1.The structure of the residential aged care sector

2.The structure of the Home and Community Care Sector

3.Philosophies of positive ageing

4.Physical and Psychosocial aspects of ageing

5.Changes associated with ageing

6.Rights and interests of the older person

7.Experiences of loss and grief for older people

8.Delivering Quality Services

Commonwealth Department of Health and Ageing:◦ information, access to services, general information and advisory to

government and lobbyists.

Medicare Australia ◦ Funding of Aged Care Funding Instrument

NSW Department of Health:◦ legal and procedural control and standardscomplaints process,

Aged Care Standards and Accreditation Agency◦ every 3 years full application against 44 standards and support visits when

scheduled.

NSW Nurses and Midwives Board ◦ Validation of Registered Nursing staff practice and Enrolled

Nursing staff practice.

NSW Food Authority:◦ Yearly assessment of food safety program and practice

Council food inspectors: ◦ quarterly review of environment.

Work cover:◦ Monitor the safe work environment of all staff.

At least 40 different pieces of legislation affect the delivery of aged care services.

Each legislative body has their own validation process – often these are contradictory.

Major legislation areas:◦ Accreditation Agency, Aged Care Act, Poisons Act,

Therapeutic Good Act, Retirement Villages Act, Continuous Improvement

The act was designed to:

◦ account for the quality of the care

◦ the type and level of care

◦ the access and equity of that care

◦ the outcomes of the care

◦ and the accountability of the providers of the care.

Guided by Aged Care Act 1997.

Residential Care provided in: High Care- ‘Nursing home’

Low Care- ‘Hostel’

Multi-purpose services- self care facilities and high/low care.

Both high & low care providers.

◦ documents that describe an organization's policies for operation and the procedures necessary to fulfill the policies.

◦ often initiated because of some external requirement, such as environmental compliance or other governmental regulations

Policies and procedures aka

business policies and procedures standard operating procedures(SOP) department operating procedures (DOP)

Mission Statement

Philosophy of care

Occupational health and safety policy

Manual handling policies and procedures

Infection control policies and procedures

Documentation responsibilities

Staff agreement

Fire and emergency procedures

Job description and duty lists

Be aware that they must not breach their scope of practice and role.

Know your responsibilities in terms of legislation and policies and procedures

Board of Management/ Approved Provider

Senior Management

Middle Management

Workers who deliver care or services

Independent Living ◦ Retirement Village or Care at Home

Low Care◦ Hostels, Serviced Apartments

High Care ◦ Nursing Homes

Funding by Medicare Australia

Currently funding levels operate on a domain funding system

Assessment, diagnoses and documentation are the primary tools needed for current funding

Service providers are finding funding very difficult due the recent changes in the funding system.

Main source –◦ Federal and State

government

Contribution fee◦ Paid by the residents toward

costs of their care

Federal funding ◦ based on Accreditation

Licensing of beds

Aged Care Funding Instrument (ACFI)

Daily Care Fees income tested fees for personal care, living

expenses, meals, linen and laundry. Residents can not be asked to pay more then they

can afford

Accommodation Payments May be a bond as in a hostel Accommodation charge in a nursing home There are strong protections for those not able to

pay The national target for concession beds is 27%

(Refer to p.49 in your text for a table of fees)

Aged Care Funding

Instrument

3 categories/ domains:

1. Activities of Daily Living

2. Behaviour Supplement

3. Complex Health Care Supplement

Each domain has three funded levels Low Medium High.

ACFI uses information from 12 questions and 2categories of diagnosis to place a resident in the Low, Medium, or High category of each of the three funding domains.

No funding will be provided for a domain if the resident has no or minimal assessed care needs.

Government body determines suitability to move into residential aged care

Recommends services if client is remaining at home.

Provides a full personal medical and social profile for clients, families services and facilities

Required prior to entering any aged care facility Aged Care Client Record

Formal recognition

- provided to a residential aged care service by the aged care standards and accreditation standards.

- when the assessed service operates according to the requirements of the Aged Care Act 1997

- providing a high quality of care within a framework of continuous improvement

( Dept. Health and Ageing 2003)

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Plan Do

Act Check

Plan

Do

Check

Act

auditing program◦ where all systems are reviewed to ensure system

effectiveness for clients.

quality management plan/program

Four main steps to acquiring accreditation

1. Self-assessment by facility

2. Desk audit by agency

3. On-site audit by registered assessors

4. Decision & outcome of accreditation assessment.

Management Systems, Staffing and Organizational development

Health and Personal Care

Resident Lifestyle

Physical Environment and Safe Systems

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Residential Care Standards ‘ Benchmarking’

Certification

◦ inspection and approval of the building against legislative requirements

Prudential Requirements ◦ Finance e.g.Insurance

Concessional Ratio◦ financially disadvantaged care recipients gain access to aged care

Regardless of financial situation 27% of recipients must be Concessional

User Rights◦ Ensures a process for residents e.g. Charter of residents Rights

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To support older people and people with disability ◦ to be more independent at home and in the community◦ reduce the potential or inappropriate need for admission to a residential

care facility.

Federal Government -provides approximately 60 per cent of funding for the program -maintains a broad strategic policy role.

State and territory governments -provide the remaining percentage of funding-are the primary point of contact for HACC service providers and

consumers. -responsible for program management-approval and funding of individual HACC services

Commonwealth Respite & Carelink Centres;

Community Care ProgramsCommunity Aged Care Packages (CACP’s)Home & Community Care Packages (HACC)Dept. Veterans AffairsACAT- Aged Care assessment Team

Aged Care Services HACC

◦ Transport, shopping◦ MOW, personal care, home

maintenance

Community health centres◦ Education, counselling◦ Mental health

Respite programs◦ Residential care◦ In home respite◦ Activity centres

Day Therapy centres

Dementia Care

CACP packages

EACH packages

A government funded program designed to provide care and support to Veterans of war service in Australia.

◦ Services depend on the level of assessed disability or impairment and the level of assistance to government can provide for each individual.

◦ Services are determined by the colour of their card eg Gold

Community Services◦ medical care, nursing care, some domestic, meal preparation and

maintenance of homes.

Once Veterans have moved in residential care they are only entitled to a limited amount of services eg: specialised equipment, transport.

provide free

confidential information on community aged care and disability services available anywhere within Australia.

Commonwealth Respite and Carelink Centres◦ 65 'walk-in' shopfronts throughout Australia. Many shopfronts are conveniently

located near, or within, shopping centres