INsite June 2014

June/July 2014 | $10.95

AGED-care & retirement

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leaky villages

the industry's weathertight woes Design case studies

The rest home, the village, and the hospital regular

Grey Power's Roy Reid:

the state of aged care

news

Carving a path for our health and disability workforce

FOCUS: design and innovation

Building a future for

older New Zealanders

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In this issue...

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FOCUS: design and innovation

AGED-care & retirement

INsite Magazine June/July 2014 Volume 8/Issue 5 Editor: Jude Barback @INsite_NZ T: 07 575 8493 E: editor@insitemagazine.co.nz Advertising: Belle Hanrahan T: 04 915 9783 E: belle@apn-ed.co.nz Production: Aaron Morey Dan Phillips Editor-in-chief: Shane Cummings @ShaneJCummings General Manager/Publisher: Bronwen Wilkins Subscriptions: T: 04 471 1600 F: 04 471 1080 E: subscriptions@apn-ed.co.nz Publisher’s note: © Copyright 2013/2014.

No part of this publication can be used or reproduced in any format without express permission in writing from APN Educational Media (NZ) Ltd.

Editorial & business address Level 1, Saatchi & Saatchi Building, 101-103 Courtenay Place, PO Box 200, Wellington 6140, New Zealand T: (04) 471 1600 F: (04) 471 1080 ISSN 2324-4755 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).

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A long way to go – but on the right track

4

Architect Answers: rethinking rest homes and retirement villages

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Leaky Villages

Ed’s LETTER

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What do residents want?

Prior to Budget Day, there is typically a flurry of press releases and pre-Budget announcements hinting at the goodies in store. But worryingly, it all seemed very quiet on the aged care front during the build-up to Budget 2014. I took this as a bad sign.

Sure enough, 2pm on 15th May rolled around and I strained to hear phrases like “increased investment in residential aged care” or “additional funding for aged care” emerge from the long list of things upon which the record-breaking $15.6 billion health Budget would be spent.

But just $40 million has been pegged for “additional support for elderly people” – a figure that includes support for people with dementia. A rather paltry amount, given the size of the problem at hand, and a rather vague allocation – certainly there was nothing specified for increasing the level of funding to address pay equity issues in aged care, as many were hoping.

I don’t wish to seem petulant or ungrateful.

There are many wonderful things emerging from the health Budget. It is great to see the stretched disability support services sector receive an additional $112.1 million. The $96 million for homebased support is certainly welcome, however; given the recent negotiations on travel time reimbursement for community support workers, I suspect a large chunk of this will be spent on rectifying this issue.

This year’s Budget has been carefully aimed at families and sold to the public in this way. But families extend beyond two parents and their 2.4 kids under one roof. As a mother, I welcome the increase in free GP visits for children and I’m pleased to see a commitment to healthier families. As a mother, I am pleased at the health and education spend that will no doubt benefit the wellbeing of my children. But as a daughter, and granddaughter, and niece, I find it worrying that the same priority or level of investment has not been directed to aged care, when the need is so clearly there.

You’ll find more news and opinions relating to the Budget on our website, www.insitemagazine. co.nz, along with other articles and resources, including Caroline Bartle’s excellent piece on dementia-friendly environments, and more information on telehealth initiatives. While you’re there, be sure to check out our online opinion pieces on a variety of issues pertaining to the aged care and retirement village sectors.

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Silver Rainbow: the journey to acceptance in our rest homes

Regulars

Editor, Jude Barback editor@insitemagazine.co.nz www.insitemagazine.co.nz

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

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Case study: the rest home, the village and the hospital

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Keeping up with telehealth

Silver Rainbow: the journey to acceptance in our rest homes

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NEWS Snippets and updates from the industry

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Up Close & Personal with...

Bob Harkness

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Let’s snoop around: Greenwood Park Lifestyle Village

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A typical day in the life of... a needs assessor

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Last Word...

Roy Reid

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Conference Corner

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Case study: the rest home, the village and the hospital

Connect with INsite Magazine on Twitter

www.insitemagazine.co.nz | June/July 2014

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News Residential aged care not a clear winner in Budget 2014 Visit www.insitemagazine.co.nz for INsite’s Budget coverage including an opinion piece from NZACA chief executive, Martin Taylor.

Labour’s Aged Care Commissioner role Labour leader David Cunliffe’s announcement of the party’s intention to establish a stand-alone Aged Care Commissioner has been heralded by some but questioned by others.

According to Cunliffe, the new role would oversee elder abuse, neglect, and financial mismanagement.

“We hear time and time again horrific stories about our elderly being neglected and maltreated,” says Cunliffe. “These are our mums, dads, and grandparents. They deserve to be treated with respect and dignity.”

However, some members of Age Concern have questioned the need for such a role, as the national body already holds a contract

with the Ministry of Social Development on these issues.

“When it came up, our national body Age Concern New Zealand discussed the matter and they put in a representation and submission on it,” Tauranga Age Concern chairperson Angela Scott told Sunlive.

“We don't feel there is a need to appoint an outside body because we also hold the contracts for elder abuse and deal with those matters.”

Scott said creating the stand-alone role will use unnecessary money and not be helpful as Age Concern is in an ideal position to handle all the matters that would be handled by the commissioner.

Aged care providers refuse to sign contract Providers of aged residential care have told the Government they will not sign the contract variation between them and District Health Boards, citing underfunding and a lack of commitment to the interRAI quality initiative.

Failure to sign the contract means the Government will be unable to make the adoption of the interRAI initiative mandatory on all aged care providers by 1 July 2014, as it has promised to do so, says the chief executive of the New Zealand Aged Care Association, Martin Taylor.

Taylor says the changes to KiwiSaver contributions, the minimum wage increase, inflationary increases, and insurance premium increases have all led to increased costs in the delivery of aged residential care.

“Taken together, that’s a 7.6 per cent cost impact, which is unsustainable for aged care providers. This is death by a thousand cuts.

It is unrealistic to expect current levels of funding will be sufficient to maintain and improve the quality of life for those in care as well as provide for pay increases to hardworking caregivers,” he said.

The association says the aged residential care sector needs an increase of 7.6 per cent, or $76 million – which in terms of the $14.5 billion health care budget is 0.53 per cent – to even allow it to maintain the status quo.

Negotiations started for care workers’ travel time The Government has begun negotiations for a sector-wide settlement over travel time for home care workers, to the relief of many in the home and community support services sector.

Reimbursement for travel time has been a long-simmering and contentious issue in the sector, mainly due to the wide variation in DHBs’ travel policies. Negotiations are expected to address these disparities, as well as issues such as back-claiming.

The Public Service Association (PSA) has been instrumental in bringing the matter to court, filing a case with the Employment

Relations Authority, but national secretary Richard Wagstaff says a negotiated sectorwide settlement is preferable to a lengthy legal process.

“The PSA looks forward to sitting around the table with the Ministry of Health, DHBs, and contracted providers to find a solution that works for everyone,” Wagstaff said at the time of the Government’s announcement.

The PSA is now working alongside the Council of Trade Unions and the Service and Food Workers Union to negotiate on behalf of the thousands of workers they

represent to find a solution.

“Some of our members in the home care sector have to drive 600km per week between jobs, but at the moment they are not paid for this time,” says Wagstaff.

“Workers being paid close to the minimum wage have been effectively subsidising their employers in this issue, which has dogged the sector for decades.”

Julie Haggie, chief executive of New Zealand Home and Community Health Association, also says she is pleased that there is finally some movement on these issues.

Government seeks feedback on rest home audit reports and hospital stays As the Ministry of Health’s six month trial of publishing full audit reports for rest homes online draws to a close at the end of May, the Ministry is keen to gauge how the initiative has been received by the public.

The full audit reports, along with previous audit summaries and inspection reports, were published online after demands to have more information on the quality of aged care facilities more readily available to the public. There are currently around 200 full audit reports available on the Ministry

of Health website, with new reports being added every week.

Prior to the trial, only the most recent audit summary for a facility was posted and the full audit reports could only be accessed via the Official Information Act. At the beginning of the trial, in November last year, Associate Health Minister Jo Goodhew told INsite the Ministry had received just 12 requests for full audit reports since 1 January 2012. The aim of the trial was to see how many people bother to

look at the reports when the full information is available.

Goodhew now confirms that since the trial began there have been over 6800 visits to the full audit reports website, with over 2500 full audits downloaded. Over the same period 13,000 audit summary reports have been downloaded.

“With the trial set to finish on 26 May, I am keen to hear from the public as to how useful or not they are finding the full audit reports,” says Goodhew.

Got an opinion? Have your say online at www.insitemagazine.co.nz 2

June/July 2014 | www.insitemagazine.co.nz

workforce

A long way to go

– but on the right track The recent Careerforce Workforce Development Conference in Wellington addressed pay and training as crucial to aged care’s future, as JUDE BARBACK discovered.

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pon analysing New Zealand’s health and disability workforce, Dr Ganesh Nana, executive director of Business and Economic Research Limited described the typical worker as “female, old, brown, untrained, and low paid”.

His somewhat blunt description was founded upon concrete statistics: 89 per cent of carers are female, compared with 48 per cent for the total New Zealand workforce; nearly 80 per cent are over 50 years old – a figure that has crept up significantly since 2006; the vast majority of the health and disability workforce is Māori, Pasifika or Asian, with 32 per cent born overseas; a quarter of carers have no qualification whatsoever; and the majority of carers earn less than $20,000 per year, with 44 per cent working less than 30 hours a week.

While Minister of Tertiary Education, Skills and Employment Steven Joyce spoke to the conference about vocational pathways as a potential measure to attract younger people into this line of work, and Minister of Immigration Michael Woodhouse launched new guides for supporting migrant workers in aged care, the two problematic descriptors were the references to the workforce being untrained and low paid.

Dr Judy McGregor brought these issues to attention in addressing which recommendations set out in her report, Caring Counts: Report of the Inquiry into the Aged Care Workforce had been achieved so far. Pay parity, as highlighted by the ongoing equal pay case led by aged care worker Kristine Bartlett, is yet to be achieved in the sector.

McGregor described the issue of low pay as “the elephant in the room” and references to the sector’s underfunding from Government underpinned nearly every presentation. National’s absence from the political panel discussion was frustrating and conspicuous, yet the representatives from Green, Labour, NZ First, and Māori parties, while seemingly well intentioned in their claims to turn things around for the sector, failed to impart any meaningful detail about how they would go about doing so.

With regard to training, the Caring Counts report recommends providers in the aged care sector and Careerforce commit to ensuring all new staff members achieve a Level 2 Foundation Skills qualification within six months of starting and that all existing staff members achieve this qualification in the next two years. Within five years, Level 3 should become the normal level of qualification for all staff with 18 months, service or more.

Although not quite there yet, the number of people completing training is rising, and much of the conference was focused on further increasing the uptake of training and qualification attainment.

A major focus was the announcement of the Kaiāwhina Workforce in Action Plan, a five-year plan feeding into a 20year vision for bringing systemic change and a cultural shift to the sector. The strategy is the result of collaboration between Careerforce, Health Workforce New Zealand, and independent facilitator Cathy Cooney, and is aimed to build a workforce

that “adds value to the wellbeing of New Zealanders by being competent, adaptable and an integral part of service provision”.

Its focus is not only on the consumer and aspects of quality and safety, but also on career development and workforce recognition.

All importantly, it strives to distance the workforce from the clunky and negative descriptor of ‘unregulated’ that has burdened this sector for so long.

Crucially, the conference included the perceptions of employers, and Chris Harris of Spectrum Disability was quick to point out that training is, in itself, not a “magic bullet” and won’t turn around performance unless it is managed effectively.

The overriding feeling of the conference was that while there is a big task ahead to bring about the necessary transformation in this workforce, the sector is on the right path.

www.insitemagazine.co.nz | June/July 2014

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Design

Architect Answers: rethinking rest homes and retirement villages

INsite asks GEOFF PENROSE of Lifemark and BRETT RIDLEY of Dalman Architecture about what the future aged care facilities and retirement villages will look like.

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INSite: What do you perceive to be the current and future trends when it comes to designing for the aged care and retirement village sectors?

Geoff Penrose, Lifemark: The baby boomer generation creates unprecedented opportunities and challenges for the retirement sector.

The next 30 years will see more development than ever before and a number of new entrants will come to the market in response to the increased demand. Whilst location is an important factor, an increasing sophistication in terms of amenities, service design, and physical design is expected.

The villages will need to operate on a social scale providing a sense of community, whilst attending to the increased medical and technological needs. The Lifemark standards identify minimum expectations in terms of how a person will be able to freely move within their unit villages; those who do not respond to these design imperatives run the risk of doing expensive rebuilds as this generation continues to expand with social media and obtains feedback and expectations of how best practice villages operate and are designed.

Brett Ridley, Dalman: From our experience, current trends suggest that operators are looking to provide hospital-type care facilities as part of a retirement village. This requires significant design and functional knowledge to ensure the facility meets both the operator’s and regulatory requirements. The architect has to have an understanding of each stakeholder’s needs and then has to interpret these into a design solution. The decision by an operator to provide such care within an existing village involves sensitive, knowledgeable and practical design skills.

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June/July 2014 | www.insitemagazine.co.nz

Design Master planning is an essential part of designing a village. This is true for both new facilities and re-working an existing complex.

Provision for dementia care is an expanding need and requires specialist design awareness to be successful.

Residents are often more mobile, active, and aware of their personal needs, and therefore, have a ‘voice’ on their expectations of a village.

This then is reflected in design briefs.

[In terms of future trends] baby boomers are generally very mobile. They have car(s), are technically savvy, independent but socially active, educated (tertiary or technically), well-travelled and physically active. This places a new focus on what a village can and will provide, such as a swimming pool, computer room, bars, ‘storage’ needs and car parking.

Many people of this generation are used to design considerations across many cultural activities like music, arts, and architecture.

Many are professionally or technically trained and have careers with significant durations. Although independent, involvement with their children and grandchildren can involve a large part of their lifestyle.

It must be a thin line between creating something modern and cutting edge while still retaining elements to which older people will relate. Do you find this to be a balancing act?

Geoff: The new developments will continue to reflect modern design and contemporary living, however the challenge is for those villages that require refurbishment to determine the speed and level of refurbishment that reflects the needs of current clients and the needs of new clients who will be entering the facility.

Safety is also a critical aspect of design and well thought out safety features will help everyone enjoy the premise as much as possible, regardless of style.

Brett: Modern design has a variety of interpretations and therefore expectations.

Comfortable, warm, pleasant, safe, functional, stimulating, affordable and sustainable are characteristics of good design for any age, and no less for the aged.

‘Cutting edge’ is not necessarily an appropriate or useful design description.

It may be suitable in terms of health care awareness and technical provisions, but it may be inappropriate when considering the design of a care facility or apartments for the elderly.

The elderly can and do appreciate pleasant and well designed spaces. It is important that designers involved in facilities for the elderly regard the requirements and responses of the elderly as significant, while at that same time seeking to design relevant and modern environments.

The balancing act is often in regard to client design outcome expectations and the build cost budget.

How important is it to incorporate 'sustainability' into a design?

Geoff: Sustainability is a fundamental element to a successful operation. The construction and maintenance schedules should reflect environmental best practice, however the sustainability of people is also important.

Villages and care facilities need to ensure that the current and future needs of their clients are taken into account. This may be as simple as making sure a walking frame can be located by the bed or that the power point plugs are at least 300mm off the ground for easy access, or it can relate to ensuring that all pathways are able to be accessed by a motorised scooter and that the gradient is not too high. Developing these aspects at the design stage ensures that as clients age, the surrounding can accommodate their changing needs.

Brett: Architects by best practice should seek to design critical sustainability outcomes into a project. The selection of building materials and their durability, minimising maintenance issues, and incorporating the best practice for energy conservation, use and cost are all necessary for excellent design results.

Therefore, to achieve these outcomes, the effort placed on close collaboration between all stakeholders is essential.

It is essential to maintain a ‘long view’ of the design and resultant building to ensure the best is achieved for the cost expended.

What are your thoughts on 'future-proofing' for designs aimed at older people?

Geoff : Universal design is about including everyone and not excluding people through faulty design practices. Future-proofed designs should work for everyone, not just older people. We sometimes forget that a village is a place for visitors as well as residents and that visitors also have needs. The parent with the stroller or the person on crutches from an accidental injury also appreciates the 1 in 20 slope gradients and level entry thresholds into the units.

Brett: Facilities for the elderly that provide excellent living environments also need to be flexible enough to adjust to the aging processes and changing needs of the residents.

The matter of ongoing care while not having to relocate from their home becomes a matter of emotional and mental security for residents.

Incorporating flexible and appropriate living conditions into a design is a challenge worth the effort and outcomes.

With an increase in the number of elderly persons, combined with an increase in life expectancy, seeking to future-proof designs is not a matter to overlook if we are going to provide a high level of care and satisfying living environments.

What are the limitations? And how do you tend to get around these without overly compromising the design?

Geoff: Cost is always a factor in any development and when we look at a transport analogy we can see the similarities. How many times do we see a road developed with only one lane, only to be redeveloped 10 years later to two lanes? The need was there after three years, however it was easier to defer the cost and suffer the inconvenience. Some villages will be built to meet future needs (by supporting Lifemark certification, for instance) and others will just wait and defer this until it is absolutely necessary. Hopefully the residents will reinforce which is more desirable through their selection and choice in villages and facilities.

Brett: All building projects face similar fundamental matters that must be addressed by stakeholders, such as building and servicing costs, time and resources.

It is essential to establish the project purpose and parameters; what the concise budget is, based on the clear business model expectations, and therefore what the design brief is, so that all design consultants and stakeholders journey with the same goal in mind.

The questions that more often arise are: “what can be compromised, by how much, and what must not be compromised?” If the compromise is regarding safety and care, this should not even be entertained. However, if there is a decision to be made over equal or similar material selections then compromise may not be so difficult.

To what extent do architects learn from each other, both in New Zealand and internationally, with reference to projects in the aged care/retirement village sectors specifically? Is it generally collaborative or competitive?

Geoff: Villages have different care, community, and service features that flow over into design decisions. The architectural community is collaborative. However, the retirement sector is naturally competitive because of the growth and opportunities that it faces. Hopefully, this competition will increase the levels of facility and service delivery and the resident will be the recipient of the increased higher standards that anticipate and deliver on their current and future needs.

Brett: It would be exciting and beneficial to develop our knowledge, share our experiences and foster professional design development within the aged care sector.

This could result in established industry standards and guidelines that will enhance aged care projects.

Geoff Penrose is General Manager of Lifemark and Brett Ridley is Director of Dalman Architecture. www.insitemagazine.co.nz | June/July 2014

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Refurbishment

Leaky Villages A leaky building presents a difficult situation for anyone, but for a retirement village operator there are many layers of complexity.

JUDE BARBACK gets a whiff of the industry’s weathertight woes.

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nearly bought a leaky home once.

Undeterred by the plaster cladding and the Mediterranean-inspired architecture, we got as far as having a survey completed before we were made aware of its damp little secret. Now, whenever I see a home of that era swathed in tell-tale scaffolding, I feel relief that we dodged a leaky bullet.

Of course, it’s not just homes – many schools, corporate buildings and retirement villages built in the decade of dodgy construction – 1994-2005 – suffered the same fate.

New Zealand’s leaky little problem

The Building Act introduced in the early 1990s made building controls less prescriptive and more self-regulated. Additionally, the apprentice training system for builders went out the window, and as a result, short cuts were taken and mistakes were made. But it doesn’t fall solely on burly builder shoulders – some local councils were found to have issued dodgy building consents and code completion certificates, as well as failing to carry out inspection during construction.

The problem was further compounded by a trend towards Mediterranean-style houses with plastered exterior walls and no eaves.

Cladding that relied on a paint finish as the primary defence against water ingress was generally unsatisfactory and often poorly installed.

As if all that wasn’t enough, a change to the New Zealand Standard for Timber Treatment in 1995 allowed untreated timber to be used for wall framing.

Poor old New Zealand buildings – they didn’t really stand a chance. Sure enough, a huge number of timber framed buildings suffered from weather tightness problems; the timber began to decay, making the building structurally unsound and unhealthy to live in, due to mould and spores.

Confronting the issue

One of these buildings was Ocean Shores Retirement Village in Mount Maunganui, which was built in 1996, just as the leaky building movement was getting started.

Eighteen years later, it is fully restored and watertight, but it has been a roller coast ride for the village.

Alarm bells first started ringing for the village operator Lend Lease when the main 6

June/July 2014 | www.insitemagazine.co.nz

apartment complex began to show signs of water impingement. The decision was made during the refurbishment of an apartment to remove some of the gib board to investigate the extent of the problem. The investigation confirmed their suspicions, and the poor results of subsequent air sample testing made it clear that something had to be done.

A complete sanitisation of the apartments was undertaken while the building underwent more investigation. By July 2012, it was apparent Ocean Shores had, as manager Sandy Quigley put it, “a big problem”.

The decision was made to redevelop the main apartment complex. Australian-based Lend Lease specialises in construction, so although New Zealand construction firms were used, the Lend Lease asset team were able to provide the necessary resources.

The pre-fabrication was all done off-site by Matamata-based Stanley Construction, an innovative approach to minimise the build time, which took around 10 months.

Who pays?

I attended the opening of the newly redeveloped Ocean Shores and marvelled at the turnaround. Minister of Health Tony Ryall was there to cut the ribbon, and the big bosses of Lend Lease had flown in for the occasion. But most significantly, there were the smiling residents who had endured – and rather relished, I discovered upon talking to some – the moving around and all the change.

It must have come at considerable expense to Lend Lease, especially as the operator had no recourses through the Weathertight Homes Tribunal for a number of reasons, the main one being the age of the building from reconstruction.

The Weathertight Homes Resolution Services Act 2006 specifies a number of criteria to be eligible to claim through the system, including that the building must be built before 1 January 2012 and within 10 years prior to the day the claim was made.

Claiming through the Weathertight Homes Tribunal is not always straightforward for retirement villages, particularly those that occupy the middle ground between rest home and village, as many tend to do.

Ryman Healthcare’s Grace Joel Retirement Village was one that caused some confusion in this area. After suffering watertightness issues, Ryman filed a claim with the tribunal.

A decision was initially made by the Building and Housing Group of the Ministry of Business, Innovation and Employment that the claim was ineligible as Grace Joel fell under the category of ‘rest home’ and was thereby excluded from the act.

However, the tribunal overturned this decision, ruling that Grace Joel comprised apartments, flats, or units occupied as private residences, which qualified as ‘dwelling houses’ under the definition of the Weathertight Homes Resolution Services Act. Grace Joel retirement village was up for maintenance anyway, so Ryman decided to upgrade the cladding at the same time. The

Business as usual

One of the key challenges when it comes to major repair work is how to achieve ‘business as usual’. Schools have school holidays, businesses can usually be fleet of foot when it comes to moving premises for a short time, but when it comes to a retirement village, the challenge is to work around the place of abode of many people. And not just any people, but the elderly and vulnerable.

Ryman said it aimed for “minimal disruption” to residents during the work on Grace Joel, which was undertaken as part of an ongoing maintenance programme. No-one had to move out of the village during the process, although people were moved to other parts of the village if necessary.

Ocean Shores manager Sandy Quigley’s biggest concern was also the residents, and she led a great deal of consultation with residents and their families as a way of getting a true sense of their concerns, and for reassuring them that their care would not be compromised and they would not be affected financially.

The more vulnerable residents were moved to another wing within the village, while others were moved to the Anchorage apartments on Pilot Bay. This move in itself took a huge amount of organisation. The health and safety aspects of the apartments had to be brought up to scratch to comply with the retirement village standards. Residents’ belongings had to be stored and insured. Telephone and internet providers for each resident needed to be informed of the change.

Staffing had to be increased to provide 24/7 care provision, and Anchorage staff even had to undergo some induction training on residents’ rights. A daily bus service shuttled them back and forth to Ocean Shores, where their main meal was provided at the village for free.

Next door to Ocean Shores is Metlifecare’s Bayswater village, which was also undergoing repairs, although these were not due to the typical weathertightness issues characteristic of classic leaky buildings. Rather, the problems with the Bayswater apartment complexes, which are concrete constructions, stemmed from the waterproofing of the balconies, with water getting into some of the junctions between the balconies and the building.

Even so, Metlifecare strived to minimise disruption to residents by buying back an apartment within the village to enable residents to move for a short time while repairs were carried out. They also undertook air sampling and kept residents informed on the process.

Leaky buildings, whether they take the shape of a home, school or business, are a nightmare for anyone to deal with; however, when it is a retirement village there are layers of complexity to consider. There is the murky legal side to determine eligibility for state support, and if ineligible, the vast costs to confront.

Most importantly, there is the challenge to keep residents happy, healthy, informed and unaffected financially – a challenge most operators faced with weathertightness issues appear to have met admirably.

home care

Refurbishment

exterior walls were changed to a cavity system so they now have the now-regulatory double-wall system to stop moisture from entering.

Ryman says it was a multi-million dollar project, but they do not have a final cost, as the work is continuing. Corporate affairs manager David King says that while Ryman has fully funded the work themselves to date, the company is not commenting on where the tribunal claim is at this point.

In answering the ‘who pays’ question, it seems that it is not typically the residents. In signing a licence to occupy (LTO) agreement, a resident will generally have no liability for large-scale building maintenance. With unit title agreements, it may not be as straightforward, but generally, and certainly in the case of Grace Joel retirement village, residents are not expected to fork out to repair the buildings.

John Collyns, executive director of the Retirement Villages Association, says that it is worth observing that residents typically pay a regular maintenance fee, which is likely to go some way in helping a village to fund its general maintenance and repairs.

Up close and personal with ...

Bob Harkness

INsite gets a peek into the world of a man who suffered a stroke and now receives long-term care but still dreams of playing golf with Prime Minister John Key.

I

n business, Bob Harkness always ensured that he had good people around him. It was a philosophy that served him well – and he hasn’t changed it one bit.

Bob worked hard – probably too hard, he admits – and grew one of most successful hardware/house wares importing companies in New Zealand. At the same time, he developed an undisputed reputation for treating his staff as though they were his family.

“It’s quite simple. I always treat people the same way as I would expect them to treat me,” he says. “Yes, I had very good people around me – and that includes Margaret, of course,” he quickly adds with a cheeky grin, referring to his wife of 51 years.

Today, at 75, six years after the stroke that robbed him and Margaret of plans to share an active retirement together, Bob’s point of having good people close by continues. An astute and dedicated businessman, he is not too proud to reach out for help. But his generosity and his business reputation over the years has resulted in hundreds of friends reaching out to him. In fact, he has so many visitors dropping by that the house is nicknamed Bob’s Coffee Bar. RDNS NZ is providing Bob’s long-term care. He is one of the organisation’s 2500 clients who need nursing or other types of support at home. CEO Todd Perkinson sees the work of his staff as being as crucial as that of other health workers who may enjoy a more public profile.

“Our nurses and support workers perform quietly, professionally, and so efficiently without fanfare, making a difference to the lives of people who need it most. These may be clients like Bob who have considerable health challenges or someone who has had a serious injury, and through ACC, needs tailored and sometime complex home support. Mr Perkinson said.

Every morning, RDNS NZ Support Workers Mohammed Nisar and Robert Salivio arrive at the Harkness’ neat two-storey home about 20 minutes south of Auckland CBD to help Bob make the tricky transition from bed to breakfast. This includes the slow but methodical tasks of showering, shaving, and getting dressed while Bentley the cat snoozes in the corner.

By 9am, the house is filled with the welcoming aroma of freshly brewed coffee. Mohammed is buttering the toast as Robert brings Bob down the chair lift and gently walks him to his favorite chair. The help is crucial for Margaret, who has become his primary carer.

The sun is streaming through the sitting room window as Bob chats over breakfast. Here is a gentleman who once rowed and played rugby for Canterbury and had a golf handicap of nine. His eyes are keen and loaded with a ready smile. His face is alert. He exudes optimism. There is not an ounce of self pity or complaining. Indeed, the conversation is upbeat and positive. His metaphorical glass is more than half-full, despite the challenges.

“What I never realised is the tendency of my own family members in the past to have strokes,” he said. “Day after day, I was rushing around like Superman and travelling the world. I had just got to the stage of winding back when the stroke happened.”

Then one day last year Bob had a fall at the family beach house in Omaha, about 80 kilometers from home on New Zealand’s North Island.

The fall caused a serious brain bleed which could have proved fatal. But after delicate surgery and two months in hospital, he was back home again.

“The doctors said I was a miracle man,” says Bob. “But I have so much to be thankful for. My body might not be in such good shape but my brain is as good as it ever was.” www.insitemagazine.co.nz | June/July 2014

7

residents

What do residents want?

INsite asked residents at Metlifecare’s Papamoa Beach Village about what they like and don’t like about the design of their villas.

INsite: What design elements of your villa do you particularly like?

Val Waters: “I really love the layout of my villa and would not change anything. I love the flow from my front door to the sunroom.

Plenty of light and airy. I have also turned my garage into a laundry/library/TV room/ bedroom/picture gallery/storeroom, which is wonderful for the grandchildren.”

Erin Little: “We enjoy the layout. I particularly like my kitchen for layout and convenience; it is very workable.”

Margaret Ashton: “The open spacious design, especially in the living area.”

Hans and Julia Pyper: “We like the layout and also that we were able to, and allowed to, put our own input in the interior design.

Also our deck is a great asset of our villa.”

Joy and Mike Crean: “Not necessarily in order: we like the high stud, plenty of light (and sun), convenient juxtaposition of the living areas, plus the ease and efficiency of layout and outlook over the gardens.”

INsite: If you could change something about the design of your villa, what would you change and why?

Val Waters: “If I could change something outside, I would like a little bit more privacy in the garden area. Most other dwellings seem to be screened off, except mine, from next door and surrounds. I like the outside open plan concept but a little bit of privacy would be nice.”

Erin Little: “I would have a high window in the bedrooms to let the sun and light in.

The garage could be a bit bigger as there is limited storage in the unit. We also put a light dome in our living area to give us more light, as in winter they are particularly dark.”

Margaret Ashton: “A little wider deck to enable me to have outdoor furniture.

Maybe an easier shower design – not glass as cleaning is difficult at this stage of my life.”

Hans and Julia Pyper: “The only change we would make is a second bathroom and maybe a bigger hallway.”

Joy and Mike Crean: “Haven’t worked out an alternative solution but the access door between main bedroom and bathroom and the access door from the passage to the main bedroom get confused as to their relative open/closed part open/part closed positions.

They are too close together for part open positioning and inconvenient with one part open and the other closed. Some areas of kitchen cupboard space are inaccessible. The front door needs a more extended veranda overhang to protect the entrance from being subject to the full onslaught of heavy rain from the east. We prefer to have our shower in the bathroom.”

INSite: What do you like most about the overall design and layout of the village?

Val Waters: “Ideal for me. It would be nice if we could use upstairs sooner rather than later for our leisure activities. It is a pain having to move all the furniture every time there is an activity in the lounge. We are not getting younger!”

edward@activerehabequipment.co.nz

8

June/July 2014 | www.insitemagazine.co.nz

Erin Little: “We love the village design and layout; we don’t feel as though we are living on top of one another.

Margaret Ashton: “The position of my villa, the garden surrounding, the way each set of new villas fit in – I think our village looks very smart – just love living here!”

Hans and Julia Pyper: “We love the contemporary beach-style look and the spacious layout of the village; this attracted us straightaway. It is so different from any other retirement village. Looks more like a holiday resort.”

Joy and Mike Crean: “Landscaping – units have an individual home feeling because of their outlook over the landscaped gardens (not arranged in serried Coronation Street-type rows of houses). Well-designed community centre suited to a wide range of activities in a degree of privacy, and in particular, the swimming pool.”

What residents want:

✔✔ Sensible layout ✔✔ Plenty of natural light ✔✔ Spacious and airy ✔✔ Ability to personalise ✔✔ Large deck ✔✔ Privacy ✔✔ Storage ✔✔ Easy-to-clean surfaces ✔✔ A second bathroom ✔✔ Gardens.

Diversity

Silver Rainbow:

the journey to acceptance in our rest homes INsite talks to Claire Mooney about the third phase of a research project focused on understanding and addressing homophobic attitudes in New Zealand’s aged care facilities.

F

ifty years ago, when the current residents of New Zealand rest homes were in their thirties and forties, the word ‘gay’ didn’t mean what it does today. It is understandable that older people have held onto some of the stigma attached to homosexuality that existed in their younger years. But when such attitudes undermine the choices and happiness of other residents, and even influence those of aged care workers, it becomes apparent that such stigma and attitudes can’t be ignored.

This was ultimately what recent research led by The University of Auckland’s School of Nursing has discovered and aims to address. The research, entitled Silver Rainbow, is now in its third phase.

The first phase of the research, led by Dr Garry Bellamy, identified that while aged care workers themselves were generally accepting of older lesbian, gay, and bisexual (LGB) residents, it was dealing with the attitudes of other residents that presented more of a challenge.

However, the research also showed that staff may not be aware of their own prejudices regarding caring for LGB residents.

These findings led to phase II of the research project, which largely involved the development of a resource kit that contains a video, workbooks, and guidelines to help educate staff in aged care facilities about homophobia. The kit has been circulated within aged care networks in New Zealand and accompanied by presentations and meetings with senior older person’s health professionals in DHBs and the larger aged care providers.

Claire Mooney, Silver Rainbow project manager, says the resource has been very well received by audiences within the aged care sector and DHBs, with interest expressed from as far afield as Australia and the United States in using the resource.

Mooney says they are currently adapting the kit to include a second video with a scenario that deals with homophobic bullying amongst residents.

“This will guide staff on how to manage these situations and, indeed, clarifies that it is their responsibility to ensure that if they witness bullying of any kind they must take action to ensure vulnerable residents are protected and allowed to live free from discrimination.”

Mooney says it is difficult to measure in the scope of this project whether acceptance towards LGB residents is increasing, although she hints that a PhD student is planning to carry out research into this question, and will be looking for participating care homes to assist with this work.

For now, the Silver Rainbow team is focused on the next phase of the research, phase III, which is all about spreading the word that this resource exists and that there is a need for staff to receive education in caring for LGB residents in aged residential care.

To this end, the group is producing a pack that contains a printed sample of the education resources and a DVD with the two training scenario case studies that can be picked up by the care home educators and utilised according to their training schedules. The DVD will contain a self-led ‘train the trainer’ module so that the educators based in care homes can prepare and feel confident to present the material.

“In this phase, we plan to canvas the regulatory bodies and Ministry of Health to support a specific standard in the existing regulatory and certification process around this cultural group. We also have

the cooperation and support of the Health Quality and Safety commission.”

The group is also working in collaboration with the Northern Regional Alliance (NRA) which has recently produced Cultural and Language Diversity (CALD) tools.

In fact, the NRA, along with Bupa, has provided sponsorship for a cultural diversity conference at The University of Auckland (Tamaki Campus) on 1 July this year. The conference, led by the Silver Rainbow research team, will address the acceptance of diversity in all its forms, beyond sexual orientation to ethnicity, disability, and other aspects of individuality.

“The conference celebrates cultural diversity beautifully. It is a truly person-centred philosophy we are showcasing,” says Mooney.

“Individuals may have a culture with many joint aspects and permutations. It is essential that we know how to honour and respect the totality of residents in aged residential care.”

Of course, it doesn’t all end after the conference. Pending funding, there is a wish to have a second conference further south. And further study in this area is on the cards with The University of Auckland PhD student Erica March planning to explore the perceived issues and implications for wellbeing of older adults in residential aged care who do not identify as heterosexual. March aims to interview 20 such older adults to investigate what concerns are held about moving into a care facility and how these are addressed. Among other questions, she aims to examine how the expression of sexual orientation of older adults has affected their wellbeing when living in residential aged care, and also what influence cultural differences and the perceived judgment of carers has on the participants.

March’s research is in its very early stages and will no doubt cast more light on a subject that has, until recent years, been largely neglected in New Zealand.

For Mooney, the pot of gold at the end of Silver Rainbow will be every residential care home in New Zealand having a copy of the resources and a willingness to use them.

“We hope that we can work on developing this resource into an online learning course. Above all, we hope to enlighten them that there are non-heterosexuals in this setting who are invisible and require recognition of their entire personhood.”

If you would like to participate or find out more information about Erica March’s research, please contact her at emar054@aucklanduni.ac.nz

Person Centered Care for Diverse Populations in Aged Residential Care Seminar This one day event will focus on the rich cultural diversity of older adults living in residential aged care in New Zealand today and into the future. We will explore spirituality in older age, Maori, Pacifica, Korean, Chinese, Indian and LGB culture.

Date: 1st of July 2014 in The University of Auckland, Tamaki campus, Auckland.

To register: www.conf.auckland.ac.nz/ei/getdemo.ei?id=259&s=_3TK0OD03N Cost: $125 including lunch Email: eventsadmin@auckland.ac.nz

Silver Rainbow NZ - Facebook page:

www.facebook.com/SilverRainbowNewZealand

To download training resources:

www.gayline.org.nz/residents%E2%80%99-rights-rainbow-older-people

To watch training video:

www.youtube.com/watch?v=ZDAF4IrlDuE

www.insitemagazine.co.nz | June/July 2014

9

Design

Case study: the retirement village KATE RUSSELL shares the joys and challenges experienced by Dalman Architecture in breathing life into Christchurch’s Russley Village.

I

n 2007, when Retirement Assets set out to transform the iconic Russley Hotel site in Christchurch into The Russley Village, they envisaged developing a new form of retirement living. They wanted residents to feel like they lived in a highly desirable village with character and with no perception of it being an institution or an old folks’ home. Equally important was the development of a place where residents could feel at home in a social, friendly environment and continue to pursue a full life and a myriad of hobbies and interests– no matter what their age.

The inspiration for the village grew out of concern for a New Zealand trend to maximise the number of units on a site.

Compact living arrangements typically mean sacrifices are made in design and functionality and often result in institutional- looking buildings. A gap in the market was apparent and they set the goal to develop an integrated community where residents would be proud to live.

The solution was to design a village full of character in buildings, interior design and landscaping.

Dalman Architecture and Boffa Miskell were brought in for their expertise in the design of aged care and retirement living developments and urban design respectively.

Their brief was to minimise construction costs but strategically design an entire village that gave the impression it had been individually crafted.

A key design goal was to achieve a character environment for residents within a village atmosphere. The result is a village filled with a variety of modern, spacious interiors and attractive buildings, all comprising high quality fixtures and finishes.

Residents can choose from different levels of care to suit their lifestyle requirements, including independent living to fully serviced apartments and hospital care. The village is being completed in stages, and once finished, it will consist of 38 villas, nine terrace villas, 63 apartments, 21 assisted living apartments, and 19 care rooms. Currently under construction is an underground car park and a second stage of apartments. A community 10

June/July 2014 | www.insitemagazine.co.nz

centre, swimming pool, and hospital care facility, which will have 24-hour nursing care, is in the next and final design phase.

To achieve the appearance of individually crafted villas, nine floor plans were designed consisting of either two or three bedrooms.

This compares with standard retirement living, which normally consists of only one or two unit designs. Each villa has its own unique position on the site to provide a variety outlooks and privacy. Another point of difference for The Russley Village is the spacious floor plans.

Apartment blocks are largely a new concept for retirement living in Christchurch. However, based on the popularity of the first stage two-storey apartments, three-storey apartments are now being built. They all provide excellent outlooks, including to The Pavilion, which is the interim community centre that overlooks the village bowling green. The village is also security controlled, with gates shut after hours, a village manager and various alarm systems.

At the heart of the village will be the Russley Homestead, the main village facility.

This is a comprehensive community centre that will offer a wide array of amenities to residents. It is an important design feature of the village as it caters for a range of needs with a public area, café, restaurant, bar, movie theatre, library, computer room, billiards, health, beauty, and medical rooms.

The function rooms in the community centre offer flexibility and can be utilised by residents for hobbies, music, seminars and private use.

The design of the community centre has been carefully considered to cater for intimate or large gatherings and will be a popular place to take visitors. Through adaptive design techniques, residents can enjoy large communal occasions like Christmas dinner, yet host a family party in a private room or meet a friend for coffee without feeling overwhelmed by a void some cavernous halls can create. Once complete, The Pavilion will be converted into a full gymnasium on the lower level and the village bowling club on the upper level.

With all these features on offer, residents have everything they need within close proximity. They can choose to venture out of the village, either by themselves or in the village Mercedes minivan, or enjoy the activities and facilities the village has to offer without transportation or mobility concerns.

Landscape architects Boffa Miskell designed a Cantabrian-inspired landscape and village townscape that links to the architecture. It is an element that adds interesting views, spaciousness and optimised common and private gardens to delight the residents. With each view from the buildings and street taken into consideration, the residents have a different outlook, from indoor-outdoor living to pergolas, vegetable gardens, a bowling green, and a petanque court.

The September 2010 and February 2011 Christchurch earthquakes did not have any lasting effects on the village. Construction was underway on some of the villas during the February earthquake. However, they stood up well and were undamaged by the event. Since the earthquakes, all buildings at The Russley Village have been built to the updated seismic standards of the building code. There was an increase in building costs to meet the standards but no compromise was made to the level of finish and quality.

The collaboration between Dalman Architecture and Retirement Assets has been successful as both companies shared the same vision to develop a high quality village.

Graham Wilkinson, director of Retirement Assets states: “To get the best outcome in a village, a client needs to have a firm vision of what they are trying to achieve and the architect needs to be able to listen, interpret and deliver. In the case of The Russley Village, Dalman Architecture have certainly achieved that.”

The success of The Russley Village is the knowledge that residents enjoy living there.

In acknowledgement of this achievement a resident says, “They have made this village, and the culture of this village to be such a successful, happy place”.

The Russley Village will be fully complete in 2016.

Design

Case study: the medical facility Daniel Barrington of Klein Architects talks to PAUL PATTON about what went into creating an exciting new medical facility for Christchurch.

Forté Health

As the Christchurch rebuild finally gains real momentum, an exciting new medical facility has opened for business. Prime Minister John Key recently declared the new Forté Health facility officially opened. Located in Peterborough Street within the Red Zone, the $55 million landmark building project is the replacement for the Oxford Clinic, which was badly damaged and later demolished following the 2011 earthquake.

The owners, a collective of senior medical practioners, decided to continue business in the CBD on land that had been cleared of earthquake-damaged buildings. With the clock ticking, the brief, back in 2012, was to create a green-rated building containing a health hub facility that was specifically focused on the needs of patients, for it to be fully operational by 2014, but most importantly, resilient enough to survive further quakes. A tough and demanding brief – but one that healthcare specialists Klein Architects, working with Ruth Whitehead and base build architects Wilson and Hill, tackled by creating an inventive and striking design.

According to Daniel Barrington, project architect for the specialist fitout, part of the mission was to create an eco building, and surprisingly, this was completely client-driven.

“The client was instrumental in demanding a building that contained strong eco credentials.

This is normally encouraged by the project’s architects, but in this case, the owners were determined to create a genuinely healthy building for both patients and staff.

“The buildings’ roll call of intelligent eco features includes the use of solar power, smart lighting system, heat recovery air conditioning system, waste reduction, and an energyoptimising building management system.

“It was a real pleasure to carefully incorporate some of the latest innovations in green technology that will make the building not only more sustainable but also a healthier place,” says Barrington.

“The result of these innovations paid off, as earlier this year the hospital was awarded a fourstar Green Star design rating by the New Zealand Green Building Council. This is a terrific achievement, as this is the first hospital facility in the country to be given this award, and is one of only three in the Australasia region.”

The attention paid to the building’s green credentials extended to using locally sourced Forest Stewardship Council timbers and veneers and paint that doesn’t give off noxious fumes.

Research in the US has shown that using paint with VOC (volatile organic compounds) can trigger asthma attacks, eye irritations and respiratory problems, nausea and dizziness, among other symptoms. Prolonged exposure has been linked to kidney and liver disease, and in some cases, cancer.

Taking into account potential future earthquakes played a major part in the building’s structural design. The hospital is the first in the country to use steel PREcast Seismic Structural System Press technology and the interior detailing had to accommodate movement to ensure the facility remains fully operational after a seismic event.

The building’s tasteful interior design takes its cues from hip hotels and airport business class lounges rather than conventional hospital interiors. The Air New Zealand Koru Club was the inspiration for Klein when they were seeking ideas for the hospital fitout.

“Medical environments can often look cold and unfriendly but our brief was to create a clean, clear, crisp, modern environment.

Monotone finishes, complemented by warm tones in the carpets and timbers helps give the facility a genuinely welcoming feel,” says Barrington.

When people enter the building, one of the noticeable basebuilding design features is the central atrium that allows light to permeate into areas that would normally require artificial lighting. This has been utilised by Klein in the fitout of the hospital. A café has been deliberately placed in the centre of the ground floor that enhances the convivial feel of the ground floor area.

The building accommodation includes patient and surgical facilities, four operating theatres, a 12-bed recovery area and two day lounges on the top floor.

The ward on level one provides 14 overnight suites. Consulting suites are conveniently located on the ground and first floor, including a new home for Oxford Women’s Health, a gynaecology, obstetric, and fertility facility also lost in the 2011 earthquake.

Future-proofing was another design priority for the architects.

“It’s a bit like crystal ball gazing, but with medical facilities we have provided plenty of extra data points plus lots of structured cabling and making sure the IT infrastructure is well planned.”

Dorothy Paton, Forté Health’s general manager, says the specialists and stakeholders are thrilled with the environment that has been created for patients, visitors and staff.

“The hospital has been designed by healthcare professionals, which has provided the best outcome for all. We have had some amazing feedback about the light, room flow and design of the building.

Klein Architects proved to be an excellent design partner for this project.”

The recent completion of the Forté hospital follows on from other major projects completed

by Klein, such as the new five-storey clinical services building at Middlemore Hospital in South Auckland for Counties Manukau DHB. This $140 million, 30,000 million development sees the creation of 14 operating theatres, a 43-bed recovery suite and a 42-bed assessment and planning unit.

Klein continues its work in Christchurch leading the master planning and health design of the major redevelopment of the Burwood Health Campus which is now under construction.

The Forté building has also been entered into the prestigious World Architecture News Awards.

Forté features »» Green: solar power, smart lighting, heat recovery air conditioning, waste reduction, energy-optimising building management system »» Healthy: materials (timbers, paints, veneers) that don’t pose health risks »» Quake-proof: first in the country to use steel PREcast Seismic Structural System technology »» Modern: looked to hip hotels and airport business lounges for inspiration rather than conventional hospitals. »» Future proof: extra data points, lots of structured cabling and making sure the IT infrastructure is well planned.

www.insitemagazine.co.nz | June/July 2014

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Design

Case Study: the aged care facility Gillian Bremner, chief executive of Presbyterian Support Otago, shares why she believes consultation and collaboration is the key to getting it right when it comes to new developments.

Presbyterian Support Otago

What will make life more comfortable for residents?

How can nursing and caregiving activities be carried more efficiently? What floor area is optimal for the function of each room?

Those were just some of the questions Presbyterian Support Otago (PSO) staff asked each other and residents when it came time to modernising a hospital wing at Iona Home & Hospital in Oamaru.

The Iona project

Once input was gathered, it was clear a total rebuild between the original 1954 tile roof and an enlarged concrete base was required.

“Despite upgrades, no matter how you look at it, a 59-year old building is outmoded,” said PSO chief executive Gillian Bremner.

“The 22-bedroomed Kirkness hospital wing had just three bathrooms, a narrow corridor, no storage, small bedrooms, and was a very difficult work environment. On top of that, the wing was one of two that made up the hospital unit, yet they weren’t easily linked.”

Bremner said that working through differing options and listening to the various opinions, such as the placement of the nurses’ station and how many sluice rooms were needed, the project did end up with some late design changes, but that wasn’t unusual in a building of this nature.

“What we’ve ended up with is a very modern integrated unit of one rebuilt wing costing $5.2 million and one redecorated wing, now linked three ways, with one being a wide glass walkway overlooking two sheltered courtyards. The seating area in this section is a popular meeting point for residents and families,” she added.

Natural daylight floods into the ‘new’ 1278m2 Kirkness wing, with its wide corridors, multiple seating areas, 27 large bedrooms – each with an ensuite large enough to take a shower trolley – practical storage areas, huge main lounge, dining room, and nurse’s station. All bedrooms and lounges have easy access to verandahs and decks.

Financial support from the community allowed for a family/whānau room for families to use when spending extended time with residents.

“Residents in the old Kirkness told us windows needed to be lower and without the horizontal frame in the centre so they could easily see outside from their chairs and bed, so we took that into account.

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June/July 2014 | www.insitemagazine.co.nz

“Bedrooms are nearly 16m2 and staff no longer have to remove chairs, walkers, hoists, and other equipment from rooms before attending to residents, making for a safer and more efficient working environment,” Bremner said.

Logistically, the build wasn’t an easy one because some residents still needed to be accommodated in the wing throughout the whole process – a challenge that affected everyone at the 90-resident complex – especially as it was undertaken in two distinct stages.

“While it wasn’t easy for us or the contractors, the commitment of staff in making it as painless as possible was extremely pleasing. At most, residents were only moved twice.

“Essential services had to be maintained to all areas of the home so communication between all parties, including laundry and kitchen teams, was of paramount importance.

“The importance of constant consultation and communication with all parties, from the outset to the conclusion, is something we’ll carry forward to our new venture in Wanaka,” Bremner added.

Joint venture with Aspiring Village

The new venture to which Bremner refers is a joint partnership with Aspiring Lifestyle Retirement Village to build a care home on the village grounds.

Although PSO has its own retirement village, Wanaka Retirement Village, as well as Elmslie House Home & Hospital in the town, the organisation felt it would be beneficial to look at ways it could collaborate with another provider, rather than be in direct competition.

“That led to initial talks, and ultimately, a joint venture partnership where we share ownership of the facility, but with PSO operating the home and hospital. Elmslie House carries four-year Ministry of Health Certification so it makes sense for us to expand on what we do well.”

Aspiring Village chief executive Aaron Armstrong said that with over 60 villas and newly opened lifestyle facilities, the village was now over halfway through its development.

“Our focus is very much on the independent living end of the market but we’re keen to develop a care home on site so residents could have a true continuum of care,” he said.

“We had the land available and the experience to project-manage the build, but not the expertise in residential geriatric care, so this joint venture will bring our dream to fruition.

“We realise that providing great quality rest home, hospital, and dementia care to our residents and others in the community takes a unique set of skills, which is why we chose to form a joint venture with PSO. They have a strong reputation for providing good quality care, both in our local community through Elmslie House, and in the wider Otago region.”

Bremner added that the potential for shared resources and staffing across both facilities would be fully explored, with Elmslie House benefitting as a result.

“We’ve consulted with staff in our existing facilities on the draft plans, looking in particular at the size of the rooms. As we did at the start of the Iona Kirkness rebuild, a mock-up room has been set up with equipment to ensure space for hoists and shower trolleys is adequate. The number, size, and shape of the lounges, outdoor courtyards, and flow within the facility are all seen as critical, and there are particular design guidelines for dementia units to be utilised.”

Cost-effective heating and cooling is important in a place like Wanaka, and as in Wanaka Retirement Village, certain Green Star rating features could be included.

“By and large, the needs of residents determine the features, and the increased use of computerbased assessment tools such as InterRAI means wi-fi access throughout the facility is essential. It will also help residents communicate with relatives electronically,” Bremner added.

Working drawings by the Aspiring Village architect and resource consent applications are underway for the $5 million first stage of the three-stage care complex. Construction of the 10 dementia and 18 home and hospital rooms, along with the Upper Clutha Hospice rooms, is expected to start this September.

PSO has demonstrated that a multi-pronged approach, one that takes into account the lessons learned from previous projects such as the Iona re-build, but also employs the strengths of others, as in the Aspiring project, and constantly listens to what the market wants, can work well when embarking on new ventures.

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Eden Alternative™ Registry member homes receive International recognition We are delighted to announce that at the recent 7th Eden Alternative International Conference held in Nashville Tennessee USA, two New Zealand homes were recognised for their ongoing commitment to the Eden Alternative™.

Congratulations to Jill Woodward, CEO, Elizabeth Knox Home and Hospital for winning the Nancy Fox Leadership Award. Jill is an outstanding leader who inspires staff; residents and families to engage empower and celebrate aging in a positive and productive manner. Knox Home has also achieved recognition in all 10 Eden

Principles and is the first home in New Zealand to reach this milestone.

Presbyterian Support South Canterbury in the South Island has won the Eden Alternative Seedling Award. Through innovation and engagement of their community the Eden Alternative is enriching the lives of young and old alike and improving wellbeing for all.

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To start your Eden Alternative journey, consider 1. In house Eden Alternative training or 2. Dementia Beyond Drugs workshop options Contact: Eden in Oz & NZ Phone: +64 3 8819 4732 Email: admin@edeninoznz.com.au Website: www.edeninoznz.com.au

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www.insitemagazine.co.nz | June/July 2014

13

technology

Keeping up with telehealth RON EMERSON, global director of healthcare for Polycom, discusses how video technology is improving healthcare for older New Zealanders.

I

t’s no secret. New Zealand, like many countries around the world, is facing the impact of having an ageing population, coupled with increased pressures on its public healthcare budget. For many healthcare providers, this means helping older New Zealanders stay active for longer, focusing on wellness and prevention rather than only treating ill-health and chronic conditions. It also means finding new and innovative ways of working smarter – solving the complex challenges of caring for older patients while finding ways to manage, and where possible, reduce operational costs.

Technology as a change agent

Technology is playing a major role in changing the face of healthcare in New Zealand. With the consumerisation of IT, more homes are connected to the internet and older New Zealanders are technology literate and enjoying access to PCs and mobile devices like tablets, laptops and smartphones. All of which deliver anytime, anywhere connectivity.

According to Frost & Sullivan’s 2013 ‘New Zealand Mobile Device Usage 2013’ report, 64 per cent of New Zealanders aged 15–65 now own a smartphone, with levels expected to reach 90 per cent penetration in 2018. In fact, you only have to look at the Ministry of Health’s new multi-million dollar electronic healthcare system launched earlier this year, best described as a combination of internet banking and social media, to see how rapidly the provision of healthcare is changing.

Helping healthcare professionals work smarter Another area where technology is changing the delivery of care for ageing New Zealanders is the availability of telehealth, which allows the delivery of 14

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remote interactive medical care and education using voice and video. This enables doctors, nurses, and other health professionals in remote locations to consult with specialists about a patient’s condition. Benefits include supporting clinical care collaboration across geographic regions, enhancing equity of access to healthcare for all New Zealanders and improving team collaboration.

Globally, leading applications of telehealth include cardiology, dialysis, mental health, and ‘telestroke’. In the UK, National Health Service (NHS) Cumbria & Lancashire has a ‘telestroke’ service, which provides stroke patient consultations via video. It improves the speed of intervention, saving lives and freeing up hospital beds. The telehealth initiative has been so successful that it has now been rolled out across 10 hospitals in the region. The telestroke service has also reduced NHS costs associated with dependent stroke care by approximately £30,000 per patient.

Closer to home, the New Zealand Ministry of Health announced late last year that planning is now underway to develop an integrated national telehealth service to improve public access to a range of triage, advice, counselling and referral services.

Healthcare organisations will always be under pressure to reduce costs and deliver the best possible patient care with the available resources. At the same time, they are challenged by a growing and ageing population.

Already we are seeing innovations in how telehealth is being used in New Zealand and this is expected to grow as more healthcare providers embrace video to improve patient outcomes both now and into the future.

Ron Emerson is the global director of healthcare at Polycom and responsible for driving strategy, marketing, sales execution, industry positioning, messaging, AR/PR and partnerships and alliances for Polycom’s Health Sector.

Case Study: Canterbury and West Coast District Health Boards Complex Clinical Care Network (CCCN)

With the ageing population and New Zealanders, ongoing desire to live at home as they age, the importance of effective home care coordination is increasing. For Canterbury and West Coast District Health Boards, the introduction of telehealth solutions less than three years ago is changing the way services to older people are delivered to this remote part of the country.

Dr Michelle Dhanak, Canterbury DHB medical officer, Geriatric Medicine North East Community Service Team, West Coast Liaison, explains: “We use videoconferencing for the regional interdisciplinary teams to assist in managing complex older people in the community. These patients have multiple chronic conditions that result in disability and impact the older person’s function.

“The regional interdisciplinary teams are made up of West Coast clinicians and include the West Coast Liaison Geriatrician, Complex Clinical Care Network (CCCN) clinical manager, gerontology nurse specialist, and clinical assessors, as well as WCDHB allied health professionals (physiotherapists, occupational therapist, social worker), district nurses, Primary Health Organisation and primary care representatives (usually practice nurses), and home-based support providers.

Other disciplines such as mental health providers, kaupapa Māori nurse, and clinical nurse specialists attend the meetings if they are involved in the person’s care.”

Dr Dhanak continues: “The aim of the CCCN is to keep the older person living well in the community through interdisciplinary team management, collaboration between disciplines, and restorative home-based supports.”

assessment

Editor’s eye

Let’s Snoop Around...

A typical day Greenwood Park Lifestyle Village in the life of...

JUDE BARBACK joins residents, locals, and Metlifecare bosses for the opening of a new walk at Tauranga’s Greenwood Park.

I

was delighted to receive an invitation to the official opening of Greenwood Park’s new Quail Trail. The retirement village, located in Welcome Bay, Tauranga, is virtually on my doorstep, but I had yet to pay it a visit. So I RSVP’d immediately.

The weather forecast did not bode well for the event, but when I arrive at the village, manager Todd Jenkins appears optimistic. “It’ll clear,” he says, and sure enough, it does.

I don my gumboots regardless – it isn’t often an interview lets me foray back to my dairy farming childhood – and join Jenkins, Metlifecare chief executive Alan Edwards, Metlifecare Senior New Zealander of the Year Frances Denz, and a huge number of residents and locals for the walk along the bush track around the bottom of the village.

The walk begins with the unveiling of a new sign that outlines the course of the path. The map, beautifully drawn and adorned with native birds and trees, is the work of resident Max Edwards, whom Alan Edwards jokingly refers to as his “claimed relative”. The unveiling is met with smiles and applause.

We then proceed down a flight of steps, where Alan Edwards and the village’s gardener digs a hole to plant a kawaka tree (native cedar) to mark the occasion. More applause. More cheeky banter between residents and Jenkins and Edwards – someone suggesting to Edwards that they need a second gardener. We continue on our way.

In participating in the Quail Trail walk, I not only gain a good understanding of the physical layout and beauty of the village, but also the opportunity to witness the residents’ pride and connection with their village and Metlifecare leadership at play. Although there are more than a hundred people, the feeling is of one large happy family as they gather together.

Along the way, I chat with various residents.

One lady tells me to put moving to Greenwood Park “on my bucket list”. Another tells me how, following the loss of her husband, her children had encouraged her to relocate to a retirement village, and she’d moved to an apartment at Greenwood Park “kicking and screaming”, but now she couldn’t imagine a better place to be.

The village is aptly named. It is green, woody, and park-like. I am usually partial to shiny, new, modern facilities. Built in 1986, Greenwood Park is none of these things, but it achieves adjectives that a new build can only aspire to: it is established, timeless, comfortable, proud, and enduring.

“The developers were ahead of their time,” says Jenkins, with reference to the wide, cobbled roadways, the use of brick and cedar and the overall design. The village, comprised of 144 villas, 79 apartments and 15 serviced apartments, sprawls across an impressive 42 acres.

“I should use hectares but it sounds bigger in acres,” quips Jenkins, who has been at the helm for 14 years. When I ask if it is Metlifecare’s largest village in the Bay of Plenty, he responds: “Of course it’s the biggest – I’m a Texan!”

Jenkins has been in New Zealand for 28 years.

Prior to managing Greenwood Park, he managed a series of businesses, and prior to that, he navigated ships. He also dabbles in farming.

He’s not joking about the size of the place or about what it has to offer residents. It boasts a restaurant, swimming pool, spa, sauna, tennis court, petanque court, croquet lawn, bowling green, putting green, chapel, and even a carpentry room. I can’t think of anything not on the list.

Except perhaps a care facility. But this is on the cards, apparently.

The Quail Trail walk takes us through beautiful native bush down to an area known as Candyland, and this is land pegged for the development of a care facility at some stage.

I am surprised, perhaps because of the operator’s name, Metlifecare, to learn that of the operator’s 23 villages (25 if you count the two under development), only nine currently have care facilities. Edwards says while there are plans to increase this number, home care services are already being delivered directly to resident’s homes in all but a few villages.

This is a particularly admirable trait of both Greenwood Park and nearby sister village The Avenues Lifestyle Resort. Following a three-year pilot programme from 2001, Greenwood Park negotiated a contract with the Bay of Plenty District Health Board to provide home-based care to residents.

It makes good sense to me. Edwards is a firm advocate of the model, and he would love to see other DHBs contract directly with Metlifecare villages to deliver home-based care services.

“We’re at a transitional period as the rest home level is being squeezed,” says Edwards, of aged care in New Zealand.

He sees the delivery of home-based care to residents by the village operator as a positive solution and admits he is frustrated by the failure of other DHBs to see this as a good opportunity too. Apparently only Taranaki and Lakes DHBs operate similar models.

Edwards says to the residents and guests that he would like to eventually live at Greenwood Park – if the manager will have him. As a key player in the industry with no doubt intimate knowledge of the sector, this is a big call. However, although my visit has been brief, I can certainly see the appeal of this village too.

a needs assessor

Needs assessor Vanessa Taylor, believes she has “the best job in the world”.

It’s six in the morning and time to get up and organised for work.

I have “the best job in the world” – a sentence I have heard said by many a needs assessor.

I have been involved with NASC (needs assessment and service coordination) for the past five years. I continue to assess clients in both the community and residential facilities.

I also now hold a position as lead practitioner for interRAI (current electronic assessment tool used by all DHBs within New Zealand) for the Waikato District Health Board.

Becoming involved with NASC was a natural transition from working within the aged care sector.

The mix of face-to-face client contact along with office work is a great combination. It encompasses the ability to work autonomously as well as in a team environment.

Who wouldn’t like a nice drive in the country to see some rural clients, then back to the office to do some care planning?

Historically in the Waikato, the needs assessor and coordinator roles are separated, although there is work underway for a combined approach. In some of the other DHBs in the country, this is a dual role.

With the introduction of interRAI, needs assessments are now completed on computer.

All clients are assessed using the same set of assessment tools, and this produces equitable outcomes for all.

The biggest challenge for NASC staff has been the introduction of interRAI, with all of the changes it has brought with it, and the need to link interRAI with the NASC process.

Typically our clients include the elderly, acutely unwell, socially isolated, and fragile individuals are unable to cope alone in the community without formal support. Grief is something that we encounter often.

Being a needs assessor is a busy role, rewarded by the knowledge that you are assisting the elderly.

I work with a group of professionals here at Disability Support Link who value our elderly and are passionate about the aged care industry.

Vanessa Taylor is a registered nurse and lead practitioner at Waikato District Health Board. www.insitemagazine.co.nz | June/July 2014

15

last word

Conference Corner The RVA’s annual conference heads to Auckland this year, where, following its much-anticipated golf tournament, it will play host to an array of interesting speakers and topics. Olympic gold medallist Rob Waddell will be a keynote speaker this year, as will veteran business leader Bryan Mogridge; both are expected to entertain, challenge, and inspire delegates with their stories of success, growth and leadership.

Last Word...

Roy Reid President of Grey Power Federation ROY REID believes good progress is being made towards better care for the aged.

A

s president of Grey Power Federation, I have been very concerned about the welfare of those receiving both home care and residential care.

I was closely involved with the first inquiry that was jointly conducted by Hon Winnie Laban and Ms Sue Kedgley, Members of Parliament, who held meetings organised by Grey Power Associations to gather evidence on the care provided and the care workers’ wages and allowances.

The evidence gathered was widely circulated, which resulted in a further inquiry undertaken by Dr Judy McGregor, former Equal Employment Opportunities Commissioner, and her staff from the Human Rights Commission. They produced another report titled Caring Counts, which made 10 recommendations on leadership, pay, fair travel, qualifications, safety standards, consumer information, transparency, migrant workers, diversity of carers, and valuing carers.

Following the release of the report, a meeting of interested groups was held with a group formed to work towards the implementation of the report’s recommendations.

This group is still meeting, and I consider some progress has been made towards the implementation of some of the recommendations.

Another issue is pay parity between workers employed in DHBs, compared with workers employed in residential care and home care facilities who perform similar duties to those in DHBs. There is a case currently in the courts and, if it succeeds, hopefully some pay parity can be achieved, especially for the trained nursing staff and care workers.

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June/July 2014 | www.insitemagazine.co.nz

It would be great if we can get a travel allowance paid for the care workers who provide home care. These workers usually provide their own vehicle at little or no reimbursement. Those workers working in rural areas travel considerable distances during their day’s work, with many being unable to afford the costs incurred. It was very pleasing to learn that negotiations are currently being held, hopefully with a good outcome.

It is pleasing to see many employers encouraging their staff to train towards obtaining qualifications and rewarding them by increased pay in recognition of the qualifications obtained. I sincerely believe that this alone will help reduce the high turnover of staff that was occurring. This is a gain for the employer, staff, and the residents.

Safety standards in this area need to become mandatory, as it is for the protection of both the carer and the residents. It is pleasing to note that we are not receiving complaints like we did three years ago – a great step forward.

It is great that both the Ministry of Health and NZACA have developed websites providing information on residential facilities as these sites provide information to those families looking for a care facility that is often required at short notice.

It has been a concern that there has been little transparency in the DHB annual reports, which show increased funding for fair travel and equal pay provisions in the area of aged care delivery services. The funding from Government to the DHBs needs to be ‘ring-fenced’ so that the public can see that the funding is spent in the right areas.

We need to recognise the skills of migrant workers. It is important that the skills and training they have before arrival in New Zealand is cross-credited to an equivalent New Zealand standard of training.

Good progress is being made towards better care for the aged, which is the desired outcome.

The retirement village market will be scrutinised in a number of ways, from Sir Ron Scott sharing his thoughts on the future role that villages could play, to market experts Chris Baynes from Sydney-based Village Productions Sydney, and Justin Kean from Jones Lang LaSalle, who will discuss what drives today’s market. Katie Smith Sloan of the International Association of Housing and Services for the Ageing will look at some of the broader trends in retirement villages.

One trend that will come under the microscope is the increasing role of technology in the village, a subject that Jennene Buckley of Feros Care will address in her talk on ‘gadgets, gizmos and gaining independence’.

A CEO forum featuring leaders from Metlifecare, Ryman Healthcare, Summerset, Bupa, Selwyn, and Oceania is bound to prove enlightening; no doubt as will the reflections of Summerset chief executive Norah Barlow on the industry.

With an election looming, political commentator Duncan Garner will take the stand to look at the current political landscape and Cameron Bagrie, chief economist of the ANZ will discuss the current economic climate and implications for retirement villages.

Of course, there will be the annual gala dinner on the Tuesday night, held in the Langham’s Great Room. The conference will end with village tours around Auckland.

See next edition for Conference review including keynote speakers.

Date for the diary: • Retirement Villages Association 2014 Conference.

The Langham, Auckland; 23-26 June 2014.

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