Our New Service Model ACS State Conference 2010

1. Our New Service ModelACS State Conference 2010

2. What is a Service Model What services do we provide? To whom do we provide them? In which communities? What do we do and what do we do with others? A Service Model addresses these four questions. It also provides a basis for designing a common operating model for delivery. It is an expression of the INSPIRE Strategy and is linked to the operating model through a statement about our Operating Philosophy and cultuarl expectations.A Service Model addresses these four questions. It also provides a basis for designing a common operating model for delivery. It is an expression of the INSPIRE Strategy and is linked to the operating model through a statement about our Operating Philosophy and cultuarl expectations.

3. Aged Care Reforms National Health and Hospital Reform Commission People first not programs � deregulation of supply Single classification for care More flexibility in financing options including bonds � separation of accommodation from care Interface with Primary Health Care and Sub-acute care E health record around the client One level of Government responsible

4. Evidence base for Service Model Australian Institute for Primary Care: Active Service Model � a new paradigm for HACC (1997-2007): 1. Capacity building and restorative care. 2. Holistic �person-centered� care promoting client�s wellness and active participation in decisions about care. 3. Provision of more timely, flexible and targeted services capable of maximising a client�s independence.

5. Evidence base (cont) Ageing Well and Retaining Independence: A background paper � Professor Louisa Jorm, Director, Sax Institute (2007): To maximise health and quality of life as they age, people need to move into oler age with the highest level of functional capacity.

6. Evidence base (cont) Changing Places: An exploration of factors influencing the move of older people from retirement villages to residential aged care � Creek, Ballantyne & Byers. Uni SA (2003): Demonstrates how retirement villages are more than physical locations. They provide social space and social relations which are lost in residntial aged care.

7. Evidence Base (cont) Housing and Support The AHURI report on Service Integrated Housing (Dec 2009) Building a good life for older people in local communities: The experience of ageing in time and place by Godfrey, Townsend & Denby (2004): Ageing is not just about decline, it is seizing opportunities and managing transition and loss. A good life in old age = inter-dependence. The localities where older people live are tremendously important.

8. Evidence base (cont) Frailty and Recovery The Frailty Study http://www.rehab.med.usyd.edu.au/tie/fit Older people with age-related disabilities living at home: health and support service implications by Lawton, Wasilewicz & Huges (April 2008) Studies showed when intervention is clinically positive with capacity to respond quickly services may only be required on a temporary basis and reduce further risk of institutionalisation and decline.

9. Evidence base (cont) Social Networks Social Networks and 10 year survival of older Australians by Giles, Glonek, Luszcz & Andrews Found the composition of networks was a key predictor of longevity. Participants who retained a significant number of non-family supports were likely to live longer. This is associated with remaining active and having control over your interactions.

10. Evidence base (cont) Carers Trends in Aged Care Services: Some implications. Productivity Commission Research Paper 2008. Most care is currently provided by family members and other informal unpaid carers and their availability is expected to decline over next two decades. Main concerns: information, financial supports, respite, flexibility in the workplace, and training and assistive technologies.

11. The Service Continuum

12. Separation of accommodation from care

13. How we developed the Service Model Extensive market research and literature reviews throughout first half of 2008 A draft position paper was prepared Workshops held in second half of 2008 involved around 100 participants Position paper prepared Service Model launched in 2009. Identified as an additional project when the Executive met in December 2007 on the Bowral Plan. Market research included recent Government reports, extensive analysis of all publicly available data and some market research especially around housing was commissioned. Marketability did this work and each Region received a pack which highlighted and mapped demand and need around housing and provided a housing affordability index and competitive analysis. Market shares were calculated based on publicly available information and this was projected based on publicly available demographic projections. The analysis around the service mix built on this work.Identified as an additional project when the Executive met in December 2007 on the Bowral Plan. Market research included recent Government reports, extensive analysis of all publicly available data and some market research especially around housing was commissioned. Marketability did this work and each Region received a pack which highlighted and mapped demand and need around housing and provided a housing affordability index and competitive analysis. Market shares were calculated based on publicly available information and this was projected based on publicly available demographic projections. The analysis around the service mix built on this work.

14. FOUNDATION PRINCIPLES Client Choice and involvement Independence and wellbeing Social Inclusion Social Justice Separation of Housing and Care Recognising the value of carers Independence and well being � A focus on wellness and keeping people healthy and in control in a range of accommodation options. Social Justice � We operate in accordance with our social justice principles � advocate for effective public policy � emphasis on achieving equity for all. Social Inclusion � challenging negative stereotypes about ageing and older people. Just because someone is old and/or at the end of life is no reason to segregate them from society. Age friendly communities. Separation of accommodation from care � this is the foundation for consumer directed care. Advocated in a number of key reports including the Productivity Commission and NHHRC Report. Care entitlement with the person to receive in the accommodation setting of their choice. Provides more flexibility for how the accommodation is funded including through more user pays and other funding sources eg NRHAS, Economic Stimulus Recognising the value of carers � A trigger for entry to residential care is not having a carer and living alone. Demographic changes will see reductions in the number of carers. Client Choice and Involvement � Changing community expectations. Baby boomers will not be placed into a limited range of service options. They will want to choose and they (or their families) will increasingly be paying more for the services they receive. Independence and well being � A focus on wellness and keeping people healthy and in control in a range of accommodation options. Social Justice � We operate in accordance with our social justice principles � advocate for effective public policy � emphasis on achieving equity for all. Social Inclusion � challenging negative stereotypes about ageing and older people. Just because someone is old and/or at the end of life is no reason to segregate them from society. Age friendly communities. Separation of accommodation from care � this is the foundation for consumer directed care. Advocated in a number of key reports including the Productivity Commission and NHHRC Report. Care entitlement with the person to receive in the accommodation setting of their choice. Provides more flexibility for how the accommodation is funded including through more user pays and other funding sources eg NRHAS, Economic Stimulus Recognising the value of carers � A trigger for entry to residential care is not having a carer and living alone. Demographic changes will see reductions in the number of carers. Client Choice and Involvement � Changing community expectations. Baby boomers will not be placed into a limited range of service options. They will want to choose and they (or their families) will increasingly be paying more for the services they receive.

15. Key Features of the Service Model Single access point for services Comprehensive information service across NSW/ACT Our own brand of INSPIRED CARE Special focus on helping people navigate all parts of the service continuum Focus on specialised services especially for those who are vulnerable and disadvantaged.

16. Key Features of Service Model A focus on community care � assertive growth Medium growth in a range of housing options Stable growth in �traditional� forms of residential care Planning around communities for social inclusion

17. Key Features of Service Model A specialised focus on Chronic Illness and disability for older people Invest in and build on areas of specialisation eg homelessness Services organised around a �hub and spoke� where the hub is ideally a community care centre Use our congregations and community networks to �go the extra mile�

18. The Common Operating Model

19. Capability Development Clinical assessment for chronic illness and disability Person Centred � Inspired Care Planning around communities for social inclusion Business development across the service model continuum Business processes changing especially at first contact and intake. Housing capability

20. Be Inspired�.. Our Inspire Journey Continues�� Only those who risk going too far can possibly find out how far we can go. TS Elliot