Inside CCI’s Aged and Health Care Risk Report 2019
2 Oct 2019
Aged care in Australia faces major change across the industry. Our generation of Baby-Boomers is living longer than previous generations. A changed funding model presents opportunities and risks to people receiving care in or outside of their homes.
CCI’s latest Aged and Health Care Risk Report identifies important issues for the industry that are likely to have an impact on providers of care. Our researchers have worked with Catholic and faith-based aged care providers across Australia to identify the top risks and challenges for organisations.
Tim Farren is CCI Aged Care Segment Lead and he outlines the key findings of the study; discussing what matters most and what needs to happen next for professionals in this sector.
The report is a must read for all who work in the aged care industry and be found here.
“We know that Australia’s aged and health care sector is changing and growing,” says Tim.
“Our senior population is larger, people are living longer and driving demand for health and aged care services higher. But there is now a shift to consumer-directed care that changes to the existing funding model will support, and this is going to have implications for the entire profession. Good or bad, it will depend on how providers manage their business going forward.”
He notes that more than a million Australians receive aged care services annually.
“By 2050, the number could reach 3.5 million. Providers will need to deliver better care, and in many cases it will be sub-acute care.”
Managing costs for recipients will prove a key challenge given the amount of services that can be outsourced to external providers, and there is a variety of funding mechanisms. With funding model changes the industry is seeing a shift towards consumer-directed care.
Change to funding will drive consumer-directed care
Consumer-directed care is a service delivery model that has been designed to provide more flexibility and choice for consumers. It is an approach to the planning and management of care that allows carers and consumers more influence over the delivery and design of the services they receive. It also allows them greater choice in the types of services and how and when they receive them.
Providers are now required to:
- Have a discussion with consumers about their needs and goals
- Co-produce care plans
- Provide greater transparency to consumers about the funding available to them under their package of care
- Provide greater transparency of how funds are spent to deliver services
- Agree with the consumer on the level of involvement they will have in managing their own package
- Monitor and reassess packages to ensure appropriateness
Best practice clinical care is the top priority
Faith plays an important role in guiding management and governance approaches to care.
“Religious activities are present in the daily life of people in care,” explains Tim.
“Commonly this involves weekly mass, visits by priests and nuns, and a range of pastoral care programs for seniors.”
At the same time though, clinical care guidelines provide the structure for the delivery of care, and delivering best practice clinical care is considered the top priority for organisations.
“It’s the changes going on in the industry and changing consumer expectations that faith-based organisations are increasingly concerned about because they have to keep up-to-date with all of these changes and reflect this in their operations.”
Pearl Forrester is Chief Executive Officer (CEO) of Kalyna Care, a home-style aged care facility in Melbourne’s west. Kalyna Care is a Ukrainian Community project that welcomes residents from all European countries – including Poland, Slovakia, Germany, Austria, Croatia and Serbia – or anyone who appreciates the European way of life.
“Residents here participate in church services, and some hand out hymn sheets and get involved by singing praise,” she explains.
“We also have an arrangement for clergy visits with people in our care. Being involved in the Church community carries on for our residents throughout their life. We operate Kalyna with this in mind. Our organisation founder at Kalyna Care was Maja Hrudka, an active member of the Ukrainian community and a nurse who resided and was cared for in this home that she helped to build and establish. As a medical professional, her standards were extremely high and when she passed away at Kalyna Care, some of the staff she had employed from the earliest days were with her.”
Staff are not properly in tune with issues
The research has revealed that there are major differences between decision makers and operations staff in the perception of how effective an organisation is in relation to its systems, emergency processes, property and staff management.
Tim Farren says that “increased focus on communication of policies and procedures for all who work in aged care will provide clarity around some of the risks.”
“What’s important to consider is better staff engagement that carries some flexibility in the workplace. There needs to be some work-life balance, and we should always encourage more support for staff mental health and wellbeing for those charged with carer roles. The need for greater risk education at the Board level was one of the interesting findings of the report.”
Pearl Forrester agrees that discussing risk is a conversation that should include policies and procedures.
“Communication is vital,” she explains.
“Risks and safety are consistently raised as important issues at Kalyna, and communication around risks forms part of our staff code of conduct. The use of internal communication systems/networks, memos, regular staff meetings; and of course leading by example by the Senior Management Team are ways to keeps people informed.”
The big challenges for aged care providers
Changes to funding pose a significant risk to operations now and in the future, for nearly two-thirds of people surveyed at faith-based organisations. Many aged care providers rely on government funding and public benevolence, and changes to these conditions will have implications.
Tim Farren notes that looking ahead, some providers may be feeling ambivalent about the feasibility of their operations.
“Many providers rely on donations and the government purse and would find it extremely difficult to carry on if either was withdrawn or reduced. Public benevolence is an important income stream for numerous organisations providing care or welfare and organisations may be wise to consider news avenues for raising money.”
Pearl Forrester agrees and sees some benefit in the effort to raise funds independently.
“While we recognise that government funding is critical, we know that this stream of revenue will not increase or improve. We must therefore look at other revenue streams not tied to the Aged Care Funding Instrument (ACFI). Some providers may think it’s worth lobbying the government to try to mitigate the risks brought about by changes to funding. We find that the government has seats on a range of committees for the larger organisations, but rarely do they care to listen to those of us who are smaller operators.”
While demographic changes are viewed in a positive way they will present challenges for the aged and health care industry, nevertheless.
Tim explains that “a larger population of senior Baby-boomers and a shift towards consumer-directed care will need to be managed by more staff and staff development.”
“Organisations will need to invest in staff training, and attention to specialised care is going to become more common among providers. The development of dementia care training and dementia management strategies will become more important.”
Pearl expects there will be a need for more highly-trained aged care professionals within residential care to meet the needs of a shifting demographic.
“We are looking at increasing staff training budgets to upskill and retain good staff. Modes of training will include online and in-person. Training will come from Aged Care Quality and Safety Commission (ACQSC) courses, The Wicking Dementia Research and Education Centre, and Gerontology. And we shouldn’t forget palliative care training as well.”
She sees demographic changes overlapping with changes to hospital settings.
“Aged care is becoming more sub-acute,” she explains.
“I see hospitals seeking the early release of patients to aged care – so Transition Care will become part of ‘ageing in place’. I would like to see aged care come under the auspices of geriatric care – which is a formal nursing and clinical discipline. This will give aged care nurses and staff a level of ‘credence’ usually reserved for the likes of theatre nurses or Accident and Emergency nurses. There has to be an eventual consolidation of retirement villages with aged care, because while retirees stay in their retirement village units they still receive residential type care (and not home care) through the use of technology (monitoring and alerts, for example).”
An ageing population represents opportunity for providers
Tim Farren expects most will be enthusiastic about the potential for growth in their industry.
“It’s the Baby-boomer generation that has very different expectations about their retirement compared to those generations that have come before. They will prefer to stay at home and receive in-home care if they need it, and if they happen to move into an aged care facility they are going to have different expectations about the standards of facilities and the clinical care they receive.”