Home' Australian Ageing Agenda : AAA Jul-Aug 2014 Contents Gorm Kirsch
CDC in action
If you haven't started delivering
consumer-directed home care
packages, get practicing because
from July 2015 it is CDC or bust.
Natasha Egan gets some
tips from two providers already
embracing the CDC way.
Since Gorm Kirsch took over as CEO in May
2010, Home Nursing Group (HNG) has
transformed from a local DVA provider based
in Armidale to a regional community aged
care provider serving the New England and
mid-north coast regions of NSW. It now also has offices
in Coffs Harbour and Tamworth. The provider's core
business is Home Care Packages, but as of January
2014 it also provides 60,000 HACC hours and some
GETTING CDC READY
HNG secured its first community aged care packages in 2011 with
the second round of funding under the pilot consumer directed
care program. As they never had traditional packages, Kirsch
says they were able to start with a "clean sheet of paper" when
designing their CDC packages.
Even so, HNG still had to learn the CDC way, which Kirsch
says involved extensive research into consumer directed care,
restorative and enabling care approaches and market demand
among local aged care consumers. The research highlighted
community concerns about administrative costs and a perceived
lack of transparency among some providers, he says.
"Our CDC approach is premised on the idea that our primary
job is to support consumers as they make decisions about their
own goals and care options by providing as much information as
required, in a relevant and timely manner.
"We never present consumers with a limited menu of options,
rather we work with them to develop flexible, responsive service
packages enabling them to meet their own goals."
Kirsch highlights the following as key organisational issues
that HNG spent time on during implementation:
• intake and budgeting systems to manage expectations and
• staff training, such as in restorative and enabling approaches
and open-ended language for goal exploration and storytelling
• reviewing technology including both internal systems and
assistive technology for consumers
• aligning the quality framework with the CDC approach, such
as accounting for the "dignity of risk," which refers to an
individual's right to make choices for his or herself
It is necessary to know your operating costs and also
how to explain those costs to customers, Kirsch says.
"This is the essential first step to ensure
transparency and long-term viability. Most consumers
accept costs, including administrative overheads, as long as they
are justified, reasonable and well-explained. We have a team
who prepare and check budgets and also report monthly to
management and consumers about over- and under-spends."
Kirsch says it is important that clients, as well as family members,
understand fully and from the outset what can and cannot be
delivered within a certain budget. "Too often, consumers and
their informal carers have unrealistic ideas about how many
hours of care can be delivered per day. We therefore ensure the
package funds are being used very efficiently, for example, paying
private housekeeping services rather than using AINs to do
CLEARING UP CASE MANAGEMENT
Case management is essential for effective service coordination
but it is not well understood by clients and their informal carers,
Kirsch says. "We therefore break down the components of case
management during our early discussions with consumers to explain
what it is and why it is an essential component of the package."
Input from consumers plays an important role at HNG, Kirsch
says. HNG also consults in the local health and community aged
care communities and holds regular meetings with an advisory
committee. Discussions cover business strategy, policies and
procedures, future planning and quality assurance including
customer feedback surveys. Clients say they greatly value the
control, choice and individual budget offered by CDC, he says. n
Packages fully utilised with approximately 20 people on a waiting list
across levels two to four but vacancies (4) with level one packages.
Home Nursing Group
Home Nursing Group worker and
CDC client discussing the day's plans.
34 | JULY -- AUGUST 2014 | AAA
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