This is likely a longer piece than usual, but I think important as we all consider the place of leadership mid-way through the term of appointment of the Royal Commission into Aged Care Quality and Safety.
I have been asked many times over the years I have served as a CEO, to define leadership. There are of course quotes such as “It is an art, rather than a science”. Or “You can tell if you are a leader when there is someone following behind you”. What seems to be true is that you are not born to be a leader, and leadership is not achieved from a one day development training session. However, we can grow as leaders every day – and indeed we must. And leadership is about people, whilst management is about tasks and things.
But even those small truisms above do not do justice to this
thing called leadership. Most of us can
likely recall our own examples of where we have experienced poor, or
ineffective leadership. We may even now
be wincing as we read, recognising our own lack of skills in a leadership role
at some time in the past. We can also
likely recall and acknowledge some fine experience of leadership that was such
a joy to be party to.
Good leadership is a thing of beauty to experience. Much like a diamond. A diamond has so many qualities and when cut well, is a thing of beauty to behold. It is hardly surprising that “diamonds are a girl’s best friend”. As the following picture shows, even a so called six sided diamond has much more to offer than the “simple” six sided cuts.
So it is with leadership.
I provide below just six sides, or attributes, of leadership that I believe if practiced (well) every day will not only assist us to be better performing leaders but will drive better performance in our organisations. I am certain we can all accept that leadership is more complex than these six, but these are a sound foundation. The attributes are provided in alphabetical order only for convenience:
The following link points to the substantive comments I made in a recent submission to the Royal Commission on Aged Care Quality and Safety. As a very recently retired Chief Executive in the aged care sector, with some 37 years of continual involvement in aged care related matters, I feel I can comfortably comment upon my own research into matters around minimum levels of staff. Additionally, and importantly how, I believe, the aged care sector has been left in a quandary as to how best to navigate through these troubled times due to funding constraints placed on (at least) the residential aged care.
I have read with interest late last week the very freshly released Royal Commission research paper (1) into aged care staffing requirements, and the shortfall in funding needed to raise the staffing mix and levels to appropriately care for the average residential aged care service consumer.
The following excerpt from the recommendations paints a picture of what residents, families, advocates, and indeed some providers have been saying for some time – the level of service provision (staffing) in residential aged care in Australia is substandard.
My conclusion is that because that level of provision is so strongly associated with the operating funding mechanism, the funding mechanism for care is equally substandard:
“more than half (57.6%) of Australian residents receive care in aged care homes that have unacceptable levels of staffing (1 and 2 stars).
To bring staffing levels up to 3 stars would require an increase of 37.3% more staff hours in those facilities. This translates into an additional of 20% in total care staff hours across Australia.
We have not limited our analysis to determining the additional resources required to bring facilities up to an acceptable level. We have also provided an indication of the additional resource requirements that are required to deliver staffing levels consistent with good practice and best practice care.
For all residents to receive at least 4 stars (what we consider good practice) requires an overall increase of 37.2% in total care staffing while 5 stars (best practice) care would require an overall increase of 49.4% in total care staffing.” (2)
As you are probably well aware, I am the CEO of Braemar Presbyterian Care (“Braemar”). To put our services into perspective, since I joined Braemar in March 2017 we have been increasing hours per resident per day to a level that is close to the current national average as recorded by the StewartBrown benchmarking service (3) reporting. And, as far as is reasonable, we have been improving our subsidy income to match the staffing. But that recurrent income is not enough.
According to this research paper, prepared for the Royal Commission into Aged Care Quality and Safety, less than 3 star level of staffing is unacceptable, while a 4 star staffing is good practice, and 5 star staffing is best practice. Yet 57.6% of residents receive less than 3 star (unacceptable) staffing and only 1.4% receive best practice staffing.
How is this translated into the care of our elders?
Over the past several years I have written often on how much funding I believe the aged care sector has been short-changed by a range of political and bureaucratic decisions over. Aged care funding is not adequate to meet the health care needs of Australia’s frail elderly, vulnerable, care recipients. My comments apply across residential aged care funding and home/community care package funding alike. You can review some of my previous articles in the footnotes below. [1] [2]
Patricia Sparrow, Chief Executive of the not-profit aged care peak body Aged and Community Services Australia (ACSA), commentating recently on home care packages, lamented the lack of preparedness and capability of our aged care system, saying “Until we see adequate long-term planning for the structural and funding issues, Australia won’t be able to fully address the needs of older Australians”.[3] Sean Rooney, Chief Executive of Leading Aged Services Australia, similarly recently commented that the “aged care system needs adequate funding to be sustainable and meet the needs of seniors” and called for an additional $3 billion to “improve the viability of the sector”.[4]
Just this week I was briefed about the outcomes of a very recent Faster Horses Inside Aged Care Report (2019) of perceptions around aged care in Australia. I recommend this review to all readers of this blog. Reviewing response from over 1,500 people from a cross section of metropolitan centres, the response to two specific questions piqued my interest.
I am going to assume that most people reading this article will be aware that there is currently a Royal Commission reviewing matters of Quality and Safety in Aged Care. Among other things, that Commission is inquiring into matters where poor and substandard care have been provided to residents in residential aged care and to care recipients in home and community-based care.
Where there have been findings of substandard care, all providers in the aged care sector should stand resolutely with care recipients and be highly critical of the events that took place to permit such poor care being delivered. However, without wanting to escape from the responsibility of being a provider of aged care I do want to highlight again the dilemma that providers find themselves in desiring to provide the best care that they can.
One of the threads arising through the Royal Commission Hearings, and for some time prior to the Commission commencing has been a call for a higher staff ratio in care services being delivered.
Braemar Presbyterian Care is
offering a free community event for local people of Perth, who are interested
in learning more about palliative care.
The team have developed a Living
with Dignity, Dying in Comfort information evening, which
will take place on 22 May from 5:30PM at Braemar House, located at 10 Windsor
Road, East Fremantle.
I
spoke recently with our Professional Standards, Quality and Risk Specialist,
Bernadette Samura, who has a lot of experience in this area – having previously
managed Braemar House.
Bernadette was quick to point out
that palliative care is far more than just end-of-life care, and that it is
essential to challenge the myths and stigmas around palliative care. ‘We want
people to openly discuss it as a normal part of their future planning,’ she
told me. It is Braemar’s desire to ensure everyone involved in this quality of
life process is very much part of the care and friendship philosophy that can
add so much to quality of life.
The
evening involves a keynote presentation from Bethesda Hospital’s Clinical Nurse
Manager, Ed Gaudion, as well as exhibits showcasing various care approaches. It
is a free event, and is open to members of the community, their families with
loved ones in care facilities, those planning to relocate to residential aged
care, as well as anyone keen to learn more about palliative care.
Hope to see you there,
Wayne.
Note: The Living with Dignity, Dying in Comfort information
evening will take place on Wednesday 22 May at Braemar House in East Fremantle,
from 5:30-7PM. Coffee and light refreshments will be provided. Anyone
interested in attending this session can find out more details by contacting 08
6279 3654
A former Australian of the Year recently said, “The standard
you walk by is the standard you accept”. In aged care, we are entrusted to care
for and support some of the most vulnerable in our community. It is my belief
that in this industry, we must only accept the highest standard.
While I am proud of the quality of care we deliver at
Braemar, I am a strong believer in creating an environment that encourages
constant improvement. We want to be open and accountable in all we do.
To ensure that everyone associated with our organisation is
able to have their voice heard; about any issues that cause them concern; we
have introduced a new service called Your Call.
Your Call is an independent, third-party reporting service
which allows residents, family members and staff to report any matters of
concern in relation to the care and services we provide.
Sometimes, for various reasons, we might feel uncertain or
uncomfortable about directly raising an issue or reporting something we have
seen.
It is my hope that this new service will provide those
living in care, as well as their families, friends and staff, with an
environment in which to raise any concern – no matter how big or small.
Reports to Your Call can be made anonymously. Those lodging
a report can do so by phone or online – 24 hours a day. All reports are
forwarded directly to me for immediate consideration and action.
Contact details for Your Call have been distributed
throughout Braemar’s facilities. This has been done via the installation of
large posters; while printed information and updates are being made available.
This service is available to all our staff, residents and
family members and friends. It is essential that as aged care providers we
ensure we are transparent in all we do.
I want to ensure we hear from you if you have any concerns.
I am excited to see Braemar lead by example in this area.
These days I only read the newspaper on the weekend. My favourite is still The Weekend Australian. It often has thought provoking articles, and occasionally some fodder upon which one can reflect from an aged care sector perspective.
The December 8-9, 2018 edition is just one of those occasions.
On page 2, there is an article bemoaning the recent year upon year increase in private health insurance premium rates. The article reports that ‘Health Minister Greg Hunt … expected to approve an industry average below 3.95 per cent … the lowest since 2001.’ It also includes commentary about the anticipated significantly lower rate increase out to 2022 promised by the current Federal Opposition.
According to Australian Prudential Regulation Authority (APRA) figures cited by The Weekend Australian, the industry weighted average premium increases approved by the Minister for Health since 2015 are as follows:
I understand the impact of high levels of private health insurance premiums, that seem reachable by those who for whatever reason determine them to be affordable. What is more, in contrast to aged care funding, the payment of insurance premiums does not come from the Government purse, but rather from individuals who have determined their affordability.
I find this article useful, if only because for almost the past twenty years I have been monitoring Health Ministers making similar approvals for health insurance premium increases yet at the same time, as the senior Minister over the aged care portfolio, makingstarkly lower indexation for payments for recipients of care or, more indirectly, to the providers of care to aged care recipients.
The comparison of funding increases made to aged care providers through the various indexations against several alternate indicia is shown below:
The chart above clearly shows that whilst aged care funding indexation has indeed kept fairly much in line with CPI, it has failed to keep close to Work Price Index (“WPI”), Average Weekly Earnings (“AWE”), and the greatest gap is between aged care funding and private health insurance premiums.
I will be among the first to say that additional funds are not always the determinant of better quality. Yet the absence of an equitable funding methodology in residential aged care since 1997, and growing concern about insufficient supply of places in community based aged care since February 2017, seems obvious.
Inclusive of some $1.7 billion removed from forward funds in 2015 and 2016, there is a clear pattern of diminishing Government expenditure in aged care over the past twenty years to a point where it is highly unlikely that even courageous and good providers of care will be able to sustain their service provision without a sizeable injection of funding.
It has been just three days since the Federal Standing Committee on Health, Aged Care and Sport recommended support for the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018.
I support the recommendation that aged care providers disclose their staffing ratios. However, it would be unreasonable to expect that providers will be able to achieve a reasonable staff ratio without an immediate and substantial injection of funds – albeit with reporting requirements.
Perhaps the Royal Commission can consider this matter in their review processes into the whole aged care sector quality and safety funding and performance?
House of Representatives Standing Committee on Health Aged Care and Sport, ‘Advisory Report on the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018’ (Commonwealth of Australia, Canberra), December 2018
Sean Parnell, ‘Rise in health premiums likely lowest in decades’, The Australian (Sydney, NSW), 8 December 2018
I gathered these thoughts together the day the Royal Commission into Aged Care Quality and Safety was announced – Sunday 16 September 2018 if my memory serves me well.
This information gathering was in response to the first question of the Prime Minister when making the announcement. The question was around the alleged $1.2 billion cuts to aged care.
Folks, I get it – there have been many cuts from both major sides of our Australian Government over a number of years. And there has been continuing growth in aged care funding based on population related indices etc. But what is galling around these discussions is that the major political parties and the bureaucrats seem unwilling to give simple, transparent responses to questions about these matters.
The recent Federal Senate Community Affairs Committee Hansard from 24 October 2018 make for mind numbing obfuscation around this very issue, with Opposition asking relevant questions, and Government, and Officers, all putting in their opinions, without any direct answer to what should be a simple question. This of course happens regularly at such Committees and is not confined to Aged Care. But this Australian is over it!
Why cannot our elected leaders and paid Officers answer simple questions and be held accountable for the policy and funding interventions they create into valued human service provision? We are projecting tens of thousands shortfall of residential aged care places by 2025 (ref 1) and now some 121,000 not provided with an appropriate level of community care packages short for older Australians already assessed by Government as needing community delivered aged care services. (ref 2).
Of that number, almost 57,000 had no package allocated. A discussion around the residential care funding issues can be found below. Parliamentarians prefer to support their side of the debate, but the Department of Health and Federal Parliamentary Library advice really does paint a helpful and insightful picture into this matter of “funding cuts”.
I shall leave it to you to decide. But if you were to ask me, a return to the residential aged care sector of the $1.2 billion in ACFI funding cuts, along with a requirement for providers to sign off on their direct care staff ratios, would provide, on average, an immediate return to a ratio of 3.2 Hours per Resident per Day (“HRPD”), and begin a move to the 4.3 (or from my research, 4.2) HRPD as soon as possible.
ACFI – December 2015 MYEFO (might be a repeat of the May 2015 budget papers) – https://manad.com.au/aged-care-cut-in-mid-year-economic-and-fiscal-outlook-myefo/ The following is on an Australian Parliamentary Library page and really cannot be disputed. The page is at – https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Librar y/FlagPost/2017/March/Residential_aged_care_funding
“Recent changes:
ACFI subsidy expenditure has been growing more quickly than expected. The Australian Government believes the unexpected growth in claims cannot be explained by an increase in the frailty of residents, although many in the industry disagree. In order to rein in expenditure, around $1.7 billion in savings over four years were included in the Mid-Year Economic and Fiscal Outlook 2015–16 (MYEFO) and the 2016–17 Budget, to be achieved through changes to ACFI scoring and subsidy indexation. Despite these savings, residential aged care expenditure was still forecast to grow at around 5.1 per cent per annum.” A summary of the impact of these two difficult measures can be found below – https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Librar y/pubs/rp/BudgetReview201617/AgedCare
“Rein in expenditure.” Is that not just a euphemism for a cut to funding?
You decide. Nice chatting!
References:
Ref 1- Aged Care Financing Authority, ‘Sixth report on the Funding and Financing of the Aged Care Sector’ (Aged Care Financing Authority, 2018), 36.
Ref 2 – Department of Health, ‘HOME CARE PACKAGES PROGRAM Data Report 4th Quarter 2017 – 18’ (Department of Health, 2018), Table 7, 11.
I am a person with no clinical or “care” background. But after almost forty years in senior management and executive roles across the spectrum of health and aged care – particularly aged care – I have gathered some insights into the nature of care being provided throughout our care services.
And before I suggest anything more, let me say this – my view is that if the major hospitals around Australia – public and private – were put under the same scrutiny and regulatory framework that residential aged care services are for the quality and accreditation of services that are provided in and through them, we would see hospitals falling into sanctions.
I am of the view that we have an aged care system that is too focused on beating the regulatory compliance framework as opposed to funding and providing appropriate levels of care and support to all clients.
On the one hand I am an incredibly strong advocate of high quality services accompanied with some form of accreditation. On the other hand, I believe we have an aged care accreditation system that we can really ill afford.
It underpins inadequate funding levels that cannot provide enough resources for many providers to meet the expressed needs of care for residents. In the same way, our community aged care system is creaking because we cannot provide enough funding for the community aged care packages assessed by the Australian Government as needed by our citizens.
I hear staff all over Australia clamouring, not always for more wages, but for more pairs of hands to do the work. To do more than the system underpins…To go the extra mile… To sit for a few minutes when that is what the client really wants, and really needs… To spend time hearing what the real story is…
To quote a UK study of its Home Help services from the early 1980s – “Too much Charring and not enough Chatting”.
I could ask the question – Which provides more care, the Chatting or the Charring? Neither is necessarily more correct, but often we cannot even get to the question. The bureaucratisation of aged care is with us and the paperwork must be done at our own peril.
I have colleagues that will not (at this time) support minimum staff ratios. Quite rightly they see them as an un-affordable cost under the current funding methodology. How sad that we do not all see them as providing perhaps the single greatest opportunity right now to see a reduction in abuse, and a reduction in short cuts in care. How sad that we do not see minimum staff ratios as an opportunity to support our staff and see a visual improvement in the increased in quality of care. But implementation of minimum staff ratios will be quite costly.
I am still of the view that in Australia we have one the best aged care systems in the world. But for a range of reasons it is creaking.
Let’s all is to consider how much of a cost is there to stop, take stock, and with the next round of changes, really consider the long term impact of where we are heading and fight more intensely to protect the rights of those who are dependent upon us, the general public, for their livelihoods?
And who knows – the Royal Commission might investigate several inter services aspects around care of our elderly folks? One matter that I have discussed for the past decade is how much more proactive care we can provide in our aged care facilities, that might actually have a positive, beneficial impact on our national health and hospital care services.
In the past twenty years we have missed the opportunity to think outside the square with respect to fixing major State based hospitals. As a “cohort” of patients, frail elderly people are significant and frequent users of hospital services. Perhaps if we reviewed the aged care sector and its inherent possibilities we might find better solutions to our hospital problems.
Chatfield’s cartoon below was first published by me in December 2010 in an article containing many of the words in the commentary above. Not much has changed it seems!
So, what is the elephant in the room with aged care at the moment?
In a report released Friday 17 August 2018 that showed a recent increase in home care funding for elderly care recipients, there was a worrying trend in demand versus ability to provide that needed care.
That is, despite the growth in older people desiring home care services, the number of home care packages assigned (or available) is simply not keeping up with demand.
At 31 March 2018, according to figures only released on 17 August 2018, the queue waiting to receive a package had risen to 108,456 people. That is an increase of 3,854 on those waiting at 31 December 2017. Not only that , but just over half of all those in the queue have been assigned a package at a lower level than their needs require. Remember this is all based on the Australian Government’s own approved needs assessment, and allocation of packages.
Contemporaneously we have demographers projecting the number of residential aged care places required to be built/developed is now at about 75,000 by 2025. That is only eight years away.
The word governance may well have been used by Chaucer in 14th century England, but the phrase ‘corporate governance’ has only been commonly used since the 1980s.
Major corporate failures such as Enron, WorldCom, HIH, the dot.com crisis, the global financial crisis, and the Royal Commissions into institutional abuse of children and the banking sector, have increased governance expectations.
The community requires corporations to improve the way in which corporate governance is practiced.
That is, more is expected from companies behaving as good citizens.
Although not a legal term, ‘corporate governance’ does carry the sense of needing to be defined. It regularly arises in actions or Commissions as something lacking in practice.
Yet the concept of corporate governance has struggled to have a single definition. Early definitions were based around corporate governance being the ‘system by which companies are directed and controlled’ (Cadbury Report, 1992; King, 1994).
The Australian Stock Exchange recently broadened the scope of the concept of corporate governance to ‘the framework of rules, relationships, systems, and processes within and by which authority is exercised and controlled in corporations’.
Similarly, the G20/OECD principles discuss how the monitoring of performance against structure of organisational objectives can deliver better
governance outcomes.
I have never been a great advocate for regulated minimum staffing ratios, but prefer regulation of the things that are really important around provision of care services to the people, our care recipients. If you like, having enough of the right people at the right time, and not just to fulfil a compliance requirement around the number of pairs of hands.
In completing this Review my own views around staffing, quality of care, industrial considerations and the like have changed – for the better. It remains to be seen if those with the capacity to make an even more profound difference to improve care outcomes for frail, vulnerable, mainly elderly recipients of care – the Australian Government and Parliament – will actually choose to support those whom we serve.
Introduction
It seems that in Australia rarely a month goes by where the public is not informed of another aged care failing. There is wide spread public perception of a lack of care and low quality of life for residents within the aged care system. The call for greater regulation of minimum staffing standards and additional funds to meet them is prominent but seems to fall on deaf ears of the Australian Government.
Without residential aged care provision, residents would likely be inpatients in State based hospitals at several times the daily cost of care of a residential aged care facility. However, the proportion of funds spent on care and service provision should be acquitted on what really matters – the care of people.
I have been tracking various residential aged care data and some interesting comparison figures for two decades now since the Aged Care Act came into being in 1997.Please allow me to say right upfront – collecting relevant and appropriate data from indices can be difficult and not always truly comparable.
The data represented below is purely to make us think, and perhaps identify for providers at least, why it seems to have become so much more difficult to maintain a high quality residential aged care service today to people with more pressing multiple morbidities than ever before.
Clearly, by comparison, our funding foundation has worsened over the past twenty or so years.
Some time back during one of our regular Braemar senior leadership meetings in 2017, we decided to take the lead in protecting our residents from influenza by offering complementary flu vaccines not just for our staff and residents, but also volunteers and the families of those in our care.
This week, free vaccinations were available at Braemar Cooinda and Braemar Village, while next week we will be providing the vaccines to those at Braemar House.
This move predated the recently announced Government plan to mandate all aged care providers to provide free flu vaccines to their staff. It was a decision we took as we felt it was an effective way to help reduce the risk of influenza entering the aged care environment.
The idea to expand the service to families and volunteers was developed by the Braemar team under the direction of Renee Reid, General Manager of Workforce. When chatting to Renee, she expressed the team’s desire to ‘meet and exceed best practice levels to reduce the risk of our health and care professionals contracting flu or passing it onto our residents,’ which to me demonstrates a commitment to resident health and wellbeing across the organisation.
I might just be getting old, but not a year goes by that I don’t think more deeply about Easter. Don’t get me wrong, I really love Christmas, and from the perspective of being a follower of Jesus, that is obviously a very special milestone of my faith. But Easter … Easter is the cornerstone event of my relationship with Jesus Christ.
In late January and early February 2018 I had the privilege of joining the Global Conference on Integrated Care (“GCIC”) in Singapore. I am delighted to say that for me this was the most beneficial conference that I have attended since my re-connection to the aged care sector in August 2016.
Every nation represented at the Conference shared information about their significantly growing healthcare budget and rapidly ageing population. All nations have health and aged care systems that were created for a previous generation. They are not designed for the massive ageing population growth that require more and more health, social and aged care services.
As often as I remind others of the difficulties aged care providers, their workforce and clients are confronted with, I remind myself that we belong to a bigger system of health and social care provision.
Many parts of that system attract what seems to us, by comparison, to be outrageous funding. Maintenance care only in a hospital costs approximately $1,200 per day. A day of care in an intensive care unit costs $6,000 plus per day. That is not to say of course that these services are not important and desperately needed.
Despite the sector’s many recent advances, the clinical governance systems in residential aged care “are lacking”, an Australian aged care CEO will tell an international conference.
I am about to board a plane for Singapore where this week I will be speaking at the GCIC 2018 conference on integrated care.
My topic will look at where the industry may go next in its clinical governance responsibilities. I thought this was interesting to look at twenty years on from the introduction of the Aged Care Act in 1997.
I will share my full paper next week and explore some further ideas following the conference. In the Essay, I have strived to briefly describe the history of residential aged care in Australia and show how economic drivers that largely determine the funding of care may also be diminishing the clinical appropriateness of care. This can place care recipients, providers, and program funders alike potentially at risk of failure of service in financially constrained times.
Wayne Belcher (OAM) will speak at the Global Conference on Integrated Care at the start of February, where he will present an analysis of Australia’s aged care sector, two decades after the Aged Care Act (1997) was implemented.
His presentation will cover areas including the history of aged care in Australia and how it has transitioned from basic care homes to a major industry, a review of the care models currently being employed as deregulation takes effect, and a review of clinical governance.
International experts from the USA, UK, Canada and Hong Kong will be among the conference speakers, which will take place at the Resorts World Convention Centre in Singapore from 1- 3 February 2018.
I have been working back in the aged care sector since August 2016, and as many of you know I have been the Chief Executive Officer of Braemar since March 2017. A few weeks back I did seek comment from colleagues and visitors to my blog about these “end of life choice” matters. Thank you to those who have pondered, commented, and otherwise contributed on these things.
Pain, suffering, and distress are existential. The desire to end one’s own life is based on existential circumstances with perhaps the view that there is little hope for any future improvement in life’s outlook. The majority Christian view still is that Christ offers hope for an end to all suffering, but that happens at the natural end of this life – not a life brought to early closure. The endurance of pain and suffering can seem intolerable, and the grasp of hope seemingly so far away. We must develop ways in which we can assist to bridge the perceived gap between the existential pain and future hope by how we manage our pain, symptoms, and suffering and sense of loss; yet contemporaneously offer support to others afflicted by such suffering, grief and loss.
Two quite important matters are being discussed by parliamentary committees here in Western Australia over the next twelve months or so, and I seek your advice, attitudes, and thoughts on these matters.
The first matter, and also being discussed by the New South Wales and Victorian Parliaments respectively, is around “end of life choices”.
I seek your advice, attitudes, and thoughts about this important matter.
I recently chaired an afternoon session for a “Law in Aged Care” seminar in Perth. It was a very useful day’s focus on the myriad of interaction that aged care providers have with the law daily. There can be matters associated with town planning, local government, occupational health and safety, fair work, accreditation and liability issues, and that might be just before morning tea …
In October 2017, the residential aged care sector reaches twenty years since the enactment of the Aged Care Act 1997 (Cth). As I recall, for Western Australians it started on Monday 1 October being a public holiday Monday. The then new Act was a mighty and useful change from the Aged and Disabled Persons Homes Act and the Health Act. Whilst it has not all been plain sailing the Act pertaining specifically to aged care has, in my view, served Australia well.
For months, if not years, we have been hearing about Western Australia’s fair share, or rather the lack of it, with respect to GST payments to the States form the GST raised by the Australian Government.
Western Australia, under the current arrangements, receives just $0.34 from each $1.00 raised from within WA from GST revenue to the Australian Government. It clearly seems unfair. Particularly clearly unfair by direct comparison: Continue reading “How fair is the Western Australian GST share?”
Wayne Belcher, CEO of Aged care operator Braemar, says the proposed changes will place a burden on already stretched Aged Care providers.
“The proposal suggests that providers pay for both the existing accreditation process, as well as pay AAQCA to do one of their mandated Unannounced Visits. This is a cost of between $2,700 to $5,880 – per facility, per annum.”
“Braemar’s CEO Wayne Belcher has launched a blog concentrating on Aged Care news, thoughts and opinion. Located at wlbelcher.com the blog will share thoughts and ideas from Mr. Belcher’s decade’s long experience in Aged Care. It is illustrated by cartoonist Jason Chatfield, the artist of iconic comic strip Ginger Meggs.”
The proposal to charge providers for unannounced accreditation visits is a cost too high for an industry-specific quality assurance system, writes Wayne Belcher.
I have been back working in the aged care sector for almost twelve months now – first on an interim basis with Baptistcare here in Perth, and for the past four months or so as Chief Executive with Braemar Presbyterian Care in WA.
One of the most common questions on my return to the sector is about the amount of change there has been in “aged care” since I left the sector back at the end of 2010.
One could say that the change has been enormous, with refundable accommodation deposits now part of residential aged care, and significant changes having been made to funding around client centred care in the community aged care sector.
On the other hand, one could quite calmly suggest that no great change has happened. After all, since I first entered the aged care sector back in 1982, we have had at least some fifteen (perhaps closer to twenty) Australian Government Ministers with responsibility for aged care services over the past thirty years. In that same period, we have had at least three major changes to the funding regimes that providers live with daily.
Wayne Belcher (OAM) is an experienced Chief Executive in the aged care sector.
Having entered aged care early in his career, he has held roles including Chief Executive of Bethanie as well as a Director and Interim Chief Executive of Baptistcare WA.
Wayne was awarded a Medallion of the Order of Australia in 2007, in recognition of his significant contribution to community services. This in part acknowledged his dedication to aged care as well as the assistance he gave to the Howard Government in an advisory capacity.
Wayne holds postgraduate qualifications in Health Administration, Divinity and Ministry. He is also alumni at the Wharton Business School, University of Pennsylvania.
Until recently Wayne was a Pastor at Lake Joondalup Baptist Church. In 2017 he joined Braemar as Chief Executive. He will lead Braemar’s service delivery, growth and development into the future.