industry & reform
Outside the box
Pandemic leads to positive change for one provider .
By Amber Mills and James Finnis
COVID-19 has created both
challenges and opportunities for aged care providers , staff and clients . This article looks at how the Brotherhood of St Laurence ( BSL ) Aged Care division changed its approach to home- and centre-based service delivery during the first national lockdown .
“ NOT JUST FAIR-WEATHER SERVICES ” The division made an early decision that both Home and Community Care were essential services . Support continuity was particularly important for the BSL as many clients have complex behavioural , social and / or clinical needs .
The BSL maintains a strong commitment to the most disadvantaged community members . Centre-based programs therefore do more than just provide leisure activities : centres provide meals , welfare support , social connection and a sense of community . Many members visit every day . In this context , support continuity was paramount .
While closing centres , in line with government directives , staff and case managers ensured that clients were supported , heard and connected . This included adapting centre-based programs to home settings .
This often involved going above and beyond ‘ typical ’ home care . Beyond guaranteeing essential needs , staff conducted welfare checks , linked clients with other available services ( particularly if their previous supports were no longer available ), checked in with families and carers , and managed people ’ s anxieties and fears around COVID-19 .
Operating across metropolitan Melbourne , BSL case managers reported the following :
• Clients welcomed service continuity , but some families were concerned about receiving care workers at home . Case managers conducted more engagement work to reassure families and clients .
• A lot of case management work already involved phone-based check-ins . During lockdown , daily phone calls allowed case managers to communicate to clients and their families that it was safe ( and indeed safest ) to receive care at home .
• Addressing social isolation through technology has benefited some clients , but others require ongoing support to use it . Likewise , telehealth consultations have had a mixed response – useful in some instances and unsuitable in many others .
• Staff saw a marked change in caseload ; clients who were previously quite independent suddenly became less so . In some cases , families stepped back due to restrictions . Formal supports became increasingly important to meet personal and clinical needs . A critical decision involved rapidly upskilling home and community care staff in providing clinical support and to use outreach case management approaches . With these changes , services continued operating under the challenging circumstances imposed by social distancing requirements , even while other providers were altering , closing or withdrawing services .
KEYS TO SUCCESS Practice shifts in home and community care were rapid . Changes were underpinned by the following four factors :
• Operational success was partially determined by having a “ single source of decision-making ” on COVID-19 matters . Daily meetings ( which included senior managers and other staff from across the division and organisation ) enabled updates on current information and policy announcements . A secondary benefit was a structured management approach for escalating issues and making quick decisions .
• The division is a strong supporter of case management , particularly for older people experiencing disadvantage . During this period , case management provided a basis for more proactive outreach and monitoring to check in on client welfare and wellbeing , and helped comfort clients and manage a phased return to receiving services ( where they had stopped ).
• By responding to changing need in the community , the division had to broaden the scope of support provided ; this required greater workforce assistance . Senior managers supported home care staff by developing and rolling out new learning modules that used a combination of digital and face-to-face training . Training in infection control , use of personal protective equipment ( PPE ) and hand hygiene was provided to all staff online . Small-scale , inperson training was used to reinforce hygiene techniques and teach correct donning and doffing procedures for PPE .
• Upskilling home and community care staff had an additional positive impact , reassuring staff that they knew what they were asked to do and that their jobs were secure ; subsequently , very few withdrew from work for personal or health reasons . In turn , staff could better communicate to clients and their families that it was safe to continue receiving services .
LESSONS FOR THE FUTURE This pandemic has had the unforeseen effect of enabling the BSL ’ s Aged Care division to improve staff skill development and strengthen its approaches to client care . In extraordinary times , staff and clients have benefited from adaptability and the introduction of different measures and approaches into daily practice . By adopting a clinical approach to upskilling our personal care workers and community support workers , services continued to operate and meet the growth in demand . ■
Dr Amber Mills is senior research fellow ( inclusive ageing ) and James Finnis is policy advisor ( inclusive communities ) in the Research and Policy Centre at the Brotherhood of St Laurence .
16 agedcareinsite . com . au