LASA Fusion Winter 2015

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

WILL IT BE CONSUMER DIRECTED CARE OR CHAOS?

Image courtesy of Ivelin Radkov/shutterstock.com

FOCUS ON... WORKFORCE

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PUTTING A DOLLAR VALUE ON WORKPLACE CULTURE

43

ACCOMMODATION PAYMENTS EXPLAINED

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NEW WAYS TO MANAGE PAIN

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CONTENTS The voice of all aged services

NATIONAL UPDATE

Winter 2015 | www.lasa.asn.au

5 CEO Report 7 Chair Report

EDITOR

8 FOCUS ON

Katie Mckeown

LASA FEDERAL

15 NEWS

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

OPINION 27 Federal budget analysis

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

FEATURES 32 CAPABILITY Gender equality in aged care

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

A new leadership framework

LASA SA

rural needs

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

LASA WA

36 FUNDING Revised funding scheme to address

FEDERAL BUDGET 2015 28 : 2015 Federal budget observations

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

39 ACCESS The right Information 43 WORKFORCE Measuring workplace culture 52 QUALITY New Rainbow Tick Accreditation Leading reconciliation in age services

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

BUSINESS MANAGEMENT 55 Accommodation payments for low means residents

ADBOURNE PUBLISHING PO Box 735, Belgrave, VIC 3160

57 Is there a business model

Adbourne

that guarantees financial success

PUBLISHING

Advertising

Melbourne: Neil Muir (03) 9758 1433

Adelaide: Robert Spowart 0488 390 039

WORKFORCE

HEALTH & WELLBEING 59 The value of spirituality

Production

Emily Wallis (03) 9758 1436

48 : A top job in a top industry

61 What the new healthy eating pyramid means for aged care

Administration Robyn Fantin (03) 9758 1431

65 Couples Counselling for RACPs

Susan Moore Marketing susanmoore@y7mail.com

& GPs

71 A new approach to pain

DISCLAIMER

management: An evidence based approach

Fusion is the regular publication of Leading Age Services Australia (LASA). Unsolicited contributions are welcome

76 CPD Activities

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 from the article’s author.

SPONSORS:

PAIN MANAGEMENT

77 EVENTS

71: Breaking through barriers to pain management

84 WHAT’S NEW

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CEO

| NATIONAL UPDATE

CONSUMER DIRECTED CARE OR CHAOS COME JULY 2015?

The full rollout of Consumer Directed Care is now under way and it’s becoming clear the architects are over simplifying the realities of transition.

R

ecently Assistant Minister for Social Services, Mitch Fifield, criticised some home care providers for failing to make the transition to consumer directed care early enough, reminding providers they had three years to prepare for the changes and address the loss of the ability to cross subsidise clients.

The Minister said there was an expectation that providers would transition people over time as consumers left packages, but “what is becoming increasingly clear is that not all providers have done what they should have done over that period…so that’s disappointing,” he said.

The view that providers should have a Pollyanna approach to changes in government policy that materially affect their livelihoods, their staff and client outcomes is patently cock eyed rent seeking from the government.

A key issue the Minister has missed is that the guidelines were only released in June/July 2014 and then updated in August 2014 just as they were supposed to be implemented. These delays also meant that software vendors and other supports were unable to develop IT solutions to ensure automation of new requirements to do individualised statements through integration of care systems to financial systems. We are yet to see a fully integrated solution from industry vendors and many early adopters of CDC have built bespoke systems or have invested heavily in their own infrastructure to meet the requirements.

When you also consider the Medicare payments and means testing debacle was at its full pitch right at this time, which drained resources and funds from providers at a critical moment for CDC, it is hardly surprising that many providers feel that there has been no tangible support from government on how to cost or manage service changes, develop service offerings, train staff, defray costs to purchase infrastructure and generally align the cultural requirements of the new approach to home care.

Patrick Reid Chief Executive Officer Leading Age Services Australia

Despite being a partner, we are disappointed that www.homecaretoday.org.au and its related seminars (which members have to pay to attend) is the only support being funded by government. LASA state offices have run sessions for members (and non-members) in an attempt to offset the information gap but the consensus is that government has simply not provided enough on the ground support.

The Minister also claims that, as the average tenure on a package is two years and all long term clients who were receiving care above their allocated package through cross subsidisation should have moved off their packages up to the next level or into residential care.

The contingent issue is LASA members have clients who have been on packages longer than three years, receiving above their budgeted amount, and these are the clients who are struggling.

LASA members continue to negotiate in good faith with consumers around their package requirements but there will undoubtedly be more than a handful who will lose a significant amount of care. The reality is that there simply aren’t enough level 3 and 4 packages around to absorb all those who need these packages and the care they represent, so consumers languish on level 2 packages subsidised by providers as they await an available higher package.

While some may not have done all they should, it is unacceptable to blacken the names of providers who have taken all reasonable steps to follow the government policy, just because they have long term consumers who have had the benefit of arbitrage arrangements to ensure an appropriate quality of care.

If the Minister and Department are serious about a co-design approach to solving the issues of aged care, they will work with us and our members to find solutions for struggling consumers on a per case basis.

Members are encouraged bring specific cases of concern to the attention of their state LASA office so we can demonstrate real case studies to government. ■

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2014 winners, left to right: Jennene Buckley, representing Feros Care; Graham Custance, Care Connect; Paula Fievez, Ageing Wisely.

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CHAIR

| NATIONAL UPDATE

OUR ACHILLES HEEL Apologies to Samuel Taylor Coleridge when I paraphrase one of his lines to suggest, “workforce, that vulnerable heel of the aged care achilles!”1

T

he aged services workforce is estimated to grow from 352,100 to 827,100 employees by 20502. Yet today, 75 per cent of residential facilities and 50 per cent of the home care community report skill shortages in one or more occupations.

It’s anticipated the increasing demand for nursing and allied health professionals in the age services industry will be further exacerbated by increased competition for staff with the staged introduction and upscaling of the National Disability Insurance Scheme (NDIS).

Therefore, it makes sense to consider the learnings and context of the NDIS workforce strategy: • Workforce shortages: estimates vary on how many workers will be required in the future; however, support is labour-intensive and some estimate the demand for workforce will grow in line with the market.

• Increased fragmentation of jobs: the most common form of employment for non-professional workers is permanent part-time and there is also a relatively high proportion of casual employment.

• Lack of appropriately skilled workers will undermine choice and quality: As participant choice and new technology shifts the provision of support to the home, skills and associated job roles will need to change. There are widely diverging views about skills required and who should provide them.

• Uneven access: People from minority groups such as Indigenous and some ethnic communities, LGBTI and homeless people currently lack access to appropriate support. The distribution of the available workforce does not match the geographic spread of current and future NDIS participants.

• The number of informal carers is expected to decline, as a result of ageing, the changing roles of women and changing family structures.

This projected increase in demand for age services requires tangible actions to ensure the industry can meet the needs and demands of all older Australians.

Tangible actions are needed ensure the industry can meet the demands of all older Australians.

Although LASA national CEO, Patrick Reid, chaired the workforce audit working group on behalf of the Aged Care Sector Committee, the report still sits with DSS several months after the initial work was completed.

In January this year Minister Fifield said the audit would provide an evidence-based foundation for developing an aged care workforce

Dr Graeme Blackman OAM Chair I LASA development strategy. The working group furiously agreed this audit was only a precursor to work that should inform an urgently needed workforce development strategy. Concern remains that the government does not consider workforce development a priority.

To achieve a meaningful outcome, LASA conceives an aged care workforce development strategy that produces a workforce equipped to best meet the changing needs of all older Australians regardless of their circumstance or background.

This will only be realised when we see conditions that support an industry funded and structured to perform highly in skills, health, safety and positive work life balance via consistent and appropriate training delivery.

LASA has identified three pathways to help meet the identified expanding requirements of the workforce: 1. The Commonwealth must invest in enhanced training opportunities and initiatives, including mandatory clinical placements in aged services facilities, and offer financial incentives and funding for placement and employment opportunities in the age services industry.

2. A review of workforce constraints and improved access opportunities is needed with respect to Australian immigration laws. Sensible adjustments and amendments to immigration laws that provide greater access for overseas workers to join the age services industry must be considered.

3. Transitional funding for displaced workers to encourage and target opportunities within the age services industry must become a priority focus. All pathways and workforce considerations must ensure sufficient training to bridge any language, cultural or other barriers to attracting and retaining the workforce. Initiatives need to take into account mobility and resources to meet age service needs in rural, remote and other special needs areas.

If we consider aged care reform to be the many battles that we have triumphed over, we cannot allow an unsupported workforce to be a poisonous arrow lodged in our heel. ■

REFERENCES 1. “Ireland, that vulnerable heel of the British Achilles!” from 1810 2. www.myagedcare.gov.au

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FOCUS ON

Charles Wurf Chief Executive Officer LASA NSW-ACT

Barry Ashcroft Chief Executive Officer LASA QLD

Paul Carberry Chief Executive Officer LASA SA

Trevor Carr Chief Executive Officer LASA VIC

Beth Cameron Chief Executive Officer LASA WA

FOCUS ON... WORKFORCE LASA has five strategic goals that help to guide and prioritise the work we do on behalf of our members. These goals have been determined by the national board, which consists of representatives from every state. To help translate these goals into the issues that impact the industry, service providers and people, in each edition of Fusion we will focus on one of our strategic goals and key issues relating to it.

New workforce policy for age services LASA’s annual consultative policy review process has culminated in a number of updates to our existing policies. To ensure accurate, comprehensive and transparent representation of the whole age care industry, this process draws on information and contributions from across the industry as well as seven specific working groups at national level, supported by multiple working groups at state level.

Our workforce policy has recently been updated to reflect the 2015 budget announcement that the Government is planning to cut 15 per cent of the Aged Care Workforce (Development) Fund, which may jeopardise innovation and put quality at risk. With forward estimates predicting that the age services workforce needs to triple in size by 2042, the reduction of available funding to support training and education, in conjunction with the decrease of Aged Care Service Improvement and Healthy Ageing Grants Funds, the concerns around the Severe Behaviour Response Teams and the loss of supplements is not supportive to the industry. An available, accessible and appropriately skilled workforce is a fundamental

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requirement of the growing age services industry. Sourcing and maintaining a sustainable workforce is therefore a significant issue.

More than 240,000 workers are employed in direct care roles in the age services industry. Of these, 147,000 work in residential facilities, and 93,350 in community outlets.

Residential, home and community care providers continue to struggle to access appropriately skilled and available staff. All providers need support, funding and new initiatives so as to adequately fulfil current and future staffing needs.

Research indicates 75 per cent of residential facilities and 50 per cent of the community outlets report skill shortages in one or more occupations.

It is anticipated that the increasing demand for nursing and allied health professionals in the age services industry will be further exacerbated by increased competition for staff with the staged introduction and up-scaling of the National Disability Insurance Scheme (NDIS).

With the clear move towards consumer directed care and client determined service outcomes LASA advocates for a national industrial relations

FOCUS ON

framework that will protect and preserve measures that enable maximum workforce flexibility.

With an expected increase of assisted technology to support the delivery of care and services LASA supports employment laws that allow aged care employers to be agile and adapt to the changing demands of their clients.

While aged care (specifically residential) remains working under a medical model, consumer focused flexibility work practices may not eventuate.

As identified by the Australian College of Nursing, nurses may take on leadership roles beyond the nursing domain, and nurse leaders are needed in all settings and across all levels of the organisational hierarchy. Nurses (including Nurse Practitioners) need to take on the clinical leadership role, which involves delivering and monitoring evidence-based best practice, evaluating outcomes within a continuous improvement framework, assessing and mitigating risks, improving efficiency and coordination at the point of care while advocating for those they care for. The NILS Report also states that there is significant variation in the management skills and training between care providers. A direct correlation has been noted between these skills and the workplace satisfaction of the direct care workers. A specific issue of note is the concern that the training generally provided is focused exclusively on residential care and does not address the community sector appropriately.

Urgent need for young health professionals in aged care New aged care training programs are attracting a cohort of health professionals; however, the proportion of age care professionals under the age of 35 in the workforce has not changed since 2003.

The proportion of age care professionals under the age of 35 remains at 18 per cent, in spite of the fact that the overall aged care workforce is rising.

While the residential aged care workforce grew 29 per cent between 2003 and 2012, the average age for residential direct care workers is 48 years and 50 years for community direct care workers.

“There is a perception that aged care is an unappealing career option for people under 35 years, and yet there are many genuine career opportunities across the sector that can make a meaningful difference to people’s lives” LASA Victoria CEO, Trevor Carr, said.

“We know that aged care professionals derive a sense of satisfaction from the positive benefits they bring to those they are caring for. They find their careers satisfying and value the career opportunities the sector provides.”

“We need to create more awareness that working in aged care can be a very rewarding career pathway personally and professionally,” Mr Carr said.

Key objectives

Statistics highlight a critical shortage of aged care professionals today – not five or 10 years from now.

1. Workforce development

The industry needs job growth of 300 per cent to reach the 1,000,000 roles required to care for an ageing population.

2. Attraction and retention 3. Review of workforce constraints With more care being delivered in the home, with a total number of packages increasing from 60,000 to 100,000 by 2017 and more than 40,000 additional packages from 2017-18 to 20217 and under a framework of consumer directed care, care delivery models and those delivering care will need to change to meets the growing demand.

LASA has identified a number of pathways that can assist in meeting the identified expanding requirements of the workforce. The industry calls for a review of workforce constraints and improved access opportunities with respect to Australian immigration laws. Sensible adjustments and amendments to immigration laws that provide greater access for overseas workers to join the age services industry and opportunities for age service providers to increase their labour pool must be considered. Secondly, transitional funding for displaced workers to encourage and target opportunities within the age services industry must become a priority focus.

“We need to train and develop the next generation of the age care workforce, particularly in regional areas where we know the number of ageing people needing services is growing more rapidly than the national average,” Mr Carr said.

Members are encouraged to use training programs on offer by LASA to ensure their staff receive the most up to date information in their course and best practices are followed.

Supporting members to understand and comply with employment relations Since the launch of the new national LASA Employment Relations advice series, we have published 15 advices to support members to understand and comply with Australian employment relations and keep up to date with inquiries and decisions.

The following advices have been issued since January 2015: • Productivity Commission Review of the Workplace Relations Framework

All pathways and workforce considerations must ensure sufficient training is available to bridge any language, cultural or other barriers to attracting and retaining a workforce and initiatives need to take into account that the age services workforce needs to be mobile and resourced to meet age service needs in rural, remote and other specific needs areas.

• Productivity Commission issues papers released - inquiry into the performance of the Australian workplace relations framework.

As part of our advocacy for employment laws that enshrine workforce flexibility and equity, LASA supports and encourages fairness and equity across the industry. LASA encourages federal and state governments to ensure all aged care employers are given an equal opportunity to receive/ apply for grants, concessions, supplements and exemptions.

• International Criminal History Checks

To view the full policy go to www.lasa.asn.au/lasa-policies

• National Annual Wage Case Decision

• Modern Award Review Process: Aged Care Award 2010 and the Social, Community, Home Care and Disability Services Industry Award 2010

• Government response to the Independent Review into the integrity of the subclass 457 visa programme • Modern Award Review Process: Transitional Provisions

For more information or for a copy of an advice please contact your LASA office.

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FOCUS ON

Two new decisions affecting annual leave and wages handed down by Fair Work Commission

Employers bargaining an enterprise agreement may be requested to include the above variations when drafting and negotiating the terms of an enterprise agreement.

A decision handed down by the Full Bench of the Fair Work Commission (FWC) on 11 June 2015 will result in a number of changes to paid annual leave provisions across nearly all modern awards.

Employers currently operating under an enterprise agreement should review and compare these new entitlements to those contained in their current agreement. This decision will be of interest if soon renegotiating an agreement as it may impact the Better Off Overall Test (BOOT).

The changes detailed in the decision will impact modern awards including the Aged Care Award 2010, Nurses Award 2010, and the Social, Community, Home Care and Disability Services Industry Award 2010.

LASA supported variation applications submitted by the Australian Chamber of Commerce and Industry has summarised the key changes for members in a table below.

The variations detailed will need to be reviewed to ensure compliance with modern awards.

Policies and procedure documents may need reviewing in accordance with new modern award entitlements and employers should consider communicating these changes and what they mean to terms and conditions of employment with their employees.

To view the model clauses to be included in modern awards and to download the Summary Decision please go to www.fwc.gov.au/cases-decisions-andorders/significant-decisions-summaries-orders/summaries-decisions-interest LASA will advise members when these determinations have been finalised and take effect.

On 2 June 2015 the Expert Panel of the Fair Work Commission handed down the national annual wage decision. The decision confirms an increase to the National Minimum Wage of $17 per week and an increase of 2.5 per cent to modern award wages.

LASA will advise members when these determinations have been finalised and take effect. For more information on our Employment Relations Advice please contact your LASA Office.

Application

Decision

Awards

Cashing out annual leave

A Model term to be included in all modern awards allowing for the cashing out of annual leave in certain circumstances.

Aged Care Award 2010

The Model term proposes allowing an employee to cash out a maximum of 2 weeks’ accrued annual leave in a twelve month period, so long as the employee maintains an annual leave balance of no less than 4 weeks’ accrued annual leave.

Excessive annual leave

Provisional view of the tribunal is to include a Model term in all modern awards allowing an employer to require an employee to take annual where an excessive balance has been accrued.

The draft Model term defines excessive annual leave as an accrued annual leave balance of more than 8 weeks’ for non shift workers, and more than 10 weeks’ for shift workers.

Nurses Award 2010 Health Professionals and Support Staff Award 2010 Social, Community, Home Care and Disability Services Industry Award 2010 Aged Care Award 2010 Nurses Award 2010 Health Professionals and Support Staff Award 2010 Social, Community, Home Care and Disability Services Industry Award 2010

The Model term only allows an employer to direct an employee to take annual leave after attempting to meet and genuinely discuss steps to reduce the excessive balance with their employee. Furthermore, an employer cannot direct an employee to take accrued annual leave that would result in the employee’s remaining accrued entitlement to paid annual leave at any time being less than six weeks.

Annual close-down

Provisions dealing with close-down clauses should be considered on an award by award basis.

Aged Care Award 2010 Nurses Award 2010 Health Professionals and Support Staff Award 2010 Social, Community, Home Care and Disability Services Industry Award 2010

Granting annual leave in advance

A Model term to be included in 48 modern awards that were the subject of this application. The Model term provides where an employer and employee agree, an employee can take annual leave in advance of its accrual.

Draft determinations will be prepared and published on the FWC website for comment.

Purchased leave

Interested parties are asked to consider whether a provision for purchased leave should be included in modern awards. The matter will be listed for further hearing before the Full Bench on 28 July 2015.

Payment of annual leave entitlements on termination

As a matter is currently being considered by the Full Court of the Federal Court on a claim of a similar nature this matter was adjourned. Interested parties may seek to have the matter called back on for further programming and submissions.

EFT and paid annual leave

Modern awards (that were the subject of this application) to include terms that allow annual leave to be paid in accordance with an employee’s usual pay cycle.

Draft determinations will be prepared and published on the FWC website for comment.

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Aged Care Award 2010 Nurses Award 2010 Social, Community, Home Care and Disability Services Industry Award 2010

Nurses Award 2010

FOCUS ON

Resources to support employers Two useful workforce resources designed to assist with improving age and disability workforce engagement and management practices are available to LASA members.

Age Management Toolkit for Employers was developed by National Seniors Australia and contains leading age management practices that can be tailored according to an organisation’s individual strategic goals, size and age profile.

The toolkit comprises evidence-based information, resources, guidelines and good practice examples that have been sourced from a wide range of leading national and international agencies and expert bodies specialising in the fields of employment, management and workforce ageing.

It’s available at www.nationalseniors.com.au/be-informed/research/agemanagement-toolkit.

One in five people in Australia have a disability and people with a disability face obstacles to accessing employment on the same basis as other people. These obstacles may include a lack of clarity about the risks associated with employment of people with a disability and a mistaken belief that people with a disability have limitations that restrict them to basic unskilled roles.

The Disability and Work: A Guide for Aged Care Employers is designed to debunk these myths and highlight the opportunities for aged care employers to benefit from tapping into the talent pool represented by candidates with disability. The guide covers: • The various benefits of employing people with disability • Diverse examples of roles being undertaken in our sector by employees with a disability • The significant resources and support available to employ people with disability

The Disability and Work: A Guide for Aged Care Employers was created

by LASA Victoria and the National Disability Recruitment Coordinator to assist Members to understand the support available and the benefits of employing candidates with disability.

• Common myths about disability and work • Managing and developing people with disability in the workplace.

For more information go to http://lasavictoria.asn.au/workforce-ir/agedisability-workforce-resources/

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FOCUS ON

A National Code of Conduct for unregistered health workers Unregistered health practitioners are individuals who provide a health service that is not registered under the national law, for example complementary and alternative medicine practitioners, counsellors, dieticians, naturopaths, nursing assistants, personal care workers and even social workers employed in a health environment.

The Office of the Health Ombudsman (OHO) is responsible for receiving complaints about health services provided by registered and non-registered practitioners. This includes receiving complaints from members of the public, as well as receiving notifications from employers, educators and health practitioners in relation to the health, conduct and performance of qualified health practitioners.

The OHO commenced in Queensland on 1 July 2014, seeing Queensland join with New South Wales and South Australia as the only states that give power to health regulatory bodies to impose sanctions on unregistered health practitioners. The other Australian states and territories have Commissioners in place with the ability to investigate complaints in regard to unregistered health practitioners, but with no powers of enforcement.

At present, New South Wales and South Australia have Codes of Conduct that apply to unregistered health practitioners; Queensland and the other states do not.

However, in its final report “A National Code of Conduct for health care workers” published in April 2015, the Australian Health Ministers’ Advisory Council recommended terms for a National Code, that when implemented, will introduce new obligations for unregistered health practitioners and expand on some existing obligations found in the New South Wales Code.

Obligations imposed by the National Code include: • Providing services in a safe and ethical manner; • Obtaining consent from the client prior to commencing a treatment or service;

The National Code is yet to be implemented, however unregistered health practitioners need to be aware of the proposed changes to their obligations to clients and perhaps incorporate many of these principles into their current best practice standards.

Age and disability discrimination inquiry A new inquiry into age and disability discrimination will have until July 2016 to report its findings and recommendations.

Attorney-General George Brandis requested that the Australian Human Rights Commission undertake a National Inquiry into employment discrimination against older Australians and Australians with a disability.

In launching the Inquiry, he said employment discrimination against older workers or people with a disability potentially affects millions of Australians and also has a significant economic and social cost to the broader community.

The Willing to Work: National Inquiry into Employment Discrimination Against Older Australians and Australians with Disability, will examine practices, attitudes and Commonwealth laws that deny or diminish equal participation in employment of older Australians and Australians with disability.

The Commission has been asked to consult broadly and with specific regard to: • The obstacles faced by older people and those with disabilities in actively participating in the workforce • Discrimination against them as a “systemic problem and a considerable barrier to their enjoyment of human rights” • economic, social and productivity costs resulting from the discrimination • The government’s commitment to promote and protect the human rights of older Australians and those with disability.

• Reporting concerns about other health care workers; • Disclosing adverse events to the both the client and relevant authority, and taking remedial steps to reduce the risk of recurrence; • Adopting standard precautions for infection control; • Seeking advice from a registered health practitioner when suffering an infectious disease on necessary steps to avoid the possibility of transmission to clients; • Not making claims to cure certain serious illnesses such as cancer; • Not to practice under the influence of alcohol or unlawful substance; • Taking advice from a prescribing health practitioner or dispensing pharmacist on the impact of prescription medication on their ability to practice • Seeking advice from a registered health practitioner when suffering an impairment; • Not to financially exploit clients; • Not engaging in sexual misconduct; • Complying with relevant privacy laws and keep appropriate records; • Obtaining appropriate indemnity insurance cover; and • Displaying a copy of the Code and information on how a client may make a complaint.

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NEWS

NEWS Fight continues for payroll tax exemption LASA is continuing to lobby state and federal governments on behalf of members impacted by the Payroll Tax Supplement cessation.

LASA maintains the decision to cease the Payroll Tax Supplement was ill considered and detrimental to the delivery of care to older Australians today and in years to come.

“LASA’s executives have made multiple representations to state and federal ministers to reverse the decision or apply a broad-based exemption to the tax for organisations providing age services under the Aged Care Act 1997,” LASA CEO, Patrick Reid said.

“We are also seeking the introduction of payroll tax exemption for home care providers, and for state governments to amend their tax Acts to broaden the existing exemptions for health care services providers to include all aged care providers.”

“With six months of data now available since the cessation of the tax supplement we can already see a disproportionate impact on private providers of age services and question marks over the viability of many providers,” he said.

Data from a report by the Centre for International Economics shows that in NSW alone, if the growth in private operational places fails to keep pace with recent experience – between 940 and 2,440 places per year – demand will need to serviced by other means, most likely NSW public hospitals. The financial burden of this is estimated in the tens of millions.

“LASA will continue to fight for a better outcome for aged care and home care providers, with a new wave of state-based campaigns commencing in coming months,” Mr Reid said.

“We know some members are speaking directly to their local MPs too and we encourage them to draw on LASA’s updated policy statement, which articulates the issues, provides evidence of the financial cost and outlines viable solutions.”

“The more aligned the industry is on both messages and outcomes the more likely we are of achieving what is needed,” Mr Reid said.

LASA has been advised that the impact of the aged care changes, including the payroll tax matter, is being monitored and reported to the Minister by the Aged Care Financing Authority (ACFA). The latest ACFA report suggests that reforms are improving the overall position of providers, but all data used pre-dates the loss of payroll tax funding. The report is misleading in that the $653 million loss of funding is not shown in the final assumptions.

This will remain a key issue for LASA until it is resolved and we will continue to keep you informed of national and state-based activities.

To view LASA’s updated policy about Supplement Inequity go to www.lasa.asn.au/lasa-policy.

Image courtesy of wavebreakmedia/shutterstock.com

15

NEWS

Congratulations to our Order of Australia recipients

Entries open for Better Practice Awards

LASA congratulates the age services leaders who were honoured on the Queen’s birthday for their commitment and dedication to the industry:

Age service providers have until 6 July 2015 to nominate for the annual Better Practice Awards, run by the Australian Aged Care Quality Agency (AACQA). For the first time the awards will promote and recognise improvement and better practice across the broad spectrum of aged care services including residential aged care homes, home care service, home and community care, national respite for carers and national Aboriginal and Torres Strait Islander flexible care.

- Stephen Becsi OAM, former CEO of The Bethanie Group and past president of ACSA. - Mark Brandon OAM, former CEO of the Aged Care Standards and Accreditation Agency and a member of the Australian Government’s Ageing Consultative Committee.

- Bernard Curtin OAM, Mayor of Berrigan Shire Council, board member of Amaroo Aged Care and founding Chairman of the Berrigan Aged Care Association Committee.

There are six award categories and entrants can nominate for an Award in up to three projects, initiatives or programs each year.

The categories are: 1. Organisational leadership, and staff development

- Helen Jurcevic OAM, Founder of the Women’s Friendship Group

2. Consumer directed care (CDC) and re-ablement

- John Watkins AM, Alzheimer’s Australia NSW CEO

3. Special needs 4. Rural/ remote/ very remote

2015 WorkSafe Awards

5. Personal, medical and clinical care

Age care service providers in Victoria, Tasmania, Western Australia and Queensland still have time to nominate for their respective state WorkSafe Awards, which celebrate excellence in workplace safety and returning to work.

6. Environmental management/ living environment

If you’ve come up with a way to make your workplace safer, whether it’s an everyday achievement or a large-scale initiative, you could be eligible for a WorkSafe Award.

Close dates: VIC – 26 June, QLD – 29 June, WA – 3 July, TAS – 24 July Go to www.worksafeawards.com.au for more information. Note that categories, criteria and entry periods vary across jurisdictions so please check details with your relevant regulator. The ACT and NT do not currently hold WHS awards.

New “Readiness” self assessment tool now available The Future Readiness Review is a self-assessment tool designed to help senior managers and executives review their business models and skills mix to support their organisation’s sustainability and readiness for change.

Developed by the Community Services and Health Industry Skills Council, using a score system the tool provides users with a summary report, benchmark and action plan to inform ongoing quality systems.

For more information and to download the tool go to: www.cshisc.com.au/develop/workforce-planning-and-development/

Modern award review update The timeline for proceedings relating to the Nurses Award 2010 and the Health Professionals & Support Services Award 2010 has been further delayed. Instead of commencing in May the new timeline is as follows: • By 15 July 2015 each party is to file in the Commission a written outline of submissions in relation to any substantive claims or variations being pursued • By 21 August 2015 each party is to file a written outline of submissions in reply to any substantive claims or variations being pursued • The matters will be listed for an initial hearing before a Full Bench on 7 and 8 October 2015.

This delay follows the notification in March that the hearings relating to the review of the Aged Care Award 2010 and the Social, Community, Home Care and Disability Services Industry Award 2010 would be deferred until 2016.

LASA will continue to keep members updated as matters progress.

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To be eligible, applicants must: •

be an Australian Government-funded residential aged care home and/or

•

be an Australian Government funded home care service

• Must have not recorded any episodes of failure to meet the applicable Standards in the past 24 months.

For more information go to: www.aacqa.gov.au/for-providers/better-practice-awards or call 1800 288 025.

Accreditation change a big win for aged care innovation but success will depend on workforce LASA has welcomed changes to privatize aged care accreditation and believes quality, consumer choice and innovation will flourish as a result.

“The number of Australians relying on age services is growing by the day.

Change is needed urgently but regulation has been standing in the way of innovation,” LASA CEO, Patrick Reid, said.

“The age services industry needs innovation to drive competition, improve quality standards and give consumers more options. Experience has shown that consumer choice cannot be regulated.”

“As the voice of age services, LASA has lobbied hard for the removal of this red tape. We firmly believe the independent provision of accreditation services in aged care will lead to improved services for our ageing population.”

The 15% cut to the workforce development funds, however, may jeopardise innovation and put quality at risk.

“It is our workforce that underpins quality and innovation in age services, and the impact of changes to the not-for-profit employment benefits along with a reduction in the workforce development funds cannot be ignored,” Mr Reid said.

The age services workforce is already under immense pressure and needs to triple in size by 2042 to ensure that all older Australians have access to essential services in a timely and dignified manner.

“We view these accreditation changes as a significant win for Leading Age Services members and will continue to work with stakeholders to further reduce the red tape that is hampering innovation and quality in other areas of the industry,” Mr Reid said.

Image courtesy of JPC-PROD/shutterstock.com

Age services input vital for success of e-health records LASA has welcomed the proposed changes to the Personally Controlled eHealth Record but says consumers of age care services must be involved in any review or pilot sites.

“Changing MyHealthRecord to an opt-out model will increase utilisation by older Australians to the benefit of individuals, their carers and families, and our over-burdened health system,” LASA CEO, Patrick Reid said.

“Engaging aged service providers and peak bodies such as Leading Age Services in the review process will be vital to ensuring specific needs are considered and addressed and that everyone involved in caring for older will understand how the system will work.”

“I call on the new Australian Commission on eHealth (ACeH) to actively involve LASA in its review process and acknowledge the importance of addressing issues unique to age service providers for the benefit of older Australians,” Mr Reid said.

Sane ‘Ageing Well’ guide

“This is also an issue for states and territories, with the management of chronic and acute health problems both in aged care facilities and community settings a growing cost for state budgets.”

Mental health charity, SANE Australia, has released a new handbook to help older Australians living with mental illness, and their carers and families, plan for the future.

“COAG should also be pushing for the inclusion of aged care services in the pilot sites to ensure the needs of older Australians, their families and carers and service providers are addressed with a primary focus on improved health outcomes.”

Titled, “Ageing Well: A guide to planning ahead for older people who live with mental illness, their family and friends” the handbook covers home and social supports, health, legal and financial issues and includes a checklist to help work through the planning process.

Improved e-health records and increased utilisation stand to benefit the one million older Australians who receive age services, and transfer in between home, hospital and residential care.

It was developed following research conducted by SANE Australia found two in every three people hadn’t discussed a plan for the future with their carers or families.

“Evidence shows continuity of care, especially during the transfer between health settings and between primary and specialist care, results in improved health outcomes,” Mr Reid said.

“The process of planning ahead can be confronting,” SANE CEO, Jack Heath, said.

LASA recently completed a telehealth pilot program that indicated acute hospital admissions were reduced by between 30% and 60% for older Australians receiving eHealth enabled services, while enhanced ICT capability of aged services found a 20-30% improvement in workforce productivity.

LASA members believe the government has under-invested in aged care technology while health care providers have received incentives and funding to drive IT uptake.

“To create a sustainable aged care industry that can positively contribute to quality standards and outcomes within health care, funding must flow to give service providers adequate tools and connectivity to properly utilise e-health records,” Mr Reid said.

• The government’s commitment to promote and protect the human rights of older Australians and those with disability.

New palliative care TV program launches for aged care staff A new television program will be launched in July for people working in residential and community aged care to understand how to access and provide quality palliative care services.

Co-produced by the Aged Care Channel and specialist palliative care and advance care planning advisory service, Decision AssistCo, the 30 minute program is aimed at registered and enrolled nurses, experienced aged care staff, case managers, GPs, and allied health professionals working for residential or home care providers.

Decision Assist – Palliative Care support for Aged Care planning will air at 2.15 pm (AEST) on Wednesday 29 July 2015 and is free to all viewers.

For more information go to www.acctv.co/au/decisionassist

“We’ve spoken with older people living with mental illness and while their experiences vary widely, declining physical health, an uncertain housing future and isolation are common concerns. All these factors can complicate mental health issues and prevent a person from ageing well,” he said.

Age service providers are encouraged to download the handbook from www.sane.org/projects/aged-care or contact 03 9682 5933 to order hard copies.

My Aged Care workshops LASA Queensland in partnership with DSS and ACSA, has completed a series of workshops to help administrators with the transition to MyAgedCare.

MyAgedCare and CHSP Comprehensive Regional Support Approach aims to ensure that CHSP providers understand: • the CHSP taxonomy as it pertains to their existing service delivery and be able to translate that into the MyAgedCare provider portal • how to set up their organisation within the MyAgedCare provider portal • how to update their service inventory so that: o effective referrals can be made from 1 July 2015 o s ervice type information can be used as a basis for new CHSP agreements from 1 November 2015 • the process for establishing new agreements and provided with helpful information to prepare them for this process.

“Understanding how to implement these changes is vital to ensure that service finders within the website display accurate information that is publically available and enable appropriate referrals to providers,” Kerri Lanchester, LASA Q Community Care and Retirement Living Manager, said.

Learn more about MyAgedCare at the interactive panel session at LASA National Congress on Monday 12 October at 10 am.

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NEWS

Resistance training possible key to independence Community service provider, Burnie Brae, is helping older people to muscle up against disability and provide valuable research into the benefits of progressive resistance training through a $1.3 million grant provided by the Department of Social Services.

The two-year research project, which is expected to start in August, will work with 600 people aged over 65 who receive Home Care or Home Support services in Brisbane’s north.

The group will participate in a twice-weekly progressive resistance training exercise program utilising the latest in European, computerised HUR equipment.

It builds on Burnie Brae’s extensive expertise working with seniors in its Healthy Connections gyms in Brisbane, and will evaluate the effectiveness of progressive resistance training as a service model of care, to help people stave off later life disability and live independently for longer.

CEO, Kevin Rouse said the grant adds to the already significant work that Burnie Brae and its subsidiary, Healthy Connections, have done in the area of exercise, rehabilitation, wellness and healthy living for seniors.

“Given the strength of evidence, we expect that with regular progressive resistance training, the participants will reduce their trajectory of health decline and improve and prolong their wellbeing,” he said.

The project – led by the University of Queensland’s Dr Tim Henwood, in partnership with Burnie Brae, Bond University, HUR Australia and St Vincent’s Health Australia – will also evaluate any potential economic benefits.

The funding is part of the Department’s $34 million Aged Care Service Improvement and Healthy Ageing Grant scheme, which aims to build the capacity of local aged care service providers to better meet the needs of older Australians in the community.

For more information or to register for the quantitative and qualitative research project, titled Muscling-up against disability in older adults with home care packages: Implementing an evidence-based progressive resistance training service model of care, contact Chief Researcher, Tim Henwood PhD, BSc (Hon1 - HMS), BSc (Sp&ExSci), MESSA, EP, MAAG E: t.henwood@uq.edu.au P: 07 3720 5303

Image courtesy of Belushi/shutterstock.com

Commend aged care providers, don’t punish them with more red tape LASA has welcomed the report into residential care arrangements for young people with severe disabilities, but disagrees with the recommendation that aged care accreditation standards should be amended.

“The standards, which fall under the Aged Care Act, are designed to ensure age service providers meet the needs of ageing Australians.

They were never intended to guide the care of people with severe disability,” LASA CEO, Patrick Reid said.

“To suggest changing the aged care accreditation standards as a practical, short term solution is ill-conceived and completely at odds with the more pressing matter of finding alternate accommodation solutions for people with severe disabilities.”

“Regardless of their age, Australians with severe disabilities need and deserve to be cared for by skilled professionals who have chosen that career path, in facilities that are equipped for their needs,” Mr Reid said.

“To optimise the quality of life of the younger person and to provide the right socialisation, it is not necessarily ideal to mix younger people with an older population in which the majority have some level of cognitive impairment.

The care delivery is a completely different model.”

Despite this, many aged care facilities with clients who have severe disability are providing the best possible standard of care and have done so for years in the absence of alternate options.

Feedback to LASA suggests the majority of younger care recipients are satisfied with the care they receive in aged care facilities.

“We should be commending the staff and management of these facilities for their compassion and flexibility, not punishing them for it by creating additional red tape tied to their accreditation,” Mr Reid said.

“The committee knows that young people should not be living in residential aged care, which is why it has recommended they be transitioned to alternative accommodation by June 2018.”

“Any taskforce should be focused on achieving this sooner rather than later, not on changing accreditation standards for a whole industry based on the needs of approximately two per cent of all aged care residents,” Mr Reid said.

NEWS |

RESEARCH

Study finds falls cause most deaths New research has found that falls cause the vast majority of deaths in nursing homes.

Labelled the first research of its kind, the authors looked at injury related or premature deaths of residents in nursing homes and found that between 2000 and 2012, 89% of deaths in nursing homes were from falls.

The study, published in the Journal of the American Geriatrics Society, looked specifically at homes in Victoria, where 1,296 deaths were reported during this time.

Led by Professor Joseph Ibrahim, from Monash University and the Victorian Institute of Forensic Medicine, the study showed 7% of deaths were from choking, 1.3% were from suicides, 0.6% from complications in clinical care, and 0.5% were by resident-resident assault.

Prof Ibrahim said debate is needed over whether residents may choose activities that enhance their quality of life but increase the potential of harm or death, particularly from falls or choking.

He noted the higher incidence of falls related deaths in nursing home than the general community is likely due to the increased frailty of the residents and requirements introduced in 2007 to report deaths from falls.

To view the full study go to: http://onlinelibrary.wiley.com/doi/10.1111/jgs.13377/abstract

Study into role of Case Managers in community care Community Care Case Managers are most effective when they do not see themselves as gatekeepers or direct service providers, but rather as there to help clients to access services, a new study has found.

The perceptions of case managers’ roles in providing community aged care in Australia was the subject of a new study by University of Melbourne and the National Ageing Research Institute (NARI).

Participants articulated 16 important roles of case managers that centred around helping clients including advisors, advocates, carers, communicators, co-ordinators, educators, engaging clients and families, liaising with people, navigators, negotiators, facilitators, problem solvers and supporters.

However, the researchers were concerned that others saw themselves as brokers, mediators and counsellors.

The findings, published in the journal Health and Social Care in the Community, will assist organisations to design job descriptions specifying case managers’ roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation and ongoing development, as well as facilitate case managers to set professional boundaries in the delivery of case management interventions to their clients.

For more information go to: http://onlinelibrary.wiley.com/doi/10.1111/hsc.12238/abstract

Image courtesy of Monkey Business Images/shutterstock.com

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NEWS

New project sees consumers co-designing age services Ten community care organisations will take part in a trial co-production that aims to involve consumers as equal partners in the design and delivery of age services.

The Step Forward: Create Better Together project is managed by CommunityWest in conjunction with COTA Australia, and will focus on wellness and enablement of age services within the participating organisations.

The co-production approach has been used extensively in the UK in disability and aged care, which LASA strongly supports as the best way of ensuring the needs of consumers are adequately met.

Commencing in October 2016, the pilot phase will run for eight months, funded under the latest round of Aged Care Service Improvement and Healthy Ageing Grants (ACSIHAG).

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The organisations participating in the trial are: • Uniting Communities (SA) • Centacare Community Services (QLD) • St Bartholomew’s House (WA) • West Coast Community Services (SA) • The Society of Saint Hilarion Aged Care (SA) • Glenview Community Services (TAS) • MercyCare (WA) • Uniting AgeWell (VIC) • Calvary Home Services (NSW) • Jubilee Community Care (QLD Founder of the UK’s first social design agency, Deborah Szebeko will present case studies and innovation practices in the UK at LASA National Congress, arming delegates with practical tools, methods and tips to bring co-design to life in your organisation. Don’t miss this invaluable session on Monday 12 October at 4 pm.

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Co-Design: Tomorrow’s Age Services

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11–14 OCtOber Melbourne Convention & exhibition Centre

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NEWS

Six new policies have been developed this year, in addition to some significant updates to existing policies as noted below.

Policy Statement licy Stat of DPo d t Provision alit at enSer (CDC) Qu and oaren a y Careem t vices em B at l St d yera Directe Care PoFlic dsu er e m n A Co S A

A ion. d plet com ntinue co ing near d in the Aims: Aims: s is licie assiste ve An agepo , Older rs service LASA Aus to ha s industry that suppor tralians fit for purpose. e ofAnhoage embeolder pedservice are sup Austra SA tha p mAn ts t arelians anch was age care, to por s industr tr live e. ou e LAserv well. ble ted y ry that Gr safegu to rece serv navigat so ardsices afforda indu of th cond d and it unnece and ices and andregulat quality ssary essinnova ive, and stry ion and vi red dat to acc e se tha tion andview ians erstand tion, industry mo t safe Adory enjoyin re tral compli g a high the guards allom blicatape of th devetloispeeasy to und A high quality been ance. to provide Aus edLASA lities,dacc ged qualitylevel of public ve gnise e pu snta ent wstry os service confide as tha hareco , app via faci inviteage oach’; that ths ethe valu Aims: and inno ncerop industr and . Th withou m disaedva y whose servicetofocus prop lopm indu needs ch liseyedar rs or riatetevid ru Age of robu a ‘global appr rserving’ of vation and ve ices ion hi service deliv ly be Fo interpret oneawa w gina ulat th ns is de serv continu st data y from ence-base unde ioery.

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Evalu tifie bility ts (o of po iders, CDC able to be man the flexi ammce d in r iona for Economic Developm ged-care/a ra thel cultu (http://ww . be en field.com/ and-a w.mitchfi ages- progr need assisteorgarnisat ent be ed emen For provneedsAtonumber m fo Australia -pack iders in at of t) m Media/Sp smodofels, , provProvider s are D/836/De en home-care ArticleI of CDC ha y St tin. k he fault.aspx) obta eeches/tabid/71/ArticleType/ to CDC opinion that for ps, co have chan anthe ningwhich encare cum 7.ou Courtney, a robust be ArticleView/ those organisa thimprove Polic orge quality M, Edwards, ht do from transitio consisten d St tions Gr H, nces ig focus, and Stephan, te ment a y an The nal Bulle nt measures systemequeplace, ra t J, O’Reilly, m 1 .tly met the for residents pa reableme Re and have ed cons in and dge standards over atend bescc visor of aged care facilities: M. & Duggan, C 2003, ‘Quality clien bers Journal on proc unin prescribed(s , esse knowle of life Natio ider A literature review’, ee se there shouldwith Ad ts business emAgeing, period, le vol. 22, no. 2, pp. m en e may be that the prov ro Australas d ts 58-64. be ther ac e ian n an dgem e toconcerned thatconcerns include, atemen to th likalso tatio oups owle g new LASA St ldis nsul . 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L DRAFT) hold ard co Links to Care – Consumer Provision of Quali to ty Care Bo (V.1.1) (FINA June 1.0)2015 Access 2015 (V r (V1.1)and The

Policy name (2015)

Degree of change from 2014-15

Access to Care – Consumer

Significant

Access to Care – Provider

Significant

Repealing Red Tape

Minor

Supporting Independent Living

Significant

Consumer Directed Care

Minor

Diversity and Special Needs

Minor

Information and Communication Technology

Minor

Newly Built or Significant Refurbishment

Minor

Provision of Quality Care and Services

Minor

Residential Accommodation Pricing

Minor

Specialist Funding (Supplements)

Minor

Updated policy positions now available

Workforce

Minor

LASA has recently updated a number of its policy statements following an extensive review process involving representatives from across the age services industry.

Planning Ahead

New

Commonwealth Home Support Programme (CHSP)

New

Supplement Inequity

New

Transition from Acute to Sub-acute Care

New

Data

New

Pap

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r th

er fo

3.

Pilla force Strategic, Quality & Work Economic

er ards anag Rich yM Kay Polic nal Natio 2015 June 9th

June 2015

Services; (FINAL DRAFT) &

Informatio n

June 2015

and Comm

(V1.0) (FINA L

unication

Technolog

y

DRAFT)

LASA is the only age services peak body that actively involves its members in a transparent consultation process each year to review issues affecting the industry and develop or revise LASA’s positions and goals.

The annual process is driven by national office and supported by LASA’s seven advisory groups, which address member and stakeholder communications; home care; housing and retirement living; residential care; rural, remote and special needs; and workforce relations.

Industry leaders give their input at LASA’s annual Policy Forum before drafts are sent to members for broader consultation. The final policies are the culmination of months of consultation, review and hard work by all involved.

Additional funding won’t help many in early weeks of transition While LASA has welcomed the announcement of an additional $40 million to support changes to aged care, the funding is too late to rectify known problems for many Australians who rely on vital care during the first weeks of the transition to consumer directed care (CDC) on 1 July.

“We are now six days out from one of the most significant changes to aged care funding in recent decades. For nearly two years Leading Age Services has been advocating for additional support for both consumers and providers, realising there are people who will fall between the cracks,” LASA CEO, Patrick Reid said.

“Throwing money at a problem rarely makes it go away. Industry requires careful consideration of the supports in place to help everyone involved in such a transition. This consideration and the remedies must involve industry peak bodies like LASA.” Last week Minister Fifield publicly lambasted providers for not being ready, while today we see a mea culpa that support has been absent.

24

LASA thanks everyone who has been involved in this important process.

To view the full policies go to www.lasa.asn.au/lasa-policy or contact National Policy Manager, Kay Richards on 02 62 30 1676 or email kayr@lasa.asn.au.

The reality is there simply aren’t enough level 3 and 4 packages around to absorb all those who need these packages and the care they represent. So we see consumers languish on level 2 packages subsidised by providers as they await an available higher package,” Mr Reid said.

LASA members have clients who have been on packages longer than three years; clients who through funding arbitrage have been receiving care above their new budgeted amount, and these are the clients who are struggling.

“Our members continue to negotiate in good faith with consumers around their package requirements but there will undoubtedly be more than a handful who will lose a significant amount of care,” Mr Reid said.

“Lets not waste any more tax payer money getting this wrong. If the Minister and Department are serious about a co-design approach to solving the issues of aged care, they will work with us and our members to find solutions for struggling providers and consumers,” Mr Reid said.

NEWS

Housing decisions of seniors review The Productivity Commission has launched a new study into the housing decisions of older Australians and the implications on people’s standard of living, and economy-wide efficiency, equity and sustainability.

The research project builds on the Commission’s past reports in 2013 and 2011, which found many older Australians are asset rich but income poor and that the way older Australians contribute to their cost of aged care, including accommodation, is inconsistent and inequitable.

The study will also examine the impacts of various policies on the housing decisions of older Australians, focusing on: • the tax and social security treatment of the principal place of residence (including the age pension means test) • regulations affecting the supply and cost of residential aged care and other age-specific housing • the availability of market-based equity release products.

It will only consider the accommodation aspects of aged care, which LASA believes is a critically important aspect especially as the trend to in-home care escalates.

“There are various disincentives for older Australians to ‘right size’ their accommodation including state based taxation regimes. Consequently older Australians are finding themselves socially isolated especially as the demographic profile of their neighbourhood changes,” Sundale CEO, Glenn Bunney said.

“Consideration should be given to how as a society we can encourage older Australians to right size by ensuring more appropriate housing is made available to them, enabling a supply of family housing to be freed up in the community.”

Such an increase in supply may well assist in the supply of affordable housing and enable workers to be closer to their jobs – enhancing not only the quality of working life but that of family life as well.

“The whole society can benefit if we can get these policy settings right but it needs new thinking and for government at all levels to not simply seek to apply old policies in different ways,” he said.

The Commission says it will undertake broad consultations with stakeholders and release a research paper in November 2015.

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FUTURE • Est 1984 • Aged Care Specific • Mature yet flexible

EXPENSES • Wages – Cost wages based on service delivery • Purchases – Allocate third party purchases to the CDC Budget • Overheads – Automatically calculate administration and case management overheads

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

REPORT WITH CONFIDENCE • Budgets – Accurately report income earned • System Integration – Automatic generation of acquittals • Business Intelligence – Produce accurate and detailed income statements • Monitor the performance of your CDC Programs

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26

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FEDERAL BUDGET 2015

| OPINION

FEDERAL BUDGET 2015 This is a time of significant change in the aged care sector. Ageing itself is being redefined, with the wave of baby boomers coming through the system set to see the number of Australians aged over 65 increase from 3.3 million to 4.6 million in 20 years.

W

e’re committed to shaping an aged care system that gives providers the tools to respond to these trends.

The Coalition Government has built on earlier reforms, with changes in the 2015 Budget set to strengthen the system by reducing regulation and opening up opportunities for competition.

Senator Mitch Fifield Assistant Minister I Social Services

A market for quality assessments We want to work with you to identify opportunities to improve quality assessment and help the industry adapt to new consumer demands and preferences.

We’ve invested $73.7 million to attach home care funding to the individual, abolishing ACAR for home care.

While the Aged Care Quality Agency’s responsibility to maintain accreditation standards remains crucial, we will work with you to explore private market provision of accreditation services as part of a single quality regime across both community and residential care. This will reduce complexity and red tape for providers who deliver both types of care.

As you know, government funding for home care packages currently goes directly to the provider through the ACAR.

Again, we are doing this with the aim of reducing the red tape with which you currently have to contend.

From 1 February 2017, older Australians receiving Home Care Packages each year will have control over their funds and will be able to direct them to the providers of their choice.

And while this process will include the expansion of cost recovery arrangements, in the long term, a market for quality assessments will improve and simplify the accreditation process for providers, and put downward pressure on costs.

Greater choice in home care

These changes will result in a significant red tape reduction for aged care providers, as you will no longer be forced to apply for places through the annual Aged Care Approval Round.

Funding will now come straight from the consumer who wishes to use your services, freeing you from the burdensome ACAR process and allowing you to focus solely on your client’s preference.

This step will open up competition in the home care sector, leading to enhanced quality, innovation and service delivery.

Simplifying support and care at home We intend to establish a single integrated care at home programme, combining the Commonwealth Home Support Programme and Home Care Packages from July 2018.

People are either supported at home or in residential care, so it makes sense to mirror this by consolidating home care with home support.

My Department will be consulting with you on potential programme models and options for implementation and transition. Your input will be important to shaping the new programme, which will simplify the system for both providers and consumers.

Aged Care Complaints Scheme From 1 January 2016, responsibility for handling aged care complaints will transfer to the Aged Care Commissioner from the Department of Social Services. Moving these powers under the Commissioner will ensure the Scheme is robust and independent.

Short-term restorative care And finally, we are establishing a new form of short-term restorative care to help older people regain independence after a setback, like an illness or a fall.

The new programme will allow providers to develop and offer restorative care, and will incorporate the existing Transition Care Programme. Places under the new programme will be included in the target operational care planning ratio from 1 July.

These changes are designed to build on existing momentum as we move to a more market-driven aged care system that gives providers the freedom to respond to their clients’ needs and preferences.

I welcome your feedback on how, together, we can continue to strengthen and improve the system to ensure we are ready for the bright future that beckons as the preferences of older Australians generation shape the industry going forward. ■

27

OPINION |

FEDERAL BUDGET 2015

2015 FEDERAL BUDGET OBSERVATIONS

By StewartBrown I Chartered Accountants and Specialists in Aged Care and Community Services

The 2015 Federal Budget did not contain many revenue or expenditure measures that were directed specifically at aged care. However, in a budget that was unadventurous on matters of reform, the aged care sector did see an acceleration of the reform process in relation to the way care in the home will be provided.

F

rom 1 February 2017, funding for home care packages will be “attached” to the consumer rather than the provider, meaning:

• Packages will no longer be allocated to providers through an ACAR process.

• Consumers will select the provider of their choice. he package will move with the consumer if they move home.

• T • T he consumer will be able to change providers at any point in time.

This policy change should provide a true market in home care service provision, including allowing new entrants into what has been a difficult market to enter.

It should also drive innovation in both the types of services delivered and the method of delivery.

From a provider’s viewpoint there are risks and opportunities associated with these changes.

On the opportunity side: ✓✓ It will allow existing providers to expand into new markets as well as expand their range of services in existing markets.

✓✓ I t will allow providers to win business based on the quality of the services they provide and on the price levels they can achieve.

On the risk side: ✓✓ F or some smaller providers there is a risk they will become uncompetitive due to the level of resources available to them. ✓✓ For existing providers the value of existing packages will diminish. If providers have purchased the packages then consideration will need to be given to impairing their value. ✓✓ Competition is also likely to drive down margins for many providers, particularly if they are competing on price alone.

In our Aged Care Financial Performance Survey we are already seeing the profit margins on CDC packages decline to levels that are significantly lower than those of the traditionally delivered packages. Time will tell if that trend reverses but it is likely that the additional costs associated with managing a CDC package, combined with increased levels of competition, will continue to drive margins downwards.

The majority of providers will need to review their existing business models and implement processes to be ready for the next round of reforms. A large majority of providers were very slow to transition to the CDC regime – they cannot afford to be so again with this round of reforms

✓✓ There will be opportunities for new providers to enter the market.

This will be good news for those providers who want to provide

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funded packages into their retirement villages but have not been successful in obtaining them through the ACAR process.

One thing is for certain, the majority of providers will need to review their existing business models and implement processes to be

FEDERAL BUDGET 2015

ready for the next round of reforms. A large majority of providers were very slow to transition to the CDC regime – they cannot afford to be so again with this round of reforms.

Following on from this reform will be the integration of the Commonwealth Home Support Program and the Home Care Program into a single program to deliver services to older Australians in their homes. The impact of this is likely to be felt more by the smaller providers of these services than the larger providers, and is why there has been so much activity of late for providers, large and small, to form alliances and in some cases merge so that they can be in a better position to compete with the larger providers when the time comes.

There were, of course, some other measures that will affect the sector in a variety of ways. One of the major negatives was the removal of $40.2 million in funding of the Aged Care Workforce Fund over a five-year period. This is unfortunate timing given the aged care workforce is under considerable pressure and needs to attract and train a significant number of new entrants to the sector over that timeframe. Interestingly, part of the savings measure was to “better target” the funding by renaming the program the Aged Care Workforce Development Fund.

Another renaming exercise has also bought savings to the Government. The Aged Care Service Improvement and Healthy Ageing Grants (ACSIHAG) Fund will be redesigned and renamed the Dementia and Aged Services Fund. In doing so the Government will save $20.1 million over four years.

| OPINION

between those that pay for their accommodation costs by way of lump sum and those that pay by way of periodic payment. This will minimise the incentive to pay by way of periodic payment to avoid or minimise the amount of the means test fee.

There were also a number of measures in the budget that will have some flow-on effects for aged care providers, including: • Pensions will continue to be indexed using existing methods, which have seen them rise by slightly more than CPI in most cases. This also flows through in the level of resident fees received by aged care providers, as the basic daily fee is pegged to the single aged pension rate.

• There will be a 10% cap of the deductible amount for pension income received from a defined superannuation scheme for the purpose of the social security income test and this measure will also be incorporated into the aged care fee means test.

• The assets test thresholds for older Australians will also be changed. This being done in two ways. The lower threshold has been increased which benefits those that have modest assets over and above their family home. For those above the new asset thresholds, the taper rate at which the amount of the pension is reduced will double from $1.50 for every $1,000 over the threshold to $3.00 for every $1,000 in excess of the threshold. This effectively decreases the level of assets that a person can have before losing the pension altogether.

For a homeowner couple this will decrease from $1,298,000 currently to $1,023,000 from 1 January 2017.

Lurking in the reform background is the discussion paper on tax, and the Government has said that they will rule nothing in or out of that discussion.

The Budget also confirmed the funding for an initiative that was announced in February this year to establish Severe Behaviour Response teams consisting of clinical experts to provide timely and expert advice to residential aged care providers that request advice on how to address the care needs of people with the most severe behavioural and psychological symptoms of dementia. The cost of this program is estimated at $54.5 million over four years.

A move that has been generally welcomed by the industry is a move towards creating a market for the provision of accreditation services by parties other than the Aged Care Quality Agency. The first step in this process will be the introduction of a new schedule of fees to be charged for those activities currently undertaken by the Aged Care Quality Agency to recover the full costs of those activities. So while the move to a competitive market is a good one, the first step will see the costs rise for providers. A 50% discount will apply to small residential facilities with fewer than 25 places as well as those who receive the viability supplement.

The change to the means testing arrangements from 1 January 2016 for persons entering residential care will see an alignment of the treatment of rental income from a resident’s former home

Employees of not-for-profit providers will also be hit in relation to the capping of some fringe benefits that were previously exempt. The Government will introduce a separate grossed-up cap of $5,000 per year on the FBT concessions for salarysacrificed meal entertainment and entertainment facility leasing expenses (meal entertainment benefits) for employees of certain not-for-profit organisations. All meal entertainment benefits will also become reportable benefits and count towards an employee’s “reportable fringe benefits amount” for an income year. This will apply from 2016.

For those employees that use their own vehicles for work related purposes there have also been some changes in how they can claim their expenses from 1 July 2015. Work-related car expenses from then can only be claimed using the ‘cents per kilometre’ method or the logbook method. The ‘12% of original value’ method and the ‘one third of actual expenses incurred’ will be discontinued from that date.

So while there was not a lot of reform, the aged care sector got its fair share. There were some positives and some negatives, and hopefully some consistency in policy direction for the next few years.

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OPINION |

FEDERAL BUDGET 2015

But providers should not be complacent. Lurking in the reform background is the discussion paper on tax, and the Government has said that they will rule nothing in or out of that discussion. In relation to the playing field between private and charitable sectors, the discussion paper raises the following questions for discussion: • Are the current tax arrangements for the NFP sector appropriate? Why or why not?

• To what extent do the tax arrangements for the NFP sector raise particular concerns about competitive advantage compared to the tax arrangements for for-profit organisations?

• What, if any, administrative arrangements could be simplified that would result in similar outcomes, but with reduced compliance costs?

• What, if any, changes could be made to the current tax arrangements for the NFP sector that would enable the sector to deliver benefits to the Australian community more efficiently or effectively?

No doubt there will be more to come on that discussion over the coming months. ■

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FEATURES |

CAPABILITY

GENDER EQUALITY

STILL HAS A LONG WAY TO GO

IN AGED CARE When we think of the business of yesteryear it has some common features: 1. It was entirely male and white.

2. Women filled only support roles.

3. C ompanies thought they knew best and largely ignored stakeholder interests.

W

hile organisations today are nimble and reflective of their bases, there continues to be a struggle for gender equality. In some industries this means women far outnumber men at operational level, in others it is the opposite. But across all industries men continue to outnumber women at management and Board level.

When I first started engaging more with business and the economy I thought I would see the breadth and depth of Australia’s cultural, age and gender diversity that is reflected in our communities.

I was wrong.

In aged care things are not much better.

Across private and non-profit operators, large and small, diversity of all sorts remains an issue.

Diversity ought to be a priority in this field. Not because everyone else is talking about it, but because the aged care base demands it. This is a broad-based field with stakeholders representing all

Image courtesy of Tyler Olson/shutterstock.com

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Conrad Liveris Researcher & is on the GLBTI Rights in Ageing Board

demographics of society. Therefore, one could assume this should be reflected by organisations and in the industry.

Decisions cannot be made in the best interests of older Australians if large subsets of community are not represented fairly at Board or management levels, let alone minority groups. But going into executive and board meetings, even in the health and aged care sectors, which employ far more women than men, I see the same person. He’s an ageing white man, likely married and with corporate experience.

Aged care is going through profound change. More companies are listing and commercialising. Government attention is heightened, and we are all looking forward to some well-needed deregulation.

What this means is the expectation has changed. We don’t compare the large providers to the small; older Australians expect a well-oiled commercial operation that understands their needs, and the baby boomers have even higher expectations.

CAPABILITY

If we look to the top ASX-listed companies they have all prioritised diversity in their leadership, while Deloitte has found that diversity can lead to an 80 per cent improvement in business performance.

The Centre for Talent Innovation has found that organisations with two-dimensions of diversity, that’s both demographic and experience, were 45 per cent more likely to expand market share. At management level, Credit Suisse has even found that diversity builds innovation as a core element of culture.

Generally speaking, companies with at least 30 per cent women on their board perform better financially.

In the health care sector, which aged care falls under, 80.5 per cent of employees are female, according to the Workplace Gender Equality Agency. But if we look at full-time equivalent roles alone for the sector, there’s a 16.4 per cent gender gap. This is not helped by the fact that two-thirds of CEOs and over 50 per cent of management personnel are male.

So, how do we change this?

Simply put, diversity is achieved by working with the willing. If you’re even still reading this you clearly care on some level, which is a great start.

| FEATURES

Confronting our own biases is the next crucial step. Unconscious bias training has the power to help us understand our preferences. Now a compulsory management training module in many large corporations, Qantas’ Alan Joyce made every manager undertake this training because he found it transformative to his thinking and outlook.

An early example of recognising unconscious bias was the blind CV test undertaken by the New York Philharmonic. It found that when the recruiters knew the gender they were biased towards men, and women would miss out on roles. When gender was not known and raw talent was critiqued, equitable numbers of women were appointed.

Achieving diversity also cannot be the sole responsibility of Human Resources. This is a wide issue that is transformative to all parts of our businesses.

And lastly, we cannot shy away from quotas. They are a vexed issue across all industries, while most male directors and managers tend to have a bias against quotas, they work.

There is plenty of evidence that shows diversity makes sense, it passes the economics test and it is immoral and illegal to actively discriminate.

You can either start acting now and be ahead of the game, or be behind the ball and risk future clients and your reputation. ■

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FEATURES |

CAPABILITY

AGED CARE

LEADERSHIP CAPABILITY: a framework for the future

The recent launch of the Australian Aged Care Leadership Capability Framework is a true landmark for Australian aged care.

Cynthia Payne It signals an important point in our sector’s development, because now CEO I SummitCare we all have the tools to navigate a future as a professional, passionate and adaptable industry. It will help us grow our own leaders, drawing as it does on a remarkable resource: the knowledge of more than 450 aged care leaders.

I

believe it will not only strengthen each one of our organisations, but will go a long way towards enhancing aged care’s reputation and its appeal as an employer.

SummitCare is proud to have been involved in the creation of the Framework, which details the knowledge, abilities and skills required by aged care leaders at all levels, and will be relying on it into the future.

I would like to touch upon each of its domains and some of our associated activities or approaches.

Self The expected behaviours in this domain really address the personal in each of us: from how we face adversity right through to what we eat and how we sleep.

Wellbeing, one of the domain’s key elements, is an intrinsic part of SummitCare’s values and brand. We work to enable the physical, emotional and spiritual wellbeing of our customers and their families, but also that of our team members.

Our comprehensive Wellbeing Framework underpins our activities; we host an annual Wellbeing Week centred on enhancing employee wellbeing; and we work directly with our team to ensure they are happy and healthy.

We have introduced a signature behaviours card to our team, which reinforces and reminds everyone of SummitCare’s expectations on a daily basis. These expectations echo those of the Australian Aged Care Leadership Capability Framework,

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which outlines acting with integrity, courage and self-awareness as core leadership behaviours.

Others This domain in the Framework speaks to the important of elements such as strong interpersonal skills, negotiation and influence in a leadership role.

For this to occur requires awareness and emotional maturity.

You cannot change who you are, but at SummitCare we ensure our team members have strong insights – using formal assessments and profiling – into how they operate as leaders and team members.

This is the key to everything, because it ensures our people are equipped to become the best version of themselves at all times and function as a leader.

Purpose Aged care leaders are the representatives of our organisations.

As they go about their days, they are the ones who must inspire by living out the values and vision of their business.

SummitCare’s strategic plan is closely aligned around our value set, which results in very careful recruitment and cultivation of our internal talent in line with our values. I also use our values and our customer focus as the parameters to our decision making, and I know that this can then filter to our leaders, and from there to our entire team.

CAPABILITY

| FEATURES

We want our leaders to inspire others, to think strategically, to operate under pressure. My leadership team and I keep a close watch on our emerging leaders, considering where we can enhance their development journey and where we can challenge them, so their purpose becomes apparent.

All these elements are clearly dissected in the Purpose domain of the Framework.

Business This domain is really about the nuts and bolts of our operations.

Outcomes of planning, understanding our financial imperatives, supporting marketing functions, complying with safety regulations – these are all vital components of the toolkit of a good manager.

We aim to future-proof our SummitCare leaders, by giving them knowledge and experience of all aspects of our business while they specialise in their own. Effective communication is a key part of this.

No matter where in the industry our leaders might find themselves, this means they have the capability to make informed decisions that are in the best interest of their organisation. It also means we are growing well-rounded professionals in the aged care industry, which can only serve to benefit the reputation of our sector.

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Change Change is possibly one of my favourite domains in the Framework, as this is about adapting to the climate in which we operate.

To be a leader in aged care now, you must be able to lead through change. Uncertainty abounds but those organisations that are able to survive and thrive are those that have leaders that are up to the job.

The Change domain outlines that leaders must be able to articulate the need for change, seize opportunities, work with ambiguity and be a champion for our sector. SummitCare has crafted its learning experiences to ensure our leaders are invigorated by change, and rise to challenges. We want them to understand that with change comes opportunity, and growth. So we push our team members outside their comfort zones – and seeing them come out the other side having achieved what they never thought possible is one of the best things about my job.

Overall, I would describe the Australian Aged Care Leadership Capability Framework as one of the most timely and necessary tools we have in aged care. We are fortunate to be able to draw on it, and I urge all in aged care to take a look and use it.

It is simple, powerful and can be used in all aspects of your business from recruitment to succession planning.

We certainly don’t profess to have all the answers at SummitCare to growing great aged care leaders. But with our experience, and now the Framework, we do have the tools that help us discover the answers. And so does everyone in the Australian aged care sector. ■

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REVISED FUNDING SCHEME

–required NOT REPORTS to address rural aged care needs Rural and remote communities need solutions and not more reports to address the aged care crunch, LASA has warned.

I

n response to an independent report into factors affecting the financial outcomes of aged care providers, which found rural/ regional providers are significantly disadvantaged, the Aged Care Financing Authority has been given until mid December 2015 to look further into issues affecting rural and remote providers.

“Right now there is an aged care crunch occurring in rural and remote Australia because there is insufficient funding and support at federal and state levels,” LASA CEO, Patrick Reid said.

“Fluctuating demand for beds, staff recruitment and retention, reduced access to allied health services, higher costs to access training and

36

support and anomalies in current funding schemes are the primary challenges for aged care providers in rural and remote areas.”

“These issues have already been identified by providers, peak bodies and communities. Now government has a report that shows it’s time for solutions,” Mr Reid said.

“We need sustainable solutions co-designed between local and state governments, federal government, providers, communities and peak bodies. This would include a viable rural funding scheme that prioritises care, to enable services to be delivered in the communities where older Australians need them.”

FUNDING Through its members LASA has identified five funding areas that need review to address the aged care crunch in regional and rural communities. These include: • increased access to the rural viability supplement • a rural base rate for all rural/ regional providers • localised solutions for supporting people with dementia

| FEATURES

and associated with the variable financial performance of different residential aged care providers.

The report by RSM Bird Cameron into factors influencing the financial performance of residential aged care providers found regional providers are significantly disadvantage by having fewer beds, lower revenue and higher costs. They are more focused on care outcomes and less focused on achieving financial performance outcomes, are less likely rely to specialist services, receive lower government subsidies and as care levels increase, EBITDA declines.

Right now there is an aged care crunch occurring in rural and remote Australia because there is insufficient funding and support at federal and state levels

• a rural/regional approach to Home Care allocations to ensure continuity of care • pooled training funds for rural and remote staff.

“Failure to enable older Australians to access services in their home towns results in social dislocation and puts increased pressure on families and carers, and regional centre services including hospitals,” Mr Reid said.

“Supporting service providers to deliver care in smaller communities will not only mitigate the impact of social dislocation but create new opportunities in towns that are doing it tough,” he said.

In June 2014, Aged Care Financing Authority (ACFA) engaged RSM Bird Cameron (RSM), in association with PricewaterhouseCoopers (PwC), to study the qualitative and quantitative factors influencing

Senator Mitch Fifield recently responded to ACFA acknowledging the report and asking for a similar report on factors influencing the financial performance of the providers of home care packages and by 30 September 2016, and to provide analysis the issues affecting rural and remote providers by 16 December 2015.

To view the full reports and responses go to www.dss.gov.au and search for factors influencing the financial performance of residential aged care providers. ■

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ACCESSING THE ‘RIGHT’ INFORMATION:

Why independent publishers will always be a step ahead It’s undeniable. Aged care is experiencing an enormous period of change – both for consumers and industry professionals.

A

s the Federal Government continues to introduce its myriad of aged care reforms to the way older people choose and access their care, we’re finding that anxiety and confusion is creeping into the path of people’s minds – whether the elderly, their families, and even those working in the sector.

The most recent population-wide anxiety attack occurred last July when the RAD and the DAP began being published. The fear of the populace, and especially those with limited means, was that: without assets, a person could not now access residential aged care. Fortunately, this has abated but now the fears and anxieties about home care services are heightened.

needs, it has chosen to waste resources on duplicating the information services that exist both in the private sector and NGOs. These resources would have been better allocated to supporting consumers as they ride the emotional roller coaster of accessing care.

According to statistics, more than one million people living in Australia receive aged care services, with more than half a million receiving support at home.

Aged care is the only current sector where the Government has taken on the role of trying to monopolise the provision of information to consumers.

With the focus now towards Consumer Directed Care (CDC), this means existing and potential care recipients can decide what services they want and from whom. In saying this, consumers should have immediate access to reliable information – positioning them as ‘central’ to the care model.

The issues around care dollars being spent on administration and the strict adherence to assessed care hours is a topic that needs exploring further. But, the consumer also needs easy and reliable access to quality information, and will the My Aged Care website be able to provide that?

Whilst the Government believes it is responsible for assisting consumers in the process of care and later-life accommodation

David Baker CEO I DPS Publishing

The most difficult part of the aged care journey for a consumer and their family is actually not the knowledge but the decision-making based on the information and the integration of care services within their lives.

In saying this, information is important, but more critical is how consumers understand the issues and the process of change.

As chief executive of DPS Publishing, Australia’s leading private aged care information resource, we’ve been addressing the issue of access to useful material during the past three decades. We are now focusing on the development of more interactive, intuitive and dynamic information provision to assist consumers to know more and be able to integrate this knowledge into their lives.

On the other spectrum, the My Aged Care website, designed as part of the Federal Government’s Aged Care Gateway to navigate people through the aged care system, has likely focused too much on what has been available for decades and not enough on integrating the portal with sites such as AgedCareGuide.com.au.

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FEATURES |

ACCESS

Aged care is the only current sector where the Government has taken on the role of trying to monopolise the provision of information to consumers. Why? They are doing this because they have been sold the misinformed opinion that ‘there is nowhere to find the information about where to start’.

As a result, policymakers have misjudged and developed a system that duplicates commercial services and information already in existence.

For example, the DPS Guide to Aged Care has been available via Aged Care Assessment Teams (ACATs) since 1998 as a single information source, and its website, AgedCareGuide.com.au, has been a ‘one stop’ comprehensive source of information for more than a decade.

Had the Government been serious about providing a quality ‘onestop’ service, it would have consulted with current private providers prior to the development of My Aged Care. In doing so, I suspect the Government would have come to the same conclusion – that it didn’t need to duplicate what is already there.

Fortunately, the MyAgedCare provides many other services apart from information, and these are well overdue. Single client records are by the far the most welcomed.

My Aged Care will have many positive outcomes for providers but, if providers are left to update their own records, there will be plenty of disappointment. Many providers will not – and where does that leave the consumer?

So, what does the future hold when it comes to accessing valuable information to guide a person and their loved ones through the aged care journey?

Access to information will always mean the ability to find the information you want, whenever you want it.

I think there will always be the need for trusted and reputable information; it’s just a matter of finding the right channel. ■ DPS Publishing’s chief executive, David Baker, will present on the access to aged care information at LASA’s National Congress ‘Co-Design: Tomorrow’s Age Services’, at the Melbourne Convention & Exhibition Centre from 11 - 14 October 2015.

So, how has this duplication of information occurred and excessive expenditure from the public purse that needn’t have occurred? A discussion for another day.

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COMPUTER SOFTWARE | TECHNOLOGY CDC financial management: are we ready? www.capitalguardians.com

With the looming deadline of 1 July 2015 for full transformation of all home care packages to consumer directed care (CDC), organisations are facing major challenges.

Financial management is one of these, requiring re-configurations of administrative support and systems to cope with providing individual monthly income and expenditure statements to homecare customers.

There has been a lot of commentary and debate in the industry regarding the system needs of this transition.

Accounting systems might have initially appeared to offer a natural solution, given their abilities around financial reporting. On closer review, however, frontline care management staff struggle using accounting systems.

There is also a massive effort required for an organisation to go from several cost centres to hundreds (one cost centre per package) and then manage these cost centres on behalf of the care recipients.

Next in line have been the care management systems that have many advantages over the accounting system, such as care management staff familiarity and the ability to capture a sta significant amount of relevant care recipient information. Care management companies have been spending the year building CDC financial reports, many of which are working to different degrees, albeit still with challenges for getting information in and out from other areas, including payroll and accounting. p Many larger organisations have had some success having spent the best part of the past year integrated various systems. The ongoing cost of staffing these integrations and new processes is not yet entirely clear. Time will tell, as these costs need to be passed on in a transparent manner to care recipients as an administration charge. CDC is empowering

home care recipients to select their providers of care management services, and cost of administration will play a role.

While processes and systems are being re-engineered, other options with negligible costs are appearing, such as cloud services provider Capital Guardians, a product that pr combined a bank platform and invoicing system. Designed to eliminate the traditionally high sector costs of administration, governance and software, it automates all invoicing with all suppliers through smartphone applications, and interfaces that work with all accounting systems.

Ross McDonald, CEO of Capital Guardians, said: “While our headline value comprises a system with no initial costs and low ongoing $3 monthly fee, the real value is the systems elimination of all administration, limiting care coordinators management to uploading individual budgets and the online authorisation of invoices for payment against these budgets. The system is being used by dozens of operators alongside their care management systems, without the need for finance staff, allowing CDC providers to maximise their care packages with the lowest administration costs.” administ

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WORKFORCE

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MEASURING WORKPLACE CULTURE

TO QUANTIFY ITS RETURN ON INVESTMENT Addressing workplace culture is one of the most challenging tasks a director or manager can be given. Once considered a nice-to-have-but-not-crucial-to-core-business element of operations, studies have proven a positive workplace culture has a quantifiable impact on EBITDA. To support age care services tackling this issue, LASA has partnered with Pulse Australasia to bring you a four-part series covering what you need to know about changing workplace culture.

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cross the sector, age care providers invest millions of dollars annually on strategy, systems, processes and compliance to ensure residents and clients receive the best possible care and service. A number of providers are recognised globally for their clinical governance and compliance performance, yet many CEOs still receive complaints from families of clients, residents, and staff who report inadequate care and unacceptable behaviour from staff.

This tells us that while the systems and processes themselves are sound, there is a disconnect between their development and implementation. Which brings us to people. The key driver for ensuring the success of a system or process is people.

Those who are responsible for implementing the systems and process. And if these people aren’t fulfilled or committed to their jobs, they are less likely to adhere to systems or processes.

of the interventions to address these behaviours have shown few positive results. Providers in Australia, United Kingdom and the United States all report that poor behaviours continue to impact the client experience and overall business performance. These behaviours include things like bullying and harassing colleagues and sometimes even residents, high rates of sick leave and staff not showing up for rostered shifts with no notice to the employer. Lack of good documentation in case notes or the recording of accurate documentation all impact the funding providers can claim to care for residents.

Boards, CEOs and managers cannot ignore that aged care sector is in a period of intense change right now, but how these changes are addressed requires a fundamental shift in the workplace culture.

Boards, CEOs and managers cannot ignore that aged care sector is in a period of intense change right now. Not only are there significant changes occurring at policy level that affect staff benefits, tax and income, but staff are acutely aware of the increase in mergers and acquisitions and competition following consumer directed care changes. How CEOs and managers address these changes requires a fundamental shift in the workplace culture.

Staff engagement results continue to demonstrate poor behaviours, which have been present in aged care for decades and yet most

Staff engagement surveys themselves are no longer considered a good measurement tool for workplace culture, as they measure opinion – what people think about the organisation, not what they do or how they behaviour. Deloittes’ latest trends report from earlier this year found that annual staff engagement surveys are in fact becoming obsolete as businesses realise that workplace culture is influenced by what people do; not what people think.

Invest in staff, not just systems There is widespread belief that aligning staff behaviour with business goals is easy to say, harder to do and even harder again to quantify.

But this is not true.

The ratio of investment in strategy, systems and processes compared to investment in aligning staff behaviour to business KPIs is around 10:1 across aged care providers. In some cases

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Workplace culture is influenced by what people do; not what people think... Signature Behaviours are the tangible actions through which we can demonstrate values and key business objectives it’s even less. Staff development and culture initiatives are often the first line items cut when efficiencies are sought or cash flow is tight, but these are the very times when such investment should be maintained, if not increased.

Aged care providers generally look at key areas that are critical to the success of their business, for example EBITDA per bed, Stuart Brown index, occupancy rates, agency costs, ACFI, workers compensation and absenteeism. However, performance outcomes from these key areas are reliant upon your staff. Your people.

And people are not inclined to carry out tasks purposefully or successfully if they do not understand why it’s important, how doing so will contribute to a greater goal, or if they are not motivated and collectively aligned to do so.

Quantifying the impact of staff behaviour CEOs and managers often think about the impact of staff behaviour in relation to how things are done in their business, for example how staff treat one another or taking accountability for their actions and behaviours, which ultimately forms organisational success and therefore company culture.

When asked how they measure workplace culture and rate its impact on business performance, executives often respond with statements that relate more to organisational success: “I think our culture is quite good” or “our culture is not very good, but it’s hard to find staff”. Even aged care providers that have comprehensive people and culture programs in place cannot always quantify the impact of their investment on their culture, and ultimately their bottom line.

Regardless of where your business is at in terms of maturity, structure, business model or size, three key considerations that Boards and management should be aware of when looking to direct and influence company culture include:

Signature Behaviours are a combination of the values you would like to see positively demonstrated by staff combined with a focus on what the provider would like to see the organisation achieve collectively. An example of Signature Behaviour may be “do what we say we will do” or “we communicate openly, honestly and respectfully”. These differ to company values because Signature Behaviours are the tangible actions through which we can demonstrate values and key business objectives. This may include objectives like superior customer service or responsible documenting for ACFI or case note records.

Research has found that when the majority of staff in an organisation positively demonstrate the Signature Behaviours there is a clear connection between the uplift in staff attitudes and behaviours and key performance measures. Below is an example of one Australian aged care provider’s correlation between their Net Culture Score and EBITDA over a 12-18 month period.

EBITDA can fluctuate from month to month and can be dependent on a number of variables, but what is important to understand is the positive correlation/trend between an organisation’s NCS and financial performance.

Continuous Reinforcement – Normalisation To strengthen and align culture Signature Behaviours need to be normalised to achieve successful outcomes for the business. B.W Skinner’s principle of continuous reinforcement demonstrates that in order to normalise a new behaviour we must consistently repeat a message or stimulus at appropriate time intervals until such time as the new behaviour has formed or been repeated on enough occasions that it becomes familiar and the way we do things around here. When this occurs a new behaviour has been normalised. For example, if staff are rated on how often they communicate honestly and transparently and the rating occurs at consistent time intervals, then the reinforcement of the rating on an ongoing basis will influence staff to communicate honestly and transparently until such time as this behaviour is normalised.

3. NCS – Net Culture Score

Signature Behaviours need to be reiterated and demonstrated throughout the organisation in a non-hierarchical manner from the CEO through to care workers to create an environment where everybody is accountable and culture is strengthened from top to bottom and vice versa.

Signature Behaviours

Net Culture Scores

To intentionally align staff to work toward a common objective and create ‘collective achievement’, an organisation must develop between one and five powerful Signature Behaviours that are aligned to business KPIs.

One the most effective ways to measure culture is through a Net Culture Score (NCS). A NCS is the sum total of the positive demonstration of specific behaviours that are aligned to the organisations most important KPIs accountable for organisational

1. Signature Behaviours 2. Continuous Reinforcement – Normalisation

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aged care industry that are outstanding in care, service and attitude, sadly there are also staff members who engage in behaviours that exacerbate this risk. Findings by Pulse from analysis of its clients in Australia and Europe highlight some universal behaviours within the aged care cultural environment such as:

CEOs and Boards can now tangibly assess and minimise risk and the impact on resident experience and business performance.

• bullying and harassment between staff • negligent care of clients • high levels of absenteeism

success. It is an analysis of how well staff are positively demonstrating the Signature Behaviours and is presented as a percentage. For example, an NCS of 62 per cent suggests that 6.2 out of every 10 people in the organisation are positively demonstrating the Signature Behaviours. If an organisation has moved from an NCS of 35 per cent to 62 per cent, the result will positively correlate against the key business performance measures.

• lack of accuracy in ACFI and client case notes • poor attitudes and behaviours of staff on site • high levels of blame and lack of personal accountability • despondency, anger and frustration Such behaviours are of serious concern because they not only breach aged care providers’ governance policies, but they increase the risk of serious incidents, which can result in legal and reputational consequences. Measuring, monitoring and influencing the behaviours and attitudes of staff through the NCS means that CEOs and Boards can now tangibly assess and minimise risk and the impact on resident experience and business performance.

The point of difference between the NCS and a staff engagement survey, where employees give their views and opinions about company culture and performance, is that the NCS measures what staff are doing rather than what they are thinking.

For CEOs and Boards, measuring and monitoring the organisation’s NCS is an important part of governance and risk monitoring. One of the greatest risks for aged care is ensuring the clients and residents are treated and cared for correctly. While most staff working in the

Pulse’s findings also indicate that as aged care providers work to increase their NCS, improvements are made to results such as

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EBITDA per bed, agency costs, workers compensation claims and client experience. Other outcomes include positive impacts on care, compliance, and staff and client retention. This suggests that significant improvements can be made within aged care by creating an aligned and purposeful culture linked specifically to business outcomes.

With workforce recruitment and retention an increasing challenge for aged care providers, in addition to increased competition and deregulation, it is incumbent upon CEOs and Boards to increase the priority and focus on culture. They must seek to understand the culture of their organisation in the same way they understand their EBITDAs or other key performance measures. They must be able to quantify the effects of behaviours and attitudes and understand the impacts of these behaviours against their business measures. ■

As aged care providers increase their NCS, improvements are made to results such as EBITDA per bed, agency costs, workers compensation claims and client experience

Accreditation Non-Compliance

ASIC SHINES SPOTLIGHT ON LINK BETWEEN BAD CULTURE AND BAD CONSUMER OUTCOMES ASIC has warned it will be incorporating workplace culture into its role as conduct regulator and is seeking stronger laws to be able to prosecute individual company officers.

Reduction in agency costs

Watchdog chairman, Greg Medcraft told a senate economics committee that bad culture often leads to bad conduct, which can inevitably lead to poor outcomes for consumers.

While he was referring specifically to the financial services sector, growing demand and supply of age services will see greater attention on the industry in coming years.

The potential for aged care providers to intentionally direct a consumer-focused culture and to quantify and benchmark this culture across the industry is a real game changer. CEOs and Boards of aged care providers are encouraged to take the opportunity to strengthen and align culture by including it as a business measure, and intentionally monitoring, measuring and influencing a positive NCS. Directors and executives should not tolerate or accept any behaviour that is not aligned to their Signature Behaviours. To accept staff demonstrating poor attitudes and behaviours increases the risk of poor or negligent care being provided to residents and clients; diminishes surpluses; and prevents growth and expansion.

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The areas ASIC plans to target are those where poor practices may increase potential for poor conduct; therefore increase the risk to trust, and investor and consumer trust and confidence.

This will include incorporating culture into its risk-based surveillance reviews; using surveillance findings to better understand how culture is driving conduct among those that regulate; and communicating to industry and firms where the regulator has problems with their culture and conduct.

While ASIC is currently limited in how it can address workplace culture under existing criminal laws, it wants to be able to try company officers “as accessories” under new civil laws covering financial offerings.

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A TOP JOB IN A TOP INDUSTRY Mention aged care as the top career option in Australia to young job seekers and they will think you are kidding.

Shayne Neumann MP Shadow Minister for Indigenous Affairs Shadow Minister for Ageing

H

ard, labour-intensive work. Poorly paid. A dead-end job.

The perception is inaccurate and unhelpful. Albeit, not entirely wrong.

Deloitte has listed aged care and services as one of the top 25 growth sectors, forecasting an annual growth of 5.1 per cent through to 2033 – mostly due to the ageing of the population.

Likewise, one of the greatest opportunities is the reskilling of the ageing workforce.

On the flipside, the need for rapid expansion is one of the significant challenges facing the sector.

Workers are not attracted to the sector, which is renowned for low pay, casualisation and limited career paths.

The previous Labor Government had implemented the $1.2 billion Aged Care Workforce Supplement, as a first step in addressing the need for better pay and workforce development.

This was one of the first items axed by the Abbott Government, with funds used to top up subsidies with no conditionality or expectation that funds would be used to develop the workforce.

In fact, there is no evidence there has been any improvement in aged care pay and conditions.

Meantime, those increased subsidies have been eroded by further cuts, including the Aged care Payroll Tax Supplement and the Dementia and Severe Behaviours Supplement.

The decision to axe the Workforce Supplement appears to be little more than an ideological decision.

In spite of the Assistant Minister’s promise to develop a workforce strategy in early 2014, to date we have seen nothing.

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With the report on the stocktake of Commonwealth funded workforce development programs yet to be delivered, it is unlikely that a fully developed, coherent strategy to address the growing crisis in the sector will be available any time soon.

Workforce Development is not an optional area of policy for the Government. The ageing of our population has put incredible pressure on the sector and the projected demand for services in the coming decades means we need to see the workforce triple by 2050.

In the next eight years we need another 55,770 aged care workers.

This represents several challenges for a sector that has low competition for vacancies and skills shortages.

This is a sector facing increased competition from other related sectors for the same pool of workers.

In a moment of honest, ideology-free assessment of the situation, the Assistant Minister for Social Services revealed to Australian Ageing Agenda on 20 May 2015: “Government can’t escape their obligation in terms of funding workforce. Building a better skilled, more appropriate aged care workforce will improve outcomes for older Australians.”

Likewise, in a moment of honest bipartisanship, I agree with Senator Fifield – the Government has an integral role to play in ensuring this nation has the right workforce to meet the needs of older Australians now and into the future.

Unfortunately, the Senator made this statement a few days after delivering a $40 million cut to the Aged Care Workforce Development Fund.

Image courtesy of Robert Kneschke/shutterstock.com

As Patrick Reid, LASA CEO, pointed out, that represents a 15 per cent cut.

Essentially, this was a Budget decision made without any regard for a potential workforce strategy, or in spite of it.

It demonstrates the depth of ignorance in the Treasury benches for the economic potential of aged care services, nor for the critical need for appropriately skilled, qualified and dedicated workers.

Labor stands with the aged care services industry, waiting for a workforce development strategy. This is not a looming crisis; it is a current reality.

The Federal Labor Opposition will work with the sector to address these issues. That includes the various segments of that sector, including peak bodies such as LASA, aged care and service providers, consumers, and the relevant unions.

It is our vision that aged care and services provide careers of choice for young people as well as mature aged workers.

Careers in nursing, health and allied health, caring roles, as well as information technology, law, finance and investment, marketing and management, to name a few.

The first step is developing a plan. While we wait for the Government’s stocktake, Labor will ensure we have a developed, considered and costed plan to take to the next election. â–

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LASA APPLAUDS VET OVERHAUL AND CALLS FOR NEW INDUSTRY REFERENCE COMMITTEE LASA has commended the Abbott Government on its decision to overhaul the vocational education and training (VET) system and empower industry to play a more active role in workforce development.

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s an industry, Health and Community services is currently the biggest employer in Australia, however, it is battling critical workforce issues that require immediate attention.

Aged Care alone is Australia’s eighth largest employer.

“The workforce issues in age services are like a perfect storm that we can see is brewing and requires action at a national policy level,” LASA CEO, Patrick Reid, said.

Almost half of the current age services workforce will retire in the next 15 years, while the number of people requiring these services is increasing exponentially.

To keep up with demand and ensure that all older Australians have access to essential services in a timely and dignified manner, we need an additional 650 workers moving into this industry per month for the next 10 years.

Industry training requirements will change over the coming decade, especially as we see the advancement of technology and its integration in home care, community care and residential aged care facilities. As such, it is vital that industry is empowered to determine the skills required for safe, effective practice at entry level through to which skills are best developed over time.

“If we are to maintain the standard of care and services that older Australians deserve, training and development for people working in age services must be aligned with industry requirements,” Mr Reid said.

“Australia’s ageing population must at the centre of decisions made in relation to training or workforce on behalf of these professions.”

As the voice of the aged care industry LASA is well placed to operate as part of an Industry Reference Committee taking responsibility for training package development.

LASA has been responsible for a range of innovative aged care workforce development initiatives including the development and delivery of the first Consortia driven Aged Care Nurse Graduate Program involving more than 40 providers of all types and sizes in Victoria.

It was a member developing the first aged care leadership capability framework and associated tools along with the purchase of a Simulation Van that enables the delivery of mobile high end

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technology driven clinical programs to staff in aged care organisations.

“These significant changes to the VET system are a positive step in addressing the workforce issues plaguing age services. If we are to truly address the root of our workforce issues however, greater attention needs to be paid to selecting ‘right fit’ candidates to undertake aged care training, to reduce dropout rates and the resource drain on aged care employers in inducting and mentoring poorly selected personnel,” Mr Reid said. ■

SCHOLARSHIP PROGRAM FORGETS FUTURE LEADERS IN AUSTRALIA’S BIGGEST GROWTH SECTOR Workforce development is one of LASA’s priorities, with severe staffing shortages looming if more isn’t done to attract workers into age services over the next decade.

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he latest Intergenerational Report notes that age services, which spans aged care, health and community services, business, innovation and technology, is a key driver of the future of Australia’s economy.

Yet the Federal Government and Australian Institute of Company Directors (AICD) has failed to recognise female leaders working in age services in its latest scholarship round.

“The AICD claims that initiatives to boost the number of women on boards, including the scholarship program, are aimed at sectors expected to dominate future economic growth,” LASA CEO, Patrick Reid said.

“Age services is the largest growth sector in Australia. While women make up the majority of the age service industry’s workforce, they remain grossly under-represented at board and executive management level.”

“It is for both these reasons that aged care should be included in the next round of scholarships, and prioritised in the same way the oil, gas and energy sectors have been in this round,” Mr Reid said.

“LASA fully supports efforts to increase the proportion of women on boards by 30 per cent, and believe this percentage should be even higher in industries where women form the majority of the workforce like age services,” Mr Reid said.

“Many of our members already provide professional development opportunities for their staff to improve retention and prepare tomorrow’s leaders for the challenges ahead.”

“Investing more in the high performing women already working in age services is one of the ways in which the federal government can address the economic impacts of our ageing population.” ■

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NEW RAINBOW TICK

ACCREDITATION

IDENTIFIES INCLUSIVE CARE & SERVICE Older Lesbian, Gay, Bisexual, Transgender and Intersex Australians have lived through a time in the nation’s history when they suffered stigma, discrimination, criminalisation, family rejection and social isolation1.

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ccording to Australian Bureau of Statistics and Kinsey Institute figures, approximately 250,000 people across Australia over the age of 55, identify as Lesbian, Gay, Bisexual, Transgender or Intersex (LGBTI). Given this number is expected to rise to 500,000 people by the year 2051, retirement villages, aged care facilities and service providers in particular, need to ensure they are considering and supporting the needs of people from the LGBTI community.

LGBTI people have the same right to access safe and high quality services as anyone else in the Australian community, however, not all service providers understand or respond well to the needs of the LGBTI community. For some LGBTI people, the experience of exclusion, discrimination and violence can contribute directly to poorer health and well-being. The mental health of LGBTI people is among the poorest in Australia2.

Actual or perceived discrimination by services also means LGBTI people are more likely to avoid or delay seeking care or support.

Consequently, LGBTI consumers and residents want to know that they can access services where their sexual orientation or gender identity will be valued and where service providers understand and can meet their needs.

In 2009 a research project titled ‘My People Project’ was undertaken Dr Catherine Barrett from La Trobe University’s Australian Research Centre in Sex, Health and Society (ARCSHS). The results of this research highlighted a number of issues faced by LGBTI residents within aged care facilities: Aged care providers were unaware of or unresponsive to the particular needs of LGBTI clients; LGBTI clients felt unable to be themselves and were forced to hide their true sexual identities; and residents had experienced threats, harassment, ridicule or invasions of privacy from other residents or staff members.

In 2012, the Australian Government announced the National Lesbian, Gay, Bisexual, Transgender and Intersex ageing and aged care strategy. This strategy demonstrates a commitment to ensuring

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equitable access to high quality, culturally appropriate aged care for all LGBTI people.

Recognising the challenges many LGBTI people face, whether younger or older members of our community, Gay and Lesbian Health Victoria (GLHV), La Trobe University and Quality Innovation Performance (QIP) have worked collaboratively to improve the delivery of inclusive service provision and health care within Australia by developing the Rainbow Tick.

The Rainbow Tick Standards and accreditation program is a voluntary program which aims to address the service inequities for LGBTI people by assisting health and human services to understand and respond to the needs of their LGBTI consumers.

The Rainbow Tick supports organisations, including aged care services, to understand and implement LGBTI inclusive service delivery and reassures LGBTI consumers, residents and staff that an organisation will be responsive to their needs.

Most organisations employ diversity policies, statements and practices to address, encourage and value workplace diversity and to support inclusive service delivery. Organisations usually have systems and processes in place which encompass Cultural, Indigenous and Disability diversity however few organisations formally recognise LGBTI diversity within their workplace.

Assessment against the Rainbow Tick Standards takes this and a number of additional areas within an organisation into consideration and guides organisations to make improvements to better meet the needs of their LGBTI members.

Rainbow Tick accreditation involves assessment against six standards: 1. Organisational capability 2. Cultural safety 3. Professional development 4. Consumer consultation

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5. Disclosure and documentation 6. Access and intake processes Achieving a Rainbow Tick requires planning, resources and commitment to make a change. Organisations are provided with the opportunity to partake in staff LGBTI training and professional development to ensure a foundation is built for a culturally safe environment, as well as the chance to undertake a pre-accreditation audit to assess how their current practices, protocols and procedures meet each of the six standards.

QIP’s Client Liaison Team is on-hand to support organisations throughout the entire accreditation process to ensure the process is as streamlined as possible.

Receiving a Rainbow Tick supports an organisation in demonstrating a commitment to valuing diversity and inclusive practice while identifying that the organisation provides a more positive service experience for members of the LGBTI community.

Take a positive step toward inclusive service provision for a large proportion of older Australians. Contact QIP to find out how you can receive your Rainbow Tick at www.qip.com.au or phone 1300 888 329 or email info@qip.com.au ■

Keep an eye out for this accredited symbol to help you identify Rainbow Tick organisations within your local community.

References 1. The Australian Government Australian Government announced the National Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) ageing and aged care strategy (2012).

2. Leonard et al. (2012); Corboz et al. (2008); Suicide Prevention Australia (2009).

Are your residents enjoying Silver Memories Nostalgia Radio in your Aged Care Home?

Silver Memories plays cheerful music from the 1920s to the 1950s twenty-four hours a day, every day, includes cheerio greetings and birthday calls, old radio serials and comedies which people listened to before the advent of television. Residents around Australia love it! ❖ Ideal for aged care homes ❖ Triggers happy memories ❖ Reminiscence Therapy

❖ Helps people to relax ❖ Relieves depression ❖ Radio as it used to be

Silver Memories has been endorsed by the Australian Medical Association (Qld) and Alzheimer’s Australia (Qld) who use it in their Dementia Behaviour Management Service (DBMAS).

Residents’ quotes “I find it a relief from TV, the doom and gloom. Silver Memories is very friendly” “There is no other radio station that provides the music I want to hear.

“I enjoy it, it is different. It makes me happy and sometimes I sing along – well I try to.”

“It is a necessity to my life – It gives me happiness.”

“With Silver Memories, I never feel lonely any more.”

Have Silver Memories installed in your Aged Care Home 4mbs.com.au/silver Peter McCahon 07 3847 1717 I peter.mccahon@4mbs.com.au

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LEADING RECONCILIATION

IN AGE SERVICES Hall & Prior is a private, family-owned organisation with a passion for providing quality aged care. As both an employer and an age services provider, it is leading the way for Reconciliation within the industry.

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n December 2014 Hall & Prior unveiled its inaugural Reconciliation Action Plan 2015-2017, which reflects the journey it has taken and serves as the foundation for the organisation to listen, learn and improve its services so they are appropriate for people from all walks of life.

The action plan is the culmination of consultation with Whadjuk Noongar people, the Aboriginal Traditional Owners of the Perth metropolitan area and wider Swan River plains region. It is coordinated by Hall & Prior’s Indigenous Advisor, Clayton Lewis, and a working group comprising staff from across management and clinical teams.

“Our vision for reconciliation is for all Australians to be connected, dynamic and strong with an embedded acknowledgement and respect. Our plan is to lead the way in the provision of aged care services and employment opportunities for all people within our community,” CEO Graeme Prior said on launching the action plan.

The celebration events saw indigenous film screenings at Hall & Prior nursing homes; acknowledgment plaques installed in each Hall & Prior home, acknowledging the Traditional Owners of the lands on which the homes sit; and Aboriginal Flag and Torres Strait Islander flags given to each Director of Nursing for their residence.

Residents and management staff also enjoyed a traditional Aboriginal lunch consisting of a Kangaroo Stew and mash potato.

“The activities that each of our Directors of Nursing ran to celebrate National Reconciliation Week is evidence of our organisation’s wide commitment to promote reconciliation with Aboriginal and Torres Strait Islander people.

This commitment will be further demonstrated in the coming years as we deliver on more aspects of our Reconciliation Action Plan,” Mr Prior said. ■

Our vision for reconciliation is for all Australians to be connected, dynamic and strong with an embedded acknowledgement and respect.

In the last six months Hall & Prior has set out to deliver on its promise, embedding Reconciliation into its day to day operations and services. It now celebrates all events of significance to Aboriginal and Torres Strait Islander people with these incorporated into Hall & Prior’s annual planner.

National Reconciliation Week 2015 was celebrated with events held in each of its homes and corporate offices. The dates commemorate two significant milestones in the reconciliation journey—

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the anniversaries of the successful 1967 referendum and the High Court Mabo decision.

BUSINESS MANAGEMENT

ACCOMMODATION

PAYMENTS FOR

LOW MEANS RESIDENTS Accommodation payments for low means residents are still causing some confusion for operators and residents alike.

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rior to the aged care reforms the amount a supported resident could contribute towards the cost of their accommodation was assessed purely on their assets and was fixed at the date of entry. Residents who have entered aged care post reform have had their eligibility to be a low means resident assessed based on both their assets and their income.

The formula currently is: 50c per dollar above $25,264 (single) $24,796 (couple) plus 17.5 per cent of his assets $46,000 - $157,051 If a person is classified as low means when they enter care then they always will be, unless they leave care for more than 28 days.

However, that doesn’t mean that their accommodation contribution remains the same. If a low means resident has a change to their assets or income their accommodation contribution will be recalculated. Similarly, if the change to their means determines that the calculated amount of their contribution is above $53.39 per day they can start paying a means tested care fee. This is commonly the case where a husband and wife are both entering care.

But the variability doesn’t end there. A change in circumstances for the facility can also mean a change in the amount that the resident can be asked to contribute. A facility who is not significantly refurbished but later meets the criteria will see their accommodation supplement increase, and with it the maximum amount their residents can pay as a Daily Accommodation Contribution and equivalent Refundable Accommodation Contribution. Facilities whose supported resident ratio is above 40 per cent but drops below the threshold will see the reverse.

Let’s look at an example.

Fred and Shirley are full pensioners. They have a home worth $650,000, $80,000 in the bank and $6,000 in personal effects.

Fred is moving into care today and Shirley is moving into care tomorrow.

Fred’s accommodation contribution today will be zero because the house is exempt and his share of the assets outside the house are below $46,000. As a full pensioner Fred’s income doesn’t exceed

Rachel Lane Principal I Aged Care Gurus

the income threshold. Fred is what we used to know as a fully supported resident.

When Shirley moves into care tomorrow she will be a market price payer as her assessable assets exceed $157,051. With Shirley moving into care Fred’s assessable assets change from $43,000 to $200,051 as the capped value of the home $157,051 is now included in his assets. This change to Fred’s assessable assets means his Daily Accommodation Contribution (DAC) needs to be recalculated. The calculated amount is $53.39 per day, which equates to a Refundable Accommodation Contribution (RAC) of $306,405.

However, the amount Fred can be asked to pay as a DAC and RAC will be limited to the amount of accommodation supplement the aged care facility can receive.

The following table shows the relevant Maximum Daily Accommodation Contributions and their equivalent Refundable Accommodation Contribution.

Accommodation Supplement

Maximum Daily Accommodation Contribution (DAC)

Max Refundable Accommodation Contribution (RAC)

$53.39p.d – significantly refurbished, over 40% supported ratio

$53.39

$306,405

$40.04 – significantly refurbished, below 40% supported ratio

$40.04

$229,789

$34.79 – not significantly refurbished, over 40% supported ratio

$34.79

$199,660

$26.09 – not significantly refurbished, below 40% supported ratio

$26.09

$149,730

In addition to the increase in Fred’s accommodation contribution there would also be a means tested care of around $1 per day if the house is retained and significantly higher than that if the house is sold.

There is no doubt that the confusion suffered by residents and operators is well founded, especially when you throw in the added complexity that these figures can change on a daily basis. Quality financial advice can help your residents understand how their cost of care can go from $47.49 to over $100 per day and budget for it. ■

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BUSINESS MANAGEMENT

Aged Care Gurus Adviser Network is a team of dedicated professionals committed to providing quality financial advice to senior Australians and their families

Aged Care Gurus

Adviser Network Victoria ASHLEY ROWAN Adv Dip FP

Queensland GAVIN WHITLOCK MBA, Advanced Diploma of FP, ACSA

Meritum Financial Group ashley@meritumfg.com.au www.meritumfg.com.au 24A Darlot Street Horsham, VIC 3400 1800 009 533

Insight Aged Care Services P/L gavin.whitlock@insight-acs.com.au www.insight-acs.com.au 28 Pandora Street Boondall, QLD 4034 (07) 3265 4659

MATTHEW WOOLFORD

JULIE LOCKERIDGE

CFP®, B. Bus Acc.

CFP®, Dip FP

FSS Financial Planning mwoolford@fssfp.com.au www.fssfp.com.au Level 13, 15 William Street Melbourne, VIC 3000 (Also in Geelong and Bendigo VIC) (03) 8613 9825

Kimmorley Financial Management julie@kfm.net.au www.kfm.net.au Suite 1404, Level 4, 56 Scarborough St Southport, QLD 4215 (07) 5591 1725

LISA DUGGAN

SHAUN AKROYD Bravien Financial shaun@bravien.com www.bravien.com Suite 9/60 Macgregor Tce Bardon, QLD 4065 1300 272 843

BBus-Acc, Dip.F.P., C.F.P.

Epona Financial Guidance lisa@eponafg.com www.eponafg.com Suite 6 Level 1, 329 Mitcham Road Mitcham, VIC 3132 (03) 9874 4311 RICHARD MEADEN B.Ec DFP

Advisersure Financial Consultants richard@advisersure.com.au Suite 3/333 Canterbury Road Canterbury, VIC 3126 (03) 9836 8399 SUSAN COOPER AFP®, MBA, Adv.Dip.FS(FP)

Epona Financial Guidance susan@eponafg.com www.eponafg.com Suite 6 Level 1, 329 Mitcham Road Mitcham, VIC 3132 (03) 9874 4311

GAVIN WILLIAMS Garden Financial Services gwilliams@gardenfs.com.au www.gardenfs.com.au 1/5 Oval Avenue Caloundra, QLD 4551 (07) 5437 2744 BRAD MONK LifePath Financial Planning info@lifepathfp.com.au www.lifepathfp.com.au 643 Kessels Road Upper Mt Gravatt, QLD 4122 (07) 3219 4670 0433 271 001 JASON GORDON

CLAUDIA RIGONI-BRAZZALE ADV Dip FS(FP) B App Sc AFA

Aged Care Specialists VIC claudia@agedcsv.com.au 163 Cape Street, Heidelberg, VIC 3058 0419 319 386 ROBERT REARDON BBus (Acct)- ADFS (FP)-Fch FP

Aged Care Specialists VIC robert@agedcsv.com.au Suite 22 level 1, 797 Plenty Road South Morang, VIC 3752 0417 343 392

Dip FP, B. Bus (Accounting) Brisbane Hillross

jason.gordon@hillross.com.au www.brisbanehillross.com.au Level 8, 141 Queen Street Brisbane, QLD 4000 (07) 3012 8040

New South Wales

Australian Capital Territory

MARK CUPITT Pinn Deavin Securities P/L mark@pinndeavin.com.au www.pinndeavin.com.au Level 2, 2-4 Northumberland Road Taren Point, NSW 2229 (02) 8525 3700

JEREMY GILLMAN-WELLS

GEOFF WHIDDON Dome Financial Group geoff.whiddon@domefinancial.com.au www.domefinancial.com.au Level 1/1 Hopetoun Street Charlestown, NSW 2290 (02) 4969 7069 Freecall: 1300 723 300 ROBERT CRAVEN BCom, DipFP, DipAII, JP

Affinity Wealth Services P/L robert.craven@affinitywealth.com.au www.affinitywealth.com.au Level 9, 60 Carrington Street Sydney, NSW 2000 (02) 8078 0888 0432 124 834 Western Australia GEOFF WOTZKO FCPA FCTA Dip FP

Western Pacific Financial Group P/L geoff.wotzko@westernpacific.com.au www.westernpacific.com.au 355 Scarborough Beach Road Osborne Park, WA 6915 (08) 9340 9200

CFP®

Bravien Financial jeremy@bravien.com www.bravien.com Level 1, 29 Bentham St Yarralumla ACT. 2600 (Also in Bardon QLD) 1300 272 843 South Australia DREW POTTS CFP® Senior Financial Advisor

Western Pacific Financial Group drewpotts@westernpacific.com.au www.westernpacificpa.com.au Level 3, 97 Pirie Street, Adelaide SA 5000 (Also in Port Augusta SA) 1300 684 402 KATE PHILLIPS DFS, ADFS, B T. , B Ed.

Tend Financial Planning kphillips@tendfp.com.au www.tendfp.com.au 48 Fullarton Rd Norwood SA 5067 (08) 83624555 MICHAEL YOUNG Second Innings Pty Ltd michael@secondinnings.com.au 156 Commercial Street East Mount Gambier SA 5290 (08) 8723 0411

CRAIG BILLING CFP®

Western Pacific Financial Group P/L craig.billing@westernpacific.com.au www.westernpacific.com.au Suite 2, 165 Seventh Avenue Inglewood, WA 6052 (08) 9381 6622 ALDIS PURINS CFP®

Western Pacific Financial Group P/L aldis.purins@westernpacific.com.au www.westernpacific.com.au 355 Scarborough Beach Road, Osborne Park, WA 6915 (08) 9340 9200

Want to know more about aged care? ...Ask the Gurus!

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Aged Care Gurus Email: asktheguru@agedcaregurus.com.au Web: http://www.agedcaregurus.com.au

BUSINESS MANAGEMENT

IS THERE A BUSINESS MODEL THAT GUARANTEES FINANCIAL SUCCESS IN RESIDENTIAL AGED CARE? Research undertaken by RSM Bird Cameron for the Aged Care Financing Authority analysing the financial performance and factors that influence the performance of residential aged care providers was published on June 3, 2015 RSM Bird Cameron Report. The researchers had access to the General Purpose Financial reports of all providers in Australia and in addition conducted a qualitative survey that we representative of all providers in the industry.

T

he report categorised financial performance based on Operating Earnings Before Interest Tax Depreciation and Amortisation (OEBITDA). This measure normalised the reported results for related party transactions and the impact of lump sum accommodation charges. The range of performance was:

Ten key attributes associated with varying levels of financial performance were identified. While a review these attributes is beyond the scope of this article providers future intentions (consolidation) and their approach to increasing competition and expectations of customers (customer focus) are of particular interest.

Consolidation – the success of Initial Public offerings of aged care providers on the Australian Stock exchange are fresh in the memories of most people. And on the back of this there is a lot of commentary that the industry is set for a significant level of consolidation, some even go so far as to say that stand-alone operators will struggle to survive.

The research considered the profitability of providers based on the number of facilities owned and found that operators with single facilities are more profitable than operators who own multiple

Bruce Bailey National Lead RSM Bird Cameron’s Aged Care and Retirement Living Practice

facilities. Operators of large groups were no more likely to be within the highest performing group while operators of single facilities were more likely to be within this group. The research found that within the top two performing groups, which comprised 40% of all providers, as the number of facilities owned increased the level of OEBITDA declined, with the most significant decline occurring in operators with 20 or more facilities.

In the qualitative analysis undertaken, the researchers asked providers about their intentions; whether they would; stay the size they are, look to grow or look to exit the industry. Irrespective of current financial performance only 3% of respondents indicated an inclination to leave the industry. In contrast 31% intend to seek new places in future ACAR rounds while 46% indicated they will remain at their current size. Of those planning to expand less than 15% intend to pursue an acquisition strategy.

In light of the above data it is open to conclude that; significant consolidation of the industry is either going to occur at a relatively slow pace, that it will require further change in the operating dynamics of the industry or that government policy towards the ACAR will have a significant impact on the degree of consolidation that occurs.

Customer Focus – There is much conversation about the new competitive environment and the need for providers to be more consumer focused. Our research looked at the intentions and current approaches of providers to this issue and sought to identify

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any association with differing financial performance. Some key findings were: • Providers in the top performance group had a much clearer market position or a more targeted approach to the profile of their residents • Surprisingly despite a higher focus by top performing providers they continued to focus across all segments of the industry (supported residents, dementia, CALD, etc.)

service offering. We asked a related question about how they communicate this to the market through the use of brand. There was a very clear association between providers who had updated their brand within the last 3 three years and higher financial performance.

Within the top two performing groups, which comprised 40% of all providers, as the number of facilities owned increased the level of OEBITDA declined.

• What clearly distinguished providers with superior financial performance was their specialisation or higher focus on offering only residential aged care services. On average this group provided 1.2 services while all other groups provided over 2 services. This suggests that the move into home care by residential care providers brings with it many challenges which if not managed well could lead to a decline in profitability.

In undertaking this research we looked at in excess of 600 attributes or relationships across the entire provider base.

The difference between the best performing group and the lowest performing group is approximately $27,000 OEBITDA per bed per annum. While there are legitimate reasons as to why providers will achieve different financial outcomes the range of performance outcome suggests that there are many controllable factors and therefore significant opportunities for providers to improve their financial performance. Over the coming months RSM Bird Cameron will continue to provide insights into the findings from this research project. ■

• The above matters reflect the way in which providers who are achieving higher financial performance are steering their

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HEALTH & WELLBEING

THE VALUE OF SPIRITUALITY IN MEANINGFUL AGEING

“We are not human beings having a spiritual experience.

We are spiritual beings having a human experience” – Pierre Teilhard de Chardin Dave Petty Executive Officer I PASCOP

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or those of us who know and understand the value of pastoral and spiritual care for older people, 2015 Australia is a good place to be.

After years of passionate advocacy by many organisations and practitioners to highlight the value and importance of spirituality we are beginning to see real, tangible outcomes at a national level.

Nowhere is this more evident than in the recent decision by the Australian Government to provide around $400,000 to fund the development of national guidelines for spiritual care in aged care.

While our three organisations are happy to take some credit for getting the project up and running, we are aware that our cause has been assisted by the efforts of many others over the years and the emergence of robust evidence.

The World Health Organisation views spirituality as inextricably linked to quality of life. And there is now a large body of emerging evidence showing that spiritual care is an essential part of holistic care for everyone, particularly older people, including, importantly, those with dementia.

Recent studies have demonstrated that spiritual care predicates both well being and an older person’s ability to adjust to the challenges of ageing.

The decision means that for the first time Australia will have a national standard to inform best practice spiritual care across all aged care settings — residential, community, home-based. And by delivering such a significant investment, the decision also makes it clear that the government, too, sees value in spiritual care for older people.

The intention of the guidelines is to guide best practice in the provision of spiritual care and to build the confidence of the aged health workforce to deliver that care.

There are many organisations already doing very impressive work in delivering high quality spiritual care, and the guidelines, when released in mid 2016, will provide guidance and support for other organisations to do the same.

The impetus for the guidelines project was a submission by my organisation, Pastoral and Spiritual Care of Older People (PASCOP), Spiritual Health Victoria and the National Ageing Research Institute.

And we have also been tasked with jointly managing the project through to fruition.

Recent studies have demonstrated that spiritual care predicates both well being and an older person’s ability to adjust to the challenges of ageing.

Spirituality is not just about religion and faith. It is about what gives people a purpose to their lives. It is the way they experience a connection to themselves, to others and to the world.

The need for spiritual care is often at its greatest when people are facing significant transitions in their lives — the ageing process is one of life’s major transitions.

And this is where PASCOP comes in.

PASCOP is the only national organisation in Australia focused on the pastoral and spiritual needs of older people. Our mission is to ensure that all older Australians have access to high quality pastoral and spiritual care.

Ageing is part of life’s journey. It is also for many a time of deep reflection. A time when people seek to make meaning of their life.

A time when people ask the ‘spiritual’ questions: What is the purpose of my life?

What does the future hold?

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How much time do I have?

What will happen when I’m gone?

Spiritual care means giving older people the opportunity to reflect, to question, to attend to their inner experience of ageing.

We know there are many working in aged care who understand the value of spiritual care but feel ill-equipped to deal with or talk about spirituality — they want to have the conversations but tend to stay at a superficial level because they don’t feel they have the knowledge or skills to respond at a deeper level.

We know also that there are many organisations which value and strive to provide high quality pastoral and spiritual care but are constrained from doing so by a lack of time, resources or specialist skills.

PASCOP provides the information and tools organisations and their people need to deliver pastoral and spiritual care. This includes training and education tools, advice on developing a culture that supports high quality pastoral and spiritual care and access to research and academic papers.

We also run the Meaningful Ageing Seminar Series to share and promote the latest information and experience from international and local experts, and have recently launched the inaugural PASCOP Quality Practice Award, Australia’s first national awards program

Image courtesy of Barabasa/shutterstock.com

dedicated to innovation and excellence in pastoral and spiritual care of older people.

It is a privilege to work in this space. To support others to meet the spiritual needs of those they care for. And, in turn, to play some small role in helping to make the journey of ageing a meaningful one. ■ For more information about PASCOP go to www.pascop.org.au or contact Dave Petty on 03 8387 2616 or ceo@pascop.org.au

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HEALTH & WELLBEING

WHAT THE NEW

HEALTHY EATING PYRAMID

MEANS FOR OLDER AUSTRALIANS Nutrition Australia has recently launched its updated Healthy Eating Pyramid, a visual guide to the types and proportion of foods that adults should eat every day for good health. But does it meet the needs of older Australians, particularly those in residential aged care? As with many aspects of nutrition and health, the answer isn’t black and white.

A

lthough the pyramid has been updated, overall the main healthy eating messages remain consistent: to eat a wide variety of foods from the five core food groups; choose mainly plant-based food; and limit foods high in saturated fat, salt and added sugar. What has changed is the structure of the pyramid, which provides clearer guidance to how much of each food group should be consumed on a daily basis. The new pyramid has also evolved to accommodate Australia’s changing dietary patterns and cultural diversity, with a wider range of foods included within each group.

Where the previous pyramid grouped all foods into three simplistic layers, indicating which foods to ‘eat more of’, ‘eat moderately’ and ‘eat less of’, the updated Pyramid now contains five different layers. Plant-based foods still take up the pyramid base, with fruit, vegetables and legumes and grain foods emphasised in the two foundation layers. This is followed by a middle layer containing dairy, dairy alternatives and protein foods such as lean meat, poultry, fish, eggs, nuts, seeds and legumes. At the top of the pyramid, small amounts of healthy fats have replaced all fats and sugar.

The Healthy Eating Pyramid and other national dietary guidelines, such as the Australian Guide to Healthy Eating, can all contribute relevant information on nutritional intake for older Australians however additional considerations need to be taken when addressing the specific nutritional needs of people living in residential aged care.

Plant-based foods should still make up a significant portion of an older person’s diet as they are the main source of carbohydrate.

Carbohydrates are the body’s preferred source of energy and important for maintaining body weight and optimising cognition.

Emma Rippon Managing Director & Accredited Practising Dietitian Eat Well Nutrition Service

Carbohydrates also provide fibre, important for managing constipation, a common condition suffered by elderly residents.

Ensuring foods that are high in fibre are regularly available to residents, such as fruits, vegetables, legumes and wholegrain varieties of bread and cereals, can help promote good bowel health.

The middle layer of the pyramid contains high protein and calcium rich foods, both nutrients of particular importance for later years in life. Bone health can become compromised with age, and the risk of osteoporosis high. Fractures of the hip, leg and wrist are common amongst the elderly, especially in those at higher risk of falls. Once calcium is lost from bones it is difficult to replace but consuming enough calcium, fluoride and vitamin D can limit the progression of the disease. Three to four serves of dairy per day are recommended for men and women over 70 years of age. It is therefore essential that dairy foods such as cow’s milk, yoghurt, custard, cheese or calcium fortified soy milk products, are offered at all meal times on aged care menus.

Foods in the lean meat, poultry, fish, eggs, nuts, seeds, legumes section are good sources of protein and also provide a mix of important nutrients including iodine, iron, zinc, B12 vitamins and healthy fats. The need for protein increases when we reach our 70s – protein helps heal wounds, promotes increased lean muscle mass and helps prevent malnutrition.

Avoiding weight loss and malnutrition is of particular importance for people living in residential aged care. This is one of the main reasons the Healthy Eating Pyramid poses some limitations for older people. Malnutrition rates in older people are at 8-30% of those living in the community and 40-70% of those in residential aged care. Many factors can contribute to this including loss of appetite,

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depression, infections, co morbidities and impaired cognition. Because appetites are smaller and nutrient needs remain the same or higher, food choices need to be nutrient and energy dense.

The message “choose water as your main drink” can make it difficult for older people to meet their nutritional needs. While drinking water is important to aid hydration and avoid constipation, consumption of nourishing fluids such as milk drinks and fruit juices can be an effective strategy to help meet energy and protein needs.

The updated pyramid emphasizes a stronger focus on limiting discretionary choices such as pastries, cakes, biscuits and confectionary, which have been completely removed. These energy-dense foods need not be completely avoided by older people, especially aged care residents. They not only provide vital energy to help maintain weight but offering such foods can promote quality of life and pleasure around eating. It is these type of treats that people often enjoy the most.

For older people in aged care with chronic illnesses, many restrictive diets are no longer warranted. This is because limiting food choices can increase the risk of malnutrition, weight loss and quality of life. It standard practice in aged care facilities that residents with diabetes are offered a standard menu, with the option to make any adaptations to this as they wish.

The updated Healthy Eating Pyramid is a useful tool to promote the foods that Australians should eat every day for good health. It can help to guide a healthy lifestyle and balanced diet, however special considerations need to be made for older people, particularly those in aged care, to reduce the risk of malnutrition and to optimise quality of life. ■

Nutrition Australia has a number of fact sheets and FAQs about nutrition for the frail elderly which can be downloaded at www.nutritionaustralia.org/national/resources

Dr G Allen Power, MD is a board certified internist and geriatrician and a Clinical Associate Professor of Medicine at the University of Rochester, New York, as well as a Fellow of the American College of Physicians/American Society for Internal Medicine.

Dr Power serves on the board of directors of the Eden Alterative, Inc. and is also a Certified Eden Alternative™ Educator and Mentor.

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HEALTH & WELLBEING

COUPLES COUNSELLING FOR RESIDENTIAL AGED CARE PROVIDERS AND GPS: The key to a successful marriage As strange as it sounds, the relationship between Residential Aged Care (RAC) providers and General Practitioners (GPs), and the romantic relationship between two people are not as far removed from each other as they seem.

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oth are based on initial attraction, followed by the reciprocation of needs, sustained interest, good communication, trust and reliability. A common goal of caring for older people binds GPs to RACs and the relationship is inter-dependent on care assessment and delivery.

Much like the romantic version of these relationships, GP/ RAC relationships are prone to breakdown and discontent.

to health care for residents and a reduced need to access locum services, having a regular GP brings with it increased familiarity, clear expectations, and peace of mind. This supports a community of care, a bringing together of the aged care and health care families in the spirit of optimal care provision.

GP service to aged care facilities has increased 41% in 10 years, however, there is an increasing unavailability of GPs to meet the changing needs of the ageing population

High quality, experienced and committed GPs in aged care are increasingly hard to find. Research indicates that GP service to aged care facilities has increased 41% in 10 years1, however, there is an increasing unavailability of GPs to meet the changing needs of the ageing population2. Knowledge that residents are now entering aged care older and with more complex health conditions, combined with the fact that aged care has long been regarded as the poor cousin to other more ‘glamorous’ areas of the health sector, means that maintaining a relationship with a good GP is becoming mission impossible for aged care providers.

We know that it’s critical that older people living in RAC facilities receive the best and most consistent care possible, and this includes access to high quality, appropriate and timely health care, ideally provided by an enthusiastic, interested, supported, and engaged GP, in a relationship of trust and respect.

An ongoing and positive relationship with a particular GP brings with it a number of benefits for the resident and their loved ones, plus the service provider. Beyond contributing to a proactive approach

Amee Morgans Manager Policy, Research and Innovation Benetas

We know that GPs handpick the facilities they wish to service. So, much like the quest for everlasting love, we need to explore the best way to attract the best GPs, and keep them for the long haul.

Based on the latest research recently published in the Australian Medical Journal3, here are our tips on maintaining the love between aged care and GPs.

Tip one: Don’t play hard to get You don’t want to waste anyone’s time. GPs have told us time and again they are busy and want their visit to be as efficient as possible. You need to get your facility organised, and you need to be ready. The last thing you want is for a GP to come for their visit and for residents to be unaware that they are coming or attending offsite activities. Where families are part of the decision-making team, family members should be aware of the visit to allow an opportunity for a family conversation with the GP, instead of half conversations and third party file notes after the visit.

Put simply, you need to make things as easy as possible for GPs. Things like making sure there is a car park available to them, close to the entrance, and that they have access to all the necessary security codes to get into the building – and out again – and login

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Image courtesy of Monkey Business Images/shutterstock.com

access to the information systems of the facility, will make a big difference. Getting a parking ticket, being locked out (or in) and writing notes on the back of a bit of copy paper do not inspire confidence or return appeal.

It’s also time to do your best to streamline, the time-consuming administration and cumbersome clinical processes. Of course processes required by law or put in place to protect the wellbeing of residents must remain, but opportunities exist to present the GP with new Drug Charts to be completed before they expire/ or in preparation for a second chart being needed, specialist reports and other documents being accessible, preparedness for clinical procedures, such as setting up of catheter trolleys and other basic procedure requirements. If you can cut down on the amount of red tape GPs need to cut through at your facility, you’re limiting frustration and you’re off to a good start.

Time and effort needs to go into attracting engaged, motivated, interested, GPs to residential aged care, now more so than ever.

Tip two: Hold their hand Aged care is becoming an increasingly complex environment; complicated by recent reform, and changing expectations of the government, service providers and consumers. People are living longer, but their stays in residential aged care are getting shorter, which means that building rapport with clients in aged care is harder for GPs. Providing a facility overview for GPs commencing care for new aged care clients is a great help, and supports a higher quality care relationship from the beginning.

In order to ensure residents are receiving the best and most appropriate care, facilities need to invest in their GP; supporting and equipping them with the knowledge they may lack, and need, around issues which impact service delivery day to day. If you can get your GP up to speed with aged care funding and regulatory requirements, changes to service eligibility criteria, and you’ll

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probably find that they will better understand the constraints they, and you, are working within.

On top of this, invite them to join onsite training, and provide information about resources to support specialist documentation including Advanced Care Planning and the Palliative Approach in accordance with best practice and your organisational requirements.

The more you’re on the same page as each other, and the resident you’re both caring for, the more beneficial the relationship will be.

Try and agree to a routine visit schedule that suits everyone, and be available to support them in the consultation if needed and receive a handover of care notes.

Tip three: Experience counts One of the key factors contributing to a long and meaningful relationship with GPs is the quality of staff at the facility. From management to care workers, the need for experienced staff who know what they are doing is paramount to engaging good GPs. At an industry level, staff turnover is a challenge faced by many providers. Active retention of key staff on site supports continuity of care, culture and customer service. The research shows that having qualified, permanent staff on board is a key driver in attracting equally well-qualified and permanent GP practice relationships.

You need to give GPs the opportunity to build ongoing and respectful working relationships with your staff, based on mutual respect, teamwork and trust, to help them deliver the high level of care your residents are seeking.

Tip four: Introduce them to the family Research strongly suggests that GPs benefit from good relationships with the people in the residents’ world. This goes beyond the GP/resident relationship or the GP/facility relationship, and extends to relationships with the residents’ families, friends, other allied health and community service providers and others who play a key part in supporting their wellbeing.

Developing and maintaining strong relationships with these people supports continuity of care for the resident, and ultimately optimises their health outcomes. But what if they find meeting the in-laws difficult? It’s true that GPs report that existing relationship management tools, such as the Residential Aged Care General Practitioners Guide, are not as helpful as they could be. Why not develop a simple checklist for establishing and negotiating the relationship? Or invest in care planning meetings that incorporate

Why not develop a simple checklist for establishing and negotiating the relationship? Or invest in care planning meetings that incorporate all key members of the residents’ life?.. sometimes it’s the simple things that contribute to the most significant outcomes. all key members of the residents’ life? This would help to set expectations and bridge the gap between the key interests of all parties, which are fundamentally different. What we’ve learnt from the research is that sometimes it’s the simple things that contribute to the most significant outcomes.

Tip five: Make it worth their while

simple steps that residential aged care facilities can undertake to try and support a rewarding environment for GPs to work in.

Trying to find a perfect match with a GP in residential aged care can be tricky. Just like the quest to find your soul mate, there are always going to be factors you can’t control, such as your family, external expectations, or what you look like. Time and effort needs to go into attracting engaged, motivated, interested, GPs to residential aged care, now more so than ever. It’s our responsibility as service providers to facilitate the best, most consistent and timely care for our residents, which might mean putting on some lippy and being on your best behaviour. ■

REFERENCE 1. Australasian Journal of Ageing

Most research suggests that GPs find RAC practice personally and professional rewarding. They speak about being able to make a difference, not only to the lives of an older person, but to the older person’s loved ones too. Unfortunately, more often than not, this isn’t enough.

GP work in aged care is poorly remunerated. A poor relationship makes working in the area even less attractive to GPs, who can pick up significantly greater income in the private practice setting. Until there is improvement in remuneration models for GPs, these are

2. M edical services provided by general practitioners in residential aged care facilities in Australia Stephen Burgess, Amee Morgans, Jenny Davis. General practice and residential aged care: A qualitative study of barriers to access to care and the role of remuneration, In Press with the Australian Medical Journal.

ACKNOWLEDGEMENT The Sub Acute Healthcare Linkages in Later Years (SALLY) project was conducted

by Benetas in partnership with Bayside Medicare Local, and was funded by the Department of Social Services under the Better Health Care Connections: Models for Short Term, More Intensive Health Care for Aged Care Recipients Program.

HAVING THOSE DIFFICULT CONVERSATIONS DON’T LET YOUR ORGANISATION BECOME DISCIPLINE

AND

A BATTLEGROUND

TERMINATION - MINIMISING THE RISK TO YOUR BUSINESS

This workshop focuses on giving you the skills to avoid the common pitfalls of discipline and termination and to ensure that you have a fair and effective process in place. When managing staff there will be times when an employee does not perform at the required level. Handling these difficult conversations properly can avoid unfair dismissal or adverse action claims before the Fair Work Commission. If you don’t do this properly, claims can result in financial loss to the business, potential reinstatement of the dismissed employee and payment of compensation. Can you afford for this to happen? Let us show you how to effectively manage these difficult conversations through a structured process that minimises the risks to your business.

WE OFFER THIS AS A TAILORED COURSE FOR YOUR ORGANISATION OR YOUR STAFF CAN JOIN US AT OUR PUBLIC ROADSHOW AUGUST 10TH - 13TH 2015 FOR INFORMATION ON OUR TRAINING COURSES AND DISCOUNTED RATES FOR LASA FUSION READERS PLEASE CONTACT OUR TEAM! YOUR PARTNER IN AGED CARE AND COMMUNITY SERVICES 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

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HEALTH & WELLBEING

PERFORMANCE ENHANCEMENT Leveraging the most extensive network of aged care professionals to help you maximise care, service and performance.

EXECUTIVE • • • • • • • • •

Strategic/business planning Expansion review Capacity building Vision & mission messaging Culture reviews Facility interface reviews Financial & operating reporting KPI’s & benchmarking Board education & facilitation

FINANCE • • • • • •

Occupancy maximisation RAD/DAP policy reviews ACFI system audit & maximisation Supplement enhancement Expenditure management Benchmarking & performance optimisation

REGULATORY COMPLIANCE Governance review Risk identification Policy formation assistance Continuous improvement system development • Regulatory training • • • •

MARKETING • • • • • • •

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Branding & messaging Competitor analysis Market positioning Media positioning Management of referral networks Promoting vision & expertise Community interface development

RESIDENT ADMISSIONS • Admission strategies • Accommodation payment targets & sales approach • Needs profiling & capacity • Wait list management • Facility tour program • Enquiry follow up & query management

info@ansel

COMPUTER SOFTWARE

ASSET MANAGEMENT • Expansion/development planning • Accommodation supplement maximisation strategy • Capital forecasting • Repair & maintenance budgeting • Maintenance program development

| TECHNOLOGY

HOTEL SERVICES • Hotel service efficiency & quality assessments • Catering service modelling • Laundry service system development • Contract assessment & coordination • Cultural needs assessment & planning

LEISURE, LIFESTYLE & THERAPY • • • •

Activity program review & development Service delivery & efficiency assessment Community interface program Technology use & recovery

CARE SERVICES • Clinical governance, compliance & competency assessment • Documentation audits • Clinical system implementation • ACFI system maximisation • Resource & expertise maximisation • Resident satisfaction reviews

HUMAN RESOURCES • • • • • • • • •

Rostering reviews Staffing & allocation efficiencies Recruitment & retention strategies Senior staff education Training & induction programs Performance management Succession planning Workers compensation management Interim management

FACILITY MANAGEMENT Expansion/redevelopment planning Program maintenance implementation Human resource management strategies Senior staff performance evaluation & feedback mechanisms • Professional development & career planning • • • •

To make an enquiry email, call or visit our website llstrategic.com.au | www.ansellstrategic.com.au | 08 9489 2513

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70

HEALTH & WELLBEING

BREAKING THROUGH BARRIERS TO

PAIN MANAGEMENT

Image courtesy of Dirk Ercken/shutterstock.com

Persistent pain is no longer considered a normal part of the ageing process, yet prevalence remains high amongst older Australians. Not only does ongoing pain impact a person’s quality of life, health and wellbeing, but ineffective pain management can strain facility costs and services too. With National Pain Week from 20-26 July, now is a great time to look at the latest news and resources to help age service providers manage pain.

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TECHNOLOGY |

72

COMPUTER SOFTWARE

HEALTH & WELLBEING

TAKING A HOLISTIC APPROACH TO PAIN MANAGEMENT

Physiotherapists, occupational therapists and therapy assistants are working together to deliver pain management clinics in Western Australia with great success.

H

elping older Australians manage pain is a challenge for all health professionals and care providers. Pain is no longer accepted as part and parcel of ageing, and is increasingly managed using holistic approaches that combine non pharmacological methods with a person’s medication regimen.

The prevalence of chronic pain in residential aged care is estimated to be between 49-84 per cent and it is well documented as being linked to depression, social isolation, sleep disturbances, impaired gait, increased use of health services and increased costs.

The realisation that pain management was an area where significant change could be achieved led Bethanie to creating dedicated pain management clinics for its residents.

There are specific inclusion criteria for the clinics, and all those receiving treatment undergo a thorough assessment prior to commencing. Criteria include diagnosis of pain, willing to attend, likely to be compliant with treatment and some funding criteria.

“We have a strong focus on best practice and integrating pain management to improve our residents’ quality of life. We offer a wide variety of treatment modalities including exercise, massage, manual therapy, paraffin wax, ultrasound and TENS, but we wanted to do more. We saw this as a gateway to influence and significantly improve people’s lives,” Mrs Reeve said.

If a site physio is telling someone they need to exercise once per week, it doesn’t stick all that well, but if we are also telling them on the other four days, they start to listen.

“At Bethanie we have been trying various models for years, looking at how we can better manage our residents’ pain.

Our clinics were developed by the Therapy Services team and combine years of lessons learned from other non pharmacological management techniques, which were previously limited to massage, heat packs and occasional physiotherapy interventions,” Pele Reeve, Pain Clinic Coordinator at Bethanie, said.

In February 2014 a trial began using physiotherapists, occupational therapists and therapy assistants providing pain management, mostly in a group setting, on a regular basis. The trial was a success and the clinics have been rolled out across seven of the group’s residential facilities with another set to open later this year.

Open four days per week, the clinics are onsite and allow flexibility for tailored treatment to suit the resident on the day depending on their health and other appointments. If someone is feeling unwell they are seen in their room.

Inside the clinics relaxation music and aromatherapy are in the background, and socialisation, conversation and general relaxation is strongly encouraged, to provide a genuine sanctuary for residents.

“One of the big benefits of the clinics is an increased therapy presence on site, therefore increased awareness of what we do. It also means better continuity for the site staff and residents in terms of education. If a site physio is telling someone they need to exercise once per week, it doesn’t stick all that well, but if we are also telling them on the other four days, they start to listen,” Mrs Reeve said.

“One of our most powerful tools is our ability to educate our residents and staff about how our understanding of pain can influence our experience of pain and quality of life. We are in the process of developing a series of educational posters that are user friendly, to explain the pathophysiology of pain, and how we can most effectively change this. This will assist our therapists as they continue to educate our residents and empower them to take control,” she said.

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HEALTH & WELLBEING

A total of 37 physiotherapists and OTs currently work across pain management clinics, residential, community and day therapy centres. Staffing the clinics has meant additional positions were created and new skills for staff, as everyone working in the pain management clinics undertakes specific pain management training and ongoing education and support to maintain a high level of clinical skills and knowledge.

Through reporting and tracking procedures and clear KPIs, staff have been able to demonstrate positive results linked to the clinics, relating to residents’ pain scores, quality of life and staff satisfaction.

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“Feedback to date has all been very positive. We have seen significant improvements in our residents’ pain levels from assessments done prior to starting in the clinics, and then after three months of receiving treatment. We also see some positive changes in quality of life outcome measures, with some residents beginning to reduce some medications, having improved sleep quality and quantity, and improved functional ability,” Mrs Reeve said.

“Our clinics are evidence that pain can be improved and through attending our clinics residents are empowered to continue doing the things they enjoy.” ■

HEALTH & WELLBEING

PAIN MANAGEMENT IN RESIDENTIAL AGED CARE FACILITIES The National Ageing Research Institute has developed a new paper that provides an evidence-based approach to assessing and managing pain experienced by residents of aged care facilities.

P

ublished in the April 2015 edition of Australian Family Physician, the peer-reviewed study looks at barriers to effective pain management in residential aged care facilities include patient beliefs and attitudes towards pain, communication deficits and cognitive impairment, frailty and its effect on pharmacotherapy, and the evidence behind pain management strategies for people with dementia.

The authors, Dr Steven Savvas and Dr Stephen Gibson, look at pain assessment tools including observational signs and sensory testing, pharmacological and non pharmacological pain management approaches, existing guidelines from the Australian Pain Society and barriers to addressing persistent pain.

Attitudes towards pain form part of these barriers, and the authors stress that “elderly patients may not articulate their pain experience for a number of reasons, and this may be affected by their level of cognitive impairment. In those with sufficient cognitive function, the main barriers to accurate self-reporting of pain are their age-related pain beliefs and attitudes.”

They note that, “a study in residential aged care facilities suggests that, compared with nurses, patients more strongly endorse the belief that persistent pain is a normal part of ageing and there is little potential for improvement. Other attitudes include fear of addiction to pain medications and reluctance to seek help for fear of an acknowledgement of disease progression or further functional dependence.”

The authors warn that, “physicians and nursing staff need to dispel these beliefs and attitudes, and encourage, support and even coax patients into expressing their pain experience. If patients do not acknowledge their pain, rephrasing using similar words such as ‘discomfort’, ‘throbbing’, ‘aching’ and ‘soreness’ may elicit a different response. When a patient is unlikely to self-report pain, assessment should be conducted when warranted, and routinely at least every few months.”

While the authors note that progress is being made in addressing the barriers to pain management through education programs, improved observational behaviour scales and stepwise pain management protocols, they advocate the implementation of Australian Pain Society guidelines for best practice management of pain in aged care facilities and increased nursing staff confidence.

They also note the lack of evidence behind effective treatment approaches for patients with dementia.

They conclude that, “good pain management in residential aged care settings must address a number of barriers such as attitudes to pain, communication deficiencies, heterogeneity of responses to pharmacotherapy in elderly frail patients and limited evidence for effective treatment approaches for patients with dementia.

However, developments including behavioural observational tools and stepwise pain protocols may help address some of these obstacles.” ■ To view the full article go to www.racgp.org.au/afp/2015/april/painmanagement-in-residential-aged-care-facilities

UPCOMING HEALTH WEEKS 1-30 June

20-26 July

3-10 August

Bowel Cancer Awareness Month Bowel Cancer Australia

National Pain Week Chronic Pain Australia

Dental Health Week Australian Dental Association

6-12 July

28 July

23-29 August

Sleep Awareness Week 2015 Sleep Health Foundation

World Hepatitis Day World Health Organization

Hearing Awareness Week

Department of Health

12-18 July Diabetes Awareness Week Diabetes Australia

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HEALTH & WELLBEING

EVALUATE PAIN MEDICINE USE & EARN CPD POINTS

NPS MedicineWise has two CPD activities relating to pain management for people working in age services: a new case study that can be completed by home care providers and an existing medicine use review (formerly known as a drug use evaluation). Both activities relate to monitoring and assessing the use of opioid therapy for chronic (non cancer) pain.

M

edicines Use Reviews are free quality improvement activities based on best practice standards and guidelines to help nurses and pharmacists working in residential aged care facilities review, reflect on and improve current practices within facilities.

The activity provides a step-by-step guide for conducting an indepth Medicines Use Review and allows you to generate solutions specific to your facility. Results can be easily shared with GPs, other health professionals and Medication Advisory Committees.

The Medicines Use Review has two phases: Phase 1 involves reviewing clinical materials, data collection for at least 10 patients, calculating results against best practice indicators and developing action plans to target training needs.

Phase 2 involves reviewing action plans from phase 1 and repeating the data collection process from phase 1 and comparing results at two time points.

It’s recommended to allow three months between the completion of phase 1 and the beginning of phase 2. Comparing results at two time points will allow you to evaluate improvements in practice and assess the effectiveness of any implemented changes.

NPS Medicinewise provides the clinical resources and tools required to complete the medicine use review.

By completing the case study, which focuses on a 78 year old who lives at home and suffers increasing pain from arthritis, you should be able to: • Implement a systematic approach to managing chronic noncancer pain.

•

iscuss pain management goals D with patients experiencing chronic pain.

•

Identify contributing factors (yellow flags) to chronic non-cancer pain.

•

Recognise and support patients with chronic non-cancer pain in whom a trial of opioid therapy may be beneficial.

•

List adverse effects associated with long-term opioid therapy. ■

For more information or to participate in either activity go to: www.nps.org.au/health-professionals/cpd

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EVENTS

CALM, SUPPORTIVE ROLE MODEL WINS NSW-ACT CARE STAFF AWARD

Sherrie Lee Rediger has been named the 2015 LASA NSW-ACT HESTA care staff member of the year.

T

he Assistant in Nursing in the dementia unit at Whiddon Grafton received the accolade at the LASA NSW-ACT Congress 2015 dinner on 28 May.

Sherrie Lee commenced at the Whiddon Group at in September 2013 as a Replay Trainee and graduated in October 2014 with a Certificate III in Aged Care.

The Replay Group assists employers to recruit Indigenous job seekers into paid traineeships as Assistants in Nursing in Sydney and across regional, rural and remote areas of NSW. Whiddon’s partnership with The Replay Group commenced in 2006 and since then approximately 75 trainees have passed through the program. The program currently offers Certificate III in Aged Care but this is being expanded into community and disability qualifications.

Sherrie Lee was nominated for being a great team player, a role model for other indigenous trainees and new staff and for her calm and supportive work in the dementia unit.

Speaking about her nomination, Sherrie Lee said: “I came into aged care with absolutely no experience or knowledge of what was required. The Replay Group and Whiddon have shown me how to be a great carer and how to look after myself at the same time.

From waking up a client to showering, giving them their meals and even helping them go to the bathroom, all the things we take for granted, they have shown me how to make sure that we respect the clients and that their dignity is extremely important.”

“I have only been nursing for a few years and feel that I have found my calling. To get up in the morning and be happy about going to work and knowing that you can make a difference in someone else’s life is not a feeling I had working in an office behind a desk. I would like to encourage other people to take up this career and be an example of how you can change career’s and find something that you love doing,” she said. ■

Sherrie Lee Rediger (right) with Mary Griffin, Director – Care Services at Whiddon Grafton

77

EVENTS

LASA NATIONAL CONGRESS 2015:

CO-DESIGNING TOMORROW’S AGE SERVICES Co-designed policies and programs are essential to meeting the needs of older Australians as demand for all services intensifies. No longer can the industry think in silos; integrated policy development and implementation is about incorporating the needs of older Australians, their loved ones and the industry that serves them.

T

his year’s LASA Congress builds on the success of 2014, and is about thinking ahead and connecting people, information and ideas to ensure a viable aged care industry and the best possible care for all older Australians.

This year’s Congress not only sets the course for practical reform but also confronts the controversial and uncomfortable issue of elder abuse. I am confident with our expert panels and dedicated industry leaders, we can develop meaningful solutions to ensure vulnerable older Australians are protected, respected and supported to live well.

Non-session passes If you can’t make it to Congress during the day but don’t want to miss out on the invaluable networking opportunities we now offer networking packages and single-day Exhibition Only passes.

Additional networking opportunities Last year you told us the networking opportunities at Congress were invaluable, so this year we’ve given you even more social events so you can meet new people, nurture existing relationships and do business in a relaxed environment. With the industry’s most senior leaders converging in Melbourne for our National Congress, our social and networking program is not to be missed.

Welcome Reception Pre-Dinner Drinks Gala Dinner

Program highlights What’s Happening with Mergers and Acquisitions – presented by the Commonwealth Bank, K&L Gates, and Bridge Advisory Group | LASA Member breakfast

Unleashing innovation in the CDC era – redefining community partnerships to co-create services, crow revenue and improve outcomes in a CDC market – presented by Ellis-Jones | LASA Member breakfast

Keynote speakers: Building a winning team, Alastair Clarkson, Coach, Hawthorn Football Club A life filled with passion and purpose, Naomi Simson, Red Balloon Founder and media personality Q&A Panel: MyAgedCare – have your say in this facilitated, interactive session where no question will go unanswered UK expert on foundations of co-design and social innovation, Deborah Szebeko Gain critical insight into Elder abuse and protecting our older Australians, in a panel session facilitated by Geraldine Doogue Hear the latest in reforms from senior staff at the Department

Taste of Melbourne Dinners ■

Explore innovative and co-designed aged care facilities throughout Victoria on a Site Tour

Download the full program and register at www.lasacongress.asn.au

Over 60 sessions across three days

78

EVENTS

FEaturED SpEaKErS Dianne Adamson

Dr Sophie Dilworth

Dee Jeffrey

Paris Petranis

Adamson & Associates

Arts Health Institute

PresCare

K&L Gates

Cam Ansell

Sue edwards

Deborah Jennings

Dr tanya Petrovich

Ansell Strategic

RedUse

Thompson Health Care

Alzheimer’s Australia VIC

Corrinne Armour

rhod ellis-Jones

Paul Johnson

Sabine Phillips

Extraordinary Future

Ellis Jones

BallyCara

Russell Kennedy

David baker

John engeler

Chris karigiannis

DPS Publishing

SummitCare Australia

Benetas

Nehemiah richardson NAB Health

bruce bailey

Jessica Fisher

magalí kaplan

Lisa rollinson

RSM Bird Cameron

FCB Workplace Law

Jewish Care Victoria

Brotherhood of St Laurence

tony bridge

matthew Fisher

trina kazi

Bridge Advisory Group

Greengate

Gilmore Interior Design

Ann brodie

kerry Flattley

Arthur koumoukelis

Sir Moses Montefiore Jewish Home

The Cranlana Programme

Gadens

Paul brown

Shelly Fletcher

Ann Lafferty

Gadens

Feros Care

Lifeview Residential Care

robyn brown

Judith Fox

rachel Lane

Communio

Governance Institute of Australia

Aged Care Gurus

Natasha Chadwick

Chris Frame

Sarah Leaney

Synovum Care Group

Bethanie

Thompson Health Care

Professor graeme Clark AC

Sandra glaister

Daniel Lee

Freedom Aged Care

Ansell Strategic

mandy Collin

Louise greene

matt Linnegar

Thompson Health Care

The Ideal Consultancy

Australian Rural Leadership Foundation

Caroline Collins

maggie Haertsch

Anne Livingstone

SummitCare Australia

Arts Health Institute

ACIITC

Diana Cooper

Patrick Herd

Darya mcCann

Austin Health

Community Business Australia

Communio

mark CooperStanbury

ronda Held

murray mcDonald

COTA Australia

Duplex

Silvia Holcroft

ross mcDonald

QPS Benchmarking

Capital Guardians

travis Holland

Julie mcStay

Holland Thomas & Associates

Hynes Legal

glen Hurley

Lynda O’grady

Allity

Aged Care Financing Authority

Cochlear

Australian Institute of Health and Welfare

David Cox Ansell Strategic

michael Culhane Department of Social Services

Jenny Davis Benetas

Paul Dickson

Jeremy Jacobs

Dickson and Dickson Health Care

Ansell Strategic

robert Samuel Consult Point

Anna Santikos Sir Moses Montefiore Jewish Home

Heath Shonhan Bentleys Chartered Accountants and Business Advisors

A/Prof william Silvester Decision Assist

Carolyn Smith Department Of Social Services

ritesh Srivastava Epictenet

Steven Strange Health Metrics

Leith thomas The Cranlana Programme

Catherine thorpe David & Goliath Consulting

Hugh watson Moores

kylie whicher HESTA

Pam O’Nions Qualitas Consortium

Jose yanes Commonwealth Bank of Australia

Amber Cartwright Ansell Strategic

Catherine Suva Ansell Strategic

79

EVENTS

SAGE LEADERS’ PROGRAM TOUR DENMARK AND THE UK 2015 17 October – 1 November 2015

L

ASA members are invited to join SAGE’s exclusive aged care leaders tour to Denmark and UK later this year.

Following the success of SAGE study tours for senior executives over the last nine years, this strategically prepared program will focus on leadership, innovation and strategy.

Delegates will be able to draw professional development experiences from leaders in Australia’s age services and our Danish and British counterparts and are expected to have opportunities for high level meetings and receptions with Australian embassy dignitaries and access to in-country experts. The tour also provides an opportunity to share ideas and commercial opportunities with our global colleagues.

The tour will coincide with Denmark’s Health and Aged Care Festival, giving attendees a rare opportunity to study innovation in rehabilitation and applied technology for global aged care services.

The leaders’ program is specifically designed for board directors, executive managers and senior decision makers in age services. ■ For more information please contact Judy Martin jmartin@agedcare.org.au

Image courtesy of Filip Bjorkman/ shutterstock.com

24 & 25 November 2015 Jupiter’s Hotel Gold Coast

www.itacconference.com.au

Exhibition & Sponsorship opportunities OPEN NOW

Living the Age RevoLution: IT drIvIng change

IT Awards – submission open until

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

31 JULY 2015

ITAC 2015 is brought to you by the Aged Care Industry Information Technology Council (Aciitc) supported by Leading Age Services Australia and Aged and Community Services Australia.

Image courtesy of Leonid Andronov/shutterstock.com

80

EVENTS

Left to Right: Jacqui Kelly, Lutheran Community Care, QLD; Tamara McLeod, Goodwin Aged Care, ACT; David Frost, ThomsonAdsett; Robyn Boyd, Goodwin Aged Care, ACT; our hosts, Tobias and Thomas (CEO), Reusspark, Switzerland; Alan Waters, ARV, NSW; Judy Martin, SAGE program leader; Fiona Hearn, RDNs, Victoria; Darren Pike, Resthaven, South Australia; Nick Heyward Smith, Wellness & Lifestyle, South Australia.

BUILDING KNOWLEDGE & CAPABILITY

THROUGH STUDY TOURS

LASA is proud to partner with SAGE tours to offer people working in age services the opportunity to experience first hand some of the most innovative approaches to aged care around the world.

E

ach year SAGE runs several study tours where delegates can evaluate the advancement of eldercare from a global perspective and receive insights from some of the world’s most highly respected industry professionals.

In addition to highly competitive pricing, SAGE tours set the industry standard for high quality content, relevant learning outcomes and fantastic networking opportunities. Many delegates have returned home and implemented minor and major programs based on their learnings, with tangible outcomes for residents and staff.

Tours involve: • Visiting clinical and educational sites/institutions • Fostering and Exchanging learning opportunities across different cultures • Facilitating cultural exchange at an industry and personal level • Meeting with well respected professionals working in the field • Developing an understanding of the roles of government, nongovernment organisations (NGOs) and the private sector in the provision of aged care services in other countries

Upcoming tours Boston and Toronto 4–19 November 2015 BOOKED OUT Denmark and UK (Leaders’ Program) 17 October–1 November 2015

Proposed destinations for 2016 Switzerland South Africa New Zealand The Netherlands For more information go to www.sagetours.com.au

• Gaining an understanding of alternative forms of service delivery in clinical delivery, community education, resource development and research ■

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WaterMark

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EVENTS

UPCOMING EVENTS

IN AGE SERVICES

JUL

AUG

Gender and ageing – COTA Australia’s National Policy Forum 2015 2 July – National Press Club, Canberra

2015 Australasian Better Boards Conference 24-26 July – Brisbane Convention & Exhibition Centre

HIC 2015 - Health Informatics Conference 3 – 5 August – Brisbane Convention & Exhibition Centre

2015 NIMAC Conference and Exhibition 8-10 July – RACV Royal Pines Resort, Gold Coast

LASA Victoria Governance & Leadership Seminar 30 July – Leonda by the Yarra, Hawthorn, VIC

LASA Victoria Workforce & Safety Seminar 13 August – Leonda by the Yarra, Hawthorn, VIC

Aged Care Leaders Symposium 2015 23-24 July – Crown Conference Centre, Melbourne

LASA Victoria Awards for Excellence Night 30 July – Leonda by the Yarra, Hawthorn, VIC

HESTA Aged Care Awards Dinner 27 August – CHyatt Hotel, Canberra

SEP LASA SA's 2015 Aged Care Dinner and Awards Night 28 August – Hilton Adelaide

13th Australian Palliative Care Conference 1-4 September – Melbourne Convention and Exhibition Centre

LASA Victoria Finance Seminar 17 September – Leonda by the Yarra, Hawthorn VIC

ACSA / IAHSA 2015 Joint International Conference 31 August – 4 September – Perth Convention Centre

LASA QLD Community Care QLD Conference 2015 7-8 September – Sea World Resort, Gold Coast

Australian Meals on Wheels National Conference 2015 23-25 September – Adelaide Convention Centre

OCT

Let’s Talk About Sex Conference 8-9 September – Pullman on the Park, Melbourne

NOV

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

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

National Housing Conference 2015 28-30 October – Perth Convention Centre

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

OSCAR Hospitality Aged Care Hospitality National Awards (ACHA) Dinner 30 October – Pullman on the Park, Melbourne

LASA Victoria Community & Home Care Seminar 16 November – Leonda by the Yarra, Hawthorn VIC

ITAC 2015 Conference 24-25 November – Jupiter's Hotel Gold Coast

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WHAT’S NEW

WHAT’S NEW SAVE YOUR BUSINESS MONEY. IMPROVE POWER QUALITY AND ENERGY EFFICIENCY WHILST IMPROVING RISK AND ASSET MANAGEMENT Energy is not what it seems. Poor power quality increases energy consumption and could be costing your business money. It may also be damaging your equipment leading to increased maintenance and replacement costs.

3G Energy Solutions is a business partner sharing its expertise in this complex area. With a focus on Power Quality Management and Energy Efficiencies (Lighting and other technologies), 3G works to assist businesses uncover opportunities to manage energy wastage and inefficiencies – Expert Consultancy, Engineering Expertise and Innovative Technology Solutions.

Underpinning all we do is our commitment to delivering Sustainable Commercial and Environmental Outcomes, to harness new technologies and solutions to not only increase energy efficiency but reduce carbon footprint, and improve the working environment for employees.

3G Energy Power Quality Assessment is the first step in evaluating the quality of your businesses Energy supply and usage. Our assessment is comprehensive and will provide recommendations on how to achieve optimal energy performance.

Energy Optimisation involves stabilising voltage of the incoming supply to that which is optimal for the sites requirements, improving energy efficiency and longevity of equipment.

Voltage supplied to a site is not

Harmonic distortions are waveforms caused by power flowing at undesirable frequencies. Where harmonics are present at significant levels there is potential for damage to transformers and conductors, circuit breakers, electronic equipment and other critical devices. always stable. Equipment originally designed to work on a 230VAC nominal voltage network for example, may be subject to operating at higher or lower voltages potentially causing wear and tear, shortening equipment lifespan, wasting energy and money!

Managing Power Factor is also a very important aspect of improving quality of supply. Low power factor means poor electrical efficiency, which may result in higher tariff rates for electricity.

Engage 3G Energy Solutions to conduct an Assessment of your premises.

Expert Energy Quality and Lighting Engineers will help you uncover and harness the potential within your business –

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• Significant sustainable reductions on power costs • Improved working environment • Increased asset value • Significant and sustainable reductions in carbon emission • Optimum building performance • Significant and Ongoing Financial Savings.

Power Quality Management

Energy Management Solutions

Consulting Services

Energy Optimisation

Energy Efficient Lighting and Design

Auditing – NABERS | Green Star

Harmonic Filtering

Energy Metering Software

Energy Auditing Level 1, 2 and 3

Power Factor Correction Heating and Cooling

VEET | ESCI Certificates

Surge Protection

Building Management Solutions

Emergency Lighting

3G Energy Solutions – 3G Energy – “Applying technology and good business sense to deliver sustainable commercial and environmental outcomes.” www.3Genergy.com.au 1300 34 6749

WHAT’S NEW

DON’T SLIP UP ON FALLS PREVENTION!®

SUNNY QUEEN MEAL SOLUTIONS SERVES UP REAL EGGS, REAL EASY Australia’s leading egg producer, Sunny Queen Australia, understands the importance of being able to provide a range of healthy and creative meal options that are quick, easy and safe to prepare.

Eggs are a powerhouse of essential nutrients and are an important part of a healthy diet which is why Sunny Queen have now made it that much easier to ensure they are on the menu, every time.

Sunny Queen Meal Solutions uses only the freshest eggs direct from our farms to deliver a range of high taste, super convenient egg meal products that take the stress out of keeping eggs on the menu.

GripSox® are the world’s leading form of non-slip safety socks. The independently clinically trialled GripSox®, help to reduce the physical, emotional and financial burden that falls can place on individuals and the broader community. One independent trial published in the Journal of the American Podiatric Medical Association (Hatton et al.) found that compared with normal socks, GripSox® improve the gait pattern of older people when walking on a slippery surface. Participants also found GripSox® to be less slippery than when walking in both normal socks and bare feet.

Designed by Melbourne physiotherapist Luke Goodwin (APAM), GripSox® are sold by over 200 retailers in 13 different countries. Furthermore, GripSox® are also used in over 120 hospitals and aged care centres as part of Organisations’ mandatory falls prevention requirements for accreditation.

Prepared with care in our state-of-the-art kitchen we combine the highest quality ingredients to create a variety of innovative egg dishes such as Omelettes, Scrambled Eggs and Poached Eggs; all fully pasteurised and snap frozen to ensure you get all the convenience with a great taste experience every time.

Sunny Queen’s reputation for delivering quality eggs to Australian families has not changed for over three farming generations. This commitment now extends to our convenient egg products. We understand that the best chefs want the best eggs. That’s why we offer a wide range of high quality, innovative, safe and delicious products that will enhance your menu and maximise your productivity.

For more information on Sunny Queen Meal Solutions products please visit www.sunnyqueenmealsolutions.com.au

KEY FEATURES: •

95% cotton for breathability.

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Latex free.

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Seamless toe & fitted heel for comfort.

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Grip dots withstand high temperature washing.

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Independently clinically trialled.

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Bulk discounts & free delivery with select MOQ.

Our GripSox Stretch Top® socks continue to receive excellent praise. This uniquely designed brand of GripSox® help to provide additional comfort for those individuals with swollen feet and ankles.

Furthermore, our REDuce Falls Sox® continue to highlight those individuals at greatest risk of falling. This provides high visibility for all staff and carers.

Are your non-profit directors BoardWise?

BoardWise is a contemporary membership-based online learning platform, designed to create the best possible environment for whole boards to cover specialist material specific to their non-profit governance and leadership responsibilities.

Save time and money by providing your directors with cost-effective access to high-quality professional development without the need to travel to a specific location or class. Directors from non-profit organisations both large and small are using BoardWise to upskill and claim additional CPD hours.

To read more GripSox® clinical trial information or customer testimonials go to www.gripsox.com

With BoardWise you are not limited solely to one or two topics, your subscription gives you access to everything we have to offer, plus new content, topics and presenters are added regularly.

If you would like to purchase GripSox® at wholesale discount for your Organisation, please email sales@gripsox.com or call (03) 9591 0500.

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Are you ready to take your board’s knowledge to the next level?

Join BoardWise today. To find out more call us directly on 03 5429 3786 or visit http://boardwise.net/

Don’t forget to come and visit us (Booth No. 12) at this year’s LASA National Congress in Melbourne!

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WHAT’S NEW

UTILISING HR AND PAYROLL FOR BETTER HEALTHCARE OUTCOMES As budgets tighten and output expectations are increased, attention is now being focused on human resources management (HRM) within many healthcare systems worldwide. Specifically, people management (HR) is one of three principal health system inputs, with the other two major inputs being physical capital and consumables. Generally speaking, employee related costs are the highest expenditure on healthcare providers.

Patient (or client) safety and quality care are top priorities and in the age of healthcare reform with every healthcare organisation focused on how to quickly develop better processes for providing higher quality care and increased client safety ratings.

As a revenue saving department, rather than a revenue generating department, human resources needs to be able to demonstrate its value by implementing initiatives to hire and retain employees who will provide the best possible care while in turn increasing client satisfaction.

While the costs of sourcing and onboarding (and offboarding) staff can have significant cost implications, more importantly there can be significant negative financial as well as patient related outcomes in optimising HR systems and processes.

To mitigate the risks in critical HR functions, while improving and enhancing patient care and increasing patient safety, providers need to look at: • Increasing employee satisfaction and engagement • Reducing turnover • Increasing insight in Hire for fit • Focus on retention of top performers While the list may seem daunting, a few processes and systems do exist which can empower HR (and Payroll) to leverage both their existing data and the direct engagement of healthcare workers eg: via ESS and rostering solution (including automation).

At NGA Human Resources we provide a pedigree of knowledge from working with some of Australia’s largest and smallest organisations. At NGA we provide both SaaS based HR and Payroll solutions in addition to outsourcing (of HR and Payroll administrative services) to enable customers to concentrate on their core business.

With over 35 years local experience contact us to learn how NGA can you achieve better HR and Payroll outcomes.

1300 866 400 info.au@ngahr.com

Hospitality Services Aged care organisations face increasing challenges in light of higher expectations from stakeholders. With constant changes to regulations, the planning of a facility literally moves on a daily basis. Technological changes have had a major impact on meal, cleaning and linen services affecting delivery, administration and a strong emphasis on ensuring they meet the clients’ requirements. An operational review should be undertaken every few years and is invaluable when starting new or increasing the size of the current facility. The old adage of “we have been doing this the same way for years’ does not really provide you with an understanding of what you are doing is meeting the regulations, customer safety and service or the optimum financial result.

How will you meet these challenges?

Will the future model of the Facility provide the level of resident or customer service you aspire to and is the model based on the optimum cost structure?

Careful, considered planning in the design of the service whether it be the kitchen, cleaning areas or linen services will save money and time during the construction phase and increase cost savings over the life of the services.

An operational review of these services will provide the knowledge and, detail required in the decision making process.

MAJ management consultants have many years of operational experience providing a team approach through input from staff and management at the Facility. MAJ will review and provide solutions - not only the meal services that best suit the Client but will also provide the operational approach to food service, cleaning and the laundry processes that will provide the organisation with both the ‘home like’ environment, happy staff and a financial check.

Working alongside key employees increases the intellectual capital of the organization, and ensures that ownership of the improvements lies within the business. Managing the complexities of these areas requires a different range of strategies and approaches to identify opportunities in working towards overall improvement within your organisation.

This valuable review allows boards, managers and staff to understand their operation and opportunities for growth or cost savings.

Training of staff is also seen as a key to ensuring clients and staff are able to provide the required level of service.

Menu development, production planning, written job descriptions, food safety programs, new technology, kitchen planning, cleaning programs, quality & financial control, risk management are some of the areas where MAJ can provide the ‘one stop’ solution.

MAJ provide independent advice to the Hotel Services Departments within the Health and Aged Care sectors. www.redluob.com.au

Image courtesy of annt/shutterstock.com

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COMPUTER SOFTWARE

| TECHNOLOGY

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administration Ability to measure and track staff performance