The Aged Care Royal Commission and Beyond

The terms of reference for the Royal Commission in to Aged Care have been established, The Honourable Justice Joseph McGrath and Ms Lynelle Briggs AO have been appointed Commissioners. Temporary recruitment is underway for support staff predominantly in Adelaide and a small number nationally.

Royal Commissions run on tight timeframes and an interim report is expected by 31 October 2019. Requests for information from providers may start as early as December 2018 and January 2019. It will pay to be prepared.

The scope of the Royal Commission is vast and the key focus is on the conduct of Approved Providers. There will be many stories that will be hard to hear and the media will take great interest in an organisation where issues are highlighted.

Based on previous Royal Commissions no doubt consumer interest will be high and thousands of submissions will be provided to the Royal Commission.  Consumers are quite simply demanding more and the public will be closely watching as information comes to light.

Understanding the quality of care provided and constantly challenging whether this is adequate or …

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aged care governance

Looking across the facilities that have current or recent non-compliance highlights there is more than the odd ‘blip’ or errant behaviour by ‘the Agency’ going on.

Creating and operating and aged care service that meets the care needs and preferences of residents and attracts and retains high calibre staff is no small task. It requires strong visionary leadership and robust governance and support systems.

In the rapidly changing aged care environment organisations need to identify and effectively respond to intrinsic and extrinsic factors that change and have a cumulative impact. Organisations invest in their governance and compliance frameworks and systems and recruit Board members with significant leadership and governance experience in a range of fields yet unexpectedly experience non-compliance and /or sanction.

The rate of non-compliance and sanctions has more than doubled in the past year. Organisations with a proud history of high quality service provision now find themselves on ‘the naughty list’. The impact is devastating for residents, staff and the organisation. The recovery period is long!

At Executive and Board level aggregated data may provide reassuring reports of …

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restoring stability in aged care

Residential aged care facilities are home to over 200,000 frail older Australians and is one of the country’s rapidly growing employment sectors. Turbulence in the sector has a significant impact on many.

In August 2018 there were 15 residential aged care facilities in Australia deemed to be non-compliant with the Aged Care Standards and two received sanctions; this is on the back of the doubling of both non-compliance and sanctions in the past year. So for many older people, their families and those working in the sector it is a very troubling and distressing time.

Changing resident profile

Those entering care are older and frailer and have increasingly complex care needs. In many cases the older person and their family have been ‘managing’ at home for a long time with support from family, friends, community services and home care packages. The decision to enter care is based on there really being no other feasible alternative care option for the older person and their family that can safely meet their care needs. Often the decision is emotionally gruelling, financially challenging and …

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Identify, Adapt and Deliver

The challenge providers face is to bring all this together in a care model that aligns with their organizational values, resonates with consumers, is financially viable and meets regulatory requirements.

The transition to the Single Quality Framework in aged care with its strong focus on consumers will propel services to look at and modernise their care model. The language of how quality is described changes and the service is accountable to consumers. Adapting to this providers need to rethink their business, care and service model.

Identify

Identify your strategy and determine your organisational values. Identify how you want to relate to consumers and engage your staff. Identify your financial imperatives and your market position and potential.

Challenge what you currently do and be open to opportunity and look before you say no!

Adapt

Adapt through investing in the creation of a model that articulates your values. Embark on creating a culture change that equips you for the future. Be brave and make changes.

Deliver

Deliver a clearly articulated value proposition that attracts consumers and staff and creates a competitive advantage. …

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identify, adapt and deliver

The theme of this year’s ACSA Conference is Identify, Adapt and Deliver describes how Australian providers need to respond to the continually changing aged care environment.

To thrive in the consumer focused contestable market environment providers need to focus on the consumer experience and re-think their care model, service delivery and consumer engagement from the consumer perspective.

What do consumers want?

The first step is to redefine your offering from a consumer perspective.

Ideal has surveyed potential and current consumers. They want to be in a ‘safe, happy and welcoming environment’ and they want:

Quality care To maintain their independence Quality staffing.

The most valued sources of information are people who currently live or have lived in the home and information from hospital staff, discharge planners and social workers. Information directly from staff at the home and from family and friends is more important and influential than government websites or the home’s website.

When they consider a home the most important factors ranked in order are the quality of food and the dining experience, accreditation status, the range of activities …

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aged care non compliances and sanctions double

The rate of non-compliance and sanctions has more than doubled between July 1 2017 and 21 August 2018 when compared to the 2016/7 financial year.  This is a very challenging time and the implications for those services, the older people in care and the broader sector are significant. Providers need to be actively identifying potential risks of non-compliance and act swiftly to address issues.

Metric 20 Jun 16

to 30 Jun 17 1 Jul ‘7

to  21 Aug 18 Notices of non-compliance issued 71 163 Sanctions imposed 13 28

Causative factors

Some may consider the increase in non-compliance and sanctions to be related to increased scrutiny by the Australian Aged Care Accreditation Agency in response to the Carnell Patterson Review (2017).

It is important to consider other broader sector, organisational and service related factors that place significant pressures on an organisation and subsequently increase the risk of non-compliance. These factors include:

Impact of industry consolidation resulting in change of ownership Changes in organisational structure, reporting and processes Workforce changes Impact of retirement of the generation of highly experienced …

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residential aged care occupancy

introduction

In 2017 there were 902 organisations operating 2,672 services in residential aged care, with an average occupancy rate of 92%. The financial impact of ongoing low occupancy for any provider is not sustainable. Providers are potentially foregoing considerable revenue. In the following scenario the modeled difference between 52 occupied beds and 60 occupied beds is $2,455 per day; equating to close to $900,000 in lost revenue per year.

Revenue type Daily revenue per resident Daily revenue

52 residents Daily revenue 60 residents Difference (LOST) per day Difference (LOST) per Annum ACFI[1] $172.54 $10,352 $12,007 $1,654.60 $603,929 Daily Fee $50.16 $3,010 $3,511 $501.40 $183,011 RAD / DAP / Supported payment[2] $29.91 $1,795 $2,094 $299.40 $109,281 Total $252.61 $15,157 $17,612 $2,455.40 $896,221

Our approach

The Ideal Consultancy consistently demonstrates that the occupancy and financial position of a facility can be improved through the Ideal Occupancy Program. This is achieved by:

Developing and implementing a robust market engagement strategy Improving facility presentation Improving staff skills in customer engagement Improving key staff skills in sales and marketing Providing …

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2018-19 acar opens

it’s that time again

This update highlights some of the elements related to the residential aged care application process. The forms are streamlined however the process is more competitive than it has ever been. The impetus is to be able to evidence need and demonstrate the compelling reasons your organisation and service is best met to serve the needs of our elder Australians. In the 2018-19 ACAR, nationally, applicants can apply for:

13,500 residential care places 775 short-term restorative care (STRC) places up to $60 million in capital grants

The indicative timeframe:

Opens 2 July 2018 Closes 11.59PM AEST 10 August 2018 Results expected April 2019

Priority, but no guarantees

The department will give priority to assessing and allocating places to suitable applications for residential care places to services located in regional, rural and remote areas. You are not however guaranteed places simply because you are located in a regional, rural or remote area.

The level to which applications are sought will now be given a category of prioritisation, from Category 1 (highest priority) down to Category 6 (lowest priority).

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ACAR to open July 2

The following provides a short summary of communication from the Department of Health regarding this years’ Aged Care Approvals Round (ACAR)[1]. The 2018-19 ACAR will open on 2 July 2018 and close 10 August 2018; and approximately eight months later the results will be announced. The information below is related to residential aged care places only; more information on Short Term Restorative Care places and Capital Grants can be found on the department’s website.

Distribution and targeting information will be available on the department’s website when the ACAR opens, however in the meantime the expected residential aged care places available for allocation in each state and territory are as follows:

Allocation year NSW VIC QLD WA SA TAS ACT NT Total 2018-19 3,349 1,415 4,289 3,295 431 212 360 149 13,500

Please note: the department does not guarantee that the exact number of places will be allocated to each state and territory.  The final allocation of places will reflect the best use of all of the available places, based upon the applications received and outcomes of the overall …

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2018 aged care approvals round (ACAR)

The Department of Health has released a Question and Answer Guide in anticipation of the upcoming Aged Care Approvals Round (ACAR). The following is a summary of some of the pertinent points.

There will be an ACAR announced soon. The application period is open for six weeks and the Department will take around eight months to assess applications. There will be:

13,500 residential aged care places nationally 775 STRC places $60 million in capital grants

Previous ACAR

The 2016-17 ACAR was the most competitive on record with providers applying for a total of 45,053 places. There was an allocation of 9,911 new residential aged care places, 475 STRC and $64 million in capital grant funding.

Ideal contributed to the success of close to 15% of all places allocated in the 2016-17 ACAR.

Priorities

The number of new places made available for allocation will be influenced by:

the aged care provision ratio population projections, and current levels of service provision, including newly allocated places not yet operational

The primary consideration of the assessment and recommendation processes is to ensure, where …

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