in CARE...Excellence in CARE • DECEMBER 2015 5.In Brief – NZACA news from the National OfficeIn Brief - NZACA news from the National Office Welcome Bupa We were delighted to welcome

UPfront THE CEO’S MESSAGE

Excellence in CARE • DECEMBER 2015 1.

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One voice for the aged residential care sector www.nzaca.org.nz

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P6 Advocating for Members

P8 2014 Profiling Survey

P12 Excellence in Care Awards

P19 Aged Care Cuisine

ISSN 2324-5190

The EBOS Healthcare Overall Excellence in Aged Care Award for 2015

went to Oceania Healthcare


2. Excellence in CARE • DECEMBER 2015

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3611NPD_ART_NestleDocello_PED_NZACA.pdf 1 27/07/15 2:48 PM

ADVERTISINGFor enquiries regarding advertising or to place an advertisement in Excellence in CARE please contact:

ROBYN GRAYNational OfficeNew Zealand Aged Care Association PO Box 12481 Wellington 6144 Phone: 04 473 3159 Fax: 04 473 3554

NZACA NATIONAL OFFICE STAFFSimon WallaceCEO [email protected]

Robyn GrayConference Manager [email protected]

Alyson KanaSenior Policy Analyst [email protected]

Julie EvansAdministration [email protected]

[email protected]

Disclaimer:The information in this publication is given in good faith and has been derived from sources believed to be reliable and accurate. However, neither New Zealand Aged Care Association nor the publishers accept any form of liability whatsoever for its contents, including advertisements, editorials, opinions, advice or information, or any consequence of its use.

Excellence in CARE DECEMBER 2015 www.nzaca.org.nz

4. UPfront The Chief Executive’s Report

Simon Wallace

5. In Brief NZACA news from the National Office

6. Advocating for Members FROM NZACA Chief Executive, Simon Wallace

8. Member Profiling Survey 2014 Profiling Survey

9. 0800 HELPLINE By Rhonda Sherriff

10. Conference Report By Robyn Gray, Conference Manager

12. 2015 NZACA/EBOS Healthcare Excellence in Care Awards And the winner is...

16. What is Effective Hand Drying? By Julie Sparks

18. Mind the Gap By Kathleen Collins

19. Aged Care Cuisine Senior Lifestyle Cuisine cooking competition

20. Christmas Cooking Time White Panforte & Stained-glass Christmas cookies

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UPfront — the Chief Executive’s ReportSix months into the job, I have to say that this is an incredible sector to work in — dynamic, growing, challenging.

As well as getting to grips with the issues affecting members, a key priority for me has been to meet as many of you as possible. I’ve visited numerous homes up and down the country and attended ten branch meetings, with more coming up. I’ve found these personal meetings hugely valuable and appreciated the warm welcome I’ve received.

The branch meetings are a great forum for members to network and discuss issues and opportunities on a regional level. I will be encouraging more of our larger operators to attend these meetings, as I think there is great value to be gained in strengthening relationships and sharing insight across the sector.

The 2015 conference was another opportunity to meet many of you in person. This year’s conference attracted a record number of delegates, and the positive vibe and level of engagement from everyone made for a very successful event. I found the Annual General Meeting discussion and strategy session particularly useful, providing insight on where you want us to focus our efforts over the coming year.

Congratulations to our Excellence in Care 2015 Award winners who were announced at the conference — in particular, overall winner Oceania Healthcare. Recognising success is an important way of benchmarking excellence and highlighting through the media the important contribution our sector makes to New Zealand.

The next few months are going to be extremely busy for the NZACA team. Priorities for me include working with the DHBs to improve access and availability of interRAI training, the ARRC Contract negotiations, and the Equal Pay Case. You’ll find updates on these issues on the following pages.

I’m keen to hear from you. If you’ve got an issue or an opportunity to discuss, or just want to touch base, send me an email or give me a call.

Simon Wallace Chief Executive

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In Brief – NZACA news from the National Office

In Brief - NZACA news from the National Office

Welcome BupaWe were delighted to welcome Bupa as a member from 1 September. With more than 4,200 care beds across 60 facilities, Bupa is the country’s largest provider of aged residential care. Having Bupa on board shows the industry is standing together at a time when we are facing significant challenges. It also recognises the value that the NZACA brings as the sector’s peak association. Read more. http://nzaca.org.nz/assets/Press-releases/ 2015/NZ-Aged-Care-Association-welcomes-Bupa- NZACA-Media-Release-02-09-15.

New-look website and In Touch We’ve had some exciting changes in the way we communicate with members.

Our new-look website www.nzaca.org.nz went live on 20 October. A huge amount of work went into developing a contemporary website that has relevant information, is easy to navigate and will keep you up to date with important issues. The website is device-friendly, so you can access information whenever and wherever you are.

From 6 November, we started distributing In Touch as an email newsletter rather than an MS Word/PDF download.

Items are shorter, with links to more information, enabling you to scan the weekly newsletter and then read articles that are relevant to you. The newsletter is also device-friendly and you can forward it to staff members at the touch of a button.

In Touch articles are published in the members’ zone of our new website and are searchable by topic and date.

The newsletter will continue to feature advertising. Please contact NZACA Administrator Julie Evans (email [email protected]) for new advertising specifications and rates.

Moving officeThe NZACA team is moving office just prior to Christmas! We are not going far - from the 8th floor to the 11th floor of Petherick Towers, Waring Taylor Street, Wellington. Apart from the floor change, all our other contact details remain the same.

Christmas holidays

The office will close for the Christmas break from midday on Wednesday 23 December, reopening on Tuesday 5 January 2016.

Wishing you a fantastic break from all the Team at NZACA.


UPfront – Advocating for Members

Advocating for MembersNZACA Chief Executive Simon Wallace provides an update on some of the key issues on which NZACA is advocating for members

ARRC negotiations In the upcoming Age Related Residential Care (ARRC) Contract negotiations, the NZACA will be advocating strongly for increased funding in two key areas — palliative care and bariatric equipment.

We have been seeking member feedback and you’ve told us these are both key areas where more funding is needed.

Palliative care fundingWe will be lobbying for a separate funding line in the ARRC contract for palliative care. Thirty-five per cent of New Zealanders now die in rest homes, compared with less than ten per cent in a hospice. Members are telling me that they are not funded to provide quality palliative care and that there is no recognition by the Government of the growing number of New Zealanders dying in our care. Additional resources are needed to provide quality care and support to the dying residents and their families.

Bariatric equipmentWe will also be advocating strongly for additional funding for bariatric equipment to care for the growing number of residents who are obese and sometimes morbidly obese.

While childhood obesity may generate the most headlines, elderly New Zealanders are also getting fatter, with one in three adults now considered obese — a threefold increase since 1977. That is impacting hugely on the health sector, including rest homes, and that needs to be recognised.

Our submission will stress that funding is needed for bariatric equipment so homes can provide quality care and avoid serious safety risks to staff and residents.

Next stepsWe are currently finalising our submission on the 2016/17 ARRC Contract. As well as increased palliative care and bariatric equipment funding, the submission will also canvass other issues that are important to members. Negotiations will start in February, with the new contract set to come into effect on 1 July 2016. We will publish our submission on our website www.nzaca.org.nz — under the Policy menu.

Responding to interRAI concernsMembers of all sizes have been telling me at meetings, by email and phone of their growing concern about interRAI, largely around availability and lengthy delays in access to training for registered nurses.

I have heard your concerns loud and clear and have taken up the issue as a matter of urgency with Chris Fleming, head of the Nelson Marlborough District Health Board, and the lead DHB chief executive for aged residential care.

We have had several constructive discussions and are trying to work out a system that will prioritise training needs. There’s still a way to go, but at least the DHBs are working with us to find a solution. I will update members on progress via the website and the In Touch newsletter.

Chris Fleming, head of the Nelson Marlborough District Health Board


Assisted suicide back on the agendaThe issues of legalising assisted suicide and euthanasia are back on the political agenda and, therefore, the NZACA radar.

We are currently developing a submission to the Health Select Committee, which is holding an inquiry into assisted dying. The inquiry is in response to a petition signed by nearly 9,000 people, which asked for an investigation into public attitudes on medically assisted dying in the event of a terminal illness or irreversible condition that makes life unbearable. The petition also called for a change to the existing law.

At the same time, ACT leader David Seymour has launched his End of Life Choice Private Member’s Bill to legalise voluntary euthanasia. Mr Seymour announced he would be drafting a Bill following Wellington lawyer Lecretia Seales’ unsuccessful bid for a court ruling in favour of assisted suicide.

The NZACA responseWe do not support legislation to make euthanasia or assisted suicide legal in New Zealand. We are in the care industry. Our job is to make our residents as comfortable, pain-free and distress-free as possible in the latter stages of their lives.

We will make a written and oral submission to the Health Select Committee outlining this view in more detail. Public submissions close on 1 February 2016. Our submission will be available to members on our website www.nzaca.org.nz - under the Policy menu.

I have met with Mr Seymour, stating our opposition to his End of Life Choice Bill. We will also be communicating our position to other political parties. The timeframe for this Bill to be debated could be months or longer. Any vote on euthanasia will be a conscience vote.

Equal Pay CaseThe landmark Equal Pay Case continues to take up a significant amount of our time, as it winds its way through the court process. This landmark case, which is being pursued by caregiver Kristine Bartlett and the Service & Food Workers Union (now E tū), has significant ramifications for our members.

In the latest development, the Government has announced that it will facilitate negotiations between unions and employers to settle caregiver equal pay claims. While this is a positive move, the union has not dropped its legal action, so we must continue to prepare a robust defence, with the case set to return to the Employment Court in early 2016.

At the same time, we will be an active participant around the negotiation table. In our view, for the negotiations to have a chance of success, two things are required. First, the union must drop its legal action so all parties can avoid a continuation of what has already been a lengthy and expensive court process. Second, the Government must understand that our sector cannot fund an equal pay claim without commensurate increases in its charges to consumers — most of which are paid by the Government in the form of aged care subsidies. We will not be able to settle with the union without a clear indication from the Government that they will meet the extra cost.

Find out more about the Equal Pay Case and why we need members’ financial support to fight this case on the NZACA website — www.nzaca.org.nz


Member Profiling Survey

Excellence in Care November 15 — 2014 Profiling SurveyA data gold mineMark Twain famously said, “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so”.

Accurate, reliable and timely data and insight is critical to help members with decision making and to make sure the NZACA’s advocacy work is backed up by evidence, not anecdote!

One of the most important data documents we produce is the Member Profiling Survey. Now in its 10th year, the 2014 Survey contains a wealth of valuable information on the aged residential care sector, providing the NZACA and members with a clear picture of the sector, identifying and analysing trends to help with planning

2014 Profiling Survey highlights:

and advocacy. This information is critical for our work and the wider sector.

The survey results combine information on the aged residential care sector from two sources. First is the annual NZACA Member Profiling Survey, which gives us in-depth information from our members about workforce, remuneration, services and ownership. And second is the DHB Shared Services reporting data, collected quarterly from ARC providers on bed and resident numbers.

A high response rate to both the NZACA and DHB surveys ensures the 2014 Member Profiling Survey findings are robust and representative of the entire ARC sector.

• Sixty per cent of care homes are operated as part of a group of homes, and forty per cent are operated as standalone businesses.

• Sixty one per cent of care homes are privately owned, nineteen per cent are publicly listed, 20 per cent are owned by a charitable/religious/welfare organisation and one per cent have ‘other’ types of ownership.

• As at 31 March 2015, 37,030 beds are operated by 666 aged resident care (ARC) homes, representing a net gain of 753 beds over 12 months.

• The average size of a care home in 2015 is 57 beds; the median is 49 beds.

• Occupancy for the 2015 March quarter was 87.3 per cent, nationally. Across the 20 DHBs, the overall occupancy ranged from 76.3 per cent to 93 per cent.

• Seventy-one per cent of care homes operate a mix of services.

• Two-thirds of care homes had agreements with some of their residents to pay for additional services and/or premium accommodation.

• Forty-three per cent of care homes have at least some premium rooms onsite.

• Annual turnover for the ARC workforce in 2014 was 21 per cent.

• Since 2011, there has been a five per cent decrease in overall turnover.

• The median standard hourly wage rate for caregivers was $15.40 in 2014; for registered nurses the median rate was $26.49.

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71%

60%

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0800 HELPLINE

0800 HELPLINEIt has now been a little over six months since I have taken up the role of NZACA Advisor, answering the 0800 helpline queries and questions. Without doubt, this has been quite challenging, as I juggle my own work commitments alongside the phone service. Whilst I have worked in Aged Care for well over 20 years, in a variety of management and operational roles, there are still questions that test my knowledge base and experience. I will often request some time to investigate these, as an immediate answer isn’t always available.

The way they are drafted, some of the contractual obligations that govern our sector are well open to interpretation. We may all read and interpret the governance/directives in different contexts, and draw different conclusions about what actions are required to meet these obligations. This is evidenced in the many responses I get to the questions and answers I write each week for InTouch. Without fail, most weeks, I will get feedback that certain facilities throughout the country derive a different interpretation of the contract and have actioned accordingly. A recent example of this was the reporting of resident serious harm accidents to Worksafe NZ, alongside the expectation of staff serious harm incident reporting. Many sites were only reporting serious harm incidents involving staff (as occurring in their workplace), when in fact the expectations are that we report serious harm for anyone this affects onsite in our facilities.

Many requests for clarification relate to: finances, (who is responsible for paying), premium charging, the interpretation of the ARCC Contract, Health and Disability complaints and investigations, clarification of other associated Acts (Employment, Health and Safety, etc), and issues that relate to managing challenging situations that involve residents or staff.

Most frustrating are the investigations I undertake in which I must deal with other government departments who either do not know the answer, or do not respond to the enquiries in a timely manner. Having said that, there excellent help has been provided by some people — such as Peter Morfee from Worksafe NZ (on the electrical safety requirements of tagging and testing within our facilities). A very practical approach with sound reasoning prevailed.

Health and Disability Commission investigations are always of concern to affected facilities, and I frequently field questions relating to management of the complaint investigation process and provision of evidence to the Commission. Once an internal investigation is completed, it becomes obvious whether there is a case to be answered, and it is how this is managed that becomes imperative to the findings and outcome of the complaint. A family’s distress, and blame being apportioned, can create a negative impact, but open disclosure is paramount, as are apologies to affected parties for the distress caused by errors and omissions in care. Families usually want clarification about what has happened, along with the assurance that facilities will prevent similar errors from occurring again. Management responsibilities during these investigations must include corrective actions to improve service and demonstrations of that outcome.

Our sector is under constant scrutiny, and it is a challenge to seamlessly provide high standards of care, to employ and retain trained and skilled staff, to maintain documentation accuracy, and to meet people’s continuously elevating expectations within our underfunded sector. This is a people industry with high needs and we endeavour to meet these needs on an ongoing, daily basis. To continuously keep abreast of legislative changes and industry expectations, we need to constantly source accurate information and updates.

I have valued everyone’s feedback and discussions, and I hope the helpline provides managers and owners with information that continues to assist with the day-to-day issues that arise.

Rhonda Sherriff is the Clinical Adviser for the Association and operates the 0800 helpline

0800 HELPLINE


2015 Conference Report

Conference ReportDelegates and exhibitors were welcomed to SkyCity Auckland for the annual New Zealand Aged Care Conference.

Three hundred and forty-five delegates attended the three-day event, from all over New Zealand, with some coming from Australia.

We had 90 exhibiting companies showcasing their latest products — from the most up-to-date technology, education, bedding and bathroom products, to hoists, massage beds, linen, and continence products — to name just a few of the products on display. We welcomed several new companies to the conference and hope that they found their experience beneficial.

The opening address was given by Te Radar, our Master of Ceremonies for the conference. Te Radar had many amusing stories to tell and set the scene for a great three days — he was a very popular MC, keeping everyone on their toes.

The keynote presentation was given by Jenny Basran. Jenny is the Associate Professor of Medicine and Head of the Division of Geriatric Medicine from the University of Saskatchewan. Jenny’s presentation was focused on Electronic Health Record 2.0.

Dan Levitt from Tabor Village, who is Adjunct Professor of Gerontology at Simon Fraser University in Canada, was another international presenter. Dan gave two presentations: Integrating care pathways: Investing in technology to improve health outcomes and Transform senior care through sensor technology.

Dianne Adamson from Australia presented two sessions: Building partnerships for success and Knowing me, Knowing You, and the room was packed to capacity for both of Di’s sessions. Di is a very popular presenter, with a wonderfully humorous presentation style that is very effective in getting her message across.

Social functions

Welcome drinks and nibbles were held in the exhibition area on the first evening, and many delegates took the opportunity to enjoy a drink while chatting to the exhibitors on their stands. This was a good opportunity to catch up with colleagues from previous years. Many took advantage later in the evening to enjoy a meal at one of the many restaurants in and around SkyCity.

The conference dinner, ‘A Team Game’, and the Excellence in Care Awards ceremony were both held offsite at Eden Park. The Event Impression team from Rotorua did an amazing job, as usual, and the venue looked fantastic, setting the scene for a great night. Delegates and exhibitors threw themselves into the spirit of the event.

The guests were greeted by a very noble team indeed: The Royal Family. The Queen and Prince Phillip were in attendance, along with Charles, Catherine and Beatrice (wearing her famous wedding hat). There were teams of rugby players (we expected that) the team from M*A*S*H, Snow White and the seven dwarfs, angels, nuns and many other clever costumes. Well done to those who went to such great efforts. We find that, every year, more and more love to dress up.

We were well entertained by ‘Elvis’, who had everyone up dancing the moment he started to sing. Everyone enjoyed the delicious meal, followed by the much- anticipated announcement of the winners of the NZACA/EBOS Healthcare Excellence in Care Awards.

The night continued with entertainment from Becks and Michael and the band Halo.

Conference 2016 is at SkyCity Auckland from 4–6 October.

Mark your diary now.

Robyn Gray Conference Manager


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The ninth annual NZACA/EBOS Healthcare Excellence in Care Award winners were announced at the NZACA Conference Gala Dinner on Wednesday 9 September. These awards continue to provide an opportunity for aged residential care homes in New Zealand to showcase the amazing work they do for the residents in their care, families and their staff. The entries into these awards also provoke inspiration and ideas within the aged residential care community.

Aged residential care homes submitted a written entry and provided appropriate supporting material to undergo an initial round of judging. Finalists in each of the five categories were awarded. All finalists were part of a second round of judging.

2015 NZACA/EBOS Healthcare Excellence in Care Awards

Health Ed Trust Staff and Training Development AwardOceania Healthcare — The Package

Training is an important part of the business for Oceania Healthcare, with heavy emphasis placed on training in order to improve the quality of the organisation and care delivered to their residents.

Oceania wanted to develop a new way of completing aged care qualifications in a tailored, faster, easier more cost-effective way. The goal was to bring the qualifications closer to their business and deliver them in a way that could be easily reported.

What has resulted is a qualification journey that contains Oceania assessments, Oceania trainee guides and Oceania plain English guides for staff that have English language difficulties. The programme is based on aged care requirements, including ARRC, dementia standards, and uses customised training material linked to Oceania policies, procedures and application in the workforce.

The finalist in the Bidvest Excellence in Food Award for Care Homes and Hospitals had a onsite judging were the judges arrived to take a look at the food service and dine with residents. Finalist in all other categories gave presentations during the NZACA annual conference on their entry, ahead of the winners being announced at the Gala Dinner.

We would like to take this opportunity to thank the four judges — Rhonda Sherriff, Roy Reid, Lucy Millin and Pip Duncan — for the time and dedication that went into judging these awards.

NZACA would like to congratulate all category winners and the overall winner for their success.

Oceania now knows the learning stage of every staff member and can deliver personalised support. Recognition is given to qualifications achieved by staff as part of the Oceania Healthcare career pathway as well as through staff name badges and pay rates.



QPS Benchmarking Innovative Delivery AwardHorowhenua Masonic Village — Community Activity Programme (Club HMV)

As their rehabilitation service became unsustainable, Horowhenua Masonic Village (HMV) looked for a way to continue providing services that met the needs of older people in their community, to retain specialist staff, and to best use a recently upgraded gym area. ‘Club HMV’ was created as a specialist service which has the overall aim of supporting participants to remain living in their own homes, engaged in their communities, while at the same time providing support to carers/spouses and whānau by involving them in the service.

Club HMV initially started with two days per week, and is now trending towards a fourth day. Participants attend regularly, and to date there has been a very low turnover.

Participants get involved in exercise sessions, wellness checks are carried out at least every six weeks, they have access to village groups and activities and go on regular outings. Carers are invited to join once a month, which enables support and education opportunities.

Since its inception, nine months ago, Club HMV has demonstrated that it has met the needs of participants and their carers and all the objectives set by HMV. It is an excellent marketing tool, provides a vital service to older people and maintains a strong connection with the local community.

Bidvest Excellence in Food Award for Care Homes and HospitalsAtawhai Lifestyle Care and Village, part of Oceania Healthcare: committed to delivering delicious and nutritious food to residents.

Oceania Healthcare endeavours to provide an excellent foodservice that tastes good, is nutritious, and supports optional nutritional status, while remaining within a budget so as not to compromise on other just as important areas of care.

Following an audit of all sites by the National Dietitian, it was highlighted that some areas needed more support, and desire from long-term kitchen staff for more kitchen-specific training.

Training has been the key in the effectiveness of Oceania’s comprehensive weight monitoring programme, where the results of the weight monitoring tool have been used to create individualised nutrition plans for residents identified in the monthly analysis as a risk. This innovation in weight management has changed the way clinical staff and kitchen teams approach nutrition.

Oceania Healthcare has created a comprehensive programme that includes a weight monitoring system which analyses the residents’ monthly weights. All Oceania Healthcare sites monthly enter their residents’ weights into the tool, which analyses nutritional risk

based on BMI and weight loss. In the 2015 review of the tool, weight gain was added as a risk factor to monitor, as this can become an issue — especially as the food is so delicious.

The impact of the combined focus on foodservice and nutrition has been an increased awareness of the nutritional risk of residents, and increased understanding with the help of national training and monthly support for clinical quality managers.

Most importantly, the residents love the food and the service they receive.


Medi-Map Community Connections AwardTe Wiremu House War Veterans and the community

Te Wiremu House has actively pulled together a wide range of different but specialist groups, individuals, sponsors and people to offer meaningful support to veterans and their loved ones.

Some of the services and support of veterans from the community and staff include:

• installation of flag station plaque (English/Māori)

• Armistice Day services

• oral history project — video/sound equipment and trained Tairawhiti Vietnam Veterans Association interviewers available

• access to Sound Archives

• support with War Pension applications and special pension payments where quality of life has been impacted.

• accessing NZ Defence Force medals and making arrangements for medal mounting.

Many residents’ families have appreciated long overdue recognition/support for veterans.

Although at times the services and support provided by Te Wiremu and many community organisations and individuals have not been the easiest to coordinate, they have created positive outcomes for all involved.

Jackson Van Interiors Built and Grown Environment AwardElizabeth Knox Home and Hospital

In 2009, Elizabeth Knox Home and Hospital commenced planning a new ‘home’ to expand the existing site from 140 to 190 beds. The design was based on the Eden Alternative ‘Household Model’, where life is centred around the open plan kitchen and ‘hearth’.

The objective was to create a spacious, modern, warm space, making best use of the natural environment, that supported wellbeing. This needed to be a ‘care friendly’ environment for people with high care needs.

The 60-bed resident home, divided into four households, makes best use of views of Mt St John and Mt Eden. Extensive consultation was carried out with residents, families and the team during the planning phase.

Planning ‘back of house’ functions to reduce operating costs, such as energy and water consumption, include rainwater harvesting, solar panels, skylights and glass ceilings for maximum sunlight and high electronic windows for fresh air circulation.

Nikau house was opened in August 2014 and fully occupied by early 2015. They have created the very best, cost-effective hospital-level care home in creating an Eden Alternative home. The environment enables the care team to provide residents with the right level of care to support independence. Families are actively involved in the life of the home and the small households encourage ownership.

The judges also selected one entrant as the EBOS Healthcare Overall Excellence in Aged Care Award for 2015. This award went to Oceania Healthcare.

NZACA wishes to thank EBOS Healthcare for their continued support as the partner sponsor of these awards. Also, thank you to the category sponsors of Jackson Van Interiors, QPS Benchmarking, Health Ed Trust, Medi-Map and Bidvest for their continued support this year.

We would like to encourage all NZACA members to look at what they are doing at their care homes for their residents, their families and staff, and consider entering these awards next year. These awards are a fantastic way to display to and inspire your peers with the excellent and innovative work that you are carrying out at your care homes.





What is Effective Hand Drying? Julie Sparks

Study One: A comparative study of three different hand drying methods. University of Westminster study, 2010.

Aim: to measure the number of microrganisms on the hands before washing and after washing and drying with different methods.

Have you ever wondered how efficent those hand dryers in public toliets are? Do they really work the way they should?

When you visit a public toilet and have the option of a jet/warm air blower or a paper towel, what is the best option? Well wonder no more — there have been some comprehensive studies completed and they have all drawn similar conclusions.

Spoiler alert … the unequivical answer is the single-use paper towel, but the results are quite interesting, so please read on…

Study Two: A microbiological comparison of hand-drying methods, the potential for contamination of the environment, user and bystander. University of Leeds aerosolisation study, 2012.

Aim: to compare the ability of jet air dryers, warm air dryers, and paper hand towels to aerosolise bacteria from the hands.

Results: Contamination in the air after hand drying:• jet air dryer — o airborne contamination: 71 cfu o average number of bacteria in air 15 minutes

after drying poorly washed hands: 14 cfu

What is Effective Hand Drying?

Here is a brief summary of four comparative studies of three different hand-drying methods: paper towels, warm air dryers and jet air dryers.

Results:• warm air dryer increased the numbers of all types of

bacteria of subjects. +195% finger pads + 254% palms

• jet air dryer increased the numbers of most types of bacteria on +42% finger pads, +15% palms

• paper towels reduced the numbers of all types of bacteria on -76% finger pads, -77% palms.

• warm air dryer — o airborne contamination: 16 cfu o average number of bacteria in air 15 minutes

after drying poorly washed hands: 4 cfu

• paper towels — o airbourne contamination: 3 cfu o average number of bacteria in air 15 minutes

after drying poorly washed hands: <1 cfu

Water droplets containing bacteria:• jet air dryer — 9• warm air dryer — 5• paper towels — 0

Study Three: Eurofins study, 2012. German washroom study, 2015.

Aim: to compare the hygiene of washrooms containing paper hand towels, jet air dryers and warm air dryers.

Results: The total microbe (aerobic bacteria) counts were significantly higher both on the surfaces of jet air dryers (appro. 1000 times higher) in comparison with paper hand towel dispensers.


What is effective hand drying?

References1. A comparative study of four different hand

drying methods: paper towel, continuous roller towel, warm air dryer, jet air dryer. Keith Redway & Shameem Fawdar, School of Life Sciences, University of Westminster, London, 2010.

2. Microbiological comparison of hand drying methods: the potential for contamination of the environment, user and bystander. E.L. Best, P. Parnell, M.H. Wilcox, Microbiology Department, Old Medical School, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust & University of Leeds, Leeds LS1 3EX, UK. Journal of Hospital Infection (2014) 88, 199–206.

3. Eurofins 2012 study: Protocol used, summary of test results (Excel spreadsheet), statistical analysis and review of results by Professor Mark Wilcox.

4. Comparison of different hand drying methods: the potential for airborne microbe dispersal and contamination. E.L. Best, K Redway, Microbiology Department, Old Medical School, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, University of Westminster, London. Journal of Hospital Infection (2015) 89, 217.

Study Four: Comparison of different hand-drying methods: the potential for airborne microbe dispersal and contamination, University of Westminister study, 2015.

Aim: to assess the potential for microbial contaimination from hand drying and the potential risk for airborne microbe dispersal, particularly if hand washing is suboptimal.

Result: The jet air dryer dispersed liquid from users’ hands further and over a greater range than other hand-drying methods (up to 1.5m). It was found the greatest dispersal was at 0.6–0.9 metres from the floor. This equates to the face height of small

children, who might be standing near a dryer when a parent is drying his or her hands. View a short video to demonstrate this.

http://europeantissue.com/hygiene/compari-son-of-different-hand-drying-methods-the-poten-tial-for-airborne-microbe-dispersal-and-contamina-tion/

The ETS (European Tissue Symposium) has issued the consensus statement on the matter. http://europeantissue.com/hygiene/expert-consen-sus-statement/

An extract:

There is evidence that hand drying using single-use towels rather than electric dryers leads to lower numbers of microbes on hands and in the washroom (both in the air and on surfaces).

Warm air dryers are less efficient than other methods at drying the hands. Damp hands are more likely to transfer microbes.

High velocity air dryers are particularly likely to blow bacteria and viruses off the hands and across the washroom. These microbes could contaminate the user, other persons and the air and surfaces in the washroom. Microbes have been detected in the air for at least 15 minutes after the use of electric dryers.

A Final Review

The Hygienic Efficacy of Different Hand Drying methods: A review of the evidence

Cunrui Huang, Wenjun Ma and Susan Stack, Mayo Clinic Proceedings, 2012; 87 (8); 791–798

This involved an extensive literature search — over 446 records, with 12 studied in detail.

Aim: to analyse the hygienic efficacy of different hand-drying methods, to recommend the best hand-drying option for healthcare professionals

Conclusion: From a hygiene standpoint, paper towels are superior to air dryers. Therefore, paper towels should be recommended for use in locations in which hygiene is paramount. The provision of paper towels should also be considered as a means of improving hand hygiene adherence among healthcare workers. The findings may have implications for health professionals and medical educators aiming to design effective programmes to promote hand hygiene practices.

Single-use hand towels are the most hygienic solution for drying the hands


Mind the Gap

Mind the Gap Kathleen Collins

The time-honoured phrase of British Rail has made its way into the latest New Zealand Certificate qualifications being newly offered by Health Ed Trust.

Providing opportunities to gain skills and qualifications ‘on the job’ is widely acknowledged as beneficial to all concerned — not least to the economy. But, as Zara Fraser (CEO of Health Ed Trust) discovered, ‘one-size-fits-all’ is not necessarily applicable to the aged care and healthcare sectors.

“When we were doing the preparatory work for our new Cleaning Programme*, we saw the way forward as ‘educating to the gaps’. We were mindful that English may be the second language, there would be cultural differences to appreciate and embrace and there could be hesitation from learners about returning to education after many years already in the workforce — but! ….we saw a need to recognise current competence”(RCC).

In other words, to “mind the gap”, in Underground-speak.

RCC is an important method of receiving recognition/credit for skills and knowledge an individual already has. Evidence is provided to an assessor of skills and knowledge that have been attained and how those meet unit standards.

It is probable many facilities have staff with extensive skills and experience but no formal qualifications.

For instance, does the following sound familiar when signing staff up for a qualification?

• I’ve done this work for years — does it not count towards a qualification?

• Why do I have to study things I already know?

• Can my experience be recognised in some way?

• I started my study but didn’t finish — can my experience count with this qualification?

There are ways your staff can have their skills assessed and formally recognised, thus shortening the length of time study will take and allowing people to reach their goals more quickly.

Health Ed Trust has developed a Recognising your Skills and Knowledge checklist. A learner ticks off a checklist of skills they believe they already have. These are then discussed with their workplace assessor, after which the assessor will ask questions and decide how much of the final assessment the learner will need to complete. For assessment purposes, the learner and assessor should have evidence that proves the learner has the skills and knowledge.

We are all about making study more enjoyable, more relevant and less time-consuming.

Your experience counts!

*Health Ed Trust’s new Cleaning Programme (Level 2) was released last month.

Excellence in CARE • DECEMBER 2015 .19

Aged Care Cuisine

Aged Care Cuisine on the Menu at Inaugural CompetitionCuisine for seniors living in aged care facilities came under the spotlight in Auckland at the NZChefs National Salon 2015.

The inaugural Senior Lifestyle Cuisine cooking competition showcased the culinary skills of 16 chef competitors who currently work in the aged care sector.

Event organiser Pip Duncan said competitors had just 75 minutes to prepare and serve six covers of a main dish.

“Three portions also had to be served in a soft minced format which is an important requirement in aged care facilities, due to swallowing difficulties encountered by many seniors.”

Judges assessed the dishes against a set criteria: presentation of food; taste and texture; control of cooking process; professional practice and preparation.

The overall winner was Rodney Phillips of Elderslea Rest Home in Upper Hutt, Oceania Healthcare.

Second place-getter was Deborah Dillon of Atawhai Lifestyle Taradale, Oceania Healthcare, while Avril Grant from Charles Fleming, Ryman Healthcare in Waikanae secured third place at the event.

Pip said the focus on nutrition for seniors would only continue to grow, given New Zealand’s ageing population.

“Government statisticians are projecting an increase in those aged 65 years and over to reach the 1 million mark in the late 2020s at which point this group will outnumber children”.1

“Events like this will help to inject innovation and fresh thinking into aged care nutrition. This is an exciting field with fresh frontiers to be explored, in terms of dietary factors and solutions for this age group and an expected upsurge in job opportunities in this field.”

Sponsors of the Senior Lifestyle Cuisine event included Nestlé Professional, Bidvest, vegetables.co.nz and Choice Catering Equipment.

1https://www.msd.govt.nz/what-we-can-do/seniorcitizens/positive-age-

ing/trends/ageing-population.html

Second place-getter Deborah Dillon of Atawhai Lifestyle Taradale, Oceania Healthcare.

Avril Grant from Charles Fleming, Ryman Healthcare in Waikanae secured third place.

Overall winner was Rodney Phillips of Elderslea Rest Home in Upper Hutt, Oceania Healthcare.


White PanfortePreparation time 25 minutes, cooking time 1 ¼ hours, serves 12

1 cup (160g) whole blanched almonds, lightly roasted1 cup (150g) hazelnuts, roasted and skinned100g candied citron, coarsely chopped100g dried pineapple, coarsely chopped150g glacé figs, coarsely chopped2/3 cups (100g) plain flour, sifted1 ½ tsp ground coriander1 tsp ground cinnamon1 tsp mixed spice¾ cup (165g) caster sugar¾ cup light honeyIcing sugar for dusting

Method:Preheat oven to 160 °C (140 °C fan). Coarsely chop almonds and hazelnuts, then place in large bowl with candied citron, pineapple, figs, flour and spices. Mix well. Combine sugar and honey in a pot, slowly bring to the boil, then cook mixture over medium heat until it reaches 112 °C (soft ball stage) on a sugar thermometer.Pour hot honey syrup over fruit mixture. Using wooden spoon, stir to combine (it will not be completely combined). When cool enough to handle, knead mixture with your hands to combine thoroughly.Press evenly into a buttered and base-lined 26cm springform pan. Bake for 1 ¼ hours or until light golden and slightly puffed.Cool in pan for 30 minutes, then turn out onto a wire rack to cool completely. Dust with icing sugar. Serve thin slices with dessert wine or coffee.Wrapped in plastic wrap and stored in an airtight container, this will keep for up to a month.

Christmas Cooking timeStained-glass Christmas cookies – Julie’s family favourites

Preparation time - 60 minutes, plus refrigeration time. Cooking time: 10 minutes, plus cooling time. Makes 36

250g butter, softened2 tsp finely grated lemon rind½ tsp almond essence¾ cup (165g) of caster sugar1 egg1 tbsp water2 ¼ cups (340g) plain flour90g sugar free boiled sweets, assorted colours

Method:Preheat oven to 180C (160C fan). Line two oven trays with baking paper. Beat butter, lemon rind, essence, sugar, egg and water with electric beater until just smooth. Transfer to large bowl, then stir in flour. Knead dough on cold floured surface until smooth. Cover with plastic wrap then chill for 30 minutes.Meanwhile, using a rolling pin, gently tap lollies to crush slightly, keeping colours separate.Roll dough between sheets of baking paper, until 4mm thick (keep dough cool at all times).Using medium-sized cookie cutters, cut shapes from dough. Use very small cookie cutters to cut out the centre of each cookie. (To transform the cookies into decorations, make a small ribbon hole near the top of each raw cookie).Place cookies on lined baking tray.

For the chop: before chopping roasted nuts in a processor, make sure they are completely cold. Add a teaspoon of the measured caster sugar to help absorb the nuts’ oil. Gradually pulse the mix in 5-7 second bursts so the nuts stay coarse.

Bake uncovered for 5 minutes, then remove from tray from oven. Fill cut-out centre of each cookie with fragments of same-coloured lollies. Return to oven for 5 minutes. Remove from oven then allow cookies to cool on tray.



This is a member service to help answer those questions and queries which crop up from time to time around auditing, policies and procedures, the ARRC contract, clinical operational issues, standards, and dealing with diff icult residents and staff.

NZACA have contracted Rhonda Sheriff to run this service.

Rhonda has worked exclusively in the aged care sector over the last twenty years in several roles, covering quality coordination and management, facil i ty management and operational management for large groups and standalone aged care providers. These providers have been from both the for profit and not for profit sectors.

Rhonda’s time in the sector has allowed her to develop a unique understanding of the varied aspects required to operate a successful business such as ensuring quality care delivery, meeting compliance requirements, dealing with HR issues, and overall Care facil i ty management.

Christmas Cooking time

One voice for the aged residential care sector www.nzaca.org.nz

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