquiry, LASA joined with other sector advocates in calling for a national strategic approach to address these workforce challenges and for the right platform of systems, processes, quality and people to deliver the accessible, affordable and quality care required. We also made it clear that consideration will need to be given to rural and regional providers and special needs groups. We impressed upon Senators the impact of funding cuts on our current workforce, arguing that to successfully meet the needs of our ageing population we need policy and funding stability. We stressed that the latest cuts to ACFI were directly impacting on the ability of providers to continue to deliver the levels of care that they were previously funded for, and most providers signalled that the cuts would lead to a reduction in staff. As we start to map out the future of our aged care workforce, cuts to funding like those delivered by the Government in successive budgets and economic statements are unhelpful, indeed counterproductive, and they will impact on the industry’s ability to attract, retain, build and grow the aged care workforce of the future. The Senate Inquiry is due to hand down its report on 28 April 2017. ■

NATIONAL UPDATE

FUNDING AND FINANCING THE AGED CARE INDUSTRY The 2016 Aged Care Financing Authority annual report released by the Department of Health in August this year highlights concerns about the long-term impact of reforms that will come into effect over the next year, as well as future capital investment into residential care.

apital investment is a critical element to the long-term sustainability of aged service providers. The fact remains that not everyone can afford to pay for their own aged care, and the onus is on Government to ensure access to the necessary services for all ageing Australians.

• Undertake a review of the Guidelines for applying for the Higher Accommodation Supplement as a matter of urgency with input from the peaks.

In relation to capital investment into residential care, the report identifies that about 76,000 additional residential care places will be needed over the next decade to meet demand, though the greatest demand spike will occur in 10-15 years. This is more than double the number of places that have come online over the last decade, signalling the need for providers to commence investment activities.

• Commitment by Government to reduce red tape to streamline the application and compliance process for refurbishment.

ACFA believes the sector will need to knockdown and rebuild a substantial proportion of its current stock of buildings, which it calculates will require investment of $33 billion if just one quarter is rebuilt at an even rate over the next decade. However, its observations on capital investment in residential aged care in 2014-15 compared with 2013-14 do not paint a positive picture: • Total assets of $36.6 billion, an increase of $2.9 billion; • Total liabilities of $25.7 billion, up from $22.5 billion. This includes $18.2 billion of accommodation deposits held by industry; • Accommodation deposits of $18.2 billion, up from $15.6 billion; • Net assets of $10.9 billion down from $11.2 billion. LASA has long raised its own concerns about investment into the sector, and continues to advocate for improved mechanisms to attract investment to the industry, including support by Government to facilitate greater confidence and certainty for investors. In our updated policy and position statements, we have identified what needs to happen for this to occur:

• Commitment by the Department of Health to meet timelines for decisions on applications and increased transparency and accountability to do so.

• State and Local Governments be encouraged to provide timely, transparent, robust, planning and approval frameworks. • The building code requirements continue to be administered by the States and be based on the Building Code of Australia. For home care providers, there is uncertainty ahead of the changes to consumer directed care from February 2017, and the merging of Commonwealth Home Support Programme with Home Care Packages from 1 July 2018. The Government anticipates what it describes as the “rationalisation of providers” and increased involvement by the for-profit sector in home care. For many LASA Members this will present a myriad of new opportunities. However, our not-for-profit Members who provide vital services to people who simply cannot afford other options must not be further disadvantaged or left behind in an increasingly competitive market. We need solutions that work for everyone. The importance of industry and Government working together to prepare for the future could not be made clearer by this report. LASA has already made strong inroads with the current Government on a number of issues and will continue to lobby for a stable policy and funding environment that supports capital investment on your behalf through our positions on the Aged Care Sector Committee and the National Aged Care Alliance (NACA) and regular Departmental and Ministerial meetings. ■

• Abolish the national 40% concessional rate and adopt the regional concessional rate as the trigger to qualify for the maximum accommodation supplement.

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NATIONAL UPDATE

MEET OUR NEW STATE MANAGERS LASA has recently appointed five new State Managers who will look after our Membership across the country. These Managers bring a wealth of experience and expertise to LASA and they have already hit the ground running, meeting with Members and learning about their services, listening to their issues and concerns and their ideas for building a better age services sector.

Queensland State Manager Kerri Lanchester Queensland State Manager Kerri Lanchester is well known in the aged care industry in Queensland, having operated at senior levels in aged care for the past 20 years, including with LASA Queensland. Her experience covers the broad spectrum of age services, including aged care, community care and retirement living. Phone: 07 3725 5555, Email: kerri.lanchester@qld.lasa.asn.au

New South Wales State Manager Brendan Moore New South Wales State Manager Brendan Moore has extensive experience in strategic planning, policy, communications, business development and program management, spending the past decade in senior management roles within community services, most recently as the General Manager – Policy, Research and Information at Alzheimer’s Australia NSW. Phone: 02 9212 6922, Email: brendan.moore@nswact.lasa.asn.au

Victoria and Tasmania State Manager Veronica Jamison

and has held senior executive roles in both rural Victoria and metropolitan Melbourne health services in public healthcare and not-for-profit organisations. Phone: 03 9805 9416, Email: veronicaj@lasavictoria.asn.au

Western Australia State Manager Christine Allen Western Australia State Manager Christine Allen brings to LASA over 10 years’ experience in the not-for-profit sector working with the Perth Convention Bureau, most recently as its Managing Director responsible for marketing Western Australia, nationally and internationally, as a business meeting, conference and convention destination. Phone: 08 9474 9200 , Email: christinea@wa.lasa.asn.au

South Australia and Northern Territory State Manager Rosetta Rosa South Australia and Northern Territory State Manager Rosetta Rosa comes to LASA from a leadership management position at Southern Cross Care in Adelaide, most recently to lead the Quality and Consumer Engagement portfolio across three key service areas covering; Residential, Home and Community and Retirement and Independent Living services. Rosa takes up her new role in mid-December 2016. ■

Victoria and Tasmania State Manager Veronica Jamison has extensive senior executive experience in public health, aged care, community and primary health care. Veronica has been involved in the health sector for over 30 years

NATIONAL UPDATE

THE VALUE OF

A PERSON’S ASSETS The recent release of the Subsidy Principles 2016 has sparked debate regarding the ‘loan’ of a lump sum accommodation payment to a care recipient by a third party resulting in a means tested care fee being payable by the care recipient.

rior to 1 July 2014, there were separate tests for a person’s income and assets. Where a person was assessed by the Department of Human Services as eligible to pay towards the cost of their care, they paid an income tested fee. Accommodation Bonds were only charged in low level services or services with extra service status for eligible persons towards the cost of their accommodation. The rules for charging of an accommodation bond were dealt under Section 57 of the Aged Care Act 1997. The rules for determining the value of a person’s assets were set out in Section 44-10 of the Act. Under Section 44-10 of the Aged Care Act 1997 (Act No 31), the value of an accommodation bond was excluded in the value of a person’s assets before the 1 July 2014 financing changes. The accommodation bond exclusion for the purposes of calculating a person’s assets aligned with the Social Securities Act 1991. Part 3.12, Division 1, subsection 1118 of the Social Securities Act 1991, provides a list of assets that are to be disregarded in calculating the value of a person’s assets. Item (u) in this subsection states, as a disregarded asset, “the amount of accommodation bond balance in respect of an accommodation bond paid by that person”. The financing changes made as a part of the 2012 reform introduced a combined income and assets test. The intention of the combined assets and income test for those residents entering permanent residential aged care was to “address the issue of asset-rich, income-poor residents paying for all of their accommodation and nothing for care; and income-rich, assetpoor residents paying for their care but not for accommodation. These provisions assume that where a person is responsible for their own accommodation needs in the community they continue to accept this responsibility where possible in

Loula Koutrodimos Manager Age Services Manager Business Services

residential care.” Source: the Aged Care Living Longer Living Better Bill 2013, Explanatory Memorandum. Amendments which commenced on 1 July 2014 repealed how the value of a person’s assets were calculated (Section 44-10). Section 44-26A was introduced and item 5 of this section states, “If a person has paid a refundable deposit, the value of the person’s assets is taken to include the amount of the refundable deposit balance”. As the income and assets tests were combined into a single assessment, a greater number of people became eligible to pay the new means tested fee. A debate which has arisen with the release of the Subsidy Principles 2016 is in respect to whether a lump sum payment which is loaned to a care recipient by a third party should count as an asset of the care recipient. If the loaned amount is counted as an asset (as per Section 44-26(A) -5) then the care recipient is eligible to pay a means tested care fee. Subsection 1121 the Social Security Act 1991 refers to ‘encumbrances’. Only the relevant sections have been included.

1121 Effect of charge or encumbrance on value of assets (1) If there is a charge or encumbrance over a particular asset of the person, the value of the asset, for the purposes of calculating the value of the person’s assets for the purposes of this Act (other than Division 1B of Part 3.10), is to be reduced by the value of that charge or encumbrance. (3) S ubsection (1) does not apply to a charge or encumbrance over assets that are to be disregarded under section 1118. To read the full version of the Social Security Act 1991 in relation to this subsection, you can find it at: http://www.austlii. edu.au/au/legis/cth/consol_act/ssa1991186/s11.html.

NATIONAL UPDATE

Section 11 of the Social Security Act 1991 sets out assets test definitions. The definitions of refundable deposit and refundable deposit balance have the same meaning as in the Aged Care Act 1997. A refundable deposit is, under the Aged Care Act 1997, a collective term for refundable accommodation deposits and refundable accommodation contributions. Section 11 of the Social Security Act 1991 provides definitions of assets. To view the definitions see http://www.austlii.edu.au/ au/legis/cth/consol_act/ssa1991186/s11.html. The pertinent detail here for approved providers is the explanation which states: Explanations (3AA) T o avoid doubt, a refundable deposit balance in respect of a refundable deposit paid by a person is taken to be an asset of the person. (3B) To avoid doubt, an accommodation bond balance in respect of an accommodation bond paid by a person is taken to be an asset of the person.

The non relevant sections from the above definitions have been removed for succinctness. The full Act can viewed at http://www.austlii.edu.au/au/legis/cth/consol_act/ssa1991186/ s11.html To align both the Aged Care Act 1997 and the Social Security Act 1991, subsection 11(3AA) of the Social Security Act 1991 provides that a refundable deposit balance in respect of a refundable deposit paid by a person is taken to be an asset of the person for the purposes of the Social Security Act 1991. As the Social Security Act 1991 has been aligned with the Aged Care Act 1997, it would appear that a lump sum paid by the care recipient, whether or not loaned, is considered an asset of the care recipient. The effect of this to the care recipient is that when a lump sum is included as an asset for the purposes of the combined income and assets test, the care recipient will most likely pay a means tested care fee. ■

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NATIONAL UPDATE

AGED CARE INDEXATION Loula Koutrodimos Manager Age Services I Manager Business Services

Significant changes to the Age Pension are to commence on 1 January 2017, notably to the assets test used to determine eligibility for the pension, and the amount of pension a person receives. These changes will have consequences for providers of age services.

ge care providers will need to familiarise themselves with how these changes affect their services, particularly across a number of supplements, the means tested and income tested care fees, and standard resident contribution (basic daily fee). Other changes of note are those proposed to the current indexation formula and an indexation freeze which is due to commence on 1 July 2017.

Aged Care Indexation and the Age Pension Eligibility rules for the Age Pension Individuals applying for the pension must satisfy the Age Pension income test and the Age Pension assets test in order to qualify for a full or part pension. The amount of Age Pension received is based on the test (income or assets) that delivers the lowest amount of Age Pension entitlement. An individual who fails either the income or the assets test is ineligible to receive the Age Pension. Age Pension Assets Test Lower threshold The lower threshold of the Age Pension assets test (the asset free threshold) entitles an individual to a full pension. This lower threshold is indexed by CPI on 1 July annually. Upper threshold The upper threshold of the Age Pension assets test however, is indexed three times per year in March, July and September. The reason for the tri-annual indexation is due to the fact that the Age Pension is indexed six monthly in March and September. The upper threshold is the limit that determines an individual’s eligibility to a part pension.

Age Pension Income Test Lower threshold The lower threshold of the Age Pension income test is the limit that entitles an individual to a full Age Pension. The lower threshold is indexed by CPI on 1 July annually. Upper threshold The upper threshold of the of the income test is indexed three times per year in March, July and September. The reason for the tri-annual indexation is due to the fact that the Age Pension is indexed six monthly in March and September. The upper threshold is the limit that determines an individual’s eligibility to a part pension Care recipients who enter permanent residential aged care have the option to complete a combined income and assets assessment. The combined income and assets assessment is then used to determine whether the care recipient is eligible to pay either a means tested care fee (MTF) or an accommodation contribution. Both the MTF and the accommodation contribution are reviewed quarterly – January, March, July and September in line with the threshold adjustments. Pension payments The rate of Age Pension payment is adjusted twice a year in March and September. The current indexation formula for adjusting the pension amount is based on the highest Consumer Price Index (CPI), Male Average Weekly Total Earnings (MWATE) and Pensioner and Beneficiary Living Cost Index increases (PBLCI). The PBLCI is designed to index base pension rates when the living cost index is higher than CPI. Care recipients who are full or part pensioners have their basic daily fee adjusted twice annually in March and September in line with the pension change adjustments.

NATIONAL UPDATE

Current pension indexation method The current indexation method is by determining the greater of the movement in the CPI or the PBLCI. The CPI and PBLCI are then compared against a percentage of the MTAWE.

Proposed indexation methods to commence 1 January 2017 The proposed indexation method to commence on 1 January 2017 removes the MTAWE and PBCLI measures. This only leaves CPI indexation. The result of this change curbs the rate of pension growth.

Impacts of the proposed 1 January changes The impact resulting from the 1 January 2017 changes means that pensioners receive a lower payment over time due to the lower growth rate in payment. The lower payments also impact the pension means tests. Fewer people will qualify for a payment under the income and assets tests over time. The proposed changes to indexation will result in an end to real increases in pension rates, but will maintain the real value of the payments over time.

Proposed changes 1 July 2017

of a certain value are earning a set rate of income, regardless of the amount of income actually earned. The main types of financial investments to which deeming rules apply are: bank, building society and credit union accounts and term deposits; managed investments, loans and debentures; and listed shares and securities. The thresholds at which the higher deeming rate begins to apply are indexed in line with the CPI in July each year while the deemed income rate is determined by the Minister for Social Services. The proposed measures will reduce the amount of assets to which the lower deeming rate applies to 1996 levels – $30,000 for single persons and $50,000 for couples. The effect of the proposed measures will increase the amount of income included in the income test for pensions and mean more people will receive a part-rate pension and some will lose eligibility for a pension altogether.

Aged Care Recipients The Aged Care Act 1997 provides that the Minister may, by legislative instrument (a determination), index the amount of payments in line with the changes to the consumer price index (CPI), in addition to increasing the value of caps and thresholds in line with the Age Pension. Age Care Determinations issued by the Minister provide for indexation of amounts in relation to the following: • the respite supplement

Annual CPI indexation on income and assets thresholds is proposed to be frozen for three years commencing 1 July 2017. These thresholds include:

• the caps which limit the amount of means tested and income tested care fees payable by care recipients

• Income free areas – the amount of income a person can earn before their payment begins to be reduced;

• the asset thresholds at which different taper rates apply in the asset test

• Assets test limits – the maximum value of assets a person can have before losing qualification for a payment;

• the accommodation supplement, and

• Payment limits or cap – the maximum amount a person is entitled to claim. Effectively, the freeze on the above thresholds means that there will be lower rates of payments to people whose earnings or assets increase beyond the qualifying criteria as well as from less people being eligible for the various affected payments.

Reducing the deemed income thresholds for the pension assets test Deeming is used to assess income from financial investments. Deeming assumes that financial investments

• the cap on the value of the former principal residence

• the income thresholds at which the different caps on the income tested care fees in home care apply. Additionally, the Aged Care Act 1997 at Division 52C-4 sets out the standard resident contribution (basic daily fee) as: (a) the amount determined by the Minister by legislative instrument, or (b) if not amount is determined under paragraph (a) for the care recipient – the amount obtained by rounding down to the nearest cent the amount equal to 85% of the basic Age Pension amount (worked out on a per day basis). The basic daily fee (BDF) is indexed twice a year – March and September – in line with the pension indexation. ■

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OUT AND ABOUT

OUT AND ABOUT IN NSW AND ACT Since joining LASA in late October, new State Manager Brendan Moore has been meeting LASA stakeholders from a broad cross section of industries and fields. Brendan has also been busy getting out and about across NSW and ACT meeting LASA Members, learning about their business and understanding how LASA can continue serving Members well.

o far, Brendan has met with Members in Canberra, Southern Highlands and across Sydney with further visits planned before the end of the year to Members in the Blue Mountains and the wider Sydney basin. There are a lot of Members in NSW and ACT to visit. However, Brendan says “he hopes to have met all the Members by the end of NSW Conference” in May 2017.

Brendan Moore, NSW State Manager, with Matt Fisher, Director of Greengate.

In addition to Members, Brendan has represented LASA at the NSW State Office of the Department of Health Aged Care Liaison Group meeting. Key issues of concern for LASA members that Brendan raised include: the ACFI cuts, ongoing issues with MyAgedCare and client assessment and flow through, the payment system, and the upcoming changes to Home Care Packages in February 2017. Affiliates are also key partners for LASA and its Members. In the first couple of weeks in the role of State Manager, Brendan has met with AON, Marsh & McLennan Companies and TressCox Lawyers. “LASA really values its Affiliates and the mutual benefit that they, our Members and we get from our ongoing relationships. Keeping our existing Affiliates and bringing on new corporate support is vitally important in helping LASA better meet the needs of our Members,” Brendan said. Other key stakeholders Brendan has met with include: HealthDirect Australia (operators of MyAgedCare), Aged Care Channel, Arts Health Institute, the NSW Planning Department regarding residential aged care and retirement village development approvals and consents, Home Modifications Australia and the Insight Partnership consultants. Brendan also met with the Macquarie University Centre for Health Economics for a briefing on the Adult Social Care Outcomes Tool that a LASA Member, The Whiddon Group, has been at the forefront of developing and implementing in Australia. Brendan had the pleasure of attending the Alzheimer’s Australia NSW regular event at NSW Parliament House where they launched a body of research on dementia and driving.

“I used to organise and MC these events so it was nice to sit in the back row and enjoy the fine morning tea and talk to a few NSW MPs about LASA and what we do,” Brendan said. “Driving is a really emotive issue and stopping driving due to dementia is a very fraught issue with people felling like they have lost a limb, experience social isolation, or even have suicidal ideation. “It is also a difficult public policy area where the greater public safety has to be considered. For any Members who may have clients and carers who are worried about this transition, an excellent resource was produced by the NRMA and Alzheimer’s Australia NSW,” Brendan said. This useful resource can be found at: https://nsw. fightdementia.org.au/files/NSW-Staying-on-the-move-withdementia-booklet.pdf Brendan will continue to engage with LASA members throughout NSW & ACT – to enquire about a Member visit please email reception@nswact.lasa.asn.au. ■

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OUT AND ABOUT

QLD’S REGIONAL FORUMS… PART OF OUR COMMITMENT TO DELIVERING ON THE PROMISE

Successful member engagement requires ongoing opportunities for members to engage. For our Brisbane office, a key mechanism to do this is through our quarterly regional forums.

ur Brisbane Member Advisers have recently hit the highways to hear from our Queensland Members to ensure local and regional issues are discussed and relationships are strengthened – all in an effort to fulfil our commitment to stronger advocacy. In the last four weeks, I have had the pleasure of supporting our Member Advisers, Steve Powell, Chris Edith and Vicky Boyd as they have attended ten regional forums – covering 10600kms of our glorious and diverse State of Queensland. Regional forums allow opportunities for active engagement which assists us in our advocacy and influence role. Members interact and share their concerns, pervasive challenges, successes and thoughts with their regional colleagues and LASA team members. Balancing the differing needs between residential, home care and retirement living/seniors housing providers, the key is ensuring that content is relevant so that these forums value add to the participant’s day. Members share their knowledge and daily experience, and our Queensland Member Advisers provide members with insight and commentary on key issues. In this round of forum, we had robust conversations about the ACFI cuts, updates on the Queensland based research project that is modelling the impact of the July ’16 and January ’17 changes on the residential sector. We also talked about workforce planning for staff recruitment and retention, including seasonal workers in rural and remote areas. There was discussion about the Living Longer Living Better Review, the impact of the My Aged Care online referrals and the Home Care Package claiming debacle

(with one member reporting they are still owed over $1.2 million in home care subsidies). Members also talked about the emerging Jane Davies, Regional Manager Home Care difficulties they Services, KinCare; Chris Edith, Member are encountering Services, LASA; Cathy McCann Services with clauses Manager, Liberty Community Connect and in brokerage Lyn Pascoe and Melissa Flaherty from Liberty agreements that are intended to restrict trade but seem in principle to be in conflict with the intent of the Increasing Choice in Home Care measure. The Queensland Regional Forums not only value add for the Queensland members, but just as importantly, to the Brisbane office staff. Each quarter we are invited into a new community within the region and are afforded the opportunity to be a guest in a Member’s residential facility, housing complex or office along with their regional colleagues. It is through such experiences that we continue to strengthen our relationships with our Members and learn about their unique needs. We would like to thank our Members for their hospitality this past year and their ongoing belief in the role of LASA and the value of the quarterly regional forums. We look forward to working with you all 2017. ■

OUT AND ABOUT

OUT AND ABOUT WITH VICTORIAN MEMBERS LASA’s Victorian State Manager has been traversing the state since she took up her new role meeting members and hearing first-hand about their successes and concerns.

ew State Manager Veronica Jamison recently had the privilege of meeting several Victorian members faceto-face.

“Our Members should be very proud of the care they are providing, sometimes with very limited resources,” Ms Jamison said.

Multicultural Aged Care Services, Geelong; Nagambie Healthcare; SAI Home Care Frankston; Serene Brook; South West Health; Sunnyside; Violet Town Bush Nursing Centre. A highlight was visiting Elmhurst Bush Nursing Centre who are celebrating their 100th anniversary this year.

“The one common theme across the industry in Victoria is people being collaborative and sharing information as they strive for excellence in the delivery of care and services.

“Bush Nursing Centres have a long and proud history in Victoria. They were originally set up in rural communities that could raise enough money to employ a nurse,” Ms Jamison said.

“I was just so impressed with the innovative ways providers are responding to the changing needs of people in aged care.”

“They provide important services to rural Victorians close to home, contributing strongly to older people’s sense of security and belonging in their own community.”

Ms Jamison has so far visited East Wimmera Health Service; Echuca Villages; Euroa Health Inc.; Elm Living; Elmhurst Bush Nursing Centre; Jewish Care; Lorne Hospital; Lyndoch Living; Macedon Ranges Health; Maryville Nursing Home;

Ms Jamison will continue to engage with LASA members throughout Victoria – to enquire about a member visit please email veronicaj@lasavictoria.asn.au ■

Charlton Medical’s Jenny Watts and Dr Stephen Webb with East Wimmera Health Service CEO Kathy Huett.

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OUT AND ABOUT

OUT AND ABOUT IN WA Western Australian age services providers and Affiliates were given a taste of the recent National Congress with a selection of speakers and presentations delivered at the National Congress Roadshow in Perth on 17 November.

he day’s event covered a range of topics, attracting residential, home care and retirement living providers.

the industry’s perspective to allow the industry to meet the demands of our ageing population.

LASA CEO Sean Rooney attended to give delegates a national update where he outlined recent discussions with Parliamentarians on the proposed cuts to the Aged Care Funding Instrument.

He highlighted his concerns for vulnerable groups such as the homeless, Indigenous and LGBTI communities and said he was committed to ensuring there was appropriate and sufficient levels of care available as they age.

He told the audience “we are only as strong as our Membership” and encouraged Members to actively contribute to the ongoing discussion and policy direction by joining the new LASA WA Member Advisory Group.

Minister Wyatt said that he was enjoying partnering with LASA as the Government and the sector gear up for significant changes.

Members were also encouraged to participate throughout the sessions and many voiced their concerns over ACFI and other complex aged care issues. Federal Minister, Ken Wyatt AM MP, provided the closing address for the day which was warmly received. He discussed a range of issues with the audience, including changes to the Aged Care Funding Instrument, workforce issues, Aged Care Reform and the Aged Care Roadmap. Minister Wyatt told the audience that he plans to meet and engage with a variety of providers early next year to discuss the Aged Care Roadmap and more fully understand

He also discussed the need for ACFI to be overhauled to more accurately reflect the significant differences of rural and remote residential care providers in comparison to metropolitan and regional providers. Western Australia’s newly appointed State Manager, Christine Allen, hit the ground running hosting the Roadshow and meeting Members and Affiliates as well as other age services providers. Christine told the audience she was delighted to be joining the aged care industry and hoped to bring a collaborative approach and a fresh perspective to some of the complex challenges facing the sector. ■

Christine Allen, LASA State Manager WA, The Hon. Ken Wyatt MP, Assistant Minister for Health and Aged Care, Sean Rooney, CEO LASA.

YOUR MEMBERSHIP

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YOUR MEMBERSHIP

OUR LASA MEMBERSHIP OFFER LASA’s promise to Members was that through unification we would better service your needs as a national peak body, providing stronger advocacy in a time of unprecedented change, access to support and services to all Members without any jurisdictional borders, and enhanced value for money in the way we provide our advocacy, support and services.

n 1 July 2016, LASA unified its operations to become a single membership based peak body, LASA Ltd.

We have been designing and refining the Delivering on our promise to Members and we are now proposing a suite of services and support which we believe align with the needs and expectations you have told us you want.

Our value proposition A LASA membership enables you to: • Make informed decisions – We provide Members with insight and intelligence into the key issues for the age services industry, and help you understand and interpret what this means for you • Respond to change – Our Members access LASA expertise, advice, services and events that support you, your staff and your business to navigate change and ensure sustainability

• Improved access for Members to valuable information, services and support. • Better value for money by meeting the needs of Members more efficiently and effectively.

Our Strategic Objectives Our vision Our vision is to create a high performing, respected, sustainable aged services industry delivering affordable, accessible, quality care and services for older Australians. Our purpose We represent our Members by advocating their views on issues of importance and we support our Members by providing information, services and events that improve their performance and sustainability.

• Have your say – We engage our Members on issues of importance and give voice to your views in order to lead our industry and influence decisions that affect you

LASA Member and Support Services

• Realise value for money – We deliver services to our Members efficiently and effectively, and provide access to further discounts for services and events ensuring you get great value for money from your membership.

Advocacy and influence – As the age services industry’s peak body, advocacy and influencing is core to LASA’s service offering. Our advocacy activities influence policies, programs and practices that impact Members and the wider industry. Through active engagement we provide a platform for LASA Members to bring their views to Government and stakeholders on issues of importance. We engage our Members through a range of LASA Committees, through Member regional forums and our new state-based Member Advisory committees.

A unified peak body LASA believes in the value of a strong national organisation representing and supporting our Members across residential care, community care and retirement living. While separate state bodies are our history, our future is a nationally strong and locally relevant organisation that is better equipped to meet the needs of our Members. A nationally unified, locally relevant and high performing peak body dedicated to delivering value to our Members has three key benefits: • A stronger and more influential voice on issues of importance for Members

The following services are all part of LASA membership:

Industry news and information – Through LASA’s news and updates services, Members are provided timely, relevant and accurate industry information. LASA’s team of experts are able to interpret information to ensure that Members are across the latest industry news and changes that directly affect them. Advisory and support – LASA provides expert advisory services to all Members. Through your membership you will have access to LASA’s industry expert over the phone or online to assist you in addressing compliance, policy, legal, HR and

YOUR MEMBERSHIP

business management issues. LASA also leverages our Affiliate expertise to ensure Members receive further, high quality technical advice, support and services.

relations, human resources, and financial management. Our team of experts will help ensure your organisation is high performing and sustainable.

Exclusive access – The products and services included in Exclusive Access provide extra value to LASA’s Members. Exclusive access includes Member-only purchasing discounts on third-party provided products and services, discounts on LASA services and events, and access to our online services directory connecting the needs of LASA Member to the products and services of LASA Affiliates.

Conferences and events – Our conferences and events provide you with access to industry information, networking opportunities and trade exposure. Our Members have exclusive access to event discounts and early bird prices. Events include National Conferences, State Conferences, forums, seminars and webinars.

Members will also be able to access additional LASA service offerings at discounted rates in 2017-18, these will include:

Workplace support – Our workplace support services provide your organisation with resources, advice and support to help you deliver effective and quality services to older Australians. Included in these services are workplace resources and manuals, mentoring and secondment opportunities.

Workforce training and development – Through our workforce training and development services we ensure your staff have the skills and accreditation required to deliver effective and quality care to older Australians. Included in this service is accredited and non-accredited training, professional development, learning and workshops delivered by industry experts.

Business services – To ensure your organisation operates efficiently we provide a range of business administration services so you can focus on what you do best – meeting the needs of your clients and residents. The business services we can help you with include payroll processing, client billing and employee relations.

Industry consultancy services – We provide consultancy services in a range of specialist areas such as business administration, clinical, accreditation, compliance, employee

If you are interested in renewing your LASA Membership, or becoming a new LASA Member, please contact our Membership team. ■

Additional LASA Service Offerings

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CAPITAL DEVELOPMENT FEASIBILITY

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EMPLOYMENT RELATIONS

MODERN AWARD REVIEW PROCESS

WHERE ARE WE UP TO? LASA is currently engaging in the modern award review proceedings for employers in the aged care industry.

ur engagement includes direct participation in award review proceedings, conferences, lodging variation submissions and opposing applications that will create new, additional and unnecessary costs or administrative workload for employers. Below is a brief summary of the applications we are current participating in, and keeping a keen watch on. If a Member is interested in knowing more about the modern award proceedings or have a concern with regards to specific proceedings that you would like LASA to engage in, please contact the LASA Employment Relations team at employmentrelations@nswact.lasa.asn.au.

Emma Patton National Manager I Employment Relations

Award Flexibility Time off instead of payment for overtime (or commonly called time off in lieu (TOIL)) provisions have been inserted into a number of modern awards (including the Aged Care Award 2010 and the Health Professionals and Support Services Award 2010), with a model TOIL likely to be included in most modern awards by the end of these proceedings. The new term creates an obligation on the employer and employee to create a separate agreement for each pay period in which overtime worked is subject to time off instead of pay. The SCHCDS Award remains part of ongoing proceedings with this matter listed for hearing on 5 December 2016.

Members are reminded these proceedings will impact the way you do business. This impact is irrespective of whether you operate under a modern award or an enterprise agreement. We encourage you to keep in contact with the LASA Employment Relations team to ensure compliance with any changes introduced as a result of these proceedings.

Members are advised to review their procedures when managing TOIL to ensure compliance with the new award terms.

Casual and Part time Employment

The new terms include the ability for an employee to request to cash out annual leave, the right for an employer to request an employee take an excessive annual leave balance or an employee to request to take leave due to an excessive leave balance, an option for the employer to pay annual leave as per the usual pay cycle and the option for an employer and employee to agree to an employee taking annual leave in advance.

The Australian Council of Trade Unions (ACTU) lodged an application to vary all modern awards to include terms that allow a casual employee to request conversion to permanent employment after a period of six months; minimum engagement of employment for part time and casual employees of four hours; for service of a casual prior to conversion to be counted as part of the employeeâ&#x20AC;&#x2122;s continuous service (in line with a recent decision of the FWC) and a prohibition of the engagement of additional part time or casual employees before the hours are offered to existing employees. In addition to these proceedings, specific applications were submitted by interested parties to amend the Social, Community, Home Care and Disability Services Industry State Award 2010 (SCHCDS Award) with regards to part time employment and rosters. Final submissions in relation to these proceedings in the SCHCDS Award were due by 30 September 2016, with a hearing set for Monday 28 November 2016.

Annual Leave New annual leave entitlements have been inserted in all modern awards.

Members are advised to review their procedures with regards to annual leave entitlements to ensure compliance with the new award terms.

Payment of Wages on Termination The FWC sought submissions from interested parties on their proposal to insert a new model term in all modern awards with regards to the payment of wages on termination. Specifically, the model term requires an employer to pay all amounts that are due on termination within seven days after the employeeâ&#x20AC;&#x2122;s last day of employment; or on the next normal pay day.

LASA does not oppose the insertion of the model term as proposed by the FWC. A hearing for this matter was held on 21 October 2016 and we await the decision of the FWC.

Family Friendly Measures – Parental Leave Clause The ACTU has sought to amend all modern awards to include a new Parental Leave clause allowing an employee returning from parental leave a right to return to part time work or on reduced hours. Included in the ACTU draft determination for all modern awards is the right for an employee who has changed their work arrangements in accordance with the new clause, to revert to the position and/or working arrangements they held prior to taking parental leave, up to two years from the date of birth or placement of the child. The proposed new clause also includes a new entitlement to 15.2 hours of paid leave for the purpose of attending appointments such as antenatal, fertility treatment, and pre-adoption appointments. This matter is listed for hearing in the second half of 2017.

Family and Domestic Violence The ACTU has sought to amend all modern awards and include a new term providing all employees (including casuals) the right to access ten days paid leave to assist them manage matters relating family and domestic violence. This claim has created significant discussion across employers and unions, with employer parties submitting that this issue is a social issue that Government should respond to through appropriate policies and not an issue for employers and workplaces to respond to through new terms in modern awards. This matter is listed for hearing from 14 November with closing submissions to be heard on 1 – 2 December 2016.

Individual Award Proceedings (relevant to the aged care industry) Revised Exposure Drafts where published for both the Health Professionals and Support Services Award 2010 and Nurses Award 2010 (Group 2 awards) on 31 October 2016 with a Mention and Directions hearing held on Wednesday 23 November 2016. Parties to the Group 4 awards, the Aged Care Award 2010 Social, Community and Home Care and Disability Services Award 2010 are currently engaged in conferences in an attempt to minimise and narrow the scope of claims that may go to a hearing before the Full Bench.

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Both awards were listed for Mention on 21 November 2016 with Directions agreed between the parties. Parties expect applications for the above awards to be listed for hearing in the second half of 2017. LASA will continue to participate in these award proceedings and liaise with Members regarding our applications and responses to proposed variations.

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Members are strongly encouraged to get in contact with the LASA Employment Relations team should you have any questions about the modern award review proceedings, our engagement in these proceedings or would like to provide feedback and opinion on proceedings currently underway. ■

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EMPLOYMENT RELATIONS

ENTERPRISE BARGAINING –

WHAT TO CONSIDER BEFORE YOU START Emma Patton National Manager I Employment Relations

The LASA Employment Relations team recommends, when Members are exploring whether to engage in enterprise bargaining, to consider a number of issues – this articles identifies a few.

he type of question a Member may ask include seeking advice about an upcoming bargain, an agreement already in place or from a Member under the modern award system who is considering moving to an enterprise agreement or has been asked by a union to commence bargaining.

• once an agreement is in place it is very difficult to terminate should an employer at some stage over time prefer to operate under the modern award system,

As staff costs represent approximately 85% of the total costs of aged care, the outcome of a bargain can be too costly not to get it right. With this, and where a Member is considering developing and implementing an agreement, our question to our Member is simple, yet rarely answered with confidence – “why”?

• rarely do agreements go backwards with regards to entitlements and wages,

• Why do you want an agreement? • Why do you need an agreement? • What do you hope to achieve by introducing an agreement? Generally, a Member will answer the “why” question with either or both of these reasons; they need an agreement because they feel restricted by the terms and conditions of the modern award they are operating under, or other aged care providers have an agreement in place and they want to remain competitive. The reasoning behind those responses are a fair reply to the question, an agreement can assist with attraction and retention of staff and assist an employer keep pace with other employers in the industry. Also, an agreement can enable an employer to change elements of a modern award that do not fit the way they do, or want to do, business with their clients and employees. However, there are a number of other factors that should part of an assessment when deciding whether to develop and introduce an agreement. Specifically, an employer should be aware that: • bargaining involves ‘good faith bargaining’ and engaging with union parties and/or possible other persons and employees who choose to be represented during a bargain throughout the negotiation,

• an agreement is likely to require continued renegotiations each time it expires and union parties agitate on behalf of their members for renewal of the agreement,

• in order to modify and remove award terms and conditions they must be bought out in an agreement, every employee must be better off overall by the agreement, which means an employer must be willing to offer more than what an employee currently receives under a modern award, and finally but not lastly, • commencing a bargaining period opens an employer to the ability for a union to engage in protected industrial action. Enterprise bargaining also offers a range of opportunities for an employer. An agreement can: • allow an employer to amend/modify/remove terms and conditions otherwise applicable under a modern award, • to develop and include classification and position description titles as developed by the business, • create career paths and recognition of positions otherwise not included in a modern award, • create positive engagement opportunities with staff and evidence commitment to staff representation and consultative committees by including such clauses in an agreement, • enable an employer to develop language in an agreement that identifies with that employer’s mission, values, and objectives, • offer security, by fixing the wages and terms and conditions in an agreement, an employer is less impacted by modern award review proceedings, national wage case outcomes and other proceedings that may influence terms and conditions for award system employers, and finally, but not lastly,

EMPLOYMENT RELATIONS

• assist an employer develop terms and conditions that their workforce seek, improving attraction and retention of current and potential staff. Members are reminded that the above points are detailed for consideration and not a position to, or not to, bargain. Each employer should, prior to bargaining (whether that be for the first time, or a renewal process) ponder their ‘why’ and consider what they want to achieve in their bargain.

We recommend you set your bargaining objectives, consider your bargaining framework and go into a bargain prepared. We also remind Members that while LASA engages in bargaining, and interprets agreements for members, we also offer a range of bargaining and preparation assistance, including reviewing and comparing agreements and wages tables, researching clause wordings and innovative inclusions in approved agreements in and outside the aged care industry and highlighting options available to Members depending on their current bargaining status/progress. ■

LASA Office Hours over Christmas and New Year Period All LASA Offices will close from 2.00pm on Friday 23 December 2016 and re-open at 9.00am on Tuesday 3 January 2017. We wish all Members a Merry Christmas and look forward to working with you in 2017.

CONGRESS

CONGRESS 2016 IMAGINING AGE SERVICES NO BORDERS, NO BOUNDARIES

LASA’s 2016 National Congress theme Imagining age services: no borders, no boundaries looked at innovative ways of building a more sustainable aged care industry to meet the everincreasing demand for care and services.

ver three days, an audience of 1156 attendees heard from thought and practice leaders about how aged care providers are innovating and adapting to the reforms occurring right across the industry.

For the first time in Congress history, LASA hosted a facilitated discussion between Federal Aged Care Minister Sussan Ley, Shadow Assistant Minister for Ageing Senator Helen Polley, and Australian Greens Senator Rachel Siewert. This debate came at a critical time for age services, as the Federal Government enters into a legislated Review of the Living Longer, Living Better reforms and prepares for the implementation of home care reforms in February 2017.

Congress was also very fortunate to hear directly from David Tune AO PSM, who is leading the Living Longer, Living Better Review. The Congress program of over 80 speakers gave a real insight into the ways in which providers are pushing boundaries to deliver innovation in aged care, including: • RedUSe – more than 150 Australian residential care facilities have reported a significant reduction in the use of antipsychotics and benzodiazepines as a result of this University of Tasmania quality improvement project. • Homes that Fit – an intergenerational housing project in Finland giving young people affordable housing in a Helsinki seniors home, in return for spending time with their elderly neighbours. • MySupportBroker – a disruptive UK model that is using peer review and technology to put customers in control of their care. • Nightingale Hammerson – where 80 per cent of residents have dementia (including 30 per cent in the advanced stages), this UK service has revolutionised its workforce to become a centre of global excellence in dementia care • Orange Sky Laundry – a free mobile service for homeless people has washed more than 265,000kg of laundry since 2014 and now has 620 volunteers. The sheer depth and breadth of this year’s Congress presentations was a reminder that ageing is not just an issue for seniors, aged care providers and government – it is an issue of national importance for all Australians. Following the success of this year’s event, National Congress will return to the Gold Coast Convention and Exhibition Centre from 15-18 October 2017, with an expanded offering for a growing aged care industry. The LASA National Congress 2017 call for abstracts will open on 1 February and close on 5 April 2017, with further details to come at www.lasacongress.asn.au. ■

David Tune AO PSM (Chair of the Aged Care Sector Committee) and Dr Margot McCarthy (Deputy Secretary, Ageing & Aged Care Group, Department of Health) with MC Tracey Spicer.

CONGRESS

2016

Imagining Age Services

SAVE THE DATE Queensland state conference 29-31 March 2017 NSW state conference 25-26 May 2017 National Congress 15-18 October 2017 47

LASA National Congress

2017

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HEALTH AND WELLBEING

NEW DIABETES MANAGEMENT RESOURCES FOR AGED CARE FACILITIES

One third of Australian aged care residents are likely to have diabetes. These residents may have lived with the condition for many years, they may have complications and comorbidities. Care is often complex and needs change over time.

he National Diabetes Services Scheme (NDSS) Older People with Diabetes Program has developed a suite of resources to assist residential aged care provider staff support their residents who have diabetes.

The Diabetes management in aged care: a practical handbook (second edition) is an updated version of the original resource developed in 2012. The updated version contains ‘Fast facts’ on all topics that are aimed at care staff and then ‘More details’ sections with more information for Registered Nurses, Enrolled Nurses and care staff wanting more knowledge. The handbook covers the basics of diabetes, blood glucose monitoring, hypoglycaemia, hyperglycaemia, sick day management, medications, complications and daily care of people who live with diabetes. The handbook can be used to help address gaps identified in the Audit checklist.

Thomas, NDSS Priority Leader, Older People with Diabetes at cthomas@diabetestas.org.au All people with any type of diabetes continue to be eligible to register with the NDSS and by doing so they can have access to support services and products. For information about registration or recent changes to the NDSS contact the NDSS Infoline 1300 136 588. ■

The Diabetes management in aged care: fast facts for care workers is a booklet of quick reference sheets that aim to give care staff basic information on aspects of diabetes and diabetes management. They are very visual and easy to understand and cover all the topics included in the handbook. This booklet is a great resource for care staff in the community as well as those working in aged care. A series of three fast fact posters have also been developed from the fast facts booklet. They are signs and symptoms of diabetes, hypoglycaemia and hyperglycaemia. The posters can be used in residential aged care facilities to raise awareness of diabetes within the facilities. The resources are online at ndss.com.au/healthprofessionals-resources and hard copies can be ordered by calling the NDSS Infoline 1300 136 588. For more information about the NDSS Older People with Diabetes Program contact Caroline

HEALTH AND WELLBEING

ADVANCED CARE PLANNING The death most people want bears little resemblance to the way their life actually ends – 70 per cent of Australians say they would prefer to die at home but in reality 86 per cent die in hospital or residential aged care.

he Grattan Institute report Dying Well suggests that Australians avoid discussing death and end-of-life care. The report recommends the adoption of a pathway of systematic triggers that will prompt people to discuss end-of-life care. For example, aged care staff discussing advance care planning at entry points to residential care and doctors being required to raise the issue at health checks for people aged over 75. The Grattan Institute’s Professor Hal Swerissen says very few Australians decide their end-of-life plans in advance. “Although we have well-developed systems for thinking about these things, relatively few people actually have plans for endof-life well worked out. There really needs to be a public debate about these issues. We’ve done it in a number of areas – organ donation, campaigns to prevent people from driving badly – and dying is a critical issue to have that sort of debate about.” LASA National Congress 2016 heard from a panel of experts about the importance of advance care planning, the need for public education, and some of the barriers to implementation. Below we share some of their insights with you. Julie Sutherland – Clinical Nurse Consultant/Counsellor – Advance Care Planning, Metro South Health Advance care planning must be encouraged. Evident deterioration and loss of function should be a trigger for ensuring all people with advancing illnesses have an advance care plan that outlines their values, wishes and choices for health care. Improved, honest communication is needed. Health and aged care professionals need to be able to accept the reality of increasing frailty and inevitable death. Clinicians must be better equipped to listen to people’s preferences, and have conversations with people in an honest, sensitive, caring manner about what to expect as their illness advances. Encouraging people to express their questions, fears, hopes and views about their own quality of life is the starting point for person-centred care and shared decision-making.

We must encourage the appointment of appropriate substitute decision-makers. Conversations between individuals and their substitute decision-makers will help to ensure their wishes are known if they no longer have to capacity to make decisions. Education is necessary for health and aged care professionals, and the community, to highlight the value of clear conversations about end of life care preferences. Professor Colleen Cartwright, CEO of Cartwright Consulting who designed the Advance Health Directive and Enduring Power of Attorney forms used in Queensland The whole area of Advance Care Planning has moved ahead considerably in the last decade, as evidenced by its inclusion in many government policy documents and non-government reports, such as the Productivity Commission reports. It fits very well within the Consumer-Directed Care model. However, there is still poor uptake and poor understanding of the law in various states/territories, not only among the wider community but also among doctors, nurses and lawyers. Recent research I’ve undertaken with colleagues demonstrates significant ignorance among medical specialists involved in end of life care about who has the legal authority to make decisions for someone who has lost capacity – especially if that person has not completed an Advance Care Directive or appointed their own substitute decision-maker. There is also misunderstanding about when an Advance Care Directive should or shouldn’t be followed. Finally, if people receive a diagnosis of dementia early in the disease process, it can be empowering for them, and give great comfort, if they are assisted to undertake Advance Care Planning while they still have capacity.

HEALTH AND WELLBEING

Dr Peter Saul, Director of Intensive Care, Newcastle Private and Senior Intensive Care Specialist, John Hunter Hospital Although I have chaired the committees that designed the NSW Resuscitation Plan, and that have produced the Advance Care Directives policy, I don’t believe that focusing on filling in forms is really the way forward. I’ve lost count of the number of emails I’ve received asking for the best advance care planning form, as if the best form somehow guarantees a good outcome. It clearly doesn’t. Dying is chaotic, and our main aim should be to provide a safe environment. This requires dramatic improvements in clinical handover, both of healthcare information and patient preferences. Goals of care need to be constantly renegotiated and reliably communicated. I’m not sure I believe that everybody can have a good death, but we owe everybody a safe environment in which a ‘least worst’ death is supported. Annie Dullow, Director, Palliative Care Section, Department of Health The Australian Government is committed to implementing initiatives which improve access to high quality palliative care for all Australians.

The Government provided $52m over three years from 2014-15 to 2016‑17 to improve palliative care education and training for the health workforce, drive quality improvement in palliative care services, and promote advance care planning. It also provides financial assistance to state and territory governments to operate palliative care services through their health and community service provision, and as the system managers of public hospitals. Decisions on the use of this funding, and the delivery of palliative care and hospice services in each jurisdiction, are the responsibility of individual state and territory governments. The Department of Health is currently undertaking an evaluation of the National Palliative Care Strategy (2010) and managing three research projects examining community attitudes and awareness, best practice in general practice in end of life care and bereavement. The LASA Congress panel also included Australian Medical Association Board Director, Dr Richard Kidd, and Immediate Past President of the International Society of Advance Care Planning & End of Life Care, Associate Professor William Silvester. ■

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HEALTH AND WELLBEING

LINKAGES PROJECT ENCOURAGES

COLLABORATION ON END-OF-LIFE CARE Australia’s aged care industry is committed to enhancing the provision of end-of-life care, according to the head of a national palliative care linkages project, Queensland University of Technology’s Professor Patsy Yates.

he Decision Assist Linkages Project encourages collaboration between palliative care services, GPs, and home care and residential aged care services that receive Commonwealth funding.

The project provides education and support to help aged care staff identify clients needing palliative care, thereby reducing unnecessary hospital admissions. “Palliative care is always one of those difficult topics for our community at any time, but there is a much greater understanding these days of the importance of good quality end of life care for older people no matter where they are – in residential care or in the community,” Professor Yates said. “There is a great deal of commitment now within the aged care sector to building their capabilities to provide end of life care, through a range of things like workforce development and partnerships.” Phase one of the Decision Assist Linkages project involved 20 partnerships between palliative care services and aged care facilities around Australia. These linkages took various forms; from sharing standardised documentation between services (such as referral forms, assessment tools and handover forms), through to formal agreements about shared roles, responsibilities, resources and education opportunities between sites. Victorian provider mecwacare, in partnership with Cabrini Health Palliative Care Services, developed a sustainable best practice model for end-of-life care across residential and home care settings, which can be applied to broader aged care service networks.

“We are taking those learnings and are now in a translation and dissemination phase, engaging other partner sites to extend the reach and impact of the benefits of palliative care/aged care linkages.” Phase two partner sites are being identified across a wide range of demographic and geographic areas to test the learnings against various service models. Decision Assist is also developing a tool kit of case studies, models, and templates to encourage further linkages between aged and palliative care services. “Obviously there’s a huge amount of work to be done, but the attention we are now getting for building linkages between aged care and palliative care providers is a great sign for the future,” Professor Yates said. Decision Assist provides education and support for aged care staff, General Practitioners and General Practice Nurses to enhance the provision of advance care planning and end-of-life care. You can find more information at: decisionassist.org.au. The Decision Assist Project is managed by a national consortium, including Austin Health (lead agency), Palliative Care Australia, CareSearch, Queensland University of Technology, Leading Age Services Australia, and Aged and Community Services Australia. Specialist palliative care advice for aged care and general practice staff is available 24/7 on 1300 668 908. Advance care planning advice and resources are available for aged care and general practice staff, Monday-Friday from 9am-5pm on 1300 208 582. ■

Professor Yates said learnings from phase one about how to support strong collaborations would be made available to the sector during phase two of the project.

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o be able to communicate is a considerable skill and is generally something that improves with experience. Whilst there is no single ‘right way’ to talk to people about death and dying, there are some key concepts that staff working in the aged care industry may want to consider when they find themselves in a position where they need to discuss these topics with a dying individual and their loved ones.

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The importance of good communications is generally highlighted as a key skill for the workplace, especially for people that work in the health and social care industries who are often placed in a situation where they have to communicate complex and sometimes confronting information to emotive individuals – particularly if this relates to death and dying.

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It is important to remember that families are generally complex, and the communication within a family unit can be challenging to navigate. It is important to remember that an individual has the right to make their own decisions (assuming that everyone has capacity unless it has been shown otherwise) and they may decide that they don’t want their family present at the end of their life. Whilst you may not agree with an individual’s decision, it is important to respect it. It is also important to maintain a person’s privacy and confidentiality and to be aware that some people may not want people outside of the care team to be aware of their clinical status. There are two main ways in which people communicate, verbally and non-verbally, and it is important to be aware of both of these. If you are unsure of an individual’s culture, spirituality, personal preferences, etc. it is better not to assume and instead to ask either the person themselves or their loved ones, if it is appropriate, or a colleague. In the Residential Aged Care (RAC) setting there is two types of communication: formal and informal. An example of formal communication could be in a palliative care case conference, which is a structured interaction, and an informal form of communication could be a conversation in the corridor. With discussions on emotive topics like death and dying often it won’t be a one-off conversation and it may take some

HEALTH AND WELLBEING

people multiple discussions before they feel that they can raise their underlying concerns. As much as possible, try and ensure that there is sufficient time to talk to people and that the conversation takes place in an appropriate location in which it is unlikely that you will be interrupted, this may be harder if the discussion is unexpected but it may be possible to move the conversation somewhere else. A common concern for people regarding death and dying is the fear of losing control. To assist in addressing this concern, it may be worth asking someone how much they would want to know and talk through what they do and do not want, ideally this conversation is informed by an existing Advance Care Plan/ Advance Care Directive. Additional support may be required for people that may struggle to communicate their needs but it is important to remember that people should still have the opportunity to discuss their concerns. Often people will continue to take an interest in their loved ones lives and their own interests for as long as possible, irrespective of the fact that they may be dying.

People express grief and stress differently and some will experience grief prior to someone dying. People often find it helpful to have their emotions normalised, as well as potentially finding crying a cathartic experience. Sometime it may be necessary to remind people about the importance of their own ‘self-care’, and this can be just as relevant to staff as it can be to someone’s loved ones. It is important to pay attention to your own needs, which may include the need to talk to someone about your thoughts and experiences. Aside from existing support networks, it may be worth considering professional options as well. There are a number of free, evidence based resources that include information on communication skills with palliative care, end of life and death, these include: CareSearch; www. caresearch.com.au/Caresearch/Default.aspx; the Residential Aged Care Palliative Approach Toolkit: www.caresearch.com. au/caresearch/tabid/3629/Default.aspx; and Decision Assist: https://www.caresearch.com.au/Caresearch/tabid/2583/ Default.aspx. ■

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AROUND THE SECTOR

CAREERABILITY

ENABLING CAREERS IN AGED CARE CareerAbility in Aged Care is a collaboration between two NSW (Illawarra region) not-for-profit organisations — aged care provider IRT Group and provider of employment opportunities for people with a disability, The Flagstaff Group.

RT and Flagstaff co-designed the 10-week training program that was delivered by IRT College.

“Providing high quality, supported training was critical to the success of the program,” IRT Group CEO, Nieves Murray said. “The program outcomes are two-fold — it will enable people living with intellectual disabilities to forge new careers in aged care, while aged care providers like IRT can benefit from diversifying our workforce.

“This is vital in an industry where a recent job market report found there were four times the number of jobs than there are workers.” A graduation ceremony was held on 15 November to celebrate the seven graduates of this innovative program. The students received a Statement of Attainment for completing four units of competency towards a Certificate III in Individual Care. All seven graduating students will be offered the opportunity to complete the full qualification with IRT College at no cost. The students will be funded through the NSW Smart and Skilled program.

IRT Group CEO Nieves Murray (on arm of chair), Flagstaff Group CEO Roy Rogers, The Hon John Akaka MLA, CareerAbility in Aged Care Program participants and IRT College employees.

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Pictured from left Roy Jasperson, CareerAbility program graduate, the Hon John Ajaka MLC and Flagstaff Group CEO Roy Rogers.

IRT will also offer two traineeships to graduates. Other graduates will be offered the opportunity to complete professional placements in other aged care facilities.

“We’re proud to build on IRT William Beach Gardens’ reputation as an innovative and diverse Community that values people with disabilities,” Ms Murray said.

During the CareerAbility program the students undertook three work placements at IRT William Beach Gardens in Kanahooka.

“Our participation in CareerAbility in Aged Care follows the success of Kemira at IRT William Beach Gardens — our new Community for ageing people with intellectual disability and their primary carers.”

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Delivery of the pilot program was a $30,000 in-kind contribution from IRT to the 50th anniversary Flagstaff Innovation Fund. The fund provides for training, development and employment programs for Flagstaff employees to increase their work capacity, skills, independence and self-confidence.

Minister Ajaka was impressed with the partnership between IRT and Flagstaff and what’s been achieved in providing the seven students with tangible skills, training and experience in the aged care industry.

A pilot program designed for people with intellectual disability to kick-start a career in aged care is celebrating the success of its first graduates

One of the program’s participants, Jordan Bowater, told Minister Ajaka that when offered the opportunity to participate in the program, he jumped at the chance.

The students, Ms Murray and Flagstaff Group CEO Roy Rogers, recently met with the Hon John Ajaka MLC, NSW Minister for Disability Services and Minister for Ageing, to reflect on the success of the program, and discuss the potential roll out beyond the Illawarra region.

At the Minister’s request IRT and Flagstaff will collaborate on a formal review, that will help to inform the future direction of the program with a possible roll out beyond the Illawarra region.

“I’ve tried a few different things since completing my HSC, but nothing really worked out for me. I’m always looking to gain new skills and experience, so I’m really excited to finish the 10 week course, and potentially find employment in the aged care industry,” Mr Bowater said. ■

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AROUND THE SECTOR

MEETING STAFF AND CUSTOMER NEEDS: EVIDENCE FOR A

WIN-WIN STRATEGY Dr Louise Parkes

The shift towards consumer-driven funding and greater Director Research & Development customer choice in aged care is driving a corresponding Voice Project and critical shift in focus away from simply complying with government standards, to better understanding and satisfying client and resident needs.

hen it comes to quality services, staff are a key differentiator – both in terms of the clinical care provided, and the personal interaction staff have with clients and residents. However, in an industry where staff are already under significant pressure to operate under tight timeframes and limited resources, the increased competition has potential to further stretch staff. So it is good news that recent research suggest that competitive strategies will be a win-win for staff and clients: a greater customer focus is engaging for staff, and valuing and supporting staff leads to greater customer service and satisfaction. Voice Project is a research and consulting organisation that assesses workplace practices and employee engagement, develops leadership through 360-degree feedback, and surveys customers to measure and track service quality and satisfaction. We recently combined survey data from over 6000 staff in 14 residential, respite and community aged care services across NSW, to investigate the key workplace drivers of perceived customer satisfaction. Not all of these organisations had comparable data from customer feedback, so we used the feedback from staff surveys, which has previously been shown to be strongly correlated with independent measures. Generally, most staff (82%) think their organisation provides high quality services; understands customer needs; and customers are satisfied with their organisation’s services. However, this ranged from as low as 64% to 91% across organisations. It appears that managers and office staff are a little removed from the realities of day-to-day front-line experiences of other staff – 90% of them rated their customer service positively, compared to the 80-83% of clinical (nursing and allied health), support (laundry, cleaning, catering, maintenance, driving, garden), and direct care staff.

Organisations that focus on customer service are great places to work Staff who rated customer satisfaction high, also saw their organisations as: successful, having a positive future, innovative, continually improving, and learning from mistakes and successes. Achieving organisation objectives, being innovative, and managing change well are closely associated with high quality customer service, and together these are the strongest drivers of staff engagement. Compared to other industries, staff in aged care are strongly aligned with the mission and values of their organisations, and are passionate about what they do. This helps us understand why staff who rated customer satisfaction high were more likely to feel proud to tell people that they work for their organisation, and feel a sense of loyalty and commitment to their organisation.

Workplace practices supporting customer satisfaction Of a broad range of 27 different workplace practices, we identified the strongest indicators of perceived customer satisfaction, and have broken them into two groups: positive drivers and gaps. Positive drivers are practices that are important for customer satisfaction that the aged care organisations are currently performing well. Two of these were expected, but the third was a surprise. Ethics – It is particularly important that the organisation is seen as socially responsible, for example, is demonstrably motivated by genuine care and compassion for older people (rather than profit) Results Focus – A strong focus on achieving positive results, for example, driving and measuring results through KPIs for quality of care and customer satisfaction

AROUND THE SECTOR

Safety – worker health and safety is seen as a priority of the organisation and supported by managers and supervisors. While this initially surprised us, quality and safety often sit under the same governance and organisation reporting structures. Also, both staff safety and quality of care are likely to benefit from the combination of a focus on results and responsible social ethics.

values, invest in the development of senior leaders, and improve staff’s visibility of, and communication with, senior leaders. Cross-Unit Cooperation – Sharing information and cooperating across team boundaries. This includes facilitating collaboration across services and specialties at both a macro and micro levels, so that services can share best practice to enhance organisational learning and innovation, and staff can share their knowledge of individual clients to enable personalised care.

The research also identified key performance gaps in practices that are important for customer satisfaction. Each of these practices are also strong drivers of staff engagement and wellbeing, so targeting improvements in these areas will have multiple benefits for both staff and customers.

A management challenge

Recognition – Acknowledging staff achievements, demonstrating confidence in staff, and finding ways to recognise their contributions. Staff who feel valued themselves are more likely to value and respect the people they are caring for. Involvement – Encouraging staff to have input into everyday decision-making, and ensuring they feel safe to voice concerns. This means empowering staff to be more involved in decisions about client care, and creating a culture of reporting risks, incidents and abuse. Leadership – Having capable senior leaders who model the organisation values and have a collaborative style. Attitudes flow from the top. Organisations must carefully recruit leaders for fit with

This topic was covered in a digital poster at LASA National Congress 2016. You can find the poster on our Congress website at: http://lasaposters.paperlessevents.com.au/. ■

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While most strategies combine in their benefits for staff and customers, there was one area that potentially poses a conflict of staff and client interests. From a staff perspective, the research shows that finding a good work-life balance is very important for maintaining staff wellbeing. However, of the 27 practices we investigated, work-life balance was least related to customer satisfaction. With a workforce that is largely comprised of older, female, part-time staff, this suggests there may be a tension between providing consistency of care to clients and residents and flexibility of work hours for staff. Finding creative solutions to this challenge will be critical for services to retain good staff while also meeting customer needs.

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BRINGING EVERYONE ALONG, SUPPORTING REMOTE AND INDIGENOUS COMMUNITIES IN AGED CARE REFORM

Some approved providers of home care in remote locations have found the transition to consumer directed care (CDC) challenging. There are a range of factors which restrict full implementation of a CDC model of care, some of which are relatively predictable however others are complex and unique.

n June 2016 CommunityWest was contracted by the Commonwealth Department of Health to provide education and support to three approved providers of home care package services in remote locations in WA. Clients of these three service providers were mainly Indigenous Australians. Design of the consultation, education and support was undertaken by CommunityWest in close collaboration with the Department.

• Home Care Package governance

CommunityWest began with face to face scoping of the providers’ compliance with legislated requirements (such as provision of individualised budgets) and their understanding of CDC with an ultimate aim to have all three services achieve operation in line with all elements of the Home Care Common Standards.

Rather than use a standard approach of working through set documentation, CommunityWest worked together with providers for a common understanding of what governance, CDC principles and individualised support in context might look like for that service when they achieved full implementation. Our yarning provided insight for us and education and support to the provider.

Two consultants from CommunityWest travelled to each community to gather information through face to face consultation. The focus specifically related to organisations understanding of:

• principles and philosophy of Consumer Directed Care • individualised support and personal budgets • communication of information to staff, volunteers and consumers about CDC, and • level of support required for successful transition to a CDC model.

We also worked back to identify gaps in tools/understanding, develop a gap analysis which would have mutually agreed

AROUND THE SECTOR

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AROUND THE SECTOR

strategies of improvement and evaluate the capacity of the service to implement strategies To initiate conversation, CommunityWest worked with a list of questions which were designed to evoke authentic information about the provider’s transition journey. Providers had the opportunity to shadow employees during our visits to gain a holistic understanding and appreciation of the complexities associated with each community. Providers were encouraged to give information to provide cultural context, particularly around the nuances and challenges with regard to consumers understanding and willingness to engage with a CDC model. CommunityWest identified some key areas of complexity across all three of the organisations. There were challenges in finding appropriate support staff to provide direct care. When the pool of potential recruits is small, getting additional staff on board is difficult. This is particularly challenging without training organisations and opportunities for people without work in the regions. Securing and maintaining transportation was also a difficult issue. Uber is not a possibility in remote communities and at times, there is only one transport option available for staff and for consumers. With the spread of communities across many kilometres, the logistics of transportation become complex. Training and support across regions was also challenging with isolated location is certainly an issue, but time is also a barrier. Coordinators may have direct support responsibilities as well as service coordination and administrative duties with very little operational back up. Accessing training and support is tricky when you need an airplane and a couple of days to attend a face to face training and variable internet availability means online training opportunities are not always a good choice. CommunityWest learnt that although each organisation is unique, there were many similarities evident with regards to the transition journey to a CDC model. The remoteness of each community hindered the breadth of choice in the sorts of options which would be available in metropolitan areas; however, choices with regard to innate connection to country are imperative. Australian Aboriginal culture is built around a collectivist kinship system, meaning people think of themselves in terms of their relationship with others in the community. CommunityWest found this complex and dynamic social structure influences how older people engage with individualised services. Future planning, individualised support and goal setting with older aboriginal people will need to be contextualised to ensure a positive outcome. Rural and remote consumers do not have the same choice and flexibility available to them as would exist in open market conditions typically enjoyed by consumers living in urban areas. A small marketplace means it is unlikely a host of different providers would move into these areas. For regional

and remote providers, the urban notion of flexibility can be limited by small staff numbers, limited transportation and lack of other or significantly different services. What does choice and control look like in remote aboriginal health and aged services? Choice and control in context may be a consumer who wants a choice of breakfast items in a congregate meal setting. Perhaps it may be a consumer who wants transportation for themselves and their chair to sit at a different house in the community because they feel safer or more welcome than in their current home. Choice in support is more than choosing between ‘this or that’. It’s about listening carefully to the consumer’s voice and choice then striving to make it happen. The legislation is clear about expectations, but putting CDC into practice in remote aged care services takes time, relationship building and contextualisation in order to move forward. ■

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AGE SERVICES MANAGEMENT

BACK-UP GENERATOR GRANT OFFERS SECURE POWER FOR MORE VICTORIANS

Residential care facilities across Victoria are set to benefit from the final stage of the State Government’s generator roll out program in high priority bushfire areas.

n a multi-million dollar Victorian Government program, the Local Infrastructure Assistance Fund (LIAF) began in 2012 offering auto-start, back-up generators to residential care facilities to safeguard against power outages.

The geographically staged program continues today with the opening of its last stage in January 2017 across regional and rural Victoria. The grant is designed to ensure generators keep powering facilities regardless of interruptions to power supplies and protect Victoria’s most vulnerable residents who are dependent on power for their health and well-being. Following the devastating 2009 Black Saturday bushfires, the Victorian Government established the Victorian Bushfires Royal Commission to consider how bushfires could be better prevented and managed in the future. The Royal Commission noted that powerlines and electricity infrastructure had caused a number of major bushfires in the past as well as on Black Saturday. In response, the Powerline Bushfire Safety Program (PBSP) was established to increase safety to communities by improving electricity assets and network controls to reduce the likelihood of bushfires caused by powerlines. Up to $750 million over 10 years is going towards measures to reduce the risk of bushfire starts from electricity assets, whilst maintaining a reliable and affordable electricity supply. The PBSP program comprises of five interrelated projects to: • replace bare-wire powerlines in high-consequence areas using undergrounding or replacement with insulated wire and/or aerial bundled cable; • use advanced network technologies to reduce the risk of bushfire ignition from powerlines;

• enhance control of network settings on high fire-risk days • reduce the impact of power outages on the community as a result of more sensitive network settings; • and invest in research and development. The PBSP program includes making powerline safety settings more sensitive during Total Fire Ban and Code Red days in highest-risk areas to reduce the chance of a bushfire start. The installation of back-up generators into residential care facilities ensures electricity supply for those most power

dependent is not disrupted by these additional powerline safety measures. In the lead up to Christmas 2016, the Local Infrastructure Assistant Fund will have funded the procurement and installation of over 250 generators protecting almost 14,000 Victorian residents in care facilities. Its aim is to assist government, non-government and privately owned facilities located in high risk bushfire areas to apply for the government grant which has a defined eligibility criteria. On average, a successful applicant receives around $80,000 to fully cover all aspects of the generator and it’s installation. The Government’s key objective is to assist facilities to deliver reliable power supply to ensure continuity of essential services. Assistance is also provided to successful applicants with a resource allocation of an engineering project manager to help administer the process and alleviate this burden from facilities. The LIAF team regularly receive feedback by facilities on the Fund’s framework to assist facilities receive the grant. One facility in Victoria’s Corangamite region, Cobden District Health Services, found that the framework was useful. “Every effort was there to ensure we knew how to apply, what was required and we were kept in touch throughout the whole process,” said the Service’s Jeannine Creely. Since they installed the generator Cobden have had two power outages where the back-up generator kicked in automatically to maintain power supplies to the facility and ensure business as usual. “We are happy that power failures no longer affect critical medical and life-support equipment, nor does it affect airconditioning during the heat or lighting at night, thanks to the installation of our back-up generator,” she said. The Local Infrastructure Assistance Fund will be holding information sessions for the final stage of the LIAF – Stage 6 – in late January 2017. To register your interest in attending an information session, obtain the grant criteria or ask any questions, please email: liaf.applications@delwp.vic.gov.au. ■ You can also visit www.delwp.vic.gov.au/liaf for more information.

AGE SERVICES MANAGEMENT

PRIVACY LAWS AND HOME CARE Home care providers and their employees and contractors must comply with the provisions of the Privacy Act 1988 (Cth) (the Act) and the Australian Privacy Principles (APPs). Dominique Egan Partner I TressCox Lawyers

he provision of home care services involves a number of health, allied health and personal care and other workers. Many if not all of those people will have access to the health information and other sensitive and personal information of those to whom they are providing care and services. Personal information, for the purpose of the Act, is defined as information or an opinion about an identified individual or an individual who is reasonably identifiable whether that information or opinion is true or not and whether that information is recoded in a material form or not. The Act applies to all those providing health services and who hold any heath information. A heath service is defined to be an activity that is intended or claimed by the individual or the person performing it to assess, maintain or improve the individual’s health (physical or psychological) or where the individual’s health cannot be maintained or improved – to manage the individual’s health; to diagnose the individual’s illness, disability or injury; to treat the individual’s illness, disability or injury or suspected illness, disability or injury; to record the individual’s health for the purposes of assessing, maintaining, improving or managing the individual’s health. The Act goes on to provide that the activities above include those provided in the course of providing aged care, palliative care or care for a person with a disability. While the following is not a comprehensive guide to the APPs, we do draw attention to the following. APP1 requires organisations to ensure they comply with the APPs and that the entity has a process in place to deal with inquiries or complaints. Home care providers must have an up to date Privacy Policy that addresses:

• How an individual may complain about a breach of an APP; • Whether the home care service is likely to disclose personal information to overseas recipients and if so, the countries in which those recipients are located. The Privacy Policy must be readily available free of charge and in an appropriate form. APP4 addresses how an organisation is to deal with unsolicited personal information. If the organisation could have collected the information from the individual concerned, then the information must be dealt with in accordance with the APPs. If this is not the case, then provided is it lawful to do so, reasonable steps must be taken to destroy or de-identify the information. Personal information should be used and disclosed for the primary purpose for which it was collected (APP6). It may be used for a secondary purpose in defined circumstances including that the individual would reasonably expect it; or the use or disclosure is required or authorised by law; or a permitted general situation exists; or a permitted health situation exists. A permitted general situation is includes the following: • Lessening or preventing a serious threat to any individual’s life, health or safety or the public health or safety and it is unreasonable to impracticable to obtain consent; • Taking appropriate action in relation to suspected or unlawful activity or serious misconduct; • Locating a person reported as missing.

• How the service collects and holds that information;

A permitted health situation includes disclosures of health information to the person responsible where the individual who is the recipient of the health service is unable to consent and the disclosure is necessary for the provision of appropriate care or treatment or made for compassionate reasons and is not contrary to an earlier express wish of an individual.

• The purposes for which the service collects, holds, uses and discloses personal information;

Organisations may only use personal information for direct marketing if:

• The kinds of personal information the service collects and holds;

AGE SERVICES MANAGEMENT

• The personal information was collected from the individual;

• The individual has not made such a request.

There are circumstances in which a provider may decline to provide an individual with access to his or her information. If access is refused, written reasons must be provided to the individual. Similarly, if a request to correct information is refused, the individual must be provided with written reasons for the refusal. In both cases, the individual must be provided with information about his or her avenues of complaint.

In cases where information is not collected from the individual but from a third party, the information may only be used for direct marketing if:

A copy of the APPs and further information may be found on the Office of the Australian Information Commissioner’s website: www.oaic.gov.au ■

• The individual has consented or it is unreasonable or impracticable to seek consent;

For further information or advice, please contact a member of the TressCox Health & Aged Care team.

• The individual would reasonably expect their personal information be used or disclosed for direct marketing; • A simple means to make a request not to receive direct marketing is provided;

• The organisation provides a simple means to opt-out and individual has not opted out; • Each communication includes a prominent statement that the individual may opt-out of receiving further material. Consumers have a right to access the personal and health information a home care provider may hold about them.

201610-11_Procura_Clinical_Care_Ad_Half_Page_LASA_v1_FINAL_.indd 1

22/11/2016 10:57 AM

TECHNOLOGY |

COMPUTER SOFTWARE

AGE SERVICES MANAGEMENT

404-8-8

HOW MUCH ?

ISBN 978-0 -9874

9 780987 440488 >

hen we wrote the first edition of Aged Care, Who Cares? we wanted to demystify what it means to receive aged care. We originally expected readers to be people investigating options for themselves or a loved one, but soon found that many people who work in the industry buy it and love it. This third edition not only keeps up with the ever-changing rules, but also meets the needs of both types of readers better. The book helps people who are investigating their options to understand the many wonderful choices available, while giving them some tips – and alerting them to some of the traps – of dealing with the complexities of our aged care system. The title of the book is all about the key decisions people face, which come down to where you are going to live, what kind of care you will need, and how much it is going to cost.

Where will you live? While many people are adamant about staying in the family home there can be downsides, such as finding that the home needs increasing maintenance, or finding yourself without a social network if you end up living alone. Considering other options, whether for now or for the future is always a good idea. The next most obvious choice may be a granny flat: family looking after family is certainly not a new concept. However, understanding your granny flat agreement and the implications can be enormous both emotionally and financially. We point out some simple questions, like “What would happen if the children got divorced?” to get people thinking about some of the longer-term considerations of these arrangements. Retirement villages and land lease communities are becoming a favoured choice for many retirees, because there is often a strong social network in place, and you can do what you are able to for yourself and get help or care if you need it. The buying power of these communities when it comes to services, and yes care, should not be underestimated. Of course, for many people the decision will be to move into residential aged care. There is a wide range of these – from those that resemble a 6-star hotel to those that cater for specific cultural groups.

Thi rd Edi tio n

Who Cares?

Fusion provides readers with a sneak peak of the new edition of Rachel Updated for 201 7 Aged Care Ref orms Lane and Noel Whittaker’s book ‘Aged Care, Who Cares?’

BE NIC YOUR E TO K

IDS they wil l cho nursing ose your home.

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NOEL WHI TTA Australia’s most KER is one of respected finan advisers and best selling autho cial rs. He is a pione er education and in the field of consumer including the is the author of 20 book s international Making Mone best seller y weekly colum Made Simple. He writes ns in many majo newspapers, and also make r Australian appearances s on radio and regular television.

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WHERE ?

WHERE, HOW AND HOW MUCH?

RACHEL LAN of Village Guru E is the Principal dedicated to s, an organisation provi and advice abou ding choices, for people movi t those choices, ng into a retire community. ment Rach slightly older in working in finan el has been cial services other places for 18 years and specialisin in retirement g and aged care for more than a Rachel holds decade. I may be getting older, a in Financial Masters Planning. but I refuse to grow up!

Ag ed Ca re Who Ca res?

AGED CARE, WHO CARES? WITH AGE COM ES ... and WISDOM discou nts.

Rac hel Lan e Noe l Whi ttak er

Age is inevitable. It comes to all of us if we are lucky. What distingu ishes us is, however, how we plan for it. And a key element in the plan is the appropr iate aged care. This book is intended for those who wish to secure the best possible outcome for aged care…whether it is care for themselves or for loved ones. In it we examine some of the legal and financia l implications of the various accommodation options for older people… including aged care facilities, as well as granny flats and life tenancies, retirement villages, over 55’s communities and caravan parks.

WHERE ?

HOW ? & HOW MUCH ?

Ra ch el La ne

No el W hi tt ak er

What care will you need? A crucial thing to consider in your choice of living arrangements is at what point you need to move on. What care do you need now? What can you reasonably anticipate needing in the future? Do you want to move somewhere that can support you as you age, even at the risk of having ‘old people’ around you, or would you rather kick up your heels as long as possible then move to a care environment when you need it?

How much will it cost? This is often the issue that concerns people the most, and it’s easier to understand if we break it down into a few key areas. First, is the cost of accommodation: how much will you pay now, and how much will be refunded to you when you leave? If you decide to move out of your home then you will most likely need to sign a contract for your new accommodation — in the case of a granny flat right that contract may be with your children. Understanding your contract is vital, as it not only spells out your rights, including the ability to get care, but also your responsibilities. Second, is the cost of personal expenses, which is really a matter of sitting down and doing a budget. Make sure you don’t forget the treats such as chocolates, haircuts and outings! Third is the cost of ongoing care, which will depend on whether you receive private care, a government-funded home care package, residential aged care, or a combination. Of course, once you have identified where you want to live, what care you will need and how much it is going to cost you need to figure out how to afford it. We look at a range of financial planning strategies from borrowing to fund care, keeping and renting your former home to paying more for your retirement village now to pay less exit fee later… and everything in between. Aged care choices are complex. But that is because there are so many choices — and that is a good thing. We have packed the book with case studies based on real-life scenarios, and given people some great resources that can help them to find and fund the care that best suits them. ■ Aged Care Who Cares? is available from www.agedcarewhocares.com.au.

COMPUTER SOFTWARE

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IN AUSTRALIA HAS BEEN UPDATED!

Updates include:  The aged care reforms  The changes to treatment of the former home in 2016 and 2017

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THE DEFINITIVE GUIDE

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more real life examples

AGE SERVICES MANAGEMENT

SAGE TOURS – TRENDS AND LEARNINGS

Since the Federal Government’s mandatory introduction of Consumer Directed Care (CDC) last year, the aged care and retirement living sectors have witnessed unprecedented change.

DC policy reform is designed to improve quality of life and prolong the time spent at home for seniors, by allocating funding directly to the consumer and giving them more choice and control in the type of care they receive.

Following on from these international trends it is predicted Australia will see a lot more change inspired by international exemplars, such as integrated and virtual communities and even ‘smart’ care models.

Though currently only available for home care packages, CDC is programmed to be rolled out for the residential aged care sector in the near future.

SAGE delegates report seeing a trend in virtual, or remotely connected communities, where members share a physical, central hub for social interaction, and community services for support.

The ongoing changes in the sector are forcing providers to rethink the way they design both buildings and services for aged care and retirement living.

The Managing Director of ThomsonAdsett, Chris Straw, said that integrating aged care with other active precincts and community groups, such as universities and retail centres creates a mutually positive energy for both communities, and provides opportunities for continual learning for residents.

According to Judy Martin, International SAGE Program Manager, the CDC will give consumers greater choice about where they live. “Where residents were once assigned to a facility based on the availability of care, they now have the greater power to choose where they want to live, and how they want to manage their care,” Judy said. “Through our leadership of the SAGE Study tour program, we’ve witnessed similar policies implemented in many countries around the world for some years, and one thing is certain: residential aged care providers have to be increasingly competitive to be relevant in the market and innovation is vital to this.”

“As we’ve seen smart phones and TVs adopted in households throughout the developed world, they will play an increasingly important role in the future of aged care and retirement and keep older people independent – and potentially at home – for much longer,” Chris said. ThomsonAdsett is a leading international architectural practice specialising in seniors living and aged care. Ten years ago, the firm initiated Studying and Advancing Global Eldercare (SAGE) International Tours, to stay ahead of future architectural and industry trends, such as CDC.

Over the last 10 year the SAGE Study tour program, of which LASA is a partner, Judy has visited over 300 world-leading aged care facilities in 15 countries.

SAGE 2017 program is now open for registration and includes a focussed IT/Robotics program to Japan in March, a program to Switzerland which will include attendance at the biannual The SAGE program allows delegates to study the latest trends IAHSA conference, and program to Atlanta Georgia with a focus in delivery of new models of care. The program has been in on research where the program will also include attendance at sagetours.com.au high demand by the seniors living and aged care industry, the annual Leading Age conference in New Orleans. ■ including many LASA members, since it began in 2006. LASA members can register for program or find more information at the SAGE website www.sagetours.com Over 180 Australian aged care providers have travelled with Judy on international tours to learn more about world’s best practice in the sector. “The tours explore different models of care, different designs, different ways countries approach political reform and different socio-economic responses. “The biggest change we’ve witnessed globally is the shift away from large-format institutional models of care, to a smaller, more personalised, ‘household’ system. “By reducing resident clusters to seven-to-eight people, carers can deliver more focussed care, which has a hugely positive effect on the residents.”

Japan Aged Care Tour Book Now Studying and Advancing Global Eldercare

Tailored seniors living tours since 2006

sagetours.com.au 10 years . 15 countries . 300 organisations

26 March – 2 April 2017

On The Cutting Edge: Japan’s Innovative Approach to Robotics in Elderly Care • Exclusive CEO study program • Business learning & development

AGE SERVICES MANAGEMENT

UTILISING ADDITIONAL SERVICES TO MAXIMISE

SUSTAINABILITY Following recent cuts to ACFI funding and escalating costs of care, residential care providers are seeking alternative revenue sources to support the cost of care services.

David Cox Head of Operational Strategy at Ansell Strategic

Arthur Koumoukelis Partner at Dentons Australia

hile providers argue that they should be free to charge for any service outside of the confines of the Act, the Department of Health has signalled that some practices are “not supported by legislation” and will not be tolerated.

Capital refurbishment fees

Amenity, lifestyle and service fees

The fees (so far limited to larger, for-profit operators and ranging between $10.00 and $18.00 per day) are paid by non-supported, refundable deposit paying residents and

Until recently, additional service fees were limited to “extra service” type fees like pay telephone services, internet and pay TV. As residents are required to bear the burden of the cost of care, the demand for additional services will increase. Residents and their families are now requesting a diverse range of amenity and service and proactive organisations are responding by introducing a variety of novel services to meet future demand and provide additional revenue opportunities. Additional services frequently include non-amenity options that involve additional staff contact outside of the realms of Specified Care and Services. Services that traditionally relate to Specified Care and Services are provided as additional offerings if the home has determined that there is no assessed need for the service. Homes are also targeting services to the friends and families of residents in an attempt to increase community engagement, support socially isolated next of kin and to supplement revenue. Whilst some homes charge visitors directly, others provide residents the option to pay for services utilised by family members, allowing the resident to “host” guests.

A number of operators have introduced capital refurbishment, asset contribution or room reinstatement fees. The fees have been described as a resident contribution to the refurbishment or replacement of capital as a result of the resident’s stay in the home.

Additional services provided (in excess of assessed need or Specified Care and Services): • Multiple menu choices • Additional beverage packages • Concierge services • Personalised companionship services • Hair and beauty treatments • Complimentary therapies • Intensive rehabilitative support • Personalised outings • Coordination of non-facility events and outings • Non-facility, resident-related administration/secretarial services • Dry cleaning • Personalised brand selection for care items • Customised equipment

Rachel Lane, Principal with Aged Care Gurus says that where the services being provided are valued by the resident (or their family) there is very little resistance to paying the fees.

Amenity style additional services:

“This is understandable in a user pays world where people are happy to pay for what they use. The resistance comes from residents, or families, who don’t use all, or any, of the services,” she said.

• Furnishing packages

• Private dining • Private lounge areas • Personal safe or additional storage • Communications Packages • Personalised IT support

procurement

The â&#x20AC;&#x153;Moments of Truthâ&#x20AC;? workshops are a series designed to develop and support staff in the evolving and ever changing industry. Focusing staff on the importance of business development and understanding that it connects marketing and sales.

Ensure you have dedicated positive and effective team members who support the mission of the organisation, while maintaining essential and positive care standards.

Sydney Office

Melbourne Office

ABN

78 810 112 878

Level 5, Suite 515

Level 2, Riverside Quay

Tel:

02 8624 3300

2-8 Brookhollow Ave

1 Southbank Blvd

Web:

realiseperformance.com.au

Baulkham Hills NSW 2153

Melbourne VIC 3006

Email: contact@realiseperformane.com.au

TECHNOLOGY | COMPUTER Visitor Style Services:

SOFTWARE

• Meal and snack services • Activity packages • Medical, nursing & allied health services • Transport services • Crèche and babysitting facilities • Counselling & support services • Administration services are charged either as a fixed sum or on a pro-rata basis, dependent on the value of lump sum paid by the resident. The Department say that they are not outside of normal operations of the home, do not providing direct benefit to residents and are not charged on a fee-for-service basis. Whilst some providers and legal advisors, including Dentons Australia formerly Gadens Lawyers Sydney, argue that the care recipient enters a voluntary agreement when they elect to enter the home and sign an accommodation agreement, the Government clearly does not agree. This may have significant ramifications for those proposing to charge “mandatory” fees for capital replacement or refurbishment fees. Rachel Lane said that these fees seem to be a bone of contention with consumers – largely because they see the cost as benefiting the next resident and not them.

When are additional services permitted? The Aged Care Act 1997 (the Act) and the Aged Care (Transitional Provisions) Act 1997 regulate the fees that a provider can charge to residents.

The Department has also stated that the services cannot be charged “unless the resident receives a direct benefit or has the capacity to take up or make use of the services,” meaning that service must be wanted, measurable and deliverable. Again, there is no legislative support for this statement and the ordinary principles of contract should apply. The Act permits ‘extra services’, which as a concept under the Act is a bundle of services, some of which residents may or may not utilise by choice or capacity. There is some argument, therefore, that additional services, that residents should be permitted the option to agree to receiving additional services that are offered as a bundle when they first enter a facility. Residents are able to pay the fee or agree to a deduction to be made from the RAD.

Recommendations Ansell Strategic and Dentons Australia formerly Gadens Lawyers Sydney has been advising a large number of providers on funding and pricing strategies following the recent ACFI cuts. We recommend that providers actively pursue additional service income by charging for non-specified services that have traditionally been provided in the past without charge. Further, we recommend that providers seek new opportunities, and revenue streams, for additional services that meet the needs and preferences of both current and future residents. These services should:

The Act states that providers cannot charge more than the ‘maximum resident fees’ calculated under the Act for the provision of Specified Care and Services defined in the Quality of Care Principles 2014 if the resident is assessed as requiring those services.

• meet the needs and preferences of your residents

A provider can, however, charge some residents, (typically more low care residents) for care and services included as Specified Care and Services if they are assessed not to need the care or service. A resident could, for example, be charged for one-onone overnight companionship if the service is requested but not considered a care need by the home.

• be differentiated from your “normal” services

Residents cannot be charged for services that are included as Specified Care and Services at any stage, regardless of the assessed need, if they have higher care needs (as defined by Section 7(6) of the Quality of Care Principles), do not yet have an ACFI classification or are subject to specific grand-parenting arrangements relating to 2008 and 2010 reforms. Residents can be charged for services outside of Specified Care and Services. In order to be eligible, the Department considers that the service must not form part of the “normal operation of an aged care home”. This means that if a provider is unable to charge an additional fee if the service is routinely provided to residents. This is a concept that is not defined under the Act and is inherently contradictory to what the Act otherwise allows under Division 56.

• not be included in Specified Care and Services unless the resident has lower care needs and you have assessed that the service is not required by the resident • not be deemed an assessed need if care services are provided • be agreed upon. Services should be formerly documented in an agreement to demonstrate that the resident has agreed to the service, and • be invoiced to the resident, even if the service cost is deducted from the RAD, to ensure that the resident is aware of the cost (the invoice must be itemised in accordance with section 56-1(e) of the Act and deductions from refundable deposits should only be made in accordance with Division 52J of the Act). The Aged Care Act clearly states that providers are permitted to charge for additional services. The rules, however, have become unclear and the Department have indicated that they will not tolerate the charging of fees and charges outside of those specified by the Act. The implementation of services should therefore follow appropriate market, cost-benefit and legal analysis. The use of advisors who are already familiar with the legislation and current practices of other providers is essential. ■

AGE SERVICES MANAGEMENT

Aged Care Services Russell Kennedy makes a difference as a market leader in the provision of legal services to the aged care, home care and retirement living industries. Regulatory Compliance and Litigation Victor Harcourt

Anita Courtney

Principal

Senior Associate

T: 03 9609 1693 E. vharcourt@rk.com.au

T: 03 8602 7211 E. acourtney@rk.com.au

Business Acquisition and Amalgamation Solomon Miller

Jonathan Teh

Principal

Senior Associate

T: 03 9609 1650 E. smiller@rk.com.au

T: 03 9609 1587 E. jteh@rk.com.au

Site Acquisitions, Development and Property Operations Rosemary Southgate

Donna Rayner

Principal

T: 03 9609 1637 E. rsouthgate@rk.com.au

T: 03 9609 1503 E. drayner@rk.com.au

Workplace Relations, Employment and Safety Libby Pallot

Anthony Massaro

Principal

T: 03 9609 1584 E. lpallot@rk.com.au

T: 03 9609 1501 E. amassaro@rk.com.au

rk.com.au

WHAT’S NEW

WHAT’S NEW Doctor says try it! Tender Loving Cuisine (TLC) an award winning meal delivery service has become one of the most popular and respected food services along the East Coast of Australia. They are proudly Australian owned and their products are Australian made. Many dietitians as well as general practitioners are recommending TLC meals as a healthy dietary option. Their focus is on nutrition and there are 75 nutritionally balanced, portion controlled selections laboratory tested as Heart and Diabetes Friendly, Gluten Free and Medically Low Salt. The menu also includes soups, side dishes and delicious desserts. Dr Stephanie Butler of Mindbodywellth Family Practice at Hunters Hill is seeing the benefits of older patients getting regular home deliveries of healthy meals. “Over the past 25 years, our practice has seen a wide range of patients including many seniors needing guidance with nutrition and advice on maintaining their wellbeing” said Dr Butler. “A healthy, balanced diet is important at any age but if patients need assistance with home delivered meals, I am happy to recommend Tender Loving Cuisine,” she said.

Call Tender Loving Cuisine on Freecall 1800 801 200 to check on delivery in your area. They are happy to mail you a free menu or visit the website www.tlc.org.au

Call 1800 451 737 (Monday to Friday, 9am to 5pm AEST), email freeupgrade@niproaustralia.com.au OR complete this online form http://bit.ly/lasanipro.

DIABETES IN AGED CARE As one of the leaders in diabetes care, Nipro Australia understands that there is a growing number of patients with diabetes in your aged care facilities. To assist you with diabetes management, we offer comprehensive training on all our products and quality assurance plus diabetes kits for your facility. Nipro has been delivering advanced medical products designed to enhance the lives of patients with chronic disease in the last 60 years in a global scale. Our high quality diabetes products are trusted for accuracy, precision and performance. Our diabetes kit includes a TRUEresult blood glucose meter, TRUEresult test strips, TRUEuniversal safety lancets, TRUEplus fast-acting glucose products and TRUEresult controls solutions for accreditation. Contact Nipro Australia today to take advantage of this offer.

WHAT’S NEW

Improve access control within healthcare buildings Codelocks have been helping estates and facilities managers implement cost-effective access control for many years. We understand that in a complex environment, access control products have to be easy to install and maintain, and above all effective. There are many areas within hospitals and healthcare facilities that can be given instant access protection using push button door locks. As well as the main access routes, there are also consulting rooms, reception areas, cleaning cupboards, staff rooms, washrooms, operating theatres, and areas used to store drugs and medical equipment to consider. Codelocks new CL5510 smart lock makes access control easier, offering flexibility and convenience. The locks and technology allow building managers the ability to program locks via a smartphone,

generate and send entry codes for easy access and issue smart cards for alternative entry. The locks provide all users with an access method convenient to them, whether that’s using a card, smartphone, or simple keypad code. For users that require regular temporary access like cleaners, a time-sensitive code can easily be issued on certain days or at specific times of the day. This function is useful for providing access outside of normal hours, for shift workers, or when contractors need access during certain periods for routine maintenance. The locks come with an audit trail facility which helps to monitor and track visitor and staff movement. Other advanced features, such as code-free entry, enables open access periods.

For more information on Codelocks smart locks visit www.codelocks.com.au Connect and Control. Code. Card. Phone.

Enware Aged Care Solutions Enware has recently produced a comprehensive Disability and Aged Care guide featuring solutions and guidelines. Having completed over 200 projects in partnership with some of Australia’s leading aged care operators, health facilities, architects, Government and construction developers – you can be assured Enware is an industry leader with the knowledge and insight to provide innovative solutions that continue to meet the ever changing needs of residents, patients and their carers. Enware can offer advice and direction from product suitability through to installation, working within WHS and OH&S regulations and compliance with relevant Australian Standards and Guidelines. With solutions designed to focus on and cater for differing needs and eliminate the need for renovation should patients’ needs change. Knowing we put the user first means you can choose Enware with confidence. The guide is available in hard copy from our sales team or follow this link for an electronic copy

http://www.enware.com.au/media/1902/enw344_aged-careand-disability-solutions.pdf

Data does a poor job answering questions Research amongst business leaders has revealed that 83% believe their business information does a poor job of answering questions. That’s a disturbing finding. In a world where an astonishing amount of data is available, it appears that many businesses just don’t know what to do with it. Data has the ability to provide a wealth of valuable information to businesses, helping them understand the needs, wants, behaviours and patterns of clients and customers. But it only becomes useful

when distilled, interpreted and presented accurately in the right context. Surecom is at the forefront of data analysis that delivers meaningful business intelligence solutions. Specialising in aged care, Surecom uses its expertise in both the aged care residential and community sectors to deliver advanced visualisation and modelling tools to transform data into powerful and meaningful insights.

Call Surecom today on (07) 3514 9100 to find out how they can help you dig the precious gems out of your data mine.

WHAT’S NEW

Superior continence management ensures best outcomes for residents.

The Eldercare team are pleased with the change to TENA

Change is difficult in business. For those working in residential aged care, changing something like incontinence products can seem close to impossible. However change can be hugely successful and gratifying – as South Australian aged care provider Eldercare discovered when switching to TENA®. Eldercare currently has 1,000 licensed aged care beds across 13 sites and approximately 85 percent of residents require continence management. The decision to change to TENA was based on considerations including training and ongoing support, electronic capabilities for updating prescriptions and data reporting, product innovations and cost reductions through reducing consequence costs. The TENA Plan, Coach, Monitor approach ticked many boxes. Eldercare Procurement and Contracts Manager, Tony Pascoe reported that in the trial to win the business, TENA performed 20 percent better than its competitors based on quantity and quality measurements.

“Full product and application education assisted with the change in all processes at a site level,” said Mr Pascoe. “And the change to TENA was worth it – especially for the residents.”

For more information visit www.tena.com.au

Introducing the latest from Japan – The Hug, a Mobility Support Robot Hug is designed with supporting people who face mobility issues. It allows you to move a person from bed to wheelchair or wheelchair to the toilet. Hug assists when needing to transfer a person to a sitting position or in situations where standing for a period of time is required, such as getting dressed. Hug supports those who have the ability to stand on their own, but for a particular reason, have limited mobility when standing. Hug is ready to use, anytime. Hug does not use a sling or harness, which means no consuming setup time. Hug does not only raise a person, but brings them forward in a sliding motion to stand, effectively distributing their weight to the backs of the heels and allowing the person to feel comfortable while standing up. The Hug allows and gives people their dignity as they are reluctant to move because they do not wish to burden others with heavy lifting. The Hug robot can now take over the lifting work that has been the domain of care workers to ensure less physical stress and the avoidance of back injuries.

Contact: Gerald Koh, Kobot Systems Pty Ltd Tel: 04-1996-1978 Email: gkoh@kobot.com.au

COMPUTER SOFTWARE

| TECHNOLOGY

8-9 March 2017 | International Convention Centre, Darling Harbour, Sydney

TRANSITIONING TO A CONTEMPORARY SERVICE IN A CONSUMER DRIVEN MARKET PLACE Aged Care 2017 will address reform across the following areas:

Consumer Directed Care (CDC) – the impact on consumers and providers

Innovations in technology to enhance and enable ageing in place

Remaining competitive in a consumer driven market Place

Rethinking the way we provide care for people living with dementia

Revising your business model in response to government reform and consumer demand

Moving away from traditional models of aged care, to a restorative and teaching model

Communicating with the consumer – challenges in planning and contracting support services

The design and delivery of retrofit and new build aged care facilities

Workforce requirements – do you have the necessary skills to administer CDC?

Understanding the technology investments that can bring long term financial savings and improved patient care

SPECIAL CONFERENCE PRICING AVAILABLE FOR: Government, Local Area Health Services, Public and Private Health Facilities and Aged Care Providers Visit: http://ac.austhealthweek.com.au for more information

Hands love Jasol.

NEW

From liquid to foam hand soaps with the latest dispensers weâ&#x20AC;&#x2122;ve got all your hand hygiene needs covered. NEW TOUCH FREE & MANUAL LIQUID OR FOAM SOAP DISPENSERS Jasolâ&#x20AC;&#x2122;s new wall mounted soap dispensers have a 100% disposable inner mechanism to ensure full hygiene integrity. Both units have interchangeable pumps and soap pods that can be easily switched between each. Once the soap pods are placed in the unit they only need replacing when the container is empty. The chemical is never in contact with air or germs.

NEW SAFE T GUARD Why not combine your Jasol Dispenser with our new, non alcohol, foam hand sanitiser. Also sold in 50ml and 500ml packs. Contains unique ingredients that reduce the spread of germs. Placed directly onto the skin it quickly evaporates when hands are rubbed together.

Speak to your Jasol Account Manager or contact our customer service team on 1 800 334 679 or visit jasol.com.au

Providing hygiene service solutions since 1934