Services Industry Forums Proudly supported by: Age Services - - PowerPoint PPT Presentation

Victorian Age Services Industry Forums

Proudly supported by:

Age Services Industry Forum September 2019

Sharyn McIlwain State Manager – VIC/TAS

• Leading Age Services Australia (LASA) is the national association for all

providers of age services across residential care, home care and retirement living/seniors housing.

• Our purpose is to enable high performing, respected and sustainable age

services that support older Australians to age well by providing care, support and accommodation with quality, safety and compassion - always.

• We are dedicated to meeting the needs of our Members by providing:

 a strong and influential voice, leading with authority on issues of importance; access to valuable and value-adding information, advice, services and support.

About LASA

Residential care Home care Retirement living & seniors housing

Sector Update

4

5

LASA out and about

• 11 News articles in trade and mainstream press
• 40+ LASA social media posts sharing photos from around Australia.
• LASA staff participated in Member events in Victoria, Qld SA and WA –

Thanks to all who got out and about.

Aged Care Employee Day 7/8

NextGen (Melbourne 9/8)

LASA was recently recognised for its leadership in promoting innovation in age services through the award-winning innovAGEING initiative. Merlin Kong noted that “reframing the age services innovation agenda to be about

• rganisations changing the logic of their business rather than talking about

technology has fostered a more inclusive and constructive innovation environment for our industry”.

innovAGEING

9

Reform progress??

Aged Care Reform in Australia…

Source: Report on the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia House of Representatives Standing Committee on Health, Aged Care and Sport (October 2018)

Australia’s ageing population poses a significant challenge to the Australian aged care system as it currently operates. Although change has been observed, and a focus on the consumer has emerged, there remains a need for reform.

• 2011 – Productivity Commission Report
• 2012 - Living Longer Living Better Reform ( LLLB)
• 2012/13 – Supporting Framework to LLLB Established

& My Aged Care Website introduced

• 2014 – New Accommodation Payment Structure
• 2017 – Increasing Choice in Home Care
• 2018 - Unannounced Accreditation
• 2019 – Aged Care Quality & Safety Commission
• 2019 - New Single Aged Care Quality Framework
• 2020 and Beyond?

Background - A Journey of Reforms

2002…

“Bluntly, it is very difficult for many older Australians who need care to get access to the advice, support and care services they

• need. Our aged care system is fragmented,

with no easy points of access and in many regions, too few resources to meet needs” “The adequacy of funding, with the community expressing concern about the nature, quality and amount of care available in some parts of the aged care sector, and providers arguing that subsidies and client contributions do not cover costs” “Service quality, particularly in residential care, continues to be the subject of consumer concern due to some spectacular failures in service quality”

Aged Care Reform in Australia

Living Longer Living Better Reform Package (2012)

• 10 year reform plan that:

“will build a responsive, integrated, consumer-centred and sustainable aged care system, designed to meet the challenges of population ageing and ensure ongoing innovation and improvement”

• Key Principles
• 1. Ageing in Place
• 2. Consumer Choice
• 3. Market Based Competition
• 4. Consumer Contributions

14

Funding

LASA has recently surveyed Members and found 4 out of 5 aged care providers believe current financial pressures constrain their ability to deliver the care their clients and residents need and expect. Other key findings show that if conditions do not improve:  15 per cent said it was likely or very likely that they would have to withdraw services  41 per cent said it was likely or very likely that they would have to reduce direct care staff.  52 per said it was likely or very likely that they would have to reduce non-care direct service staff.

• Is not unreasonable to expect that Australia’s aged care system is adequately

funded to be sustainable and to meet the needs of older Australians.

• However, the reality is that funding of aged care has not kept pace with rising
• perating costs and the growing needs of older Australians.

Financial Pressures

Royal Commission Update

16

Support to Members

• Information – LASA Media Watch / regular email

updates / public hearings daily summary email

• Advice – dedicated RC Response Coordinator and

advice service for Members

• Materials – pro-forma letter to residents / pro-forma

letter to staff / newsletter article skeleton / powerpoint skeleton

• Services - directory of related services with negotiated

discounts for LASA Members

• ‘rising torrent of concern that the aged care system is faltering in certain

areas of safety and quality and may not be fit for purpose’

• ‘we need to understand both what is wrong with it and what works well in
• rder to understand the changes that need to be made in the aged care

system’

• ‘important to recognize many positive examples of high quality care’
• RC is a once in a lifetime opportunity to come together as a nation to

consider how we can create a better system of care for elderly Australians

Directions Hearing (Jan 2019)

‘The hallmark of a civilized society is how it treats its most vulnerable’ ‘Frail and elderly members of our community deserve to and should be looked after in the best possible way’

‘We intend to do our best to see that it

happens’

• Choice of Commissioners
• All parts of the system being equally

scrutinized

• Recurring themes
• System complexity
• Variable quality
• Information – choice / usefulness /

transparency

• Policy and regulation (design and

application)

• Lack of time / lack of staff
• Workforce attract/retain/develop
• Dementia care practices
• Aged / primary / acute care practices
• True costs of care and funding

RC Reflections

ORGANISATION OUTCOME = ‘be resilient and ready’ 1. Respond – to RC requests for information 2. Reflect – critically review your responses (outcomes & experiences / culture / governance / systems & processes / operating context and impacts on performance / etc) 3. Deliver – continue operations / continuous improvement 4. Future Ready – org.strategy / bus.infrastructure / workforce planning & core competencies / models of care / leadership & change management / culture & governance / transparency / stakeholder engagement / etc)

COMMUNICATE / COMMUNICATE / COMMUNICATE

Responding to the RC

Aged Care: a ‘wicked problem’

Wicked problems:

• are difficult to clearly define
• are often not stable
• are socially complex
• usually have no clear solution
• have many interdependencies and are often multi-

causal.

• hardly ever sit conveniently within the responsibility
• f any one organisation
• Attempts to address wicked problems often lead to

unforeseen consequences.

• can be characterised by chronic policy failure
• involve changing behaviour

Responding to a ‘wicked problem’

Solutions require:

• holistic, not partial or linear thinking
• innovative and flexible approaches
• the ability to work across boundaries (disciplines,
• rganisations, governments, etc)
• effectively engage stakeholders and citizens in

understanding the problem and in identifying possible solutions

• skills to work collaboratively
• understanding behavioural change
• tolerating uncertainty
• a comprehensive focus and/or strategy

RC Insights for Industry (II)

• Trigg (28 June): thinking big and not tinkering

– you know, not necessarily to throw the baby

• ut with the bathwater.
• Trigg (28 June): But I think, for me, the biggest

thing I would want the Commission to remember is the answers have been in this

• room. You know, there are people in this room

who know what you need to do. There are people in this room who have the answers, who’ve been doing this stuff for 10, 20 years, and I suppose my biggest wish is that those people become the most important people in the system, and they’re the people who will guide your work

Summary…

• Aged care issues (access, quality,

funding, reforms) are not new

• Industry must act to be part of the

solution and not react as a part of the problem

• Solutions must be holistic, flexible,

adaptive and long-term

• We need to ‘think big and not tinker’

Be Alert, Not Alarmed…

Staff should be/feel:

• aware
• safe
• supported
• empowered
• confident

The Interim Report – due end October

Melbourne 14th November 19

27

Sector Perfomance

Residential Care Jan-Mar 19

Home Care Jan – Mar 19

Retirement Living

Paul Murphy:: (SRG) Stakeholder Reference Group

• 2nd meeting with CAV – Consumer Affairs Victoria – 29/8/19
• Strong focus on setting questions fro stakeholder feedback
• Issues paper to be developed by late Oct 2019
• Next meeting 7 November 2019

VIC Retirement Living

LASA Village Managers – RPL to Diploma of Leadership & Management The DCM Village Manager Professional Development and Peer Network Program is a national program providing access to ongoing professional development and support developed and delivered by industry experts. LASA endorses the program and participants will receive recognition of prior learning (RPL) directly into LASA’s Diploma of Leadership & Management conducted through LASA’s registered training institute. https://lasa.asn.au/training For more information contact: LASA: Paul Murphy PaulM@lasa.asn.au Australian Retirement Village Accreditation Scheme (ARVAS) is now open for registrations at www.arvas.com.au The industry code of conduct has been developed to support the standards and

• perators should first subscribe to the code at: www.retirementlivingcode.com.au

Vic Retirement Living

VIC RLAG The next Retirement Living Advisory Group meeting and site tour will be held at the Schiavello Factory at 1 Sharps Rd Tullamarine on Tuesday 17 September. Registrations are compulsory for this event as we have to provide names at the gate for security and catering reasons. Schiavello will also be providing lunch and a meeting room for the RLAG meeting to follow the site tour. Ladies NOTE – no heels – flat enclosed shoes must be worn. Tour: 10am – 12pm Lunch: 12pm – 1pm (compliments of Schiavello) VIC RLAG meeting: 1pm – 3pm To register, email James Williams at: james@lasa.asn.au

VIC Retirement Living

Residential Aged Care

Residential Care Jan-Mar 19

Residential Aged Care

Human Resource Management 1.6 1 Consumer Dignity & Choice 3 Personal Care & Clinical Care 7 Human Resources 8 Organisational Governance Behavioural Management 2.13 Clinical Care 2.4 Skin Care 2.12 1 Consumer Dignity & Choice 2 Ongoing assessment & care planning 3 Personal Care & Clinical Care 4 & 5 6 Feedback and Complaints 7 Human Resources 8 Organisational Governance Information Systems 1.8 As Above

Residential Aged Care

Quality Indicator Program

• Pressure Injuries
• Weight Loss
• Restraint

From July 2020

• Falls/fractures
• Medication management

CONSUMER EXPERIENCE REPORTS

• 10. Are staff kind and caring?
• 11. Do you have a say in your daily activities?

‘If I’m feeling a bit sad or worried, there are staff here who I can talk to’

Residential Aged Care

Residential Care – RUCS/AN-ACC

• Resource Utilisation Classification Study

(RUCs)

• Interesting findings
• Resulted in a proposed Australian National

Aged Care Classification (AN-ACC Version 1.0) and a funding model

AN-ACC components

• A resident assessment tool for use by external assessors
• Technical nursing, Activities of Daily Living, Karnofsky

Performance Status, palliative care, frailty, risk of pressure injury, functional independence, mobility and behaviour.

• Resident classification model (AN-ACC) allocates residents to one of 13

classes according to the staff skill and time required to meet residents’ assessed care needs

• Funding comprises three elements
• The trial will commence in the second half of 2019 and is expected to

conclude in the first half of 2020 .

• Consultation paper released

Residential Care – RUCS/AN-ACC

• Resource Utilisation Classification Study

(RUCs)

• Interesting findings
• Resulted in a proposed Australian National

Aged Care Classification (AN-ACC Version 1.0) and a funding model

Purpose:

• Field test:

the assessment tool IT Systems and hardware support arrangements assessment workforce management

• Collect Data to validate the findings
• Trial commences later this year until 30 June 2020

Trial details: ResiFundingTrial@health.gov.au submissions were due by 31 July 2019

AN-ACC Trial

CLINICAL GOVERNANCE in AGED CARE https://www.agedcarequality.gov.au/providers/quality-care-resources/clinical- governance

• Fact sheets
• Toolkit
• Developing the clinical governance resources

Clinical Governance

New Fact Sheets

• Everyone is involved

Effective clinical governance systems ensure that everyone – from unregulated care providers, to employed external regulated health practitioners, to managers and members of governing bodies such as boards - is account ntable le to consumers and the community for the delivery (Guidelines)

• It’s about meeting the Standards

A clinical governance framework will support the organisation to meet requirements of the Quality Standards such as managing high risks associated with the care of each consumer, managing end-of-life care, recognising and responding to changes in a consumer’s condition, effective fectively ly communic unicating ing withi hin n and between een servic vices es, managing referrals, and addressing systemic priorities such as re reduci ucing ng inappropria riate e antibiotic iotic pre rescrib scribing ing and the inappropriate use of physical and chemical restraint. (Fact Sheet 1)

Clinical Governance – the ACQSC

• Understand key clinical risks for the service, ensure that controls and

mitigation strategies are in place to address them, and that these are reviewed regularly to ensure they remain effective

• Monitor and evaluate all aspects of clinical care through regular and

rigorous reviews of clinical quality and safety performance data

• Delegate responsibility to the senior executive and relevant committees

for the implementation, monitoring and evaluation of the service’s CG arrangements and the provision of safe and quality clinical care

Clinical Governance

• We have already heard of:
• Assessors attending Board meetings and “testing” Board/committee

members

• What is the procedure for informing?
• Reviewing ToRs/minutes of meetings
• Reviewing position descriptions/delegations
• Reviewing criteria for Board/committee member selection

Assessment – what we ‘hear’

Leading Age Services Australia (LASA) is the national peak body representing all providers of age services across residential care, home care and retirement living.

Thank you sharynm@lasa.asn.au