What is The Better Practice Project? • The Better Practice Project aims to support the community care sector in adopting evidence-based practices that enhance the autonomy and quality of life of people requiring support to live at home in their community. • The Better Practice Project has at its foundation, an enabling approach. An enabling approach in community care means ‘doing with’ and supporting the individual ‘to do’ rather than ‘doing for’, or ‘doing to’ the person being supported.

The Better Practice Project • Developed in close consultation with the sector • Built on national & international evidence • Launched by NSW Minister for Ageing in Oct 2010 • Has initially focused on frail older people, their families and carers • Is relevant to people under age 65 requiring support to live at home in their community

What is an Enabling Approach? • Focused on what each person can do and wants to be able to do • Actively involving each person in setting and achieving goals that are important and meaningful to them • Working collaboratively with each person, their carers, social networks & other providers, tapping into both formal & informal supports • Focused on outcomes for people (e.g. the achievement of each person’s goals) • Entails regular reviews of each person’s goals • About working with people to reduce unnecessary service use, and improve their functional independence in ways defined as important by them. • Is based on the same evidence that underlies WA’s Wellness approach, Victoria’s Active Service Model, Re-ablement in the UK, and TARGET in New Zealand An enabling approach is a way of supporting individuals to live at home in their community. It is:

What people are saying about an enabling approach • “I get a lot of benefit….So does my wife. She was having to do everything for me before. Now I do it all myself: my shower, getting dressed, everything.” • “I am starting to get my old confidence back and by the end of the program I will have learned some new skills to keep me going on my own.” • “I was shocked that at my age (93 years) I would be considered for a program that will help me get back to doing things for myself.”

Why move towards an enabling approach? • To get better outcomes for people requiring support • To improve staff satisfaction and staff retention rates • To build sector capacity in using evidence-based better practices • To better manage increasing demand for services

What the evidence shows • People can make gains physically, socially, & emotionally even when they are frail in their 80s and 90s • Frail older people can re-build muscle strength, regain mobility, & establish or re-establish meaningful social connections • Low level exercise can improve confidence & morale, functioning & personal wellbeing • It is possible to reverse or slow down deterioration with modest low cost interventions e.g. using aids and equipment and encouraging attention to diet, exercise and nutrition • Community care support services that place an emphasis on “doing for” the frail older person (e.g. doing the shopping, doing the laundry) may be unintentionally creating dependence and working against the goal of enhancing independence

What the evidence shows When successfully targeted and implemented with older people at risk of unnecessary decline, an enabling approach that includes early short term restorative intervention (8 to 12 weeks) may: • improve physical/social functioning • enhance individual autonomy and independence • delay the need for ongoing support services/higher levels of care; • reduce hospital admissions

An enabling approach in community care The Enabling Approach is relevant to the existing community care context, as it is: • Consistent with the aims of HACC • Aligned with the NSW State Plan e.g. embedding early intervention & prevention; preventing unnecessary hospital admissions • Aligned with the new Community Care Common Standards requiring service providers to shift their focus from outputs to outcomes being achieved for individuals • Clearly articulated in the new vision for care & support outlined in the Caring for Older Australians, Productivity Commission Draft Report • Aligned with the Towards 2030: Planning for our changing population a whole- of-government strategy for actively planning for the ageing of the population

A handbook for community care services • Practice ideas and client and carer stories from over 50 services • Key lessons from services using enabling practices • Fact sheetsand contact details for people and services who participated in this project • Other resources such as websites, presentations tools and manuals for people interested in an enabling approach As part of The Better Practice Project a mapping innovation and better practice initiative was undertaken across NSW. This resulted in A handbook for community care services which contains The practice ideas and client and carer stories in the handbook come from both small and large services operating in metropolitan, regional and rural areas. Four practice ideas are from Aboriginal services and six practice ideas from services that support people from culturally and linguistically diverse (CALD) backgrounds).

The Better Practice Enabling Demonstration Projects • There are Four Enabling demonstration projects in NSW: • Clarence Valley, Northern NSW • Singleton, Hunter Valley • Northern Sydney • Eastern Sydney • Each project is unique, however they all share common characteristics and a flexible approach that aims to put each person at the centre • Program participants are at risk of unnecessary decline, eligible for HACC, and interested & willing to participate in a short-term program (8 to 12 weeks) aimed at enhancing their autonomy & independence • Participants to date - mostly in 75 to 84 age cohort • Each participant is actively involved in setting goals that are important to them • The Demonstration Projects are being independently evaluated and the results of this evaluation will be communicated to the sector.

Conclusion • Individuals requiring support to live at home want greater autonomy, choice & control over their everyday lives • Service providers want to adopt better practices & achieve the best possible outcomes for the people they serve and support • News is travelling about the positive results being achieved for individuals, families, & local communities & about the positive experiences of staff • Aged Community Services Association of NSW & ACT (ACS) will be conducting a targeted awareness-raising education program later in 2011 around an enabling approach

Next Steps – How you can be involved • Learn about the practice ideas, case studies, and client and carer stories featured in A handbook for community care services on this DVD • Find out about the Demonstration projects by reading the flyer on this DVD • Read the paper Towards an enabling approach in community care on this DVD • Register your interest in future communications / education / awareness-raising at the ADHC stand at the HACC Conference • Visit www.adhc.nsw.gov.au>Doing business with us>Home and Community Care Program for more

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