INsite 2016

March/April 2016 | $10.95

AGED care & retirement

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Retirement Villages

EXPORTING OUR WORLD-LEADING RV INDUSTRY DEMENTIA

SPOTLIGHT ON

AGED CARE

equal pay negotiations

– are we ready for plan b?

TECHNOLOGY

RESOLVING INTERRAI TRAINING

DEMENTIA DESIGN

Retirement Villages

NOT A CLOUD IN THE SKY... OR IS THERE? The long-range forecast for rv operators

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Ed’s LETTER Clinical trials for the world’s first antiageing drug will reportedly begin this year, paving the way for humans to live until they reach 120 years. The scientists behind the research, based at the Buck Institute for Research on Ageing in California, say that slowing down the ageing process would theoretically slow down any diseases associated with ageing such as Alzheimer’s and Parkinson’s.

While I typically take news of this variety with the proverbial pinch of salt, it did get me thinking about the implications of living longer. Even without such radical advances in medicine, life expectancy is steadily increasing.

The challenge for society is how to meet the changing needs of a growing older population. It’s not just about anticipating the right number of beds that will be needed – although that is certainly a major part of it. It is about considering how people will want to be supported in their later years and meeting their needs.

Will more people aim to remain in their own homes? Will retirement villages continue their upward popularity spiral as older people seek living arrangements with similar folk? What shape will village life take as trends and tastes evolve? Will acuity levels for those entering residential aged care continue to increase, forcing care providers’ priorities to change?

Upon compiling our special online edition last year, it was fascinating to get a peek into the minds of industry leaders about what the future holds for New Zealand aged care and retirement.

We’ve included some snippets in this issue to highlight the scope of possibility within our sectors. Among the topics under inspection are alternative funding models, workforce issues and the changing demographics – all of which will have a bearing on how things evolve for our aged care and retirement system.

After much contemplation, I’ve decided I’d quite like to live to be 120 – provided I can retain good health and lead a life that is rich in support and choice. So bring on the anti-ageing drugs!

Let’s just hope the system can keep pace.

Editor, Jude Barback

In this issue...

FOCUS: Retirement villages as a business

2

Not a cloud in the sky... or is there?

7

Dairy, tourism... retirement villages? Exporting our RV industry

9

Getting your brand right

11

Village complaints – code change ahead?

12

Sector leaders speak up

17

Plan A or Plan B – how will the equal pay issue be resolved?

18

Resolving interRAI training issues

20

Is there room on the ARRC?

21

The changing face of palliative care

22

New dementia design guidelines – do we need them?

23

The new Health of Older People Strategy

24

On the soapbox … Julie Haggie

25

Conference Reports

27

Up close and personal with… Gráinne Moss

28

Let’s snoop around… Mitchell Court

29

Aged Advisor cements its place in sector with awards

30

A day in the life of… a village manager

31

Last Word… Alan Edwards

Editor Jude Barback 07 542 3013 editor@insitemagazine.co.nz Advertising & marketing manager Belle Hanrahan 04 915 9783 belle@nzme-ed.co.nz

For aged care news, views, trends and analysis visit: www.insitemagazine.co.nz Connect with INsite magazine on Twitter Follow INsite for breaking news, the latest innovations, and conversations with editor Jude Barback on the professional issues close to your heart. Find us on Twitter@INsite_NZ

Publisher & general manager Bronwen Wilkins production Aaron Morey Subscriptions Gunvor Carlson 04 915 9780 gunvor.carlson@nzme-ed.co.nz images iStock

INsite is distributed to key decision makers in the aged care sector and its distribution is audited by New Zealand Audit Bureau of Circulation (ABC).

March/April 2016 Volume 10/Issue 1

NZME. Educational Media, Level 2, NZME. House, 190 Taranaki Street, Wellington 6011, New Zealand PO Box 200, Wellington 6140 Tel: 04 915 9780 © 2016. All rights reserved. No part of this publication may be copied or reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopy, recording or otherwise without the prior written permission of the publisher.

ISSN: 1173-8014

Errors and omissions: Whilst the publishers have attempted to ensure the accuracy and completeness of the information, no responsibility can be accepted by the publishers for any errors or omissions. www.insitemagazine.co.nz | March/April 2016 1

Retirement Villages

Not a cloud in the sky...

or is there?

JUDE BARBACK talks to industry experts about the potential threats to New Zealand’s booming retirement village industry.

Y

ou didn’t hear it here first – New Zealand’s retirement village industry is booming. The recent ​Jones Lang LaSalle (JLL) Subscriber New Zealand Retirement Village Database (Subscribers NZRVD) concluded that the growth in demand for retirement village living has been “nothing short of spectacular”.

2 March/April 2016 | www.insitemagazine.co.nz

A good time to be in the game Operators are building units as fast as they can to keep up with demand. According to JLL’s research, in the next three to five years we’re likely to see retirement village units increase by around 62 per cent. More than 80 existing villages have around 6,000 units at some stage of consent or construction and an additional

65 villages have plans for around 10,200 units.

That’s a lot of growth.

Everything stacks up nicely for operators at the moment. The ageing population is on the rise as the baby boomer generation start to make their presence felt. And more older people than ever are opting for retirement village life, as booming house prices mean

Retirement Villages

“

Home ownership rates are high in the heritage and baby boomer cohorts and generally homes are unencumbered by the time the owners are contemplating moving to a retirement village.”

they can sell their family home for a fine sum and comfortably downsize into an environment more befitting their needs.

Furthermore, people have become more accepting and trusting of the licence to occupy model, and regulatory measures as set out in the Retirement Villages Act 2003 and the Code of Practice 2008 help to keep things transparent.

Potential threats It might be plain sailing for operators at the moment, but experts in the banking, investment and property sectors say there are many factors to be mindful of going forward.

the housing market Given that people typically need to sell the family home to buy a retirement unit, are falling home ownership rates likely to affect retirement village businesses?

ANZ healthcare, commercial and agri-relationship manager Reuban Dalzell believes home ownership rates could have an effect.

“As home ownership is linked to affordability, which varies across the country, those larger businesses with scale and geographical spread can spread this impact across different markets. The outlook remains positive, however, with increasing penetration rates and wealthier baby boomer generation with more diverse asset sources entering the market.”

ASB’s client director Ross Currie doesn’t see home ownership levels presenting any short-term risk to retirement villages.

“Home ownership rates are high in the heritage and baby boomer cohorts and generally homes are unencumbered by the time the owners are contemplating moving to a retirement village.”

Currie says that in the longer term falling ownership rates could mean increased risk that owners find it more difficult to release their equity to purchase an Occupation

Right Agreement, although he says ownership rates would really need to plummet for this to eventuate.

According to JLL, home ownership rates were at 68 per cent in 2001, 67 per cent in 2006 and 65 per cent in 2013. JLL experts Angela Webster and Matt Straka believe this slight downward trend is counterbalanced by the strong growth of the population, resulting in an increase in the actual numbers of homeowners. They don’t envisage it having any adverse effect on retirement villages.

However, an ageing and declining population could also reduce overall demand for housing. Take Japan, for example, where there are now many vacant properties in previously fully occupied suburbs and residential prices have fallen in line with reduced demand – all due to an ageing and declining population.

“Based on the latest census data, this scenario could play out in New Zealand post-2060,” says Currie. “The unknown variable is immigration that may delay the ageing population effect.”

Oversupply of retirement village units A lot of retirement village development has taken place in recent years, and more is on the horizon, particularly in Auckland. To date that supply has been met by an increase in the older population cohort, coupled with an increase in the penetration rate.

A number of operators still report waiting lists.

However, there has been some speculation that we could be facing an oversupply a little further down the track.

What would prompt an oversupply? And how will operators manage?

Jeremy Simpson, senior equity analyst and director of research at Forsyth Barr, says potentially there could be an oversupply in the near term if there is a housing market correction.

Operators will find various ways of managing this risk, like lowering their prices, for example. Independent operators will pause plans for new development and larger operators will build in stages for this very reason.

Ross Currie agrees.

“When the property cycle turns, as it inevitably will, operators have the ability to slow new unit development so that supply does not outstrip demand. Whether or not that happens remains to be seen.”

“

Should supply exceed demand, vacancies will occur in older villages/ units that have not been upgraded to meet the expectations and demands of potential residents.”

Currie believes the older villages will be the ones to suffer.

“Should supply exceed demand, I think that vacancies will occur in older villages/ units that have not been upgraded to meet the expectations and demands of potential residents, whereas newer villages that offer a range of floor plan choices, community facilities and a continuum of care are more likely to be able to sell available units.”

Cam Ansell, managing director of Ansell Strategic, agrees that operators need to pay attention to the quality of their units.

“People are going to want the best quality unit they can find close to where they live.”

JLL says operators should have a thorough understanding of the supply and demand equation and should, as a precaution, be factoring in a potentially longer sell-down www.insitemagazine.co.nz | March/April 2016 3

Retirement Villages period and what impact that could have on their bottom line.

“Due to strong demand for retirement village units, any slight potential for oversupply would be short term and limited to spots/suburbs as opposed to the whole market.

Not a significant impact overall; however, operators do need to be aware of this.”

Reuban Dalzell agrees there is minimal risk in this area.

“All operators I deal with are very experienced and perform detailed due diligence in their locations to ensure demand matches supply. I am currently seeing record levels of village sales in Auckland, indicating no oversupply,” he says.

Acronym overload – are LTOs, ORAs and DMFs still working for the market?

The increasing penetration rates would indicate that the licence to occupy (LTO) model with its deferred management fee (DMF) system is gaining acceptance. Those who move into a retirement village recognise that they are buying a package of benefits and a lifestyle rather than entering into a real estate transaction. The transparency and consumer protection provided by the relevant legislation have also helped to promote trust in the model.

JLL has analysed alternative options and liaised with government officials about these

“

Operators are always looking to differentiate themselves in some way and variations to the ORA terms are an option.”

models. They concluded that alternative models also have their shortcomings and that the DMF model is a sound model for both residents and operators.

However, in an effort to remain competitive, operators are already making slight variations to their LTO agreements – such as capping the DMF, freezing the level of weekly fees, or even stopping them altogether. Many have scrapped the capital loss clause and one has even introduced a share of capital gains arrangement.

4 March/April 2016 | www.insitemagazine.co.nz

“

John Collyns, executive director of the Retirement Villages Association (RVA) says he expects these agreements will continue to evolve.

In the 2015 ANZ Annual Survey of RVA members, around 66 per cent of respondents saw no pressure on the ORA model.

However, a significant 20 per cent believed a freehold model may emerge in the next seven years, and 25 per cent of members expected to see companies willing to start sharing capital gains in the future.

Ross Currie believes the baby boomers are likely to push the boundaries of the standard model.

“When the baby boomer cohort is ready to enter the retirement village, I think they will be a lot more demanding and will want to negotiate the terms of their occupancy. The financial component may be part, but not all of that negotiation. In general, baby boomers are the wealthiest generation ever; they know what they want and are prepared to pay for it. Operators need to prepare to meet their needs.”

Dalzell agrees. “Operators are always looking to differentiate themselves in some way and variations to the ORA terms are an option,” he says.

Cam Ansell agrees that some flexibility around the model is likely to be necessary as future generations enter retirement villages.

He urges operators “not to get too hung up on the DMF model”.

Failing to meet future needs and demands Ansell believes the biggest threat facing operators is failing to provide the future market with what it is seeking.

“I think the way we calculate demand is flawed. At present we look at the percentage of older people residing in retirement villages and project it out. The next generations are not all going to want to live in villages that look like Legoland. The baby boomers created consumer choice, so they will want a different offering, not what the market is dictating to them.”

Currie agrees, and says that baby boomers will be more demanding than current residents.

“Operators need to remain open-minded and adapt their facilities (including the physical real estate) and operating model to

The baby boomers created consumer choice, so they will want a different offering, not what the market is dictating to them.” give baby boomers what they want or risk being left behind.

“What these needs are remains unclear at this stage, but they could include village design, integration into the community, what community facilities are provided, and demand for a user pays methodology and an ageing in place model that allows them to remain ‘in place’ rather than having to move within the village to obtain care.”

Ansell believes operators need to focus less on what they have to offer people and more on what is motivating people to seek retirement village living.

“Operators should learn not to rely on pull factors and instead need to concentrate on push factors.”

Downsizing is one such push factor; however, it is the need for care services that he believes provides the greatest impetus for people to move into a retirement village.

Jeremy Simpson says the increasing acuity levels and age of people entering retirement villages is an indication that people’s decisions are driven largely by their needs.

“But operators do need to account for changing tastes and preferences and like any business, continue to evolve and innovate.”

Bad publicity and government intervention In addition to these potential threats, JLL experts believe negative public relations could be damaging to the retirement village industry.

Dalzell agrees, citing loss of reputation and decreasing consumer confidence as potential areas of concern for the sector.

“Reputation and brand development has been a key focus for operators to differentiate themselves from other operators and give confidence to intending residents. The industry has worked hard to raise the profile of village life and protracted negative publicity would be harmful.”

JLL also said government policy could potentially have an impact.

Currie agrees. “I think the industry is doing a good job of self-regulation. It needs to maintain discipline and fair-mindedness between operators and residents or risk government intervention.”

Retirement Villages

The importance of care provision JLL believes aged care provision is good for retirement village business as it increases the demand for units in the village and provides an annual cash flow. This message has clearly hit home for the industry, with 80 per cent of new villages within the development pipeline now incorporating plans for aged care.

“Providing aged care makes the business more defensive,” agrees Forsyth Barr’s Jeremy Simpson.

Interestingly, Forsyth Barr’s August 2015 Golden Days report discusses an expected shortfall of quality aged care beds over the medium to longer term in the Auckland area, which could benefit those villages providing care at the expense of lifestyle villages if an oversupply situation emerges.

Currie thinks aged care should be profitable in its own right, accepting that the financial model and returns are different when compared with a retirement village that doesn’t offer care.

“What on-site care may provide is ongoing ORA sales/resales and higher

village occupancy enhancing village returns, compared with having no care offering.

“The regular cashflow generated from profits of the care businesses is also beneficial to the business and can offset resale cashflow that can be seasonal in nature,” says Dalzell.

“Continuum of care has emerged as very important to village businesses,” continues Dalzell.

“Villages are attracting an older age group with more acute needs and the ability to deliver greater care services is becoming more important.

Like Dalzell, Currie believes strongly in the importance of providing a continuum of care.

“When potential residents are looking at retirement villages they are looking for the ability to age in place rather than needing to move again to obtain rest home and hospital care,” says Currie.

He believes operators that offer care on site have a competitive advantage over pure “play” retirement village operators, although the latter can address this by entering into alliances with aged care providers located nearby.

“

The regular cashflow generated from profits of the care businesses is also beneficial to the business and can offset resale cashflow that can be seasonal in nature.”

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Retirement Villages << Continued from previous page

Home-based care Care provision follows a continuum right through to acute hospital-level care and specialist dementia care. However, earlier care needs can often be addressed in the home through home-based support services.

John Collyns feels strongly about the need to better incorporate home-based support into retirement villages. He voices a familiar frustration: the inconsistent approach of district health boards (DHBs).

“DHBs allow iwi providers to provide home-based care – why not retirement villages?” he says.

Cam Ansell agrees. He says village operators are best positioned to provide 24/7 care on site, yet this is stifled by the DHBs being restricted to a certain number of service provider contracts.

While the in-between travel time legislation, which recently passed its third reading, is good news for carers who will now be fairly remunerated for their travel time between clients, it will essentially have

“

DHBs allow iwi providers to provide home-based care – why not retirement villages?”

a detrimental impact on village residents requiring home-based support. Ansell believes the time taken to travel to the resident could be better spent by getting physical care from people on site poised to deliver it.

“I think that future residents will want to remain in their existing homes in the village rather than moving from a villa, to an apartment, to a serviced apartment and then into care,” says Currie.

Encouraging innovation Intergenerational villages?

Industry experts don’t expect there to be high demand for intergenerational models, whereby older people live together in a community with younger generations, sharing facilities.

Ansell says he can’t see it happening. He gives the example of a New Zealand operator who built a range of housing, including expensive units aimed at wealthier people, rental units aimed at the less wealthy and a nursing home – only to find that the wealthy residents didn’t want to mix with the poor or the disabled.

“If we can’t see social cohesion in a New Zealand retirement village then what chance have we for an intergenerational village?”

Ross Currie agrees we’d need to see a significant cultural change before we saw intergenerational villages emerge.

“In general Kiwis in their old age don’t want to live with their kids and the kids don’t want their parents living with them. The kids would rather pay for their parents to have quality care if the parents can’t afford to pay for themselves. This is different from other cultures where it is normal to care for the older generation.

That said, Currie believes operators should be future-focused in their thinking, and should not discount the possibility of facilities being used by younger generations.

“New retirement village developments should contemplate a potentially declining population from around 2060 and include alternate uses in their design, primarily the facility being designed to also accommodate families and working-age couples. That would allow for the family generations to live in close proximity to each other so that the younger generation can look out for their parents without being under the same roof.”

Rental retirement units Rental units are another possible direction for the retirement village industry. Some operators have explored rentals; however, this is typically for short-term rentals to maintain occupancy until future residents sell their existing property. As an alternative to the ORA, experts believe the rental approach is unlikely to take off, particularly for the corporate sector.

“Rental units are popular but diminishing in number,” says Dalzell. “The difficulty is making them work economically for operators, versus the ORA model. I think the future for rental units in New Zealand currently remains the domain of the not-forprofit sector, which may be less motivated by the returns to shareholders.”

JLL believes the rental approach may be adopted for locations at the lower end of the market; however, they would not expect to see it taking off in affluent suburbs or higher value areas.

“Due to the less certain nature of renting versus owning and unjustifiable rental levels, which would be required, we do not see the rental model as making a wide appearance.

“Rental units would require a new funding model, both debt and equity. Without modelling it the financial incentive to provide rental units rather than ORAs appears limited,” says Currie.

Looking forward While retirement village operators need to be mindful of the risks and threats to their businesses, it seems clear there is an abundance of opportunities. With a strong springboard underfoot and relative freedom from stifling government policy and intervention, the industry has the opportunity for great innovation as it looks forward to whatever the future has in store.

Ross Currie is an employee of ASB Bank Ltd. Where his views and opinions are cited above, they may not necessarily be the views of ASB Bank Ltd.

6 March/April 2016 | www.insitemagazine.co.nz

Retirement

Dairy, tourism... retirement villages?

Exporting our RV industry New Zealand’s retirement village industry is considered among the best in the world – so much so that other countries are seeking our help. But have we really got it right?

JUDE BARBACK looks at the strengths and limitations of our retirement villages industry.

Weifang Construction Conference.

T

he population of the Chinese city of Weifang is double that of New Zealand, yet until recently, I had never heard of the place. Such is the enormity of China’s population.

It was Retirement Village Association (RVA) executive director John Collyns who enlightened me. Collyns had recently returned from Weifang where he was invited in a consultant capacity to share his expertise of New Zealand’s retirement village industry.

His invitation was extended by the Changda Group, developers with an interest in building a retirement village on a 40-hectare site near Weifang.

The Chinese retirement village and aged care boom “China is where New Zealand was 25 years ago,” says Collyns of China’s burgeoning retirement village industry.

Indeed, retirement villages in China are a relatively new concept. Chinese culture tends to subscribe to the same approach that many Asian and African cultures take when it comes to caring for older adults; that is, the children are expected to look after their parents when they reach old age.

However, this culture of filial piety has been challenged by the effects of China’s controversial one-child policy. The policy was introduced in 1979 to help curb a growing population. While the policy is formally being phased out, China is now reaping the

“

New Zealand’s retirement village industry is worldleading.” consequences of falling birth rates coupled with increasing life expectancy.

The weakened family structure and shrinking labour force resulting from the one-child policy has seen a sociocultural shift, whereby children are increasingly unable and unwilling to care for four parents between a couple, and in many cases grandparents as well. Further, China’s pension and healthcare systems are ill-equipped to deal with the demands of a rapidly ageing population – a generation of older people that increasingly has to look beyond their children for care and support.

The upshot is that there has been a move in recent years towards rest homes to help relieve the burden from China’s generation of ‘only children’. But the cultural pendulum has swung swiftly. Not only are older people increasingly placed in aged care facilities, but their children are prone to forget about them.

So much so, in fact, that several years ago a law was amended that requires adult children to visit their aged parents on a regular basis.

The new clause was introduced in response to a growing number of reports of elderly parents being abandoned or ignored by their children.

What makes our RV industry the best in the world?

As China’s retirement village and aged care industry begins to boom on the back of cultural change, it is faced with the challenge of finding proven models that will work for its rapidly growing demographic. The benefit of being a late starter is observing which countries have robust retirement village industries and emulating their success. This was the approach taken by the Changda Group.

John Collyns is not surprised New Zealand’s expertise was sought for the Weifang project.

“New Zealand’s retirement village industry is world-leading,” he says.

Collyns puts this down to the strength of the LTO (licence to occupy) model. An LTO agreement gives residents the right to occupy the unit, usually for the rest of their lives or until they need to move elsewhere for more care.

“The LTO model is profitable,” says Collyns, somewhat apologetically. “And from the residents’ perspective, it meets many needs including security, a social life and a pathway to care.”

That may be so, but there have always been resident niggles about the LTO model www.insitemagazine.co.nz | March/April 2016 7

Retirement – usually around the fact that they are not entitled to any capital gains when their unit is vacated and sold. Under most LTO agreements, residents would have to take on a capital loss – although Collyns says to his knowledge a capital loss situation has never emerged and there is talk about this particular clause being phased out.

The other issue consumers typically have with the LTO model concerns the deduction of the DMF (deferred management fee) when the retirement village unit is vacated. This is typically calculated as a percentage on the LTO purchase price for a specified number of years and is there to meet refurbishment costs for the unit as well as any repairs, maintenance and upgrades for the village.

Operators often comment that it is usually the resident’s children who bemoan the DMF, as they have not personally benefitted from the operation of the village. They fail to appreciate the “enjoy now, pay later” philosophy behind the DMF as they walk away with a smaller pay-out at the end of their parents’ time at the village.

The weekly fees are sometimes a source of contention too, with residents complaining about increasing fee payments.

Collyns acknowledges such concerns, but says over the years there have been numerous changes to LTO agreements to encourage a fair deal for residents. Ryman Healthcare, as an example, freezes its weekly fees to the level at which the resident moves in; caps the DMF to 20 per cent overall; does not include the capital loss clause; and ceases fees when the resident moves out (instead of when the unit is sold).

While many operators have adopted similar changes to the LTO agreements and others have gone further again, with some even now sharing capital gains with residents, Collyns says it is unfeasible to make blanket recommendations across the industry.

“Operators view risk differently,” he says, in reference to the capital gains and loss clauses specifically.

Despite this, he feels there is a move towards more flexibility on the part of operators, and an ever-increasing understanding and acceptance on the part of the resident about what an LTO agreement entails and the benefits it can have for the later stages of their life.

Certainly, the statistics are proof that residents are becoming more comfortable with the model. Collyns says 50 new residents move into retirement villages each week.

He says New Zealand’s retirement village industry has also earned its ‘world leader’ badge from its approach to consumer 8 March/April 2016 | www.insitemagazine.co.nz

protection. The Retirement Villages Act 2003 – which includes a Code of Residents’ Rights – and the Code of Practice 2008 offer protection for both residents and operators.

The legislation is also subject to refinement, with the Code of Practice being modified in 2013. The disputes procedure is also being tweaked at the moment, with extra steps being added to the process including a compulsory mediation step.

Many industry experts feel that the level of legislation and regulation around New Zealand’s retirement village industry is pitched at about the right level, with enough guidance to keep things consistent and transparent, but leaving enough room for providers to innovate and differentiate themselves.

“Many of the new opportunities in Australia have come from poaching New Zealand models, which are typically less regulated and more innovative,” says Cam Ansell, managing director of Ansell Strategic.

Ansell views the drivers for New Zealand’s success as increasing competition and the level of private sector investment. In Australia, by contrast, there is a tendency to over-subsidise, he says.

What’s lacking?

However, Ansell does feel providers’ hands are tied in not being able to provide homebased care and his preference is for a more consumer-centred approach to home-based care, which originated in Europe and is being developed in Australia.

Collyns agrees and says he would like to see DHBs extend their home-based support service contracts to retirement villages that are well placed to deliver in-home care to their residents.

Ansell also believes we need to think carefully about why people are not opting

for retirement village living. During his time working on the 2010 Grant Thornton Aged Residential Care Service Review, he became more interested in the 95 per cent not living in a retirement village. After exploring this further he realised that future potential customers are likely to expect more choice.

Ansell argues that we should be placing more emphasis on changing tastes and preferences when it comes to estimating future demand.

Ansell believes operators need to factor this into their long-term thinking and need to think more carefully about ‘push’ factors, such as care service provision.

Adaptability and anticipation Our industry is certainly not the finished article, but rather, a work in progress – an organic, adaptable sector that is constantly working to improve itself. As we export industry know-how to other countries eager to learn from us, like China, India and Thailand, the sector’s adaptability is perhaps its most important attribute to promote.

Collyns says officials involved in the Weifang project were dubious about how people in China would react to some aspects of the New Zealand retirement village model, particularly the LTO. He says this is understandable, given the initial resistance to the model here in New Zealand, some 25 years ago. But time has proven that it can work.

I look forward to following the progress of the Weifang village. It is to be an intergenerational village. Although many have doubts about the success of an intergenerational model in New Zealand, this may be a success in China with its filial piety influences.

In any case, the key appears to lie in anticipating what your next consumers want next – and when it comes to this, even world leaders can’t afford to rest on their laurels.

Design and innovation

Getting your

brand right Does your branding and marketing tell the right story about your village? JUDE BARBACK talks to branding expert Gill Walker about why good branding is critical to success.

I

t’s easy for industry insiders to assume that the general public understands what a retirement village is all about, but without clear imagery, branding and marketing, this message can easily be lost.

As a village positions itself in a community, it needs to communicate what it represents, who belongs there, and what happens there.

This is no simple task, especially when it is met by a public with preconceived ideas about what retirement villages are, who they’re for and what goes on inside them.

Why is branding so important?

Gill Walker, who runs Evergreen Advertising, a 50+ specialist agency, knows all about the importance of getting the marketing message right for this demographic.

According to Walker, it’s just not good enough to offer the same products or services as your competitors and hope that your name simply wins the favour of the consumer.

“People make choices based on combinations of objectivity and subjectivity, rational and irrational motives, and knowledge and judgement.

“The first step to building engagement with consumers is to have a clearly defined brand that stands for a unique set of values. These values represent strengths experienced through all touch points, where users, suppliers, staff and anyone else come into contact with the organisation or product.”

Walker said that 20 years in the advertising business had shown her first hand that brand

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“

As the brand must be reflected through all touch points, participation by all stakeholders of the business is paramount.”

workshops and guidelines had become too expensive and too slow to implement for start-ups and middle-sized companies.

“We noticed the more rules and larger the brand guidelines documents became, the less they were read and understood – many became doorstops. We knew there needed to be a process to capture the insights, take everyone on the journey, manage that discussion, then get agreement on the true and magic elements that would differentiate.”

And so the Evergreen Essence programme was born. It is essentially a brand discovery process requiring input from all parties involved. The programme involves developing market and internal insights, and running a team workshop for representatives from management, food services, sales, marketing, architectural design and finance.

“As the brand must be reflected through all touch points, participation by all stakeholders of the business is paramount,” says Walker.

The process in action Australian aged care provider Living Care sought the help of the Evergreen Essence programme when it found that its three divisions – retirement villages, residential care facilities and home care services – were operating independently without cohesion.

Through the Evergreen Essence programme, Living Care uncovered its key attributes or brand values. These helped form the master brand and the sub-brands for the divisions. Positioning headlines, colour palettes, imagery and a new web presence all helped reinforce the overarching philosophy that emerged. A brand guidelines manual was created for staff and suppliers to help maintain communications.

Walker views this as a great example of an umbrella brand that traditionally worked in silos and after the rebranding exercise began to work together as a family of services.

Continued on next page >>

sales@activehealthcare.co.nz

www.insitemagazine.co.nz | March/April 2016 9

Design and innovation

Words of wisdom “Don’t get tempted to rush and ‘just get’ something started with a range of suppliers/or friends working on ‘bits’ for your marketing communications. It will look like a dog’s breakfast and as far as brand consistency will be a waste of money as no-one has the guidebook and they all have an opinion and agenda.

“You must have your brand positioning strategy sorted first – then that strategy thoroughly explained to any communication partners and then applied to every touch point – from website, local area marketing, staff attitude, staff performance, PR and financial processes – everything.

“When you check-in with Virgin you feel their brand, when you get served your in-flight meal your cabin crew lives the brand and when you see Richard Branson milking PR it’s always to the Virgin brand personality.”

Gill Walker, Evergreen

Continued from previous page >> In another Australian example, Stockland Retirement Living engaged Evergreen to create a brand for its new retirement village, Macarthur Gardens Retirement Village.

The brand had to resonate with its local community and reflect the values of Stockland at the same.

Kiwi example of branding success Retirement Assets Limited (RAL) – founded by retirement and aged care developer Graham Wilkinson – is the first New Zealand company to invest in the Evergreen Essence process.

The aim was to create a new master brand that enabled each of RAL’s four retirement villages to keep its individuality and identity while being strengthened by an umbrella brand.

The result was ‘Generus’.

“We wanted our parent brand to really capture what we stood for as a national group,” says Wilkinson. “Category values of care and security are important, but the points of difference that elevate our villages are passion, individuality and what we call ‘generosity of spirit’.”

Wilkinson says this generosity of spirit is reflected in many ways throughout the villages: 10 March/April 2016 | www.insitemagazine.co.nz

spacious designs, extra services and financial flexibility.

“When Evergreen presented our new brand identity, Generus, it was an instant ‘yes’ from me. The logo design is contemporary and celebrates the vibrant and unique style of today’s retiree. There are no cookie cutter designs at Generus Living Group.”

Certainly the imagery complementing the brand is a far cry from the traditional stock shots of happy, smiley old people. Captured by leading New Zealand photographer Mike Langford, the images depict real residents and real locations and the ‘generosity of spirit’ that the brand strives to convey.

“The style is contemporary and freedomoriented in the outdoors. Intergenerational relationships are important – no boring, happy smiling oldies,” says Walker of the imagery.

Costs and timing Walker says the process typically takes about three weeks and costs around $15,000 – excluding travel costs. This includes Evergreen’s tour of the key facilities, the insights presentation, facilitating the in-house workshop and developing a brand positioning statement. The creation of a master creative concept and logo design is an additional $10,000. Walker says this provides an

actionable idea for a company to implement and has proven popular with customers.

Walker says companies can expect to pay a lot of money over a long time if they want to own a category generic value, or a brand value associated to another brand. By contrast, the Evergreen process is founded on the premise it’s fundamentally cheaper to sacrifice and differentiate.

“We haven’t met a company yet that has managed to run that process successfully internally so that’s where we come in. An important part is having all the stakeholders’ commitment, as self-sabotage is common when some people do not feel heard and part of the process; that said, only involve true stars in the brand workshop process, people who you want long term for your company.”

Applying some branding expertise to your offering might seem a costly exercise, however the process can help guide an organisation down a path of discovery and identify the building blocks of its brand, then develop a unique positioning and proposition from which communications can be developed to engage with consumers and build equity.

Policy

Village complaints – code change ahead?

MICHELLE BURKE looks at what the proposed changes to the complaints process could mean for retirement village operators.

T

he Retirement Commissioner has published proposed variations to the Retirement Villages Code of Practice on complaints resolution. Submissions closed on 7 March 2016.

The proposed variations are as a result of a monitoring project carried out by the Retirement Commissioner as to the effectiveness of complaint resolution in the retirement village setting. The project included a review of practices overseas and interviews and consultation meetings with a wide variety of stakeholders including residents, operators, statutory supervisors, experts in conflict resolution, and advocate organisations for older people.

The resulting monitoring report identified key issues for improvement and the proposed variations to the Code are in response to these.

Recurring themes from the report were that the formal disputes panel process was not user- friendly for all residents, there are a lack of alternative dispute resolution options, and there is a need for better information and support of residents with complaints.

The principal proposed changes are: 1. A specific statement that an operator’s training of staff must include “complaint facility management best practice, interpersonal communication skills and conflict resolution”. The change does not say if this training applies to all staff or rather only to those who manage the village.

2. Two statements of general intent that the complaints process section of the Code is meant to “provide a framework for age appropriate resolution processes that help resolve issues at the earliest possible opportunity and produce positive outcomes for participants” and to “provide a complaints reporting and monitoring regime that facilitates continuous improvement in the retirement villages sector”.

3. A definition of complaint as “an expression of dissatisfaction”. The stated intention of this definition is to “include informal approaches by residents and make it less intimidating for them to raise ‘complaints’”.

The other result is the capture of day-to-day minor issues within a formal complaints process.

4. An obligation on the operator when a resident makes a complaint to provide the resident with a copy of the complaints

The meetings did, however, highlight operator concerns about complaint resolution in villages: 1. Dealing with residents with cognitive impairment whose complaints, while sincerely made, in fact have no substance because they have been dealt with and the resident has forgotten that.

2. Dealing with frivolous complaints that may be sincere but are time-wasting, vexatious, or not capable of resolution.

3. Managing the cost of the dispute resolution process. The Code currently requires the operator to bear the entire cost and the variation adds in new processes that can be invoked regardless of the cost and where it may fall.

4. Resident vs resident disputes that the operator cannot resolve but is responsible for costs of attempted resolution.

5. Managing complaints from residents in care who have purchased an ORA for their room and are legally part of a retirement village, but whose issue should correctly be dealt with via another process.

policy and procedure rather than the resident having to request a copy.

5. An operator must “take all reasonably practicable steps to ensure that residents are supported to make complaints and participate in the complaints process”.

6. There is a requirement that the operator must offer a mediation service for informal discussions and offer residents a range of alternative complaint resolution options at any stage of the complaint process.

The Retirement Villages Association is making There is no requirement that a professional a submission on behalf of its members. mediator needs be used and a village and The Retirement Commissioner has a resident may use any trusted person as indicated that she hopes to finalise the changes a mediator, examples being a religious to the variation in April and then to present minister, representative of Aged Concern or them to the Minister of Housing for approval a community constable. in May. The Minister determines when the 7. A statement that operators are required to variations will come into force. report to the Retirement Commissioner annually on the operation of the complaints Michelle Burke is a partner at law firm Anthony facility in their village. Section 36 of the Harper, specialising in retirement villages.

Act obliges operators to supply information relating to the village as reasonably requested by the commissioner and this change can be seen as simply a restatement of a right in the Act. It does however raise questions as to what information the commissioner will require and how the commissioner will use this Experienced practice nurse information. required to join our friendly Medtech The Retirement Villages Association of New Zealand has held consultation meetings with its members in Christchurch and Auckland. Members generally feel that there are few complaints and that the monitoring report’s conclusions do not reflect the reality in their villages. There was little support for the need to change the Code.

practice in Avondale. Vaccinator and smear taker a must, we are looking to offer 4 days a week.

CV to d.trask@avondalehealth.co.nz or Ph 09 8282066

www.insitemagazine.co.nz | March/April 2016 11

POLICY

Sector leaders

speak up INsite’s outstanding special e-edition, ‘The future of aged care and retirement living in New Zealand’ was published at the end of 2015, bringing together the varied and considered opinions of sector leaders to reveal the key issues New Zealand aged care and retirement faces going forward. Here is a taste of some of the topics and views that emerged. e-edition 2015

Different approaches to funding

Earl Gasparich, Chief Executive, Oceania Healthcare

AGED cArE & rEtirEmEnt

We’ve got your industry covered i www.insitemagazine.co.nz

The future of aged care and retirement living in New Zealand

12 March/April 2016 | www.insitemagazine.co.nz

Gráinne Moss, Managing Director, Bupa Care Services New Zealand “Models of care will change as the needs of the ageing population change – acuity in residential aged care will continue to increase.

We will see more stepdown care from hospital to residential care as the sector provides a more homely and effective rehab setting for older people needing short-term postoperative care.

It isn’t new that funding will need to change. The ‘investment gap’ has been clear since before the Grant Thornton report [the Aged Residential Care Service Review, 2010].

The service that future customers and their carers will demand is not being provided – and with the current government pricing mechanism it will not be provided in the future either.

The ageing of society, of the buildings used to care for them and the current pay pressures will change the sector. These pressures are likely to result in innovative solutions that require a more user-pays approach to care options – many of which will be delivered in the retirement village setting.”

“The lacklustre growth in the aged care sector can only be attributed to the current funding model, which fails to recognise the capital cost of providing a bed. With 900 to 1,200 additional beds estimated to be required per annum, and only 640 beds forecasted to be built each year under the current funding model, Deutsche Bank predicts a shortage by 2022 at the latest.

There’s no doubt that a new approach is urgently required if we want to avoid a chronic shortage of aged care beds in the near future. We believe that a solution to the aged care funding crisis exists in the merging of the retirement village and aged care business models through the use of Occupation Right Agreements (ORA) to source the capital investment required to fund an aged care bed.

This concept is already well established in the New Zealand market and has similarities to the Australian approach, where refundable accommodation deposits are collected from residents by the providers of aged care beds.

Oceania’s care suite product, which combines the ORA ownership model with the provision of certified care services, is effectively a private sector response to the underfunding of the New Zealand aged care sector.

“With aged care already representing a significant proportion of the total Ministry of Health budget, a considerable increase in funding is unlikely and we simply cannot afford that approach. Instead, all of New Zealand needs to take responsibility for the costs of caring for its elderly and we encourage our industry to embrace the Oceania model as a means of addressing this looming crisis in aged care.”

POLICY

“

Perhaps it is time to consider appointing a Parliamentary Commissioner for the Aged to bring some cohesion and coordination to this extensive and very important problem.”

Equal pay and in between travel time

Brien Cree, Managing Director, Radius Care “How the Government can think we as a sector can provide the level of care we want to for our elderly based on this rate is beyond me. It is a sign that there is very little understanding of what it costs to provide the services that residents need and deserve, despite the fact that the information is readily available.

The reality is that we need to change the model if we are going to provide a proper standard of care for the elderly into the future.

If the Government isn’t going to pay the true cost of caring for an ever-increasing ageing population, those who require the care should have the option of paying towards their care if they want to by topping up the Government’s contribution.

If there was a co-funding model where residents were able to contribute if they wanted to, then we would be able to offer a base level of care that would mean no one was denied care. For those who could afford it, we could also provide more premium levels of care because we could charge the rates that would allow this.”

Simon Wallace, Chief Executive, New Zealand Aged Care Association

Alastair Duncan, Industry Coordinator – Community Support, E tū

“... at a time when we need to be investing in facilities and employing more staff, the aged residential care sector is facing an unprecedented challenge from the equal pay case currently before the courts. The Service and Food Workers Union (now E tū) has talked about increasing the average caregiver rate from $15.30 an hour to $26 an hour. Our calculations show the sector would need to find an additional $500 million annually to increase caregiver rates to this level.

That is clearly unsustainable and would force homes out of business, resulting in job losses and a lack of beds when demand is growing. The case, which is being taken by caregiver Kristine Bartlett and E tū, claims caregivers are paid less than equivalent employees based on gender. That is incorrect.

Pay is based on the market and the ability to pay.”

“Belatedly the Government has now engaged over the summer and a tripartite body of officials, providers and unions will be working hard to see if an out of court settlement can be reached that delivers equal pay for Kristine and the thousands of other women who have now joined the case.

Today, most carers earn between $16 and $17 an hour. Kristine says the rate should be closer to $26 an hour. In 2012 the HRC costed pay parity – paying carers in the private sector the same as those in DHBs – at around $140 million. But parity isn’t equity and female carers in DHBs are also undervalued so it was left to the workforce and their unions to test the law.

Now, with the tripartite group looking at a possible out of court settlement that includes not only residential care but also home support, disability and mental health, the numbers are a lot closer to an extra $1 billion every year. That’s about the size of the taxpayer bailout of South Canterbury Finance, or a flag referendum every month, or a third of the income the much-vaunted TPPA is supposed to deliver.” www.insitemagazine.co.nz | March/April 2016 13

POLICY

Workforce development

Julie Haggie, Chief Executive, Home and Community Health Association “The In Between Travel Time Settlement (IBTT) and now the pay rate negotiations have started the dialogue. Part B of the settlement required an investigation by an independent panel of client needs and what is needed to support them. It questioned the rationale for variation in funding of, assessment of, and access to services across New Zealand. It heard from consumer and worker advocates, providers and funders, and its response is expected to be both strategic and pragmatic.

The report of the panel is ready to be presented to Cabinet, which will decide how to respond to the second half of the IBTT settlement: regularisation for the workforce and sustainability for providers. Dialogue and action are also being facilitated by Health Workforce New Zealand and Careerforce, through the development of the Health and Disability Kaiāwhina Workforce Action Plan.

“The word ‘transformation’ has been tarred somewhat by the self-help philosophy market.

But it is the right word to use in relation to the home and community support sector.

In order to attract and retain engaged and skilled Kaiāwhina workers who can be more productive, employers need a reasonable level of financial security so that they can manage change and innovate. That requires a sizeable shift to some grown-up contracting behaviour by funders and providers, and that is the next discussion that needs to happen.”

14 March/April 2016 | www.insitemagazine.co.nz

Ray Lind, Chief Executive, Careerforce

Julian Cook, Chief Executive, Summerset

“Within the next 15 years, research anticipates we will require more than 50–70 per cent more workers to meet the needs of our ageing population. There will be a greater need for home help and rest home care and a significantly higher demand for advanced care in hospitals, dementia and palliative care facilities.

The most important thing we can all do right now is to ensure aged care facilities have an effective workforce development plan in place. A significant part of this includes the upskilling of existing and newly employed workers.”

“An important element to attracting and retaining staff is to provide career progression.

We offer a qualification programme for our caregiving and nursing staff that enables them to get NZQA qualifications and a progressive pay scale that reflects their accomplishments.

We also have many examples of progression through the business into senior management including within our executive team.

Can we do better? Of course we can.

Continual improvement is a constant and if we’re not looking for it, we would be letting ourselves down. We provide an environment that values and supports our people and we are always open to their ideas on how we can be better. As long as we have this focus, we will meet the increasing demand for people to join this sector, as well as continue to lift our already high standard of care and support to older New Zealanders.”

“

There’s no doubt that a new approach is urgently required if we want to avoid a chronic shortage of aged care beds in the near future.”

POLICY

Future needs for older people

Hon Maggie Barry, Minister for Senior Citizens

Bill McDonald, Chief Executive, Arvida Group

“We need to plan ahead so that our towns, cities and communities are able to meet the needs of our ageing population so that all older people can stay independent, healthy and connected. Part of this is to encourage communities to become more ‘age-friendly’.

The Office for Senior Citizens is working to promote the concept, based on guidelines from the World Health Organisation, with councils across the country.

An age-friendly community is a place where it is easy to get around – with wide footpaths, wheelchair-accessible ramps, places to sit and regular and accessible public transport. They would also have well lit and safe public spaces like parks, easy access to buildings and lots of inclusive events that give older people a chance to get involved and stay connected.”

“Our industry’s physical facilities and service models are not designed to meet the needs of future residents whose life experiences, and therefore expectations, will vary considerably from those we understand today.

Compounding this is the ever-increasing longevity and enduring health of older people into older age.

Future resident populations who have not experienced wars or periods of depression but rather prosperity, sharehouses and overseas travel will forge a whole new look and feel to the industry. Driving this change will be the desire of future residents to remain independent for as long as possible.

Even as they lose their independence, they will most likely not lose their desire for personalised and holistic care that focuses on the individual and their wishes as a person. A subtle shift is required away from our clinical orientation to a ‘whole of person’ approach if we are to keep pace.”

Diane Maxwell, Retirement Commissioner The Commission recently carried out a survey with the Financial Markets Authority, which found that only one in four retirees had saved enough to do everything they wanted in retirement. Nearly one half could afford some spending on the top of the basics and the rest did not have the money to do the things they wanted.

Just six per cent of those nearing retirement thought they could manage on New Zealand Superannuation alone, which means the rest of us need to think about the sort of retirement we’d like and work out how we’ll get there financially.”

Val Thomson and Imelda Corby, Waikato region, Retirement Villages Residents’ Association New Zealand (RVRANZ) “What will the demographics and the economics of the next 30 years bring? An awareness of encroaching urban sprawl is already a concern, so intensive housing of retirement-village style may accommodate more people in smaller land areas. Some operators favour smaller, ‘boutique-size’ villages in smaller urban communities.

Villages are frequently sited away from city centres, thus travel issues remain significant for both dependent and independent residents. But lifestyle plans for fit retirees embrace a range of activities with travel, motorhomes, cruise ships, sports, hobbies, etc. making the convenience of a retirement village more attractive as a secure home base.

Will immigration have an impact?

Is retirement village living a ‘Western’ concept? Will it appeal to, and be viable for, Pacific Island migrants? For people of Middle Eastern cultures? For Asian people?

Sustainable materials and design could introduce different changes. Should solar heating be mandatory? Fruit and vegetable plots sought for economic and health reasons?

What about recharge bays for electric vehicles?

Will water meters and water limits become the norm – or will water tanks reappear to catch rainwater for domestic use? And will there be ultra-fast broadband everywhere?

Will some of these possibilities be a reality in less than 10 years? Very likely!”

www.insitemagazine.co.nz | March/April 2016 15

POLICY

Retirement Village development

Tom O’Connor, National VicePresident, Grey Power Federation

John Collyns, Executive Director, Retirement Villages Association

“The main issue for any government faced with this complex range of problems is, of course, one of costs, but no matter how much money might be available, finding the medical specialists to carry out the work poses other difficulties.

For the elderly people themselves there is the problem of knowing what services and facilities are available and how to access them.

Perhaps it is time to consider appointing a Parliamentary Commissioner for the Aged to bring some cohesion and coordination to this extensive and very important problem.”

“The principal challenges for the sector revolve around managing that success – finding suitable land in the right place and at the right price, ensuring the consent process is efficient and effective, and finding the right people to manage and run the villages.

The RVA is working with local government on their strategic planning processes and with central government on amendments to the RMA that will see retirement villages as a residential development and ease the way to establish them so they are part of their residents’ natural community. As the majority of residents move to villages that are no more than 15 kilometres from their homes, it’s essential that villages are part of those communities.”

Disability support

Garth Bennie, Chief Executive, New Zealand Disability Support Network (NZDSN) “Many responses to this growing population’s needs present challenges to past practices and funding models and require collaboration between community support (including disability support providers) and health providers.

Consumers of disability support, their families, and the workforce supporting them are considering ways to support quality lives for people across their whole lifespan.

Internationally and within New Zealand, good practice guidance is emerging and yet to be universally implemented.”

“

In order to attract and retain engaged and skilled Kaiāwhina workers who can be more productive, employers need a reasonable level of financial security so that they can manage change and innovate.”

The full online edition can be found at

https://issuu.com/apnedmedia/docs/insite-dec2015-e-edition.

16 March/April 2016 | www.insitemagazine.co.nz

Aged care

Plan A or Plan B – how will the equal pay issue be resolved?

It seem likely that the long-running equal pay dispute will be resolved through the out-of-court negotiations process. But what happens if a settlement can’t be reached?

JUDE BARBACK talks to providers and unions about the possible paths ahead.

T

he out-of-court negotiations process to resolve the equal pay dispute in aged care began at the end of October between the providers, unions and Government. Four meetings were held before the end of the year, mainly to establish the process and look strategically at the task at hand.

Negotiations recommenced on 20 January with the Crown negotiating team running separate meetings with provider and union representatives. Working parties were then formed to consider in more detail the various issues relating to a potential settlement.

The New Zealand Aged Care Association (NZACA) has surveyed its members to aid the work of the provider working party, led by NZACA deputy chair Max Robins.

The union-led working parties are looking at two work streams.

One is a possible financial settlement enabling the litigation to be withdrawn, and the other an agreement around what principles could inform equal pay determinations.

“I believe the negotiations process is helping,” says NZACA chief executive, Simon Wallace. “The meetings have not been heated, nor have they been convivial. They have been run in a business-like, rational way.”

He says the NZACA is fully committed to achieving an out-of-court settlement that is acceptable to NZACA members and that will result in an increase in pay for care and support workers.

However, the unions are taking a more guarded view of the negotiations process.

“The unions are hopeful but at the same time are conscious that any settlement that does not deliver true equal value may not be acceptable to the workforce. We have already identified to the courts a base hourly rate of $26 an hour,” says E tū spokesman, Alastair Duncan.

Meanwhile, the court case between aged care provider TerraNova and employee Kristine Bartlett that instigated the negotiations process has been parked, so as to allow for an out-of-court settlement to be reached by the end of March.

However, there is some concern that the NZACA isn’t ready for further litigation, should a settlement not be reached through the negotiations process.

Terry Bell, executive director of TerraNova, the provider at the centre of the equal pay court case, is among those concerned.

“I will be delighted if a resolution can be reached through the tripartite negotiations process. But if we don’t get a decision, we’re going to be left scrambling with our pants down around our knees,” says Bell. “Clearly there hasn’t been enough preparation for continued litigation. There appears to be a very strong reliance on the political process.”

Wallace says the Association will be prepared for more litigation if necessary.

“Going back to court is the least preferred option for the NZACA, but the Association will be prepared for that eventuality if and when it arises,” he says.

The unions have a clear plan should settlement not be reached.

Duncan says E tū has secured over 1,000 further authorities from residential aged care and disability sector employers.

“In the event there is no agreement these will be pursued. We are looking at filing additional cases if the need arises.”

Meanwhile, work on the broader pay equity principle initiative is running in tandem to the negotiations process, involving a joint working group of government officials, Business New Zealand, Council of Trade Unions and other parties. Wallace says the NZACA is not privy to these discussions.

“

Going back to court is the least preferred option for the NZACA, but the Association will be prepared for that eventuality if and when it arises.”

Recommendations to Ministers are expected by the end of March 2016 and some may need to be included in legislation, if accepted by the Government. Unions have agreed to put their legal action on hold until then.

Changes to the legislation and any resulting from the settlement process could have an impact on the Age-related Residential Care (ARRC) Services agreement. The NZACA says that if the final settlement from the Equal Pay negotiations requires NZACA members to provide services that exceed their agreed contractual responsibilities under the ARRC agreement, then the Association would likely invoke the A23 variation to agreement clause, which states that the terms of the contract may be varied if any law changes or cost changes come into play.

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www.insitemagazine.co.nz | March/April 2016 17

Technology

Resolving interRAI

training issues Providers are becoming increasingly frustrated at the lack of training available on interRAI, but TAS says there is light at the end of the tunnel.

JUDE BARBACK reports.

I

nterRAI became mandatory in July last year although some providers are reportedly still not using the standardised clinical assessment tool due to insufficient training on the system.

Concern over training New Zealand Aged Care Association (NZACA) chief executive Simon Wallace says that getting RNs trained on interRAI in a timely manner is still proving difficult.

He reports concern across the NZACA membership over access to and availability of training as well as the quality of training.

Victoria Brown of Care Association New Zealand (CANZ) agrees.

“Although interRAI is supposed to be mandatory, the training has not kept up with demand,” she says.

Michele McCreadie, general manager interRAI Services at TAS confirms there has been “exceptional demand” for initial training, due to new nurses being employed, the turnover of nursing staff and from facilities wanting more nurses trained.

TAS was selected as the national provider of interRAI services by the Ministry of Health and district health boards (DHBs) in association with the NZACA. McCreadie says TAS is managing the high demand through a prioritisation process that was agreed with the NZACA. Top priority goes to facilities with no nurses trained to use interRAI, followed by smaller facilities which are vulnerable to turnover.

If there is no immediate space, nurses go on a waiting list and receive training as soon as a space becomes available.

TAS has also developed special “intensive” training sessions, which can see nurses trained to full competency over two weeks instead 18 March/April 2016 | www.insitemagazine.co.nz

of slowly over 16 weeks. These have proved popular and mean facilities can plan cover for the absence and their trained nurse can start assessing residents sooner. Further intensive training sessions will open in May 2016, aiming to train 50 people per month.

McCreadie urges facilities that find themselves in vulnerable positions to contact the Education and Support team at TAS so they can be prioritised for training of new staff.

Providers want to train themselves Given the training pressures faced by TAS, the NZACA wants to see providers granted the ability to offer training themselves – a stance reflected in the association’s submission on the Age-Related Residential Care (ARRC) agreement.

Bupa, which was initially reluctant to join interRAI, is one provider keen to train its own staff.

Initially a Memorandum of Understanding was signed that allowed Bupa to train its own staff to use interRAI. However, that has now expired and hasn’t been renewed, leaving Bupa with qualified interRAI trainers who are now required to work alongside the TAS trainers.

“We have created the capability in our business; why would the Ministry want to take that away?” says managing director Gráinne Moss.

McCreadie says TAS has discussed ongoing arrangements with Bupa and has given a clear indication that TAS wishes to work in partnership with Bupa to meet national standards and consistency.

However, there is no indication from TAS that they would defer training to the private sector.

“Oversight of interRAI Education and Support Service activity and ensuring national quality, standards and consistency is the prime priority for TAS in its role as the national provider of interRAI Services in New Zealand.”

“TAS meets and exceeds the targets set by the Ministry for the training of assessors and is continuing to train as many as possible as quickly as possible,” says McCreadie.

McCreadie expects the current levels of demand for training will level out soon.

“TAS expects that this high demand will even out over time, as more and more nurses are trained and the aged care sector will continue to gain from this expertise when nurses move between employers.”

Doubts over data Victoria Brown says while it is clear TAS is trying very hard to prioritise training, CANZ members are also concerned that they don’t get any information or data back from interRAI that they could feed into their practice and help them improve.

“

New Zealand is the first country in the world to implement the use of interRAI tools on a nationwide basis, which gives us a unique opportunity to gather wide-ranging information to help deliver better services for our older people.”

Technology “The reality of interRAI is different from what was sold to us,” she says.

NZACA members would also like to see some reward for their efforts in incorporating the tool.

“The sector has embraced interRAI, which is a flagship policy for the Government,” says Wallace. “It has been a huge cultural change for the sector – not in terms of the clinical side of things, but from the inclusion of technology into their work.”

Its ARRC submission calls for a more consistent approach to data provision at both the individual and aggregate level.

“Data and insight of this nature is critical to shape future policy settings so it is essential that progress is made to make this information available,” the submission states.

However, data is on its way shortly, according to Michele McCreadie at TAS. TAS has established a National interRAI Data Analysis and Reporting Centre to gather that data in one place and provide a national and regional view, and create reports for DHBs and Aged Residential Care (ARC) providers.

McCreadie says an initial baseline national annual report for the 2014/15 year has been developed, with some interesting and detailed

information on interRAI assessments in New Zealand. TAS expects to be able to publish the first annual report in early April.

“New Zealand is the first country in the world to implement the use of interRAI tools on a nationwide basis, which gives us a unique opportunity to gather wide-ranging information to help deliver better services for our older people.”

Light at the end of the tunnel Michele McCreadie concedes that the implementation has not been without its challenges.

“Introducing interRAI comprehensive clinical assessment has been challenging to the sector – it involves learning a new clinical assessment process, using technology that may be unfamiliar to some and changing procedures and policies within facilities to make the most of the assessment. Fortunately there are growing numbers of users seeing the benefits.”

She expects interRAI will bed down soon and become part of daily life for the aged care sector.

“Once interRAI becomes an integral part of the residential assessment and care

planning pathway, users become more and more familiar with what the tools can do and how information can be used to improve the services provided to older people, it is expected the implementation challenges will decrease over time.”

WHO HAS RECEIVED

INTERRAI TRAINING? So far, TAS has trained more than 3,100 nurses to use interRAI across all 700 aged residential care facilities in the country.

All facilities have had at least one nurse trained.

TAS has also trained more than 330 facility managers in the use of software tools and reporting capabilities that enable them to monitor and review interRAI activity and produce resident and operational summary reports that can support the implementation of interRAI in their facility.

Are your training plans aligned with the New Zealand Qualifications?

• After December 31 2015, Careerforce will not be enrolling trainees into the National Qualifications • The New Zealand Qualifications at Level 2 and 3 available now • New pathway qualifications at Level 4 available soon

Talk to your Careerforce Workplace Advisor to ensure you are making the most of all your training opportunities Find your CWAs contact details... careerforce.org.nz/employers

www.insitemagazine.co.nz | March/April 2016 19

Policy

Is there room on the ARRC? JUDE BARBACK looks at what providers are seeking from this year’s Age-Related Residential Care (ARRC) agreement negotiations.

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he annual process of negotiating the Age-Related Residential Care (ARRC) services and Aged Residential Hospital Specialised Services (ARHSS) agreements for 2016/2017 is well underway.

After submissions were received by DHB Shared Services in mid-November last year, the Joint ARRC Steering Group met to discuss the various issues arising. The ARRC Steering Group includes DHB Shared Services, New Zealand Aged Care Association (NZACA), Care Association New Zealand (CANZ) and New Zealand Council of Christian Social Services (NZCCSS).

What are the key priorities for providers?

The NZACA has placed a strong focus on palliative care this year. The association is calling for the agreements to recognise the increasing palliative and end-of-life care needs that are now being placed on providers by introducing a distinct palliative care supplement to meet the costs and resources associated with these extra needs.

However, palliative care is not such a big priority for CANZ as it affects a very small proportion of its membership. Victoria Brown says that if the parameters of palliative care were redefined to encompass a wider group of people – including those with dementia, for example – then CANZ might look to support a change in this area.

CANZ members are advocating for a general increase in funding; however, if a blanket subsidy increase isn’t possible, members have indicated they would support a targeted increase in the area of medical care and medication.

20 March/April 2016 | www.insitemagazine.co.nz

NZACA is pushing for targeted increases in bariatric care funding. Chief executive Simon Wallace says members would also like to see some of the financial pressures of costly ambulance charges alleviated with a cap on costs and trip frequency as well as a rural supplement.

Wallace says NZACA members have also indicated that there needs to be confirmation of the availability of ongoing training and funding to support the use of interRAI. Meanwhile CANZ would like to see some flexibility introduced into the auditing clause.

“We think that auditing has become really punitive, rather than a learning curve,” says Brown. “The auditors focus on the tiniest thing that is wrong and make you change it, which can be costly.

“Audits used to be an opportunity to celebrate what was going well, discuss ideas and exchange views. Now they cut across what the Health and Disability Sector Standard should be.”

NZACA also wants to see change to the audits system and have flagged the need for a nationally consistent, cross-agency framework to streamline the complaints and auditing process. They have also requested that any requirement on financial auditing with respect to additional charging is removed from the agreements, and the clauses relating to the repayment of residents and overpayments be amended from 10 to 20 working days.

NZACA has also called for the agreements to provide some incentives to members and DHBs to support IT efficiencies, like Medi-Map and Toniq, for example.

What do providers want to see in the

next ARRC agreement? · Palliative care supplement · InterRAI training consistency · Limit ambulance charges · Bariatric care funding increase · Premium charging on respite and short stay residents · Medication and medical care funding increase · Changes to auditing processes · Incentives to support IT efficiencies · Equal pay settlement incorporated into agreement

How will Equal Pay negotiations fit into the agreements?

The Equal Pay negotiations are running parallel to the ARRC contract negotiations, so the NZACA is calling for the ARRC and ARHSS agreements to recognise a settlement – assuming one is reached – in the Equal Pay negotiations for care and support workers.

The agreements will need to include the terms of conditions of the settlement as well as the mechanism by which providers pay their workers.

Policy

The changing face of

palliative care

With increasing numbers of people dying in aged care than ever before, it is time we reconsidered the way we define, structure and fund our palliative care system in New Zealand. JUDE BARBACK reports.

T

he New Zealand Aged Care Association (NZACA) is urging the Government to improve palliative care funding for aged residential care facilities and is asking for a distinct palliative care supplement for facilities as well as consistent reimbursement for palliative care across all settings of care.

NZACA chief executive Simon Wallace says the issue is front and centre of the association’s advocacy in the ARRC A21 negotiations.

Wallace says people entering care are increasingly frail and the number of people dying in residential aged care facilities has risen dramatically.

“One in three New Zealanders is dying in aged care. That’s more than in a public hospital. And it’s placing demands on staff that are being met in a capped funding arrangement.”

He says the current models of government funding do not reflect this new reality and the need for quality end-of-life care provision.

The NZACA believes the current structure of payments means that the Ministry of Health and district health boards (DHBs) have passed mortality risk and the risk of increased frailty on to providers.

The association is calling for payments to aged residential care facilities to be re-weighted to reflect the increased frailty and number of deaths.

“

If the New Zealand Government improved palliative care funding in ARC homes, it would reduce the burden on our hospitals, which will face a growing challenge with the ageing of the population.”

Calls for palliative care overhaul Clinical director of Canterbury Integrated Palliative Care Services Dr Kate Grundy says she fully supports the NZACA’s stance and describes the initiative as “long overdue”.

However, Grundy says any change to funding needs to be supported by better recognition of the role facilities play in delivering palliative and end-of-life care.

“At present accreditation of facilities does not evaluate and report on this area of care, or how advance decisions are made and documented to support care at the end of life. The funding needs to go hand in hand with an overhaul of how facilities are supported both by the DHB and by specialist palliative care services, including hospices.”

Working with the Government The Ministry of Health says palliative care has been included as a major strand in the refresh of the Health of Older People Strategy, and a review of Adult Palliative Care Services is already underway.

“The review will recommend actions over the next three to five years to ensure that all New Zealand adults who would benefit from palliative care at the end of their life receive high-quality care and a seamless experience of care, regardless of whether they are at home,

in hospital, in a hospice, or in an aged residential care facility,” says Jill Lane, the Ministry’s Director of National Services Purchasing.

Lane says that any changes in funding in the aged care sector would be considered through the Government’s budget setting process.

The Government invested $76.1 million into hospice community palliative care services in Budget 2015 to help expand community palliative care services to better support terminally ill people at home and in aged residential care facilities.

Wallace says the association acknowledges initiatives taken by the Government, as well as those led by hospices and individual DHBs, but says what is needed is a “national, consistent approach”.

The NZACA commissioned Heather McLeod and Associates Limited to provide an analysis of the current situation with palliative care in New Zealand. The report found that palliative care funding in New Zealand pales in comparison with that of other countries, including the UK, US and Australia, where higher levels of funding are resulting in fewer hospital admissions and hospital deaths.

“If the New Zealand Government improved palliative care funding in ARC homes, it would reduce the burden on our hospitals, which will face a growing challenge with the ageing of the population,” says Wallace.

“It’s not about a quick win. It’s about finding the right solution. And we need to continue working with the Government to get there.” www.insitemagazine.co.nz | March/April 2016 21

Dementia

New dementia design guidelines

– do we need them?

Providers have raised concerns that work led by the Ministry of Health concerning new dementia design guidelines “ignores financial reality and current service offerings”.

I

n the Ministry of Health’s Statement of Intent document for 2015 to 2019 Minister of Health Dr Jonathan Coleman outlined the Ministry’s aim to “provide New Zealand guidelines for the design of dementia units to providers of secure dementia and psychogeriatric services; health and support services for older people in the community; and review funding models for aged residential care”.

The huge task in tackling funding models and home and community support services notwithstanding, it is the dementia design guidelines that have prompted a range of questions from dementia care providers.

The Ministry of Health is leading the new dementia design guideline project, collaborating with researchers from The University of Auckland. Stakeholder meetings were held around the country at the end of 2015 with clinicians, DHB representatives and aged care providers.

Ministry officials and academics are now working on a draft report that will shape guidelines for the design of secure dementia units in New Zealand.

However, following the stakeholder meetings, some care providers have raised some concerns over the proposed guidelines.

The New Zealand Aged Care Association (NZACA) has gone so far as to describe new guidelines as “not necessary” in a letter to Associate Health Minister Peseta Sam Lotu-Iiga.

In the letter, dated 7 January 2016, NZACA chief executive Simon Wallace outlined concerns he had about the Ministryled work on the design of secure dementia units.

“This work on the dementia guidelines appears to be applying a ‘one-size-fits-all’ approach to the future design of secure

22 March/April 2016 | www.insitemagazine.co.nz

dementia care units that ignores financial reality and current service offerings.”

The letter states that there has been a lack of evidence presented to support a change to the design of dementia units.

It outlines concerns over an apparent lack of regard for both the financial and operational impacts that a change in guidelines might have on providers.

“Guidelines can have a habit of becoming regulation and a requirement of the HealthCERT audit process for aged residential care providers. A change like this

“

“If we can do better, we should,” said Victoria Brown of CANZ. “Clients need a better deal. We as a group need to ensure that this happens.”

She felt it was probably inaccurate to claim that the work on the design guidelines had not factored in dementia care.

Brown suspects some providers will fear the introduction of guidelines that will mean they can’t get away with putting their dementia patients upstairs with long corridors.

However, Brown did echo some of Wallace’s concerns.

If we can do better, we should. Clients need a better deal.” would require extra investment on the part of NZACA members, but without the commensurate change in funding to our ARRC agreement.”

Wallace believes any discussion around the built environment needs to factor in the models of care that are professionally and continuously developed by providers.

The NZACA is also calling for more consistency in the certification of dementia services, and suggests the Ministry of Health should be the certifying party as it is for hospital and rest home care.

Care Association New Zealand (CANZ) shares some of these concerns.

Moreover, CANZ members are supportive of the initiative to revamp dementia design guidelines.

“I have some concern around the word ‘guidelines’ as it implies regulation. But as a resource it could add value,” says Brown.

She also agreed that the cost implications deserved more consideration.

“It is going to be more expensive, so we need to relook at the financial implications for the sector.”

The Ministry’s Emma Prestidge, HealthCERT manager, confirms that extensive sector consultation is being undertaken and they will continue to engage with the sector as the project progresses.

“The Ministry wants to ensure that aged care providers and funders have the best information available when planning and making any decisions related to certified services,” says Partridge.

Policy

The new Health of

Older People Strategy

INsite looks at the co-design approach that the Ministry of Health is taking in the development of a new national Health of Older People Strategy.

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he new national Health of Older People Strategy continues to take shape as the Ministry of Health’s next phase of consultation focuses on leveraging strengths and minimising weaknesses of New Zealand’s health system with respect to older people.

The Ministry says input is being sought from a broad range of sector experts, key stakeholders, and older people, to ensure that the Health of Older People Strategy is fit for purpose and provides a clear roadmap and actions for the future.

“We want to make sure older people live well, stay well and have a dignified end of life when that time comes,” says Associate Health Minister Peseta Sam Lotu-Iiga.

The first round of public consultation took place last year. More than 20 workshops and meetings were held by the Ministry of Health

around the country to gather information on what works well for older people and what needs improvement. Older people as well as interest groups, Māori and Pacific health providers, aged care providers, clinicians, district health boards and primary care providers were involved in the first round of consultation.

A number of engagement workshops will be held early this year to focus on possible action areas to address weaknesses or widen and strengthen what is working well in the system.

The Health of Older People Strategy sits under the New Zealand Health Strategy, which is being redeveloped.

A draft Health of Older People Strategy will be available for consultation after the New Zealand Health Strategy has been completed.

Subscribe to INsite is a magazine at the heart and soul of New Zealand’s aged care, retirement, and community care sectors. Through its close ties with industry associations and attendance at conferences, INsite provides extensive coverage of the issues that are important to the sector.

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It is targeted at owners and managers of New Zealand aged care facilities, chief executives, financial officers, directors of nursing, government departments and decision makers directly involved in the aged care and retirement sectors. Subscribe to INsite today so you can be in the know about what really drives the sector.

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www.insitemagazine.co.nz | March/April 2016 23

Community Care

On the soapbox …

Julie Haggie

Home and Community Health Association chief executive JULIE HAGGIE asks why the Government has allowed the second part of the In Between Travel Time Settlement – made last year between unions, providers and the Government – to dwindle away.

T

he Home and Community Health Association welcomes the passing of the legislation that allows for a standard minimum payment to workers for travel between clients. We also welcome the injection of funding from the Government in order to address the specific issue of travel time.

There is, however, a substantial part of the settlement made between unions, providers and the Government that has yet to become reality. We are heartened to see Minister Coleman’s support for an “enduring, affordable sustainable framework” and a “roadmap for ensuring a skilled workforce to support New Zealanders”. That is what the

and worker representatives, funders and employers, and it provided its report to the Ministry of Health in August 2015.

Despite a promise in the settlement agreement that the full report would be released publicly, this has not yet occurred.

We know from our representatives who gave advice to the independent body that a great deal of evidence and data was provided: about how regularisation could be implemented; how the current regional inconsistency of funding for home support could be addressed; how service funding could be designed to ensure that there is a closer match between the individual client’s needs and the worker with the right skills; and how workers would

“

The soil for home support is currently bone dry and of variable quality; we are facing imminent crop failure at the same time as being asked to produce more.”

second part of the settlement was to make happen within 24 months of the signing of the agreement back in September 2014.

The negotiating parties agreed to a twopart settlement. The first was around the national minimum travel payments. This also importantly removed the right of workers to claim for six years of backpay on travel time.

The unions agreed to this only on the basis that both parts of the settlement would move ahead. The second part of the settlement was to develop and implement the transition of the workforce to a regularised workforce – that means guaranteed hours and workloads and workers paid by wages based on the required level of training of the worker, with that training consistent with the service needs of the population. The parties also agreed on a review of the sustainability of the whole service.

So Part B of the settlement required the Director-General of Health to set up an independent body to oversee regularisation, and to review the state of the home support sector and its sustainability. That body was formed last year. It comprised independent experts. It consulted widely with consumer 24 March/April 2016 | www.insitemagazine.co.nz

be rewarded for skill levels. Advice was also provided on how much additional funding would be required to make this happen.

It is obvious to everyone in the sector that regularisation can’t go ahead without additional funding and the development of a funding framework.

The Ministry’s lack of action on the Director-General’s report is woeful.

Employers and workers urgently need a meaningful answer to Part B. Despite a funding injection to fix the travel, the deeper issues remain and are worsening.

The minimum wage increase of 50c from 1 April 2016 has a 2.5 per cent impact on provider expenditure, yet we have not had any

indication from funding agencies how they intend to match this regulatory cost.

Last year HCHA asked Deloitte to look at employers’ financial status, and minimum wage increases compared to funder increases over the last several years. That report showed the parlous state of the employers’ finances and how this was directly linked to the cumulative impact of underfunding over time. Employers are also now facing the implications of the Employment Standards Legislation Bill from 1 April.

To be blunt, the government agencies currently contract home support on a zero hours funding model. The employers in our sector are trying to grapple with the financial implications of the legislation, but it is no doubt there will be substantial additional costs. Again, funders appear to be oblivious.

Issues such as minimum wage increases and employment legislation are interlinked with pay equity and regularisation. There is a clear pathway forward. Ensuring a skilled workforce that can meet client need means more than addressing a single legal issue.

If the potential of our workforce is to be released, then structural funding change is needed. The soil for home support is currently bone dry and of variable quality; we are facing imminent crop failure at the same time as being asked to produce more.

Part B of the In Between Travel Time Settlement offers the Government the opportunity to invest in a service that has to date shown incredible productivity and efficiency but is now starving to death. We look forward to hearing how the Government intends to support Part B of the settlement, so that employers and workers in home support can continue to assist government’s policy of supporting more people to live well, stay well and get well.

Ministry of Health Response: Jill Lane, Director, National Services Purchasing, Ministry of Health. ”The recommendations in the report to the Director General are still being worked through with the settlement parties. The Home and Community Health Association is one of the parties. Once that process is complete the report will be made public.”

Conferences

Conference Reports Careerforce Workforce Development Conference, 2–3 November 2015, Wellington Industry bodies, union representatives, government officials, international experts and education providers all came together for Careerforce Workforce Development Conference in Wellington in November last year to discuss the development of New Zealand’s health, social and community services workforce. All agreed a large, competent and valued workforce is required to effectively meet the needs of New Zealand’s growing ageing population, and delegates grappled with how to meet this challenge.

There was a clear focus on creating opportunities for young people to join the workforce. Attention was given to the Government’s Vocational Pathways programme, which gives students a chance to pursue qualifications as they transition from secondary school to the workplace. Melany-Jayne Davies of Careerforce gave the example of a successful work experience initiative at Selwyn Oaks aged care facility for students from James Cook High School. Tina Sims from the Ministry of Education shared some innovative new approaches being considered to broaden the Level 3 curriculum involving partnerships between the school, workplace and tertiary education providers.

However, the issue of inadequate funding levels, particularly for the aged care and community support workforce, was never far from discussion with some suggestion that low pay would deter young people from considering work in these sectors.

Despite a tight funding envelope, it was heartening to hear of a variety of innovative ways that progress is being made in training, education and qualification attainment.

Associate Minister for Tertiary, Education, Skills and Employment Louise Upston announced the introduction of a New Zealand Apprenticeship in the health and wellbeing sectors. The apprenticeship, developed with Careerforce, will allow people to improve their work competency and earn while they learn. Upston identified that continued innovation, including a renewed focus on apprenticeships, is required to continue to meet the market demands for a more competent and skilled workforce.

In another initiative, Donna McGarvey of DHB Shared Services shared how the DHBs and unions successfully agreed to help health support staff achieve qualifications to enable higher rates of pay.

“If it is worth doing, money shouldn’t be the barrier,” said McGarvey, “If we waited for the DHBs to have enough money to fund [the initiative], we’d still be waiting.”

International keynote speakers confirmed other countries were facing similar challenges when it came to pay and funding levels.

Rod Cooke confirmed the same issue was preventing progress in Australia’s community services and health industry sector.

“If we want workers to buy into consumer-directed care we need to pay them more than the peanuts we are at the moment.”

John Rogers from England’s Skills for Health also talked about poor government investment, stating that of the £4.5 billion spent on health education in the UK, just three per cent is on the support workforce, which constitutes 40 per cent of total staff in the health workforce.

However, in spite of the funding barrier, both Rogers and MairiAnne MacDonald from Scotland shared ways the UK have managed to leverage training and qualification attainment. Rogers spoke about the

Careerforce chief executive Ray Lind addressing the Careerforce Workforce Development Conference last year in Wellington.

need to focus on outcomes, rather than inputs, when it came to health workforce planning and the importance of putting the client’s needs at the centre.

The Kaiawhina Workforce Action Plan – introduced at the inaugural conference in 2014 – also has a strong consumer focus and delegates were updated on progress being made to achieve the early goals of the plan.

There is clearly still a long way to go in developing the much-needed ‘large, competent and valued’ workforce – however, the conference provided a valuable forum for stakeholders to work out the best way towards achieving this.

Careerforce launches NZ Certificate in Health and Wellbeing Advanced Support L4 Since its conference last year, Careerforce reports huge movement on a number of issues. One area that has seen development is the launch of the newly developed L4 Advanced Support qualification. The programme, for senior support workers, focuses on supporting complex needs, palliative care, advanced dementia care and leading a team on the night shifts.

The flexible programme can be shaped to meet the needs of any residential, home or community care team.

All Careerforce training is now delivered under the REAL model - Respectful, Efficient, Applied, Living training which is focused on person-centred outcomes.

www.insitemagazine.co.nz | March/April 2016 25

Conferences De Hogeweyk founders with Whare Aroha Care dementia village site plans.

Dementia Care by Design, 23 February 2016, Rotorua Dementia and aged care providers, Ministry of Health representatives and architects were among those who gathered at the Dementia Care

by Design conference held in Rotorua last month to hear from keynote speakers Janette Spiering and Yvonne van Amerongen-Heijer, founders of the internationally acclaimed De Hogeweyk Dementia Village in the Netherlands.

“It’s always amazing to hear them speak and to learn about their experiences,” says Thérèse Jeffs, chief executive of Whare Aroha Care, the provider hosting the Dementia Care by Design conference.

Spiering and van Amerongen-Heiger were impressed by Whare Aroha Care’s new dementia facility currently under construction in Rotorua. It will be New Zealand’s first dementia village, based on De Hogeweyk village. With foundations well underway, the village is expected to be completed in December this year.

Thérèse Jeffs said feedback about the conference was “really, really positive”.

The Dementia Care by Design conference and the Australasia Ageing conference in Auckland held in the same week both provided forums to discuss the challenges and successes of establishing a new village. Discussions ranged from what a New Zealand lifestyle and village looks like to meeting contractual requirements, training staff and financial modelling. The Dementia Care by Design conference included a panel session in which delegates had the opportunity to quiz the De Hogeweyk owners, the Whare Aroha Care operators, architects and others.

Thérèse Jeffs noted that there are many different models that effectively put the client at the centre of care delivery as Whare Aroha Care does, singling out Elizabeth Knox Home + Hospital and HammondCare as two examples that strive for person-centred care in different ways.

“Above all else, you’ve got to have passion and drive, or else you’ll never get anywhere,” she said.

26 March/April 2016 | www.insitemagazine.co.nz

Whare Aroha Care team.

Dates for the diary Retirement Villages Association (RVA) Conference, 20–23 June 2016, Pullman Hotel, Auckland New Zealand Aged Care Association (NZACA) Conference, 4–6 October 2016, SKYCITY Convention Centre, Auckland

Management

Up close and personal with…

Gráinne Moss

JUDE BARBACK chats to Bupa New Zealand managing director Gráinne Moss about her new global role, the NZACA and equal pay.

E

very now and then I allow myself to feel a little smug about balancing motherhood with a seemingly busy working life – until I think of people like Gráinne Moss, who appears to have mastered this particular juggling act. Moss has four children, the youngest six years old, and yet her career continues to go from strength to strength – a recent promotion to a global position for Bupa being the latest string to her bow.

It had been a little while since we’d had a catch-up. After general chit-chat about school camps and the daily lunch-box grind, I ask Moss about her new role, which carries the impressive title of ‘Aged Care Global Practice Lead’.

The position, which was created nearly two years ago, is aimed at sharing best practice across the Bupa aged care businesses in the UK, Australia, Spain, Latin America and of course, New Zealand.

With Bupa being the largest aged care provider on the planet, it is undoubtedly a great honour to have someone from New Zealand selected for such a big job. She humbly puts her selection down to her team.

“It is fantastic recognition of New Zealand’s strong, stable leadership team and what we’re doing here,” she says.

There is no doubting her pride in New Zealand’s Bupa operation, which she continues to manage in addition to her global role.

She believes Bupa operations in other parts of the world can learn from New Zealand’s quality customer service and its strong clinical database.

Different countries have different strengths, she says. New Zealand and Spain are both very efficient operationally owing to the funding environments, whereas Australia is very strong in marketing and presenting their propositions because of the accommodation bonds system there. Strong in technical and attitudinal training, the UK operates on a huge scale – it has the longest history with Bupa and therefore often provides a good point of comparison. For example, New Zealand Bupa recently conducted a review of its food service and looked first at what had been done in the UK.

Moss says the different sites provide opportunities to learn from each other; for example, other sites can learn from a largescale change project in Australia.

Dementia is another big area and best practice and research around design, lighting and training are readily shared between the sites. Bupa’s global dementia expert Dr Graham Stokes is a regular visitor to New Zealand and other Bupa sites, providing a good example of how talent can be shared across a global platform.

I ask whether the different regulatory and socio-cultural situations in each country place limitations on sharing best practice.

“I don’t think so,” says Moss. “Everything does need to be tailored right down to the individual customer’s needs anyway. We are becoming increasingly diverse. ‘Think global, act local’ is a bit of a cliché but it does help describe what we’re doing.”

Nursing strategy and competency, falls intervention and laundry are other examples where, regardless of regulatory and sociocultural differences, “In Spain, for example, they do their laundry at night because electricity is cheaper then,” says Gráinne. “Of course, we wouldn’t suggest New Zealand adopts this approach, but perhaps there are other aspects we could emulate that would suit our staff and clients.”

In her capacity as Bupa New Zealand’s managing director, Moss says the key priority is to continue their strong focus on the customer.

In terms of development, Bupa New Zealand’s emphasis in recent years has been on building new villages – either as an addition to an existing care facility or, if on a new site, with a care facility incorporated. A recent example was Bupa’s new Sunset Village in Blockhouse Bay, which opened earlier this year to complement Bupa’s existing Sunset Care Home.

“

The villages provide the returns to help subsidise the care, says Moss.

“With 4,200 beds, we’re overweight in care,” she laughs. “We haven’t built a standalone care facility in years.”

The equal pay case brought by the Service and Food Workers Union (now E tū) on behalf of caregiver Kristine Bartlett will have an impact on business for Bupa. Moss says she is heartened that people are getting around the table to find a solution.

“That’s the sort of person I am anyway,” she says. “I think these things should be sorted out around the table. I have great respect for the judiciary system, but I believe public policy needs to be set by the right people.

“At the end of the day we’re not a wellfunded industry, and we do our best to pay our staff well. Anything that values our staff more is a good thing.”

Bupa joined the NZACA last year and Moss says she is really enjoying her involvement with the association. She sits on the NZACA board.

“I feel we can offer a lot. We are a good employer. Around the board table there is a range of different CEOs with different styles and skills. I feel I bring some expertise around people and the operational side of things.”

Moss credits this to her prior experience running the care homes division before climbing the rungs in Bupa.

And now, with the recent appointment to the global position, Moss has climbed yet another rung. As I finish my interview, I reflect on the ongoing and simmering issues around women’s equality in the workplace and in the boardroom. Our conversation didn’t flow into feminism but I couldn’t help but think that Moss’s consummate leadership sets an excellent example not only for Bupa, but also for the entire aged care sector.

We are becoming increasingly diverse. ‘Think global, act local’ is a bit of a cliché but it does help describe what we’re doing.” www.insitemagazine.co.nz | March/April 2016 27

Aged care

Let’s snoop around…

Mitchell Court JUDE BARBACK discovers that good things come in small packages during her visit to Mitchell Court Rest Home in Tauranga.

Mitchell Court residents enjoying lunch.

W

hen I was a little girl my grandparents used to live in Matua, a sleepy suburb in Tauranga. I used to be farmed out to stay with them during school holidays, along with various siblings and cousins. At the time I remember thinking my grandparents were ancient – although I realise now that they were only in their fifties then – hence I have always subconsciously associated Matua with old people. So my visit to Mitchell Court Rest Home, located in the same neighbourhood, feels strangely familiar.

When I arrive, a lady is kindly helping a confused resident. She turns out to be manager and owner Linda Rodrigues and I am touched by how hands-on her involvement with the home is.

Linda tells me she likes being closely involved with the operation of her rest home. She’s owned Mitchell Court for five years and last year took over the management as well. Before that she ran communitybased mental health facilities in London. I can’t help thinking that sleepy Matua must be a vast culture shock after London and, as if she has read my mind, Linda confirms that she lives in Auckland and commutes during the week.

Mitchell Court is a 35-bed facility, contracted to provide rest-home level care. It is contractually allowed one hospital-level bed as well, although this – just like the palliative care that the home provides on occasion – is subsidised only at the rest-home level fee.

“The Government has priced rest homes to the last cent,” says Linda.

It is a familiar observation, one I have heard in various iterations time and time again. I ask her about her thoughts on the equal pay case and again her response is typical of providers everywhere.

“I have a fantastic team of staff here and I would love to pay more.

They deserve to be well paid. I hope they [the Government] get around to sorting that issue out.”

There are 18 staff in total. I meet Ashika, the clinical manager and one of two RNs at the facility. Both she and Linda are quietly proud of the care they provide at Mitchell Court.

“Being a small home, we can provide really individualised care for people,” says Linda.

However, the facility’s size also provides a challenge. Linda says smaller homes like Mitchell Court often get forgotten about or overlooked as all the attention tends to go to the larger facilities. She believes smaller homes play an essential role in providing residential care in their communities.

“It is very important that we [smaller facilities] survive,” says Linda.

I enjoy my chance to snoop around and am impressed by the standard of the rooms, most with ensuites. There are also two couples’ suites and seven large studios for those more independent residents.

Linda says sometimes residents can’t comprehend that they need care and the studios provide a good alternative with slightly more independence as they grapple with the realities of their new lifestyle.

My visit coincides with lunchtime so I am able to witness the hot and hearty meal being enjoyed by the residents. All food is cooked on site, including home baking each morning.

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Mitchell Court owner and manager Linda Rodrigues, with the home’s Aged Advisor award.

“

Being a small home, we can provide really individualised care for people.”

The residents come from the local Matua area and from all over Tauranga. Some have moved from larger rest homes as they find the more intimate setting more to their liking.

It seems family members are happy with the operation at Mitchell Court as well – the home was recently named a finalist in the inaugural Aged Advisor People’s Choice Award, based on independent reviews from the public. The certificate sits proudly in the foyer.

After I leave Mitchell Court, I can’t resist a quick drive down memory lane to my grandparents’ old house in nearby Woods Ave. My grandmother has since passed away and my grandfather, now living in Matamata, is at that difficult stage of not quite coping with living independently in his own home. If he does go into residential care, I think a facility like Mitchell Court would suit him well – small and friendly, with the care tailored to his needs.

I agree with Linda that there is certainly a place for smaller facilities in our communities.

Technology

Aged Advisor cements its place in sector with awards The Aged Advisor 2015 ‘People’s Choice’ Awards for Best Retirement or Lifestyle Villages & Aged Care Facilities were recently announced.

A

ged Advisor, the Matthews says there are independent ‘find, still “one or two naysayers” review and compare’ out there who have taken a website for aged care cautious approach to the site. facilities and retirement NZACA chief executive villages has announced the Simon Wallace is among winners and finalists of its those cautious about the 2015 awards. The inaugural approach taken by Aged awards honoured six Advisor. providers in three categories Archer Home receives Best Med/Large Aged Care Facility Award “I’m not suggesting that - South Island. (left to right) John Robertson (Managing Director, with winners split across we abandon ratings for rest the North Island and South Hearing Technology - Sponsor), Wayne Hodge (longest residing homes. What I’m saying is, Island. resident), Graeme Mitchell (General Manager, Archer), Nigel Matthews let’s be careful; look at what The North Island winners (General Manager, AgedAdvisor). happens in other industries, included Lynton Lodge for example, so that we’re Hospital in Auckland (Best confident that whatever we adopt is the right Aged Care up to 40 beds), Gracelands Rest system for us,” Wallace told INsite, soon after Home and Village in Hastings (Best Aged the site was up and running.

Care over 40 beds) and Abingdon Retirement The reception we’ve However, Matthews says that positive Village in Wanganui (Best Retirement/ reviews are shining through and so far the had from facilities has Lifestyle Village). site hasn’t been used solely for venting The South Island winners included Cheviot been fantastic.” dissatisfactions.

Rest Home in Cheviot (Best Aged Care up to “I have had another manager say to us that 40 beds), Archer Home in Christchurch (Best you will only get to hear the complaints and Aged Care over 40 beds) and Diana Isaac that people don’t tell you when you’re doing a Retirement Village in Christchurch (Best good job – yet over 80 per cent of our reviews activities, workplace culture and management Retirement/Lifestyle Village). are either 4 or 5 star – so clearly people want approaches. Although there was audit The awards are based on independent to share their positive experiences,” says information available on each of the facilities, reviews made through the Aged Advisor Matthews. this primarily covered health systems and website (agedadvisor.nz). The site – which has Other sceptics have suggested that the processes; there was nowhere that you could been likened to TripAdvisor – is essentially a reviews, and subsequently the awards, can be go to compare facilities or read reviews from comparison site for aged care and retirement rigged. people who were either residents or friends facilities. It was established by However, Matthews says they have looked and family that visited.”

Nigel Matthews to give the public the carefully at the review mechanism to ensure it is Matthews is pleased with the launch of the opportunity to share their experiences of fair. They have enlisted the help of a statistician first Aged Advisor awards. facilities and villages to help others make at the University of Canterbury to reflect a fair “Unlike any other awards in the aged care informed decisions. proportion of reviews against the number of sector, the Aged Advisor winners are based Matthews, who is also the founder of beds in a facility. on independent reviews and opinions from LifeFriends, a volunteer-based visitation “The reception we’ve had from facilities has customers throughout New Zealand,” says programme, says the idea for Aged been fantastic,” says Matthews of the reaction Matthews.

Advisor came from his frustration with the to the awards.

He says the awards have given the inconsistent range of care options available to One email received by Matthews from opportunity for those facilities that don’t have his own parents. the same marketing voice as other providers to finalist Mitchell Court Rest Home in Tauranga “After assisting parents move for a third reads, “Our staff are very proud today. Many have their say. time in two years due to changes in health, it thanks for making our day special”.

“This is exactly what our whole ethos is became clear that retirement homes and aged Entries are now open for the 2016 awards. care facilities varied greatly in environment, about. Real stories being heard.”

“

www.insitemagazine.co.nz | March/April 2016 29

Management

A day in the life of…

a village manager KYLA HURLEY shares with INsite why she loves her job as village manager of Chatswood Retirement Village – and where she can be found when she’s not at work!

B

orn and bred in Taranaki, I followed my passion for caring by becoming a volunteer at the long-stay geriatric Barrett Street Hospital in New Plymouth when I was 15. Once I had finished school I got my first job as a caregiver in Kauri Lodge Rest Home before moving to Hawera Hospital and completing my Enrolled Nurse training.

I then returned to New Plymouth, where I worked at Highlands Park Rest Home and Hospital. After some time I moved to Palmerston North and worked in the geriatric rehabilitation ward until an opportunity arose for me to move to Tauranga. I worked there as a nurse, supporting people with physical and intellectual disabilities. While living there I met and married my husband and we had a beautiful daughter, Maysha. Unfortunately, the marriage ended when Maysha was two and she and I moved back to New Plymouth to be near our family.

When Maysha started kindy I worked in Taurima Rest Home as team leader. A position at the hospice became available and as palliative care is one of my passions, alongside working with the elderly, I commenced work for Te Rangimarie Hospice and was employed there when we moved into a beautiful, brandnew, purpose-built hospice facility. During this time I also worked as a casual enrolled nurse at Taranaki Base Hospital.

I met my now husband Philip during this time and with his encouragement and support I applied for, and was successful in securing, my first management position at Carrington Rest Home in New Plymouth. I had found my niche! I thoroughly enjoyed working as a manager in aged care and built a strong and supportive team of staff around me. As it was an older facility it was sometimes difficult to fill the beds but we built a good reputation all the same. I was in need of a maintenance man and so Philip joined our team.

During my fifth year at Carrington Rest Home, Philip and I took a trip on our motorbikes to the South Island for three weeks. I fell in love with the scenery and the places we visited. On our return to

30 March/April 2016 | www.insitemagazine.co.nz

New Plymouth we actively made plans to sell our house and find jobs in the South Island.

I secured a job as unit coordinator for Bupa at Parkwood. I loaded up my trike and moved on down to Christchurch. Several weeks later when the house had sold Philip and Maysha joined me. Again I was in a facility where a maintenance man was needed and so Philip joined me again.

I longed to be back in a management position and so was delighted when I was successful with my application at Holmwood in Rangiora, an Oceania facility where we had both hospital and rest home levels of care.

Philip joined me again as maintenance man and we bought a house in Rangiora while also

“

It is evident in the work that the staff do that they love their jobs, feel appreciated and are there because they want to be; it is an awesome feeling to work in such an environment.” enrolling Maysha in school there. When we got our new puppy Macey, she also became a part of Holmwood, accompanying me to work every day, much to the delight of the residents and visitors!

After five years I was looking to move to a position where I could develop my skills further. When the position came up for a village manager at Chatswood Retirement Village, a privately owned establishment in Opawa, I sent my application off immediately.

I am delighted to say that I was successful in the role and have now been proudly working for Brent Ennor and Rhonda Sherriff, both owners of Chatswood, for the past 13 months.

I have a fantastic team of staff and we are very well supported by both Brent and Rhonda.

With Rhonda also being our operations manager, we have a great relationship and she is a huge support and wealth of knowledge.

Our village is beautiful with an older-style, great character rest home and a hospital, apartments and studios that are only 18 months old. We have developed a very strong reputation in our community and in Christchurch and are proud of our high occupancy with regular enquiries and people wanting beds.

When the position of maintenance man became available it made sense for Philip to again join me and Macey also comes to work every day and is a hit with everyone!

I can honestly say that having my job at Chatswood has been the best decision in my career. I absolutely love my job and look forward to getting to work every day. I have a vast culture of staff of whom I cannot speak more highly and owners who both support and appreciate everything I do. It is evident in the work that the staff do that they love their jobs, feel appreciated and are there because they want to be; it is an awesome feeling to work in such an environment. In 2010 I moved my father from Carrington in New Plymouth to Holmwood and he is now a resident in our hospital at Chatswood. I speak very highly of the care that my dad is receiving there.

Recently we were able to sell our house in Rangiora and purchase a near-new house in Opawa, so we no longer have to brave the traffic coming into the city. It also means that we have been able to see more of the city and places that we haven’t seen before since moving to the South Island six years ago.

Most Sundays you will see Philip and me out riding – both on Harleys but he’s on two wheels and I’m on my trike. Between us we have four children and six grandchildren, with Maysha living in Christchurch with the youngest of the six, Ariana, who is 10 months old and who we see most days. The residents at Chatswood also love it when they visit.

To all of you in aged care, keep up the fantastic work that you do and if you are still loving it, then I hope you are where you want to be. I am!

Management

Last Word… Alan Edwards Exiting chief executive ALAN EDWARDS talks to INsite editor Jude Barback about his time at Metlifecare, his thoughts on New Zealand’s aged care and retirement industries and his plans for the future.

INsite: Any unfulfilled challenges? If you were staying on, what would be the next thing you would tackle?

Edwards: No, we are very proud of what has been achieved over the last six years. I look forward to seeing the completion of some developments that have been started and some land that we recently acquired. I believe that The Orchards, Greenwich Gardens and the villages at Red Beach and in Albany are going to be spectacular when completed.

Metlifecare’s growth and change INsite: What was Metlifecare like when you joined in 2009, in terms of size, culture and reputation?

Alan Edwards: My time with Metlifecare commenced in August 2009. At this time Metlifecare, like many businesses around the world, was feeling the effects of the GFC. Occupancy was low at 88 per cent and debt levels were high; The Poynton in Takapuna had only six apartments occupied, Australianbased Retirement Village Group (RVG) held 82 per cent of the stock and the market capitalisation was around $220 million.

Six years later we have a values-led and aligned company culture; we have grown the number of units and beds by 50 per cent, occupancy is 98 per cent, and we have no core debt. The Poynton has all 256 apartments complete, we have opened two new villages (The Orchards and Greenwich Gardens), and the market capitalisation is circa $920 million.

Metlifecare has grown strongly since the three-way merger with Vision Senior Living and Private Life Care in July 2012 and there has also been strong growth in the development pipeline, which now has more than 2,000 beds and units to be added to the 4,392 that already exist. Together with this, underlying profit has grown tenfold, from $5 million to in excess of $50 million.

INsite: Metlifecare has certainly grown since those early days. How many villages and units have you seen built in the six years you’ve been at the helm?

Edwards: Back in 2009 we owned 17 villages with 2,954 units and beds across the Group.

Today we have 25 villages with 4,392 units and beds. The growth took place through the acquisition of five villages from Vision Senior Living and three villages from Private Life Care.

During this time we also sold two villages to reduce debt within the business. Last year, in June, we opened two brand-new villages on the North Shore of Auckland. Whilst this growth represents a 49 per cent uplift in the number of units and beds, what is more important is that we have lifted the total equity of Metlifecare from $437.9 million to $911.4 million, an improvement of 108 per cent.

The merger

INsite: What do you feel have been your biggest accomplishments as CEO of Metlifecare?

Edwards: I consider my biggest contribution at Metlifecare to be the continuous work we did to shift to a strongly values-led and aligned culture that thoroughly grasped the balance between the value propositions for shareholders, customers and employees.

This body of work, together with the collective efforts of the executive team and all Metlifecare employees, continues to be the primary enabler of the results that have been achieved over the past six years.

INsite: With the benefit of hindsight, is there anything you would have done differently?

Edwards: I believe we learn from our experiences and hindsight is one of life’s great teachers. Having said that, I spend little or no time on trying to guess what may have happened if we had done something differently; we simply learn from what we actually did and any lessons that arose from those decisions. We are proud of what we have accomplished and there is no knowing what Metlifecare may have looked like had some our decisions been made differently.

INsite: The merger with Vision Senior Living and Private Life was a bold step for Metlifecare. What did you learn from the exercise?

Edwards: In December 2011 Metlifecare had one development underway and had few other opportunities within the portfolio. To ensure Metlifecare offered shareholders an opportunity to grow value, Metlifecare had to have a growth story growth opportunity.

The acquisition of Vision Senior Living (VSL) provided five new villages, three of which were still being developed.

Furthermore, it owned a valuable site (where we are currently building Greenwich Gardens). As a developing business, VSL held considerable debt and partnering the acquisition with Private Life Care (PLC) ensured that the synergy effect was maximised as PLC provided strong and unencumbered cash flows.

The lessons from this experience were good and the outcomes we achieved were value adding for shareholders. Certainly the team required resilience and determination to ensure our internal goals around integration were achieved. Turning three into one was challenging; however, our inclusive process helped to ensure that there was a very transparent transition to a new organisation with new aspirations to grow.

Care INsite: I’m curious about Metlifecare’s strategic approach to care delivery for its residents. Metlifecare has care facilities at just nine of its 23 villages. On the other hand, Metlifecare facilitates home-based care delivery to nearly all of its villages. www.insitemagazine.co.nz | March/April 2016 31

Management Greenwood Park, for example, has a contract with Bay of Plenty DHB to provide home care services to its residents. Is there a conscious push towards home-based care or are there any plans to increase resthome-level care services at Metlifecare facilities?

Edwards: Metlifecare has clearly articulated its vision around care, meaning the company supports a resident-directed model of care. We are also seeking to increase the number of care beds within the portfolio. Currently nine per cent of all our product is devoted to care and we are seeking to increase this with a current notional target of 20 per cent. All new villages would be a fully integrated continuum-of-care village, as evidenced by the new Greenfield Villages under construction. We strongly believe that residents need to direct their care, and we fully support any resident seeking to receive care support services in their own homes, either subsidised or private.

INsite: What priority does increasing care delivery have for Metlifecare going forward?

Edwards: This is a strategic imperative for Metlifecare.

Staff, education and training INsite: Metlifecare was heralded for working with the unions to increase carers’ pay rates.

You once explained to me that the increase wasn’t prompted by Kristine Bartlett’s case, but rather a drive to see your employee value proposition integrate with your customer value proposition. Can you please explain Metlifecare’s approach to staffing (including recruitment, training, development, pathways, pay, etc) and why Metlifecare has taken this approach?

Edwards: We recognise that there is an inextricable relationship between the three key stakeholder groups – being our shareholders, our customers and our employees. Universally it is recognised that meeting or exceeding customer expectations is a minimum requirement for success. This is more easily achieved when staff have a high level of engagement, are aligned with the company’s vision and values, and are willing and able to make a difference.

For this to transpire, the experience of an employee has to be consistent with the messages we promote, from the time we seek to attract new customers through to the recruitment process, selection and appointment, orientation and subsequent learning and development opportunities.

All along the way the person needs to feel valued and rewarded for the work being delivered. Remuneration is one of the factors that build trust and loyalty between the company and the employee. The value proposition in this situation enables focus on the customer, on meeting and exceeding expectations.

32 March/April 2016 | www.insitemagazine.co.nz

“

I spend little or no time on trying to guess what may have happened if we had done something differently; we simply learn from what we actually did and any lessons that arose from those decisions.”

INsite: I know you are a strong advocate for the importance of organisational culture.

What or who has influenced your views on this?

Edwards: A long time ago I read a quote from Peter Drucker, “Culture eats strategy for breakfast”, and immediately recognised the truth in that statement. The best envisioned strategy in the world will fail to materialise without the people. So for me it has always been about the people first, ensuring that they buy into the culture. Recognising that culture describes the entire experience of the brand and ensuring that the experience of the brand is consistent with the messaging.

The best businesses have customers who frequently express that they got exactly what they expected.

INsite: When we last spoke you were keen to focus on staff education and training. What stage are you at with this?

Edwards: We are making very good progress with our learning and development opportunities. We have approximately 150 caregivers actively learning and working through the ACE programme, which is specifically designed for care. We are also focused on providing stronger orientation programmes to ensure employees easily align with, and are engaged in, our business.

In addition, we are expanding opportunities for leadership development around our core competencies. It has been a pleasure to see the rapid progress being made by our Learning and Development manager.

The sector INsite: What major changes to the retirement village and aged care industries have you noticed during your involvement in these sectors?

Edwards: The most obvious is the growing popularity of the products and services provided by the retirement village industry.

The demand is growing through the sheer numbers of additional people in the demographic, and then more of those people like what the industry has to offer. This is providing an exponential growth prospect and the growing build rates support this.

Ryman, Summerset, Metlifecare, Bupa, Oceania and a whole lot of private operators like Retirement Assets, Sanderson Group and others are collectively producing more than 1,500 units a year; this means that the industry is growing by better than six per cent

per year. To put that into perspective, the New Zealand GDP has grown by an average of three to four per cent over the past four or five years. The retirement village industry is growing at a significantly faster rate.

There has also been significant consolidation over the past 10 years, with the exception of the Metlifecare merger in 2012. Whilst the industry remains quite fragmented, the big operators are becoming more dominant in ownership as they are growing faster. This growth has been driven largely by building new villages.

INsite: What challenges do you think the sectors face going forward?

Edwards: For the past three or four years we have enjoyed a ‘rampant’ real estate market with demand remaining very solid and prices lifting rapidly. Whilst I don’t believe there are any signals around right now to suggest a massive slow-down as we experienced in the GFC, it is logical to expect that the market will correct and or slow for a period. We know that we live in cyclical times so there is a high probability that we will experience another slower period.

During these periods there is generally a slowdown in demand; however, the rates at which units are returned to the market are not linked to economic cycles, rather they are linked to health and longevity. This means that supply continues and the probability around stock growth increases. At these times businesses will always experience pressure on their cash flows. Managing the trough is always challenging. The upside is that there is always another good cycle on the other side of a slow period.

What next?

INsite: What are your plans for when you’ve finished at Metlifecare?

Edwards: I am planning an excellent holiday!

On my return I will be establishing a business advisory service as well as seeking to serve on boards where my skills can add value. I will certainly remain involved in the aged care sector as I believe there remain great opportunities to grow successfully.

Change will be constant and challenges will continue, especially around the delivery of care in people’s homes and meeting the needs of a growing proportion of people experiencing dementia and/or with cognitive impairment.

Respecting lives.

Restoring independence.

At RDNS NZ, (Royal District Nursing Service) quality care is not just about what we do in a client’s home. It’s the values our support is based on, and the services we have in place to ensure our clients can live the life they choose.

Our services include: Personal care – Assistance with showering, dressing, and meal preparation.

Domestic help – Including housework, laundry and shopping.

Restorative activities – From exercise programmes to socialisation activities, allowing people to lead more fulfilling lives.

Respite in the home – Enabling full time carers to have a break.

Nursing – Generalised and specialised home nursing including wound care, medicine management, stomal care and more.

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