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Quiet Time Opportunities The last in our podcast series on holiday planning isn’t really about getting prepared for the season but what to do over that time. Using those quiet time opportunities effectively can give you a head start for the new year. Holidays can be a perfect time to catch up all those important things that you meant to do but never quite got the time. If you only operate minimal services from mid-December through to the first couple of weeks in January this can be an ideal time to catch up. Cleaning Declutter – science has proven that clutter can raise the stress hormones in your body so do yourself a favour and sort through those piles of paper on your desk and file, shred or bin. Sort out your desk – you know that drawer where you throw everything, if it’s broken – throw it out, if you’re just not sure what that thing was so it’s stayed in the drawer just in case it was important – chuck it (if you haven’t worked it out by now or needed it, you probably never will) Dead, dried out pens (that’s probably the only ones you’re going to find in your desk anyway from my experience out bush) Clean the air-conditioning filters if you have split systems or hole in the wall varieties, vacuum or wash as required, they’ll work better and you’ll be cooler. In fact, Spring clean everything – even if it is the middle of Summer. Crank up the air-con and get to it. Loud music also helps. Remove that dead mouse from the trap and lay down new baits – this is the perfect time to do your annual checks on pest control. Don’t forget to write this in your pest control or WHS register. Carry out an audit While you’re at it check all your other registers and see if they are up to date Equipment test and tagging and fire safety equipment, when was it inspected? Add a reminder to yourself in your new diary a month out from when these need to be checked again. Feedback or Complaint register – was everything followed up? Are there any in there? Hazards and Incident registers – is it up to date, was there anything that needed to be followed up? CQI – is there anything in it? Come on now surely you’ve done something in the past year to improve your service or the way things are done. What about your Assets and Equipment register, anything need to be removed or added? If you have an equipment loans register – is it up to date, is there anything that you need to go and chase up? Is your SDS up to date – are you using any different chemicals – and check all chemicals that have been transferred into smaller containers have the correct labels. Employee register – Ochre cards or Police checks that are due this coming year – note in the diary. Training register – what was achieved in the past year, do you need to follow up with the training provider on behalf of your staff for statements of attainment or copies of certificates. It really is a good time for doing internal organisational audits, also makes it less stressful if you have a QR scheduled for some time that year. One of the important audits you should be doing (four times a year) is reviewing client files. We recommend reviewing a minimum of 5 different client files each quarter to check whether all your documentation is up to date, care plans, agreements, Centrepay deductions, progress notes. Review all your internal documents such as brochures, client handbooks and forms, are they still up to date? Review your daily operations guides – do they reflect current processes, are phone numbers up to date etc. Conduct Staff Appraisals If you have any energy left after all that and time on your hands, conduct your staff appraisals. If you’re too exhausted, then make a note in the calendar or your diary to do these and set the date. January is a time of new years’ resolutions, so once you have everything neat, tidy and up to date, it’s the perfect time to make a commitment to keep things that way, no matter what the day / week throws at you. A big ask I know but just try it. The post CD020 Holiday Planning – Quiet Time Opportunities appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

In this series, Carrie and Kell look at Holiday Planning for Aged Care services in rural and remote areas. It’s all about doing some preparation. We’ll be looking at client-related issues, staffing areas, organisational or service-level tasks and finish up with looking at how you can best use the quiet Christmas and New Year period to catch up and put yourself in a good position for the coming year. Service Operations Planning – Are You Ready? In this third podcast we look at the important things to keep in mind for your service operations while preparing for the Christmas & New Year period. So here are some of the things you’ll need to consider when planning for this time of year. What is your organisation’s stand on working over the Christmas & New Year period? Your organisation may have a policy that staff don’t work between Christmas and New Year. This is fine, but vulnerable clients still need to be supported – how will you manage this? New senior management may not be aware of Approved Provider obligations or be looking at the bottom line; they may not want to pay staff to work over a public holiday or just assume that everyone will go on leave – how will you manage this? Remember that the Home Care Package (HCP) covers the needs of the individual 365 days a year, so make sure your service is prepared to provide this level of support should they require it. Keep in mind that other services that your consumers might rely on in the community (such as the local shop or clinic) could be closed during this time. Christmas and New Year both fall on a Monday this year, so businesses could be closing their doors on the Friday 22nd of December and not returning until Tuesday 2nd of January. That’s 10 days where clients may not be able to access their usual services around the community – the clients come first and it is the centre’s duty of care to ensure their care is maintained. If you are shutting down for an extended period (and outsourcing support or meals for that time) what is your shutdown procedure? You need to think about fridges and freezers, you don’t want to come back to an almighty mess where the meat has defrosted and it’s been 45 degrees in the shade. Additional attention applied to specific areas of the kitchen or centre that may attract vermin or require additional cleaning. Move the fridges and freezers and clean behind them, it’s amazing what you’ll find. Review your food safety plan and see if you have completed all the ‘three-monthly’ cleaning tasks. Leave the place spotless before going on leave and it will be so much nicer on your return. How is your emergency plan? Every organisation should have an emergency plan in the case of cyclone, flood or fire and I would also add, extreme temperatures. What happens if the temperature doesn’t drop below 48 degrees for a month? What happens to the service during this time – can your coolrooms and fridges handle this? If your organisation has an emergency plan make sure you have a copy of it and you and other staff members know what to do. If you are in a cyclone prone area, or a location where you are likely to be cut off for an extended period of time due to flooding or cultural reasons: do you have emergency packs on hand for clients? have you stocked up on non-perishables? do you have enough continence aids on hand for identified clients? It’s a good idea to sit with local staff and run through all the things that have happened in the past and come up with some ideas of how you might address the issue – an ‘if this, then we’ll do that’ activity that local staff often enjoy working through.   Want more information on getting your service ready for the end of year period? Check out the rest of the Care Directions Podcast episodes in this series: Episode 017: Holiday Planning – Client Care Considerations Episode 018: Holiday Planning – How Do Your Staffing Levels Look? Episode 020: Quiet Time Opportunities (out soon) The post CD019 Holiday Planning – Is Your Service Ready? appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

In this series, Carrie and Kell look at Holiday Planning for Aged Care services in rural and remote areas. It’s all about doing some preparation. We’ll be looking at client-related issues, staffing areas, organisational or service-level tasks and finish up with looking at how you can best use the quiet holiday period to catch up and put yourself in a good position for the coming year. Staffing Levels over the Holiday Season In this second podcast we look at how to prepare for potentially, decreased staffing levels over the holiday season. You need to ensure sufficient staff are on hand so that clients will have everything they need during the aged care centre’s slow down period. So what do you need to consider? Who is going on leave? Many staff have children and may choose to go into a larger town or visit family elsewhere at this time. Traditionally communities have closed down for the Christmas period and generally you won’t find a lot of activity over the school Summer holiday time. Often CDCS consultants don’t travel out to community during this period as, apart from the hot temps and roads cut due to rain or ceremonial business, many staff are away on leave. Is any cultural business that they need to attend over this period? Staff members may also have ceremonial obligations that they need to attend to during this time. This is important cultural business that takes precedence over all else, including work. Look at your required minimal staffing levels to operate a basic but quality service Once you know what staff’s plans are (note, even where some local staff say they will be around to work during the time, in Aboriginal culture, if something important comes up they may have to attend to that) and you know what clients you have that you need to be concerned about during this time, you can look at your staffing levels and decide whether you have sufficient staff to provide a quality, if abridged, service. You can then roster staff accordingly. Some staff, although willing, may be able to work only a couple of hours a day due to a variety of things e.g. children at home, fatigue from the heat and not being able to sleep due to the heat, their own chronic illness or wanting to take a break during this time. What is your contingency around staffing? If you identify that you won’t have sufficient staff to operate the service safely what will you do? Options include: Having a pool of casual staff from within the community to support basic essential services. You may be able to utilise CDP staff to deliver meals if they are operating over the holiday period. Having an identified relief staff member who can be called on to provide care over the period. Using agency staff – I know, costly but may be required. Use students who are home from boarding school. Contact registered training providers to see if they have any students willing to visit over this period to gain additional experience. Consider using volunteer programs.   Want more information on getting your service ready for the end of year period? Check out the rest of the Care Directions Podcast episodes in this series: Episode 017: Holiday Planning – Client Care Considerations Episode 019: Service Operations Planning (out soon) Episode 020: Quiet Time Opportunities (out soon) The post CD018 Holiday Planning – How do Your Staffing Levels Look? appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

In this series, Carrie and Kell look at Holiday Planning for Aged Care services in rural and remote areas. It’s all about doing some preparation. We’ll be looking at client-related issues, staffing areas, organisational or service-level tasks and finish up with looking at how you can best use the quiet Christmas and New Year period to catch up and put yourself in a good position for the coming year. Client Care Considerations In this first podcast we look at your actions and planning around client care considerations. Identify vulnerable clients Vulnerable clients can be people who are very frail Have a disability that prevents them from self-care (blind or unable to walk), dementia Rely on others for assistance They may also be someone whose family may often be absent during the holiday period Vulnerable clients will usually require additional support during the hot summer months. They may require a twice daily check-up from staff e.g. check they have water and are able to move into the shade, they may need support (transport) to access the clinic or they may need to come to the aged care centre during the heat of the day (or perhaps during the winter months if it’s particularly cold). Even where you are not operating regular program services over this period, it may be necessary to provide daily access to the centre and other support to a vulnerable client. It comes down to your Duty of Care as an Approved Provider of care to the person. Liaise with other stakeholders Check with the clinic staff as well, find out if they have any concerns and what their plans are during this time (are they closed, shorter working hours, relief / agency staff) Discuss any plans the client have Identify what plans clients have for going away or for family who come to visit. In a remote setting many clients head off to visit other family over the holiday period so they may be absent from the community. If they are going to another service area you may need to ascertain whether a brokerage arrangement is possible during this period. Clients may also have other family members around during the holiday period, sometimes grandchildren who have been attending school in town may be home for the holidays. This can be good as it allows the person to reconnect with their family member and there may be additional support for the older person. On the flip side, it can present challenges if the younger person places an additional burden on the old person’s resources. Perhaps the person might need to visit the centre for day respite or for their meals. Identify if there is any cultural business that they will be attending over this period Older clients may have obligations to attend a grandchild’s ceremonial business, this can take them away from the community for a period of time or the ceremony may be close to the community and again there may be an additional resource burden incurred by the old person. Certain people hold a cultural responsibility for the provision of food over this period. Update client emergency response plans Of course the Christmas holiday season falls right at the time of cyclones up north, searing hot winds and temperatures in the Centre and bush fires further south. This is the time to be prepared for the worst. Every client should have an emergency response plan – that is, what their wishes are should there be an emergency or you can’t find the person when you visit to provide a service. These are some of the most important documents to review around October / November each year. Have them accessible should an emergency arise. The post CD017 Holiday Planning – Client Care Considerations appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week Carrie and Kell look at the importance of having a marketing plan for Aged Care services. Why should you take a strategic approach to marketing and promotion for your service? Because the introduction of Home Care Packages are now attached to the consumer rather than individual organisations this has changed the approach aged care services need to take to attract business (encourage people to bring their package to your Aged Care service) We’ve gone from a institutional model (where you took whatever you could) to a business model that focuses on consumer directed care, where we seek to meet the needs and desire of the person holding the package. Now that we are in a competitive market we have to promote ourselves and our product to attract the client base that we want. This is a whole new ball game for most organisations who haven’t had to promote themselves in the past. We’ve already seen an increase in the number of ads on TV, radio and magazines that aim to reach out and influence the holders of packages and their families (after all it is often the family members who make the decisions or assist in making those decisions). So what should rural and remote service be doing around marketing or promotion of their services, after all they are often the only provider in that community? Things are changing, we are already seeing larger organisations looking at supporting people living in remote settings through brokerage arrangements, where they are the case manager and they arrange the provision of services through the local provider or other services in town e.g. community stores, nearby road-houses or art centres. So remote services need to consider their own marketing. Marketing is an umbrella term that covers many forms of advertising and includes traditional methods as well as social media. So what are some methods of marketing that might be available to organisations in rural and remote settings? To start with effective marketing in a remote setting often relies on local knowledge, what words mean, real and relatable to the people you are trying to reach. For example use words that they use such as uncle and aunty as a term of respect, specific landmarks in the community and using relevant pictures (north and central) as well as. Promotion Opportunities and Things to Consider Advertising posters – think about the presentation – be aware of the colours, the font and not too wordy Brochures – can you use photos – refer to CDCS brochures and what we do Branding – consistency so that people know this is about aged care ( logos, fonts, colours consistent on all documents and advertising material) Radio interviews – CAAMA and 4BE in Brisbane and many communities across Australia have their own local radio stations where you can advertise your service Newsletters, many organisations have their own newsletter where you can advertise expansion of services, good news stories etc or you can advertise in other organisations newsletters such as the local bowls club, golf club, senior citizens clubs, arts and culture organisation newsletters. Newspapers – more expensive but possible to advertise in your local newspaper. Don’t need to advertise in large Australia or State wide newspapers if you are targeting a smaller area. Staff awareness training – word of mouth is really important and staff are often your biggest asset in promoting your service. Train them in what they need to say to promote your service or organisation and where to refer people to if they require further information. (doing a training session for an organisation a few months ago where staff had no idea of how important they were in promoting the organisation until we worked it through with them, then they came up with some great ideas) Community events – Get amongst it and run a sausage sizzle. Have a stall at NAIDOC celebrations or football carnivals BE INVENTIVE Other things to be aware of: Up to date website. Site not updated regularly and the advertised services no longer exist or numbers are wrong. Up to date wording in advertising eg not CACP or HACC Marketing plan. The best approach to marketing is not a slap dash style, there are specific strategies that will work best for your organisation. It’s always better to come up with a well-thought out plan that is both achievable and affordable. Don’t waste money something that sounds good but in reality doesn’t represent a good return on investment, we’re talking both time and money here. So hope this has given you some ideas on what you can do to promote your service / organisation. Please note the example document has been prepared using a standard ‘Word’ template. These templates are set to American paper sizing so don’t print true to an Australian A4 paper size. Your graphic designer should be able to develop something for you or alternatively, you could use Publisher to design a brochure. If your organisation would like some support in developing a marketing plan you can contact CDCS via our contact page. The post CD016 Marketing and Promotion for Aged Care Services appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week Carrie and Kell look at the benefits of aged care services taking a Collaborative Approach as we continue looking at what makes good business practice for community based aged care programs.  These days you need to look at more than just what your own service can offer to a client. After all, with Home Care Packages the individual now ‘owns’ the package rather than the organisation, if you aren’t giving them what they both need and want you may find them taking their package to another more flexible provider. You can’t be all things to all people.  Your main client group may be from one cultural group but all of a sudden you have a client from a minority group, with different needs and desires. How do you support their preferences? You might be really good at providing activities, domestic assistance and social support to your client base but you really can’t provide delicious meals that the clients desire. What do you do? Consumers may request services from another specific provider, e.g. they want to organise or retain their own cleaner. Recognise that: You don’t need to do everything, e.g. perhaps you are good at case management or meals and domestic assistance but don’t have the staff available for transport. Work with your strengths rather than over-stretching yourself. Brokerage arrangements can go both ways, you can broker services e.g. domestic assistance, to another organisation who manages a package on behalf of a consumer or you can do as described previously, broker out to an organisation for transport. You can’t be all things to all people, this is not efficient or effective. Every consumer is a unique individual with varying needs and wants. We draw this out from them in the assessment and planning process, if they raise a desire that you don’t or can’t provide, rather than ignore this explore other options that might be able to fulfil this. An example of a service that your organisation may not be able to directly fulfil for a client is something like accompanying a client to church on Sundays – you may not have staff available who can do this or it may be costly to be managed within their package, however you may be able to contact the volunteer services or the church directly to arrange opportunities for the person to attend. The above example demonstrates that you don’t need to directly employ all staff. It may be more effective to use volunteers, students (who are generally volunteers), brokerage arrangements or subcontractors. Look for local solutions – family, as well as others such as neighbours and friends. Stakeholder mapping is important, you need to know who is out there and how they are accessed. Stakeholders can be cultural and recreational organisations, wider community organisations or clubs, health services, independent providers of services (cleaner), small businesses (lawn mowing, mobile hairdressing, bus or bodie bus in NT or even charter plane services) and other service providers such as larger aged and disability organisations. Brokerage Brokerage is an arrangement between two parties. One who holds the funds and package of a consumer and the other who provides a service on behalf of the first organisation. For example: Organisation A manages a package for Betty. Betty receives many of her support services from Organisation A however Betty would like to access a weekly activities program hosted by Organisation B. In it’s simplest form, Organisation B invoices Organisation A for Betty’s time spent at the activity which is applied against her package. This can be applied across a larger of people and is beneficial as previously stated, organisations don’t have to be all things to all people. Organisations such as senior citizens clubs may be an example of this type of service. So how do you broker successfully? Have a written agreement, never just rely on a verbal agreement because the package manger is responsible for effective management of the consumers package and services. Agree on the price for services, times, hours, deliverables, payment methods and a ensure open communication to minimise the potential for things to go wrong. That is kept up to date. Use the KISS method – having said that you need a written agreement make sure it is simple, straight forward and easy for everyone to understand. This is not the time for 57 pages of legal jargon and endless small print. Shared work protocols and MOU’s (Memorandums of Understanding) are a great idea for organisations that you work with on a regular basis, especially where there are shared responsibilities eg local health centres and clinics. A SWP is an agreement between the organisations on the ground while an MoU is signed off at a higher level eg between head offices of both organisations. Prices and price lists. If you will be doing the brokerage you need to identify not only your cost of providing a service but also the price you will charge for that service. It is good if this can be developed into a price list that can be forwarded to other organisations should they enquire about your services. Be prepared otherwise you may find yourself undercharging for brokered services. Collaborative approaches are always better than trying to do too much with too little. Less effective for the organisation and the consumer. This post is part of a series ‘The business of Aged Care’ CD011 Understanding your Market CD012 Understanding your Product CD013 Strategic Planning for Aged Care services CD014 The importance of Aged Care Budgets Check out resources on our membership site. (Note that this is currently in the process of being completed, we estimate that access to a full set of resources, dependent on membership level, will be available by early Oct 2017)   The post CD015 Taking a Collaborative Approach appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

Budgets, love them or hate them, they are an essential part of operating a successful business. This week on the Care Directions podcast Carrie talks with Carole Stone from Enmark Accountants about budgets for aged care services, why they are important, common terminology (and what it means), what the budget should include and how to monitor. So who is Enmark? Enmark is a firm of Chartered Accountants established in 2003. Enmark specialises in providing financial, advisory and assurance services in regional and remote Australia to individuals, business, not for profits (NFP) and local councils as well as Government departments and agencies. Carole is one of Enmark’s senior consultants. Carole originally hails from Canada but has made Australia her home for the past 20+ years. Recently Carole has been busy assisting remote aged care services with financial management, including service pricing to support the development of individual client budgets. Here are Carole’s responses to the following questions. Why should an aged care service have a budget separate to the organisational budget? An organisation needs to know whether its aged care service is going to generate income, cost the organisation or have a nil impact on the organisations’ position. An estimate of revenue for the year, together with an estimate of expenses for the year, allows the aged care manager to determine the net impact the aged care service is likely to have on the organisation’s resources. If a budget it not created, the organisation will not know if the Aged Care Service is profitable or sustainable. Why does it matter if the Aged Care Service is profitable if the organisation as a whole is profitable?  There is no point in being in the business of delivering aged care if it is costing the organisation money, even if the organisation is a not for profit. In fact, an organisation needs to generate a profit from the delivery of its aged services in order to fund future capital expenses associated with the aged care service. These future capital expenses should also be budgeted for. Once you know what the expenses are, what then? Once all costs of delivering aged care are known, the estimated income from providing those services can be determined, this will allow the organisation to know if a profit is likely to be made. If a profit is unlikely to be made, the organisation will need to look at whether it can increase the prices charged for aged care services and/or reduce variable expenses such as wages. So the reason to have an aged care budget is to see if the service is profitable? The main reasons to budget is to allow for effective planning and identify problems. For example, if you reviewed the monthly aged care budget reports and noted that expenses exceeded revenue by a significant amount, you need a way to see where the problem lies? With an expected or budgeted amount for each revenue and expense item, it is easier to determine where the problem is likely to be and develop an appropriate response so that the service can be returned to profitability. The previous podcast in this series looked at Strategic Planning. A budget should reflect the actions outlined in the Strategic Plan, taking into account staffing structures and service offered etc. The budget for an aged care service is in effect the financial component of the strategic plan. Preparing a well-considered budget can highlight areas that need to be addressed which will then allow the strategic goals to be met. The budgeting process also helps to identify potential issues and allows the business to make changes to address these before valuable resources are spent. What should a budget include? A service budget should be prepared for each month for a 12-month period and will include revenue, expenses and taxes. Ideally the aged care budget should mirror the accounts in your organisation’s accounting system. Many standard accounting packages allow budgets to be prepared which then allow for easy year-to-date comparison. So how are expenses budgeted for? Budgeting for expenses is usually easier than projecting revenues. Budgets should be based on the actual cost of providing an activity, but it is common to use the prior year’s expenses recorded in the accounting system as a basis for projecting current year expenses. Many organisations start with their current payroll structure, projecting salaries and on costs through the year, and split other known, or anticipated, expenses evenly over the 12-month period. If you are a start-up business, with no previous costs to refer to, the process of budgeting expenses can be more difficult and you need to look carefully and realistically at your anticipated costs. It is important to ensure that all relevant expenses are picked up in the budgeting process. This includes overhead allocations as well as depreciation expenses on the assets of the Aged Care Service. Payroll is an important area to consider carefully. One item we often see neglected is on-costs. These may include long service leave, holiday pay loading, payroll tax, workers compensation insurance and superannuation guarantee. The full cost of an employee is not just what you pay them each month. It also includes costs that accrue each pay day. Some organisations underestimate or forget to include the additional administration or accounting cost associated with implementing the new reforms such as CDC reporting. The costs associated with repairs and maintenance, replacements and upgrades should also be included. What about projected revenues? Projecting revenues can be much more difficult, particularly in this changing aged care environment where Home Care Packages are portable. If an organisation delivers home care packages only, income items may include Medicare Subsidies as well as client contributions for meals and services.  If services are delivered to a Home Care Package recipient on behalf of another Provider, there may also be Brokerage fee income to consider. To estimate subsidy revenue, a starting point would be to calculate the daily subsidy due from Medicare times the number of packages you are managing. This would allow the organisation to determine the estimated monthly subsidy income. There is the risk though that some consumers will take their package elsewhere during the year thereby reducing future subsidies in relation to those consumers. Alternatively you may gain additional clients and therefore package funds. Although these HCP funds are to be used for each individual client who will have their own budget, you still need to see the big picture when looking at income. Projecting client contributions may be a simple as multiplying the client contribution for meals for example by the estimated number of meals for each month, adjusting again for days where the client may not be available. Projected brokerage fees can be based on your pricing schedule, multiplied by the estimated number of services you would expect to deliver during the year. Where you might find cost efficiencies when developing a budget When budgeting for the costs of aged care service delivery, consideration should be given to areas where there may be cost savings. The delivery of aged care services involve two types of costs. Overhead costs which are often fixed and constant for the year and Direct costs which often vary depending on the number of clients or services provided. Overhead costs include things such as head office electricity, rent, phone, accounting and information technology support. For a remote service operating under a local Government structure, these expenses are often common to all divisions of the organisation and as a result are often allocated across the organisation on a relatively arbitrary basis, generally they cannot be avoided. Other costs however are under the control of Aged Care management. These may be staff wages or purchases of equipment and products in relation to patient care such as continence pads. Understandably, wages comprise a large portion of the costs of delivering aged care. If the staffing and scheduling mix is inappropriate, the service can lose money quickly. One key area to save wage costs is to ensure that you employ the right staff. You want to avoid having overqualified, and relatively expensive staff performing duties that could be performed by a “cheaper” staff member. Additionally, ensuring that your processes are efficient can reduce costs. For example, it may be efficient for staff to pick up laundry at the same time that they are delivering meals and home care to the client, provided you can do this in a safe manner. Cost savings can also be made in the area of products purchases.  For example if you need to buy continence pads for clients these should be purchased in bulk where possible to reduce the cost per unit. Services should always shop around for the best prices for everything and it is best practice to try to get at least three quotes, especially where you are purchasing large items or large amounts of a particular item on a regular basis. Sharing resources of the organisation can also help to reduce costs. For example, in the Northern Territory, the government funds a program called the School Nutrition Program. By sharing the kitchen facilities used for this program to prepare meals for package clients costs can be reduced, or the vehicles owned by a Council for example could be used for the service when needed allowing only a portion of the vehicle costs to be borne by the aged care service. How to stay within budget – Monitoring income and expenditure Having a budgeting and accounting system in place is of no use to the organisation if those results are not reviewed and monitored. It is crucial for management to understand whether their aged care delivery is profitable and to know quickly if things are not going to plan. The process of reviewing actual results against budget on a monthly basis is a key component of sound financial management. Given that many Providers have only recently implemented service pricing, there may be some uncertainty as to whether the actual costs incurred to deliver aged care will exceed the revenue earned, particularly if the Provider was not rigorous in its costing and pricing processes. If prices charged are not exceeding expenses, management needs to know as soon as possible so that corrective action can be taken. Such corrective action may entail modifying the pricing structure, conducting a detailed review of costs per service, reviewing the accounts for accuracy or cutting costs. In a multi-location service, such as a regional Council, you may find that wages as a percentage of income is much higher in one location than in another or perhaps the cost of food is significantly higher from one particular supplier. Conducting a regular review and analysis helps to identify issues before they become big problems and identifies areas that require further investigation. An example of how not monitoring the aged care budget was seen recently by Enmark who were called in to act as a Financial Controller of a Local Gov’t Council in a remote setting. Enmark was placed in the role because the Council was in serious financial trouble. After analysis, it became clear that the Aged Care division of the Council was a major source of the problem. It was losing a considerable amount of money each month. Investigation by Enmark revealed that the cashflow problem was due to a failure to lodge Medicare claims in a timely basis, client contributions were down and staffing levels and service provided to clients was higher than income allowed. If regular, detailed reviews of Council operations had been conducted, the Council would not have been in the dire position that it was. Budget v actual what does this mean? Comparing budget to actual results is a key management tool to keep the business on track. Each month, a comparison of actual revenue (income) and expenses to budgeted revenues and expenses is conducted. For example, budgeted aged care revenue should be compared to actual revenue received. Any shortfalls identified can then be investigated and may be due to not lodging a Medicare claim in time, invoices not being raised for brokered services or a grant not coming in, this can then quickly be followed up, hopefully before cashflow suffers. Actual spend on expenses such as wages verses the budgeted wages for the month may identify overspends and a need to review staffing levels and scheduling. This sounds like a detailed process. Who usually performs this budget to actual analysis? Ideally an organisation will have a management accountant whose role is to analyse the monthly budget to actual results, identify issues, recommend corrective action, review cashflow adequacy and adjust the budget for new information. The management accountant communicates with Aged Care Management and staff to obtain further information about the results and should prepare a monthly management report summarising and explaining the results. Where organisations do not have the skills of a management accountant at their disposal they should consider engaging external support as this is a vital role that can help to keep the business on track. How can an aged care service improve its results?  Maximise your revenues and cashflow Claiming for everything possible – are you ensuring you are sending out invoices on time or claiming correctly. This is a big one for some organisations as they don’t claim in a timely manner. Also with the change to HCP’s if they are providing brokered services they will need to invoice in a timely manner. Don’t deliver services that are not funded . Stay within scope, don’t doing more than you are funded for or can afford to supply. Another big one for some organisations with coordinators who want to be all things for their clients. They end up blowing their budgets. We always emphasise that if you don’t have it on scope then go looking for other ways of funding it or seek more funding. Review your pricing each year. The prices set for the services delivered should exceed the cost of delivering that service including Administration, Case Management and direct service provision. In addition to covering the full cost of service provision, prices should incorporate an amount for profit, capital purchases and contingencies. Services need to know and understand the full cost of delivering services by analyzing actual costs. The full cost of Case Management and time spent on reporting is often underestimated costing and pricing aged care services. Management must ensure that the prices charged exceed costs in order to ensure the service is viable and is able to continue to deliver care. Prepare a budget and review actual results against that budget each and every month.Don’t overlook this vital step, it is really important for organisations to continually monitor their situation and tweak what they do to ensure they remain viable and profitable. The post CD014 The Importance of Aged Care Budgets appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

So far in this series we’ve looked at understanding your market and also your product which is great. However, without having a plan around using this knowledge it’s not much use to you. This week Carrie investigates the value of strategic planning for aged care services and the basics of developing a strategic plan with Donna Cross. Donna is the managing director of CDCS. She has huge amounts of experience in business and strategic planning. And is the ‘go to’ person in the business on all things relating to governance and strategic. The FOCUS approach to Strategic Planning Donna discusses using the ‘FOCUS’ approach to strategic planning. F = ‘find out’ what is going to take the service forward, ‘focus’ on the things that will make a big difference and become clear about the direction you want to take the service. O = Opportunity, identify what are the opportunities that you can make use of that will take your service forward. C = ‘Challenges’ should be identified; although the challenges faced by aged care services appear to be ongoing at the moment, knowing and naming them can lead to identifying those opportunities mentioned above. It’s a matter of saying “well this is the situation, how can we make it work for us and our clients”. U = looks at ‘unlocking’ the potential. Maintaining the theme of opportunity, a good strategic approach is to look at the potential in your organisation, your staff and their skill sets and also in the emerging trends within your industry. Identify it and then unlock that potential. S = ‘Setting’ the path. Once you have identified opportunities, challenges and the potential within your organisation or industry, you should set a clear path for making use of this insight. And don’t forget that strategic planning shouldn’t be done in isolation. It needs to include input from staff and other relevant stakeholders. This way you will have more ‘buy-in’ from those who are the intended audience. Strategic Intent V Strategic Plan – What is the Difference? Strategic Intent A Strategic Intent is a way of communicating clearly the direction of your organisation to external audience, e.g. clients or other stakeholders. It is generally an enticing document, probably not more than four or five pages. It includes things like the vision of the organisation. The key goals that you’re looking to achieve over a period of time. Some brief information about the values and the key actions of how you’re going to take that forward. Here is an example of a Strategic Intent from ‘Fight Dementia’ organisation. A Strategic Plan A Strategic Plan is an all-encompassing, significant plan, over usually a period of three to five years. Under that sits your individual service plans which should align to your overall strategic plan. In the Strategic Plan you look at the nitty gritty. That’s where you’re going to put things like your strategic indicators which are linked to your actions, and your outcomes. That level of detail is really what is there for your team to use, to guide them, going forward. Here are examples of Strategic Plans from Cancer Australia and Queensland Health. Your Strategic Plan should include: Your Vision, a brief statement about what your service vision is. Also define your purpose, including a Purpose Statement is helpful to your readership. It should have a little bit of background. You might have an external readership and they need to know what your scope of service is, what communities or areas do you cover, or where are you situated. It might also include a list of the services that you provide. This is often incorporated into the background. The other information that would usually be incorporated into the strategic plan would be things like your core values. You may also include linkages to other plans, within a larger organisation, such as within a Regional or Shire Council, there may be a statement about where your aged care strategic plan sits within the council plan for example. Then come the key focus areas or key goal areas, whatever you want to call them, but they are your top level. The strategic objectives come under that. So you have your goals, your objectives and then you’ve got your strategies that follow on from there. Finally, you need to have linked to that, the outcomes that you’re looking to achieve and the indicators that are going to tell you whether or not you’ve achieved them. Strategic planning has changed a lot over the course of the last 10 years. It’s now a lot leaner. Generally, there’s a trend away from large bulky documents that nobody tends to read. So think about making your strategic plan as lean and clear as possible. Here’s a great example of a single page Strategic Plan from the Department of Aboriginal and Torres Strait Islander Partnerships, that at first glance might appear to be simply a Strategic Intent but has all the essential information of a Strategic Plan.   We hope this episode has been helpful to you. If you would like to access support from CDCS to develop your organisation’s strategic plan, please contact us via this website or email info@cdcs.com.au. The post CD013 Strategic Planning For Aged Care Services appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

Continuing our series on the business side of operating an effective aged care service. This week we look at understanding your product. Once you have defined the target market and their needs you need to turn your attention to defining just what you have to offer that market. How the Demographic and Psychographic profiles can help you This is where you go into depth use the demographic and psychographic profile of your target market. For example, are you operating in an area where there are a lot of high equity individuals, people who expect and demand quality care and support? The information you have gathered from research indicates they don’t see themselves as needing aged care, they may prefer a ‘companion’ rather than a ‘care worker’.  Perhaps a boutique service could be your product. Or are you operating in a multicultural area, one where people have experienced change and upheaval in their long lives? These individuals may need something quite different, perhaps connection to their old cultural interests and language or foods. Perhaps some of these individuals have been traumatised at some point in their lives, this is going to impact on the care and support you provide to them. Gap Analysis Ok, so you have identified the profile of your target client base, or perhaps you have narrowed it down to one or two potential markets. Remember that bigger is not necessarily better, a niche market can be as profitable as a large, non-targeted market. To decide which is the better of two or more options, a potential business owner will often carry out a gap analysis. This analysis will consider all the identified needs of the market (use your market research) and see if there are gaps in the market that can be filled. High income individuals and no bespoke home care service in the area – there’s a possible gap; Large population of elderly Chinese migrants in an area and no specialty aged care services – there’s another possibility; No provider of specialty transport and activities in a region – hmm another option. At this point all you are doing is looking for gaps in the market using your market research and thinking about how these might be filled. While you are doing this gap analysis also seek to identify any markets that are saturated, these are ones to keep away from if you want to see a profit – and after all that is what business is all about – even for not for profits. Look at Yourself At some point you also need to look at yourself, your current organisation. Sometimes you can expand what you are doing, expand into new areas, but sometimes you need to pivot – totally change what you are doing or your target market. When looking at yourself you need to consider what you do really well. Can you do more of this? How do you know what you do well in? This is where client surveys and feedback are really handy. If you find a positive theme in the surveys perhaps this is because you are working to your strengths. Perhaps you are getting a number of people saying they like the service because the care staff are able to speak to them in their own language – that’s obviously a strength in your organisation which you can capitalize on. Look at your staff This leads on from the last example, having the right staff is important. Whatever your venture, whether aged care or other, you need to ensure that your clients are comfortable interacting with your organisation. In aged care your front line care staff are your face so ensure you match your service to the market. If you are going to offer a boutique care support service to individuals, then ensure your staff are properly dressed. This might mean smart casual wear when they are escorting a person to an appointment or out shopping rather than a polo shirt and long shorts and an id badge, or it might mean your personal care staff wear smart nursing scrub shirts or specialised uniforms. The language used by your staff is also likely to be more refined. You want to ensure you portray quality. Conversely if you are supporting people where the expectation is for a more generic, everyday aged care service, your staff need to be seen as approachable and relatable, a neat polo shirt with a logo and the long shorts might be just right here. So as part of your business planning consider the profile of the staff members that you have or need to attract, as well as their skill sets. Cost v Returns Of course you also need to consider the cost of any enterprise and ensure that it will make enough of a return to make it worthwhile. There might be more profit in setting up a boutique care service however, it might take longer to identify and attract a client base and find and retain the right sort of staff. Your operating costs might be higher – maintaining an office in the ‘right’ area, paying higher wages and allowances to staff, training staff, presenting the right sort of advertising etc. Consider also the timeframe for making a profit. Some options might make a lower profit but they return that profit in a shorter period of time allowing you to keep trading and developing your business. Once you know who it is you’re going after, you can begin to design a plan around how you will market to them. Before you even look at this though you need develop a strategic approach, that’s our next topic. This podcast is part of a series on the business side of running a profitable and effective community based aged care service. Other topics in this series include: CD011 Understanding Your Market CD013 A Strategic Approach for Community Based Care services   The post CD012 Understanding Your Product (Community Based Aged Care) appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

Good Business for Community Based Care In the last 10 years we’ve seen considerable change in the Community Services sector with more coming. We need to look at our operations from a business perspective now rather than a government led and funded medical model. Aged Care services now, more than ever, are operating in a competitive market. The next few podcast episodes form a series focused on small to medium, independent community care organisations and those who specialise in supporting CALD and Indigenous clients and Local Government operators. We will investigate the topic of whether to stay operating in the market and how to best do this. This is important as we are seeing more discussion around whether smaller organisations should continue operating or if they should consider exit planning.  We don’t have all the answers however, using our experience we can talk about some of the things that we’ve seen work well across businesses generally. Most small organisations may not have had to look at business strategies in any depth in the past. Hopefully we can provide enough information to give these smaller organisations more confidence in moving forward.   We will be looking at: Understanding your market Understanding your product Strategic approach Budgeting Marketing and Promotion Collaborative Approaches Brokerage and Exit Planning Topic 1 – Understanding Your Market When you operate any business you need to understand who your target market is and what they need and want. You may want to operate in the aged care industry but do you actually know what the people you will be marketing to actually want from you. Are there any unmet needs that these groups have that you can fill; this might make it easier to move into an area – be that location or service type. Market Research Businesses, or potential business owners, conduct market research to help them understand the needs of their potential client group. They may do this via desk top auditing and reviews or field research. The importance of understanding your potential client group cannot be underestimated, get it wrong and you won’t have a business. Demographics Understand the demographics of your client base; their age, nationality, education level, marital status, income can assist in understanding their potential needs. Psychographics By further defining the psychographic profile of your target client base you’ll understand their buying choices and be better able to market to them. Psychographic profiling includes understanding the values, attitudes, interests and lifestyles of your target consumer. The more you understand your market the better you can match their needs and desires with your product offering. Ways you can understand the aged care market better Attending industry related webinars Attending forums and workshops (Dept. ACSA, LASA, COTA) Joining Peak organisations focused on supporting an ageing population e.g. COTA Reading newsletters (including those of potential competitors) Taking to individual consumers about what they like, want, need Talking to consumer focus groups such as senior citizens groups Reviewing the ABS latest data e.g. http://www.abs.gov.au/ausstats/abs@.nsf/mf/4430.0 Read Magazines and Newspapers e.g. The Senior Newspaper (free) https://www.thesenior.com.au/ , 50 Something Magazine from National Seniors http://www.nationalseniors.com.au/be-informed/50something   The post CD011 Understanding Your Market (Community Based Care) appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This episode Carrie and Kell look at ways to approach the discussion with consumers and their families around allocation of funds in a Home Care Package. If you prefer to read about this topic see our post on ‘How to have ‘The Conversation’ – Home Care Package Budgets’ Many organisations in rural and remote areas and those working with people from a CALD background have expressed difficulty in holding meaningful conversations with consumers around Home Care Package Budgets. Why are people are have this problem? People don’t like to talk about money. Some people and/or their families see package funds as their own personal money, this can cause them to make unreasonable demands. Clients are not understanding the need for charges to cover administration and case management. What can you do about it? People from that generation often don’t like to talk about money e.g. older people often won’t discuss how much money they made in a year, it was considered rude to ask. Keep this aspect in mind and be sensitive to this. One approach it to have the person look at these funds as money that is provided for their care needs, not personal spending money. This might overcome their reluctance to engage in the conversation. In many rural and remote settings decision making processes are often a family concern. It is important that people understand and are clear about what the money is for – this is a package of care and support for this person. If people are making unreasonable demands use the excluded items list in the Home Care Guidelines. See last podcast for more information. 009 Supporting Good Decision Making Processes. When it comes to the admin and case management components, some people don’t see the need for paying for these. It is important that people see that aged care is no different to other services they purchase eg phone or power both have administration charges. People As long as any charge can be explained, people will become used to it and will probably come to understand what it is for. Get people to focus on the services or the products that the package will be able to purchase. People can be distracted when discussing large amounts of money. They fall into the trap and think that they can buy all the goodies, people can get carried away when they look at the funds as a lump sum. Instead, break up the budget into monthly sums. Draw out the conversation – literally! One way to focus attention on services is to use illustrations. Using a pen and whiteboard, draw out figures and diagrams to graphically illustrate the picture of care. Another way is use talking cards. CDCS have recently developed some cards using our distinctive pictures from our graphic artist, but you can develop your own using photos or pictures from a magazine. Lots of bright colours work well. Ask the consumer to move cards around – ask, ‘what do you like’ or ‘what do you need’. Instead of clients waiting and listening to you they become involved in setting out their plan. If consumers are illiterate use the idea of units instead of monetary values. Write the price of the service on the back of the card to identify that some services cost more than others. Have the consumer ‘spend’ their units. This is more engaging and deflects the conversation from ‘the money’ aspect to a focus on the care and support the person needs and wants. This episode is part of a series on the Home Care Package reform 2017. Other episodes you may choose to listen to are: CD005 Increasing Choice in Home Care Reforms CD006 Increasing Choice in Home Care – Debunking the Myths CD007 Bringing Your Team Along – HCP Reforms 2017 CD008 Supporting Transient Consumers CD009 Supporting Good Decision Making     The post CD010 Supporting Meaningful Conversation – Home Care Package Budgets appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week Carrie and Kell discuss how to support the process of good decision making when consumers request something that falls outside the expected scope for a home care package. Whilst in the majority of cases it will be clear whether a requested service or item is appropriate or meets the guidelines – or not, there will be instances where the request falls into the ‘grey’ areas. Information on the Home Care Package operations manual, which includes the guidelines of excluded items can be found on the Department of Health website. Any discussion needs to emphasise that the Home Care Package funds are for the care and support of the individual, they are not discretionary funds that can be used in the same way that a person would spend their pension money. Although you do not need a formal decision-making tool, having one can support you in arguing for or against an expenditure and maintain a documented account of your process. Some of the questions you might want to include in a formal decision-making tool are: Is the item or service something that an individual would normally purchase themselves? For example, a standard mattress would be something that is normally purchased out of personal funds, however, if the individual required a special mattress or topper this might be an acceptable use of package funds. Is the consumer the only person who intends using the item or service? For example, an air conditioner in a shared space would be considered differently to one in their personal bedroom. Is the item a one off or are there ongoing expenses related to the purchase? For example, if a water filter was requested the maintenance of this item may result in additional regular charges. Are there adequate funds available to cover the purchase without adversely impacting on the consumer’s current assessed support needs? If not the case manager may need to work with the consumer to identify other ways to fund the purchase. Does the funding of this purchase set a precedent that will impact on the funding of other consumers? For example, on a remote Aboriginal community there is often an openness between consumers due to the social structure. People know what each other has received from the aged care service. If there is a chance that the item or service is borderline, consider other options for the purchase. Does the item or service assist the individual to meet their assessed needs and goals? All purchases should be linked to assessed need and goals. Does it support the person to live safely and independently and will it improve their quality of life? For example, there is no sense in purchasing an item that will adversely impact on the long-term goals and wellbeing of the individual, someone might like a scooter to get around the community but is it necessarily the best thing for them? Note: It is important to consult with allied health specialists before purchasing any health related items such as wheelchairs, scooters and rails. Thanks to the case managers from Alpine Health in Victoria, for sharing their draft decision-making tool with us. This episode is part of a series, that aims to prepare and equip organisations for the reforms around Home Care Packages to be introduced on the 27th February 2017. Here are the links to the other topics in the series: CD005 Increasing Choice in Home Care Reforms CD006 Increasing Choices in Home Care – Debunking the Myths CD007 Bringing your Team Along – HCP Reforms 2017 CD008 Supporting Transient HCP Consumers         The post CD009 Supporting Good Decision Making – Home Care Packages appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week, Carrie and Kell look at transient consumers. Who are they, why are they transient and how can you support them so that they are not hit with exit fees every time they move to a new location. Who are Transient Consumers? People who live in remote areas and move around People who move between families People who travel frequently for pleasure or health Reasons for Transience Cultural festivals (e.g. Wave Hill Walk Off and Garma Festival) Mainstream festivals and shows such as the Alice Springs and Katherine agricultural shows or the Art shows and festivals such as the Beanie festival Football and sports carnivals held on various communities Sorry business (Aboriginal ritual during the time of mourning) Cultural ceremonies (e.g. Men’s and Women’s business) Church gatherings (Easter festivals) Royalty meetings and Land Council meetings Changes in family support or dynamics Medical visits for the consumer or those they support (grandmothers caring for young children or those with a disability) Move between cold and warm climates for health reasons – eg cold weather might set off asthma or joint pain Family dynamics / shared care arrangements The problem with transience for the consumer If a consumer moves from one provider to another there are exit fees, this can add up if they are continually changing providers, so how can you address this? Brokerage arrangements Think of the package as a suitcase and inside the case are the building blocks that make up their care plan – personal care, transport, laundry, social support etc. The suitcase has a bungy cord attached to it along with a number of other coloured ribbons which are attached to the building blocks The consumer holds the suitcase – it’s their package They hand the suitcase to an approved provider and maintain hold on the bungy cord – it is now up to the Approved Provider to link the building block (service) ribbons to either their own internal staff or other stakeholders or service providers to provide support. As the consumer moves around they continue to retain a connection back to their package although the service provider ribbons may need to be reallocated to other support providers in the new location. As the consumer moves around it is the responsibility of the Approved Provider to arrange continuous support. Brokerage Costs Brokerage costs can be higher so this needs to be factored into the consumers budget, however by working this way the individual saves on exit fees. You can read the accompanying blog post on this topic here. It contains a number of examples that may assist in understanding how to use brokerage arrangements. This podcast is part of series designed to support organisations in getting ready for, and working within, the Home Care Package reforms which will be implemented on the 27th February 2017. Other topics in the series include: CD005 Increasing Choice at Home – an introduction to the reforms CD006 Increasing Choices in Home Care – Debunking the Myths CD007 Bringing Your Team Along – HCP Reforms 2017     The post CD008 – Supporting Transient HCP Consumers appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

In this week’s episode, Carrie and Kell look at bringing your team along. Shining the spotlight on ‘who’ in your organisation needs to know ‘what’ in the lead up to the Home Care Package reforms that will be introduced on 27th February 2017. Additionally, Carrie and Kell discuss ways in which you can inform key stakeholders of these changes. Bringing your team along Ensure everyone in your organisation and other key stakeholders are aware of the changes, what it means to their role and what it means to the business overall. Who are the key people in your organisation? Internal Stakeholders for a remote service operating under a Regional Council or Shire model: CEO Community Managers Finance staff HR staff Care Staff Do they know what is happening and are they ready? Internal Management Questions to ask: Do they understand that the funding arrangement for Home Care Packages? E.g. the Home Care Package program is not block funded and is to be allocated to an individual? Is there a system in place for developing client budgets and statements? (may be separate from your organisation’s overall finance system) Does your organisation have systems in place to facilitate brokerage arrangements Do you have a system in place for monitoring funds coming in from Medicare? Do they understand what needs to happen to unspent funds when a client no longer needs a package? Do they understand there may need to be an adjustment in the number and type of employee in the aged care program? Do they understand the time frames for forwarding unspent funds to a new provider? How will you communicate this information? Tips for communicating this information: Have a face to face meeting with relevant staff Highlight the relevant essential information that individuals in their role need to be aware of. Eg finance and individual budgets and the time frames for forwarding individual budget surpluses and why they need to be on top of individual consumer monthly statements. Prepare a mini report on the changes and what you’ve done in the service to meet these changes. Care Staff Do care staff understand the changes and what it may mean to them in their role? Consumers may take their package to another provider The changes that are coming and what it means to them eg they may have a change in hours – more or less, different types of services they may be providing and they may be providing care under a brokerage arrangement so less flexibility – change in communication process. Different consumers will have different levels of packages and therefore different levels of support. What are the limitations to a package – what are excluded items The monthly statement – probably because they will be the ones explaining it to consumers and their families. Tips for communicating this information: Staff meetings – explain over a period of time rather than all at once Tool box talk or info share that discusses the changes in a straight forward way covering the ‘need to know’ information. Use scenarios to explain how the changes might look in their situation / community. External Stakeholders What about external stakeholders, e.g. doctors and community nurses or other community members for services that operate independent of the Community Government Council. Do clinic staff and the referring Doctors understand that consumers need to access aged care via the My Aged Care portal? Do clinic staff and referring specialists understand that you may not be able to provide care and support at the level a person requires until they receive a package? Do clinic staff and others on the community understand that your organisation may not be the only one providing care and support from 27th Feb 2017? Do clinic staff and others in the community understand that your organisation may be providing support to an individual but the management of the package may sit with another provider? Tips for communicating this information? Fact sheets that are printed from the Department of Health website. Attend a health staff meeting and explain the changes – morning meetings Own updated client information packs – some of the ones we’ve developed in the past have included client pamphlets eg fees brochures, staff brochures and client handbooks The post CD007: Bringing Your Team Along – HCP Reforms 2017 appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week’s podcast looks at some of the common misconceptions that are linked to the Home Care Package reforms and in particular the Increasing Choices in Home Care. Listen in as Carrie and Kell discuss what these are and attempt to put the record straight.   Myth #1 – From February 27th 2017 the consumer can opt to have package funds deposited directly into their account to manage their own care. Truth: Packages are linked to a consumer; however, they do not handle their funds themselves. The consumer needs to take their package to an Approved Provider to manage on their behalf.   Myth #2 – Consumers can take their package to anyone to manage on their behalf. Truth: Consumers can only take their packages to an Approved Provider of Home Care Packages.   Myth #3 – Consumers will ‘bunny hop’ between providers at the drop of a hat, resulting in decreased organisational sustainability in some areas and fluctuations in staff requirements. Truth: The charging of exit fees when consumer change providers will act as a deterrent to frequent changes of service providers. Consumers also have a responsibility to inform their service provider if they intend changing providers prior to entering into an arrangement with a new provider. Consumers also will need to activate their referral on My Aged Care for another provider to accept them onto their program. These last two points should minimise ‘spur of the moment’ decisions from being acted on and allow a service provider to discuss both the implications of a change and the reason for the change with the consumer.     Myth #4 – As long as it is identified in their care plan, consumers can use their package funds to pay for items such as fridges, televisions and air-conditioners as these items will make their lives better. Truth: There are a number of items that are considered to be ‘Excluded Items’, these are listed in the Home Care Package Operational Manual (December 2015). Even where this is listed in the person’s care plan it may need to be something that the consumer will need to save up and pay for from personal funds. Any ‘additional’ items that are requested by a consumer need to match their assessed needs and the purchase should not impact negatively on their essential service needs. Where there is a request for an item that you are not quite sure about you’ll need to ensure you show clear consideration of the item or service and the reasoning behind any decision. This should be documented clearly.   Myth #5 – When a client exits the program (dies or no longer needs a Home Care Package) any unspent funds can be used to support other clients waiting for a package. Truth: All unspent funds need to be returned to either the Commonwealth Government or to the consumer’s estate.   Myth #6 – A consumer who has had their client contribution fee waived is not paying anything toward their care. Truth: Consumers may not be paying any additional fee for their care, over and above the recovery cost for their meal, however, they are considered to be paying for their care through their package. This needs to be reflected in their client agreement.   Myth #7 – Anyone who has been approved for a higher-level package will automatically be moved to the higher package on the 27th February 2017. Eg. From a level 2 to a level 4 HCP. Truth: Unfortunately, a person won’t automatically be assigned a higher-level package on the 27th Feb 2017 however, if they are already receiving care at a lower package level they will automatically go on the National Queue. There will be no additional packages released on the 27th of February, although additional packages will be released and added to the National Package Inventory over time and therefore, potentially decreasing the wait time for a higher level package for individuals.   Additional Comments The National Package Inventory will be made up of all current packages whether used or unused at the 26th Feb. The Government will be releasing new Home Care Packages over time and these will be added to the National Package Inventory. Any packages that are not attached to consumers on the 27th February will be returned to the National Package Inventory (National Pool) and will be distributed out to consumers in the queue. All claims for Home Care Package payment will continue to be made through the Department of Human Services Aged Care Payment System – Medicare.   The post Increasing Choices in Home Care – Debunking the Myths appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

The Increasing Choice in Home Care reforms will be introduced on the 27th February 2017 and will change the way Home Care Packages (HCP) are allocated and managed. Today Carrie and Kell discuss what the changes will mean for both consumers and the organisations who support them. There are four main changes: The Home Care Package (HCP) will follow the consumer Consumers will be assessed at a HCP level 1, 2, 3 or 4 – they will no longer be banded There will be a national pool of packages and a national waitlist The process of becoming an Approved Provider will be streamlined What do these changes mean? Funding follows the consumer: All unfilled packages will be returned to a national pool – while this can have negative impacts it will also have benefits as it may have the potential to decrease waitlists in some areas The package is attached to the consumer rather than the organisation and increases the portability of the package for the consumer both long and short term relocations. Consumer can choose which Approved Provider they want to ‘manage their package’ Consumers can request services from providers outside the established arrangements that the Approved Provider has in place if this is their desire. For example they may have an existing relationship with a cleaner and wish to continue to use their services. Any unspent funds will move with the consumer. This will have benefits for individuals where they choose to take their package to another area or to another provider. Package levels will no longer be ‘banded’: No longer will people be assessed at a banded 1-2 or 3-4 ACAT will assign 1, 2, 3 or 4 based on assessed needs Those individuals who have already been assessed at a banded level will be automatically assigned the higher level. Therefore, if they are currently assessed at level 1-2, on the 27th February 2017 they will be identified as eligible for a level 2 HCP. The National Pool and National Wait List: All unfilled packages and packages that are no longer required by the consumer will be returned to a National HCP Pool. Allocation of a HCP will be Managed by My Aged Care according to the National Wait List. This will make wait list times more equitable across the country. Consumers will be prioritised based on their: Relative needs Circumstances Time they have been waiting for care The process for becoming an Approved Provider will become more streamlined: The process for an organisation to become an AP will be a lot simpler and focus on the ability of the organisation to provide quality care. Residential Care providers and Flexi care providers can ‘opt in’ and become home care providers They won’t have to go through full application process This will support an end to end care approach The impact of changes on the organisation: Many remote services who are providing support to high care needs clients wanting to live on community will receive appropriate funding – eg most remote services are currently limited to level 2 packages, this will change as consumers transition across to their assessed level. Note: many orgs in remote areas don’t think they can provide level 4 but this is not true. (often they already are) They have access to Clinics and nursing staff, podiatrists, physiotherapists etc through either private or Government Health services – don’t necessarily need to employ a nurse or health professional to meet an individual’s needs Just because a person is a level 4 doesn’t mean high care ‘nursing’ it might mean additional personal care support or increased observation requirements. Organisations need to look at the assessed needs of the individual and see how they can work collaboratively to support that person. Any unfilled packages will be returned to the National Pool on Feb 27th 2017 therefore it is important to ensure all assessments are completed in a timely manner and unfilled packages allocated if possible. Staffing levels may fluctuate as consumers come and go from organisations. Organisations may need to consider a stronger casual workforce to back up the provision of quality care. There is no monopoly, even in remote areas – don’t think you have it all your own way, outside organisations may seek to take up the opportunity to provide care and support in your area or community. It’s about the consumer, not the organisation.   For more information on the Introduction to Home Care Changes visit the Dept. of Health website This podcast is the first part in a series that we are doing in the run up the February 2017 changes that seek to prepare you and your organisation ahead of time. Next episode we’ll look at busting some of the myths around the changes and hopefully put people’s minds at ease. The post CD005: Increasing Choice In Home Care Reforms appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week Carrie and Kell discuss how to store client and staff personal information securely in order that an individual’s privacy is protected. Topics covered in this episode include: The notion that clients of any business should be able to trust that any personal information is kept securely out of the public view; when personal information is disclosed due to poor practice that trust is lost. Disclosing personal information can place individuals in an awkward position and can also place some individuals at risk of physical danger. Types of documents that need protecting: Progress notes Information containing personal details Medical histories Bank Statements Legal Documents, Eg. from Guardianship or Solicitors It’s not only client information, the personal information of staff members needs to be protected as well. Organisations are respondent to Acts and Standards including the Privacy Act 1988. These Standards and Acts cover areas such as the sort of information that needs to be protected and who can access the information. All personal information should be stored appropriately such as in a locked filing cabinet or a locked room. Information that is no longer required should be shredded or archived properly. Archiving properly means that documents are stored in secure, vermin-proof areas. Check on the archiving timeframes for your State or Territory before disposing of any personal information. It is important to ensure there is no casual observation of personal information on computer screens when you have visitors in the office and log out of client management systems to prevent people from reading personal information. Ensure that you handle requests for personal information appropriately and that your staff also understand what to do when someone requests personal information.   The post CD004: Storing Documents Securely appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week, Carrie discusses ways to capture and record information that can be used later to create your client progress notes. Remote coordinators often struggle for time with the competing demands of their job. They may be working with staff who are unable to complete documentation to the required standard. By applying some of these ideas you may be able to stop yourself from falling too far behind in writing your progress notes. Tip 1. Keep a notebook in your vehicle. When staff drive around the community, ask them to make a note of any relevant details about clients. For example, clients who are away or reports from family members. Take the time each afternoon to write up the notes into the individual person’s progress notes. This method can also prompt you to follow up on any issues such as absent clients. Tip 2. Keep a notebook at the Aged Care Centre to capture incidents and other observations. Check with staff before they finish for the day to clarify the information. This is also an opportunity to help staff learn how to write better notes. Tip 3. Daily diaries can be used to log a lot of information, refer back to incidents, visitors, or remind you of essential tasks such as client re-assessment dates. This habit makes it easy to catch up on missing documentation. Tip 4. Use your smart phone to capture pictures relevant to an incident or use the Notes App or voice recording App on the phone to capture a few notes. These can be transcribed to a client’s notes or you can upload to a client management system if your system allows this. Whatever method you choose to gather the raw information, it is important to ensure you transfer relevant records to the individual client notes. Don’t leave it too long to do so as it will only make your job harder. Get into the habit of reviewing your daily notes and transfer them at the end of each day. It will make your life a lot easier! You can read the original blog post here. The post CD003: Easy Ways to Capture Information for your Progress Notes appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

Defensible documentation, what does this mean? This week Kell offers up some tips on writing professional progress notes and together with Carrie, discusses how to write progress notes that can support you and your organisation in the case of an audit, or if your notes are called before a law court. Kell’s Top Tips: Always check that you are writing in the relevant person’s notes This means making sure you have the correct‘ identifiers’. Identifiers are a person’s name and their date of birth. Never write notes on a blank sheet, even if the notes are contained within the person’s file and always ensure identifiers are noted on each individual page. Use a blue or black pen Blue and black pens are the colours of preference for legal documents as they photocopy well and are easier to read. Avoid the use of red or other coloured pens as these are harder to read and do not photocopy well. Ensure they are indelible – this means they cannot be erased – this means you cannot use either pencils or erasable ink pens. Write legibly Your notes need to be clear and easy to read and decipher. Printed words rather than cursive lettering are fine. It’s okay to print in capital letters if this ensures your notes are legible. Note the date of your entry If you are writing about something retrospectively, you can include the date and time of the event within the body of the note. Sign your entry This may be a full signature or your initials – it will depend on your organisation’s policy. Make sure you sign directly after your last word Avoid blank space between entries Never leave blank lines or space between entries. If you have a blank line that you don’t want to write on, draw a line through it. If you start a new page and discover that the previous page still had white space left then draw a ‘Z’ shape through the remaining white space so no-one can write in this section. Make it clear if notes span more than one page If you move from one page to another Add ‘Note continues overleaf’ at the end of the page. At the beginning of the next page add the words ‘Continued from previous page Errors happen If you make a mistake, place a line through the word. Do not use white out or try to black out the entry. If you have made a note in the wrong person’s progress notes rule a line through the entry and make a note that the information was written in the wrong client’s file by using the words ‘notes entered against incorrect client’. Use the correct words Do not try to write complex words unless you are sure of their spelling and meaning. Remember that even many simple words that sound the same are spelt differently and have different meanings. Plain and simple language is the best course of action. Beware the acronym and abbreviation if you use a shortened version of a word or phrase, make sure it is either a standard across the industry, with no chance of misinterpretation, or is one approved by your organisation. An abbreviation is a shorthand version of a word or phrase that may be used repeatedly, Dept. = Department An acronym is a word or name created out of the initial letters of words in a phrase, e.g. Commonwealth Home Support Programme = CHSP. Use the full word/s where possible 11. Keep your entry professional Use no assumptions, judgemental language or red flag terminology. Keep to known observations, state only what you heard, saw, smelt or felt. Just because a person looks unhappy doesn’t mean they are sad. Just because someone is staggering does not mean they are drunk. When you state that someone was being offensive or obstructive, you are making a judgement call on her behaviour – someone’s behaviour might offend you but they don’t mean to. Just say what someone did and your response to that, you are maintaining professional neutrality. Red flag terms describe words or phrases that are sensational in nature. These could be describing a person as being the ‘victim of domestic abuse’ or ‘there is an epidemic of scabies within the household’. Just remember, stick to the facts and only the facts 12. Electronic progress notes? Content still important, don’t waffle and maintain a professional tone. Always log out after making an entry. If you would like to read more detailed information about writing progress notes check out our blog post 11 Tips for writing professional progress notes Please let us know how you found this episode in the comments below. If you have any further ideas for maintaining professional notes we’d love you to share them with us. You can subscribe to the Care Directions podcast by clicking on one of the links above. We’d also appreciate it if you left us a review over on iTunes, until next time. The post CD002: Defensible Documentation – Tips for Writing Professional Progress Notes appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.

This week Carrie and Kell look at documentation. This episode is the first of a four part series on documentation. What and when to documentation How to create defensible notes How to easily capture information to be used in progress notes How to store information correctly Today we look at what and when to document. If you would like to more detailed information on the topic of exception reporting you can read about it on our blog post ‘Progress Notes – what should you document’. The standard for reporting is ‘Exception Reporting’ – this means you don’t need to report anything that falls within the expected service plan, merely deviations from this. Issues you would report on would cover, observed changes in a person’s Behaviour Emotional state Physical wellbeing or Physical appearance You would also note Incidents that have or may impact on the client Relevant information passed on by friends and / or family Issues around service delivery (e.g. services that were not able to be provided due to organisational issues) Information and / or discussions from the health clinic, doctors surgery or discharge planner Changes to the household dynamics that may or have impacted on the person Complaints How often should you document? While the general rule is for Exception Reporting, your organisation may have a requirement for regular weekly or monthly notes in each person’s progress notes. It is important that any notes added are relevant and have value. Thanks for listening in, tune in next week for our episode on creating progress notes that meet legal and organisational requirements. To avoid missing an episode subscribe to the Care Directions podcast over on iTunes or Stitcher. The post CD001: What and When To Document appeared first on CDCS Pty Ltd - Culturally Directed Care Solutions.