Aged Care Insite Issue 114 | Oct-Nov 2019 | Page 21

industry & reform journey we’re taking on. They have to feel supported. But, beyond words, we have to provide resources, we have to provide tools to facilitate that change as well. And I think that we worked within the current funding structures and regimes to modify staffing models to facilitate our approach to relationship-based care. We brought in additional tools and resources to make that happen as well. I think these are probably the core components to pushing that change, but this was three years in the making, so a lot of work, effort and energy has gone into this shift. As a not-for-profit organisation that’s been around for 70-plus years in rural and remote locations, this Whiddon Way and these core values had always been there. As an individual, the reason I’m in this industry is because it’s an industry that really delivers some beautiful outcomes. What we’re doing is very aligned to my own personal values. So, there’s that connection that made this transition quite an easy step to make, but having said that, with this team and with the board, we could see that there were some gaps and we could see the journey we needed to take. Through my role, it was very easy to get motivated to drive resources in that direction and culturally take us on that journey as well. You have to find where that focus area is and push it. So, after settling into the role and that transition was made, you had to find the energy and the motivation to take everyone on that journey with you. Has this move towards person-centred care yielded tangible results for you? Definitely. We started with MyLife, which is our model of care and it’s the framework. And MyLife calls out putting the individual at the centre of everything we do, and moving away from a task-based, service- based approach to care, to a really holistic approach to care. That was the very first step. It’s about looking at social connections, lifestyle, emotional support and wellbeing. The foundation pillar to MyLife is relationship- based care. It’s important to understand those first couple of steps. With relationship-based care itself, it’s pretty simple: it’s just about developing deeper, richer relationships between the employee and the care recipient. And through those deeper relationships you gain greater insights and you’re able to provide deeper, more multidimensional outcomes for the care recipients. It’s important to understand that chain of events. Once we got there, we were able to measure some of these sorts of outcomes. We saw really positive outcomes across three different levels. One was with the residents and the care recipient. And with some of the groups that we were conducting a bit more research and measuring some of the outcomes, we saw lower levels of depression and anxiety. We saw increased function with those residents because they were more motivated. We started to see this positive impact on the individual as a whole. And that was one of the goals. At an employee level, we saw a positive impact. We saw less stress. And that was due to improved familiarity with the work environment. There was less handover pressure between shifts, as there was a greater reliance on the next person coming on the shift, so less work to do. Team members also acknowledged the benefits of the relationship-based care and the deeper relationships that were occurring and the outcomes that they were generating. Of course, that leads to greater job satisfaction, and we know statistically the next generation coming in are looking for that richer and deeper job satisfaction in the workplace. The last thing was to do with family. In addition to all the other surveying tools and customer feedback tools that are there, we introduced net promoter scores, which a lot of aged care providers do. We had that across the group, and what we found was really positive in terms of feedback from families, which is traditionally a very difficult area in aged care. But we had higher levels of feedback from family about some of the results they were seeing with their family members that we were caring for. Away from Whiddon, why isn’t this sort of care commonplace? Why are we at this point where we’ve had to have a royal commission? Well, it’s an interesting question. There are probably a few challenges as an industry that are holding us back. Something I’ve spoken about before is the Aged Care Funding Instrument (ACFI) funding model. When I talk about ACFI, I’m not talking about it in the context of, ‘Is it sufficient? Is there enough money there or not?’ It’s just the message that ACFI sends out to the industry. From Whiddon’s perspective, ACFI is counterintuitive to our approach to care because ACFI is funding and incentivising greater levels of acuity, and its funding [principal is] ‘the sicker you get, the more money you get’, and that’s not really the way our approach to care is. I think ACFI sends a dangerous unconscious message to the industry as a starting point and that probably weaves As an industry, it’s very clear: the viability of aged care is diminishing year on year. in nicely to the cultural challenges that we have as an industry. I said this to the commissioners as well. With the compliance regime – which is obviously necessary in aged care – and the red tape, there are so many barriers and so much fear. Culturally, we’re sort of ingrained in this space where there’s just a lack of this dynamic approach to care. You’re not-for-profit, so you’re in a different position, but looking at the for-profit companies, their shares are plummeting. How can they afford this Whiddon-type care? They will. The challenge when you look at the comparison between for-profits and not-for-profits – and I’ve got a background with a for-profits in aged care as well – is that as a not-for-profit you have more freedom to invest and to focus on this sort of thing, because you don’t have a tax burden to start with, so you’re not paying a host of taxes and you don’t have shareholders waiting for returns. So, from a funding perspective, you have more freedom; your financial structures allow you more freedom to invest in the people you’re caring for; and culturally you have more freedom as well. So, there’s a lot of pressure on for-profits from shareholders and their financial regime. By definition, that relationship- based care requires more people engaging in care, so that creates a huge challenge for the for-profits before you start. As I said, as an industry it’s very clear: the viability of aged care is diminishing year on year, and this is part of what they’re looking at with the royal commission. ■ agedcareinsite.com.au 19