New South Wales and the ACT . It ’ s a big change . It ’ s a movement away from a highly-institutionalised way of operating based on a hospital model , to really thinking about ‘ How do we ensure the residents are at the centre of everything we do ?’ And that ’ s a big shift in thinking .
In Amala we have the advantage of a purpose-built environment . But even in some of our older homes , where we do have smaller spaces and where we do not have this kind of bespoke build , you can do a lot of things . It ’ s about your attitude . It ’ s about your work practices . It ’ s about how you encourage residents to be part of the decision-making .
I asked a resident in one of our homes a couple of years ago when we were partway through implementing this what was different , and what she liked about being here . She said , ‘ People walk at my pace .’
I think there ’ s no better example or better illustration to me of what personcentred care is all about . It ’ s about trying to walk at the resident ’ s pace . And that includes things like when they wake and what they eat and how they ’ re spoken to : trying to understand what that individual needs and trying to adapt to that .
It was an eight-year construction . That seems a long time . We built it in stages . So , we built the first home , the first 40 beds , and then the second , and then the third . So it ’ s really been spread over those eight years . We ’ ve been operating the first home for about six or so years . And then the second home came along . And now the third , the remaining 40 beds .
It ’ s part of a wider village . We also have retirement living and a senior ’ s gym on the site .
Did the plans evolve considering the build happened during the Royal Commission ? They did to some extent . What we found from the Royal Commission was a nice affirmation of the kind of work that we ’ ve been doing for some years . We obviously fit into the Royal Commission as well , and tried to talk about our household model . But again , what we ’ re talking about here is trying to embody something that I think aged care has been working on for a long time , for probably a couple of decades , and trying to be person-centred .
We ’ re trying to do that within constraints , but the reality is all aged care providers want to be person-centred , want to be about the resident and their family and the network , and really , what we ’ re trying to promote in our household model is an embodiment of that .
Now , there are constraints : we ’ d love to see more staff , greater ratios , and all of those things . We ’ re looking forward to seeing the royal commission recommendations enacted by government and by us as a community , because we think that will enhance the offering in household models , but more importantly , throughout aged care as well .
Given the revelations of the royal commission and the COVID experience , do you feel this is the future of aged care – because otherwise people are not going to come and stay in aged care ? I think there ’ s a lot of things that make up the future of aged care . The household model is one , and rethinking our models to make them more focused on the individual is absolutely one of those , but so is more home care services . So is greater transparency by providers . So is better pay and better training of aged care staff generally . And so is a better funding model .
People ought to have that choice about where they ’ re supported , be it in their home , be it in an aged care facility , be it with family . To me , household is one component of what aged care reform is going to be about . But there are so many others , and really , we need those others in order for household to work as well .
We need better-trained staff that are more valued . One way of doing that is obviously pay , but we need all those things to come together to get a better service for older people and a service they deserve .
Has the royal commission changed the way you approach aged care at all ? Oh , I think so . I mean , we ’ ve advocated strongly about the need for providers to be more transparent . And it ’ s certainly challenged us to think about how we can be more transparent and prompted us to think of how we can be even more diligent when it comes to things like clinical care and reporting incidents and being clear about those . It ’ s challenged us to think about how we utilise our staff and how we work with our staff .
But these reforms are things we ’ ve been talking about for a long time . We obviously need the resources to put them into place , but we also need the will . And I think if anything , the royal commission ’ s said to us that if we ’ re going to be a responsible aged care provider , that need for greater transparency and greater collaboration and engagement with families is absolutely critical .
The other thing I think COVID and the royal commission has taught us is integration with the health sector . That ’ s certainly an area that we ’ re going to need to take up and do more with .
What would transparency look like for you ? Will that mean opening the books up and saying ‘ this is exactly where every penny we get goes on care ’? It ’ s that . And we already do a lot of that through our annual report , but we could be clearer and much more transparent about that . I don ’ t think we ’ ve been very clear about our hours of service . We could be more transparent about that on our website . We encourage our services to talk about their falls rates , their clinical issues , wound care , and so on , with their families . We could be much more transparent about that on our websites .
A lot of providers are reasonably transparent around where their funds go . The bulk of the funding we receive goes to staffing . There ’ s no secret in that . If people want greater clarity on that , we can certainly provide it .
Do providers in the sector have to lead the way on this themselves ? I think we do . And we are . We could do more , absolutely . Certainly in Uniting , we ’ re having those conversations around , ‘ what else can we publish ? what else can we put out there ?’ so people can actually see those indicators .
I know I ’ ve been in those conversations at local family and resident meetings where we ’ re talking about our falls rates , our medication issues , about the commission and what it finds and what we ’ re doing about it . We ’ re trying to be as open as we possibly can about those things .
We need our residents and their families . We need them to help us with some of those solutions to those concerns . So , it ’ s important that we ’ re transparent , really important . Yes , we ’ ll have legislation , but we can also as providers think about it very practically with things like falls rates and staffing levels that matter to families and the residents . ■ agedcareinsite . com . au 19