A large service provider across multiple sites has found there is a real appetite for change in the organisation and they are making sure their clients have a positive experience with Consumer Directed Care (CDC) as they sprint towards 1 July 2015. Jonathan Pietsch, Home Care Today’s Service Provider Consultant, interviewed Fonda Voukelatos, Executive Manager Business Development at Uniting AgeWell. Fonda is the executive sponsor responsible for the implementation of CDC within the organisation.
Uniting AgeWell provides residential and community aged care services to over 7,000 people each year and delivers 564 Home Care Packages, mostly level 2 and 4, from multiple sites across Victoria and Tasmania. While some preparation had been done in the early part of 2014, the past eight months has seen an increased focus on being CDC ready by the first of July 2015. This focus is very much on transparency and ensuring our clients are receiving services that provide them with maximum benefit. In the past program drivers have been about risk aversion; clinical needs and occupancy and in a sense, like many agencies, we had inadvertently formed a co-dependent relationship with the client rather than primarily focussing on the client’s goals and independence.
The whole notion of transparency is driving a critical attitude change for both our staff and our clients. In the past, clients have always been incredibly grateful for the services provided and whilst that is heartening, many have had no understanding of the mechanics of the Home Care Packages Programme, let alone what the government subsidy was and where monies were being apportioned. Rather than seeking gratitude, we are seeking feedback that indicates we are providing an effective service that is also good value for money.
The employment of an Executive Manager Business Development, with significant expertise in research, co-development and consumer direction has enabled a program logic and project management methodology approach to be used. The key steps have been:
- to establish a vision, strategy and focus and systematically implement it; the number one driver being to serve and make sure we can assist people to live the life they want
- having high level management support, driven by the Board and Executive team
- co-development and design to create a strong evidence base
- adopting a whole of organisation effort including finance, quality, marketing and service delivery staff
- investing in our people at every opportunity and enabling them to contribute to the development of the delivery approach
- making sure IT systems are supporting the change and increasing efficiencies
- planning, planning and more planning!
The first of July deadline has certainly created the sense of urgency and has been a call to action for Uniting AgeWell. Sixteen separate projects were identified as critical to being ready. This has resulted in 65 to 85 packages being converted to CDC every week. It’s certainly felt like a sprint but it’s all in preparation for running the marathon.
Significant change has occurred in IT systems with the adoption of E Tools software; an excellent system, easily picked up by our staff and aligned to systems already in place. It has resulted in assessment requirements being less invasive and clinically orientated and more focused on the presenting need, interests, goals, choices and wishes of the client. Clients are responding very positively saying things like, “I have never been asked that before” or “I now feel able to make informed decisions”. It’s early days, but the program really feels like it is providing a unique service for each client.
A key challenge continues to be making sure the client understands their agreement and for goals to adopt a standard and language that makes sense to them rather than the professionals. The opportunity is to provide and explain information in a logical and easy to understand manner, that the person can identify with and to ensure this process is backed up by an exceptional service experience.
A moral challenge for the sector is how we stick to optimising a person’s health, wellness and other needs in a system which rewards providers by length of stay, declining health (increase in subsidies) and being reactive rather than proactive and pre-emptive. Again, an opportunity for sector leaders.
Being an integrated service provider of community, senior living (retirement and social housing) and residential care services presents some great opportunities for Uniting AgeWell. In particular, CDC is not limited to Home Care Packages; the philosophy and framework has broader applicability across all of our HACC, day therapy and carer services. It has also led to organisational developments including the modernisation of our clinical assessment framework; minimised duplication for clients and their families by having one approach across the organisation and its application to residential care.
The longer term challenge is going to be how our relationships work out with our partners who are also competitors. Managing the competition and collaboration required to ensure clients get the best deal will be essential. This highlights how important Uniting AgeWell’s commitment to making a positive impact on every client will be today and tomorrow. So yes, we are ready for the first of July but more importantly we have the systems, staff and resources in place to assist our clients to be as independent as possible well into the future.