Home' Australian Ageing Agenda : AAA Jul-Aug 2014 Contents from managing community services
over many years that staff can struggle
with individualised goal-based planning,
sometimes because they don't think in
terms of goals for themselves.
However, she says it is all about knowing
the right questions to ask and points to the
work by UK consultant Helen Sanderson.
"What does a good day look like? What do
you enjoy doing? What really makes you
excited? They're the sort of questions that
people need to learn to ask," she says.
Similarly, when coordinating the package,
it is important for workers to realise they
are facilitating rather than managing, says
Held. While case management and capacity
building are phrases commonly used in
the sector when talking about CDC, the
terminology can be confusing.
"We are really trying to shift that
language to more an advisory and
facilitation role. Consumers don't like the
term case management at all," says Held.
"We need to get the mind shift from that
traditional case management approach to
one of an advisory role where the consumers
are making the decisions and persons in the
agencies are supporting that."
Similarly, Held says they prefer to
use "capability" rather than "capacity"
because saying you're building people's
capacity implies they don't have the
capacity in the first place.
"They probably have the capacity but
they don't have the information or the
understanding of how the system works to
be able to use their capacity. It is really about
people understanding the complexities of
the system and what their options are and
being able to make choices based on that."
Equally important when explaining options
and providing choices are the initial and
ongoing conversations with clients to
determine and deliver the amount of control
and information the client wants, says Held.
For example, in dealing with the budget,
she is getting feedback that some consumers
are confused by the monthly statement and
think it is a bill they have to pay.
"If someone says I can't cope with any of
this. I want you to take my budget and talk
to me about what I want and deliver it; that
is consumer directed as well," she says.
Overall, the shift to individualised
budgets and a client-driven environment
means that frontline workers now need
advanced skills in managing budgets and
helping clients understand their monthly
Lorraine Poulos, an industry consultant
who offers training in a range of aged
care areas including budgeting for CDC,
says the first thing everyone needs to
remember is that the budget is not the
actual. Rather, it is a plan, and each month
the budget statement shows whether you
have gone under or over, she says.
Poulos agrees that everyone in the
organisation needs to be behind the
transition to CDC. She says one of the
richest parts in budget training sessions
is when the finance people and the care
coordinators are in the same room.
"When that happens, the finance
people actually get to understand what the
community care service is about and why
they need to have flexibility around the
way they manage the service," she says.
Looking at the interface between the case
manager and the organisation's database,
Poulos says it is important to make the
budget available in real time. She gives the
example of a home care package recipient
in hospital who is allowed to return home on
the weekend if they have some support.
"The systems have to be responsive
enough for the case manager to be able to
approve sending in some additional care
on the weekend, knowing that the client
in general has enough money in their
budget," Poulos says.
Bringing care planning, service
coordination and financial skills together,
Poulos recommends that care coordinators
find out from their Medicare Local what
existing services are available for clients
to access, as well as any private health
entitlements for allied health services, and
then build the budget around that.
"If the case manager was able to help
clients navigate that so they could access
those services, that's where the richness
of the work and their skills come into
play," she says.
AND COMING SOON
Looking forward one year and whether
the sector will be ready, Held says July
2015 is essentially just the starting point
of an ongoing cultural change project.
While it is true that, early on,
organisations were not learning from
each other as well as they could have,
as many organisations were protective
of their models, the situation is now
improving, she says.
"We are hoping through the Home Care
Today medium we can start doing more of
that - things that are shared; that we are
learning along the way."
Resources for consumers include
a printed and downloadable CDC
information booklet and 45-minute face-
to-face peer-education sessions, which are
being rolled out by COTA over the coming
year. Providers can also book these peer
education sessions for their existing
clients prior to transitioning to CDC.
Specifically for providers, Home Care
Today is developing a range of sharable
content, some of which will be delivered
by the peak bodies. Trainer and student
materials will also be available on the
website for organisations to run their own
Projects completed or underway
include the development of tools to:
determine internal costs and build budgets;
help workers have person-centred,
consumer directed and restorative care
conversations; and design a co-production
CDC approach. There is also a longer term
project looking at legal issues and risk in a
consumer directed environment. n
Some useful and informative sources of ideas, information and advice for
organisations on the CDC journey.
HOME CARE TODAY
• organisational self-assessment tool
for CDC readiness
• implementation checklist
• common challenges and solutions
• a knowledge centre
• materials to carry out internal CDC
• consumer engagement advice
• peer education session for current
Go to: homecaretoday.org.au
CS&HISC YOUTUBE VIDEOS
• Consumer Directed Care - It's a matter
• Time for action
Go to: youtube.com/user/cshisc
• The UK consultant has a range of books,
videos and other resources available
Go to: helensandersonassociates.co.uk
Continued from page 30
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