Monthly Care Statements implementation

This webinar gave providers and workers information about how to provide Monthly Care Statements. This included how to register for the voluntary start and how they can count towards care minutes. It also covered the benefits for older people, their representatives and providers.

Audience:
Health sector
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to
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Webinar recording

00:58:44

[Opening visual of slide with text saying ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘Monthly Care Statements – implementation’, ‘This webinar gives providers and workers information about how to provide Monthly Care Statements. This includes how to register for the voluntary start and how they can count towards care minutes. It also covers the benefits for older people, their representatives and providers’, ‘agedcareengagement.health.gov.au’, ‘29 August 2924’]

[The visuals during this webinar are of each speaker presenting in turn via video, with reference to the content of a PowerPoint presentation being played on screen]

Ingrid Leonard:

Good afternoon and thank you all for attending today’s webinar. My name is Ingrid Leonard and I am from the Choice and Transparency Branch within the Department of Health and Aged Care.

I’ll begin by acknowledging the traditional owners of the lands on which we’re virtually meeting today. I’m based in Canberra on the lands of the Ngunnawal people and I would like to acknowledge and pay respect to their continuing culture and contribution they make to the life of this city and region. I also extend that acknowledgment and respect to other families with a connection to this region and any other Aboriginal and Torres Strait Islander people who are joining us today.

A few quick housekeeping items. So the webinar slides are now available on our website for those participants seeking a copy. And this session is being recorded and will be published on our website in the coming days.

So I’d like to start by introducing today’s speakers. We will hear from Katy Roberts from the Choice and Transparency Branch within the Department on how and why we’re encouraging aged care providers to voluntarily offer monthly care statements from 1 October this year. I’m also very pleased to welcome Anne Muldowney who is a Senior Policy Officer from the Older Persons Advocacy Network and Corey Irlam who’s the Deputy Chief Executive Officer of the Council of the Ageing. So Anne and Corey will each speak with us today about the practical differences monthly care statements can make for residents.

So the topics we’ll cover in today’s webinar include what are monthly care statements, benefits for residents and providers, the approach to staged implementation, preparation and key next steps, how monthly care statements contribute to care minutes and privacy considerations.

I would also just like to point out that there will be a Q&A session at the end of the webinar. You are free to submit questions for the Q&A at any time throughout the webinar using the panel on the right hand side of your screen. You may need to click on the Q&A icon at the top of your screen to activate the function before submitting any questions. Thank you to those who have submitted questions as part of your registration and we’ll certainly look to work through those in this afternoon’s webinar as well.

We might not be able to get through every question and we may not have an answer at hand for every question however after the webinar we will publish an FAQ document that answers all of the remaining relevant questions.

And finally please note that there’s no option for attendees to turn on their video or microphone.

So before I hand over to Katy I’d like to set the scene for the introduction of the statements. The statements were announced in response to the findings of the Royal Commission into Aged Care Quality and Safety which highlighted concerns about the lack of communication flowing from providers to their residents, representatives and families about a resident’s care. This remains one of the top ten complaints raised with the Aged Care Quality and Safety Commission.

So the Department started off with a pilot which was conducted by the Nous Group with assistance from the Aged and Community Care Providers Association. The pilot explored what should be included in the statements and what steps are needed to produce them. Now some of you here today may have participated in the pilot and I just want to extend my thanks for that. 

So the design of the statements is based largely on the findings from the pilot. We’ve taken into account advice from providers given during the pilot that you’ll need time to build your processes for the statements. And this is why the statements are being introduced voluntary ahead of a mandatory implementation.

One final piece of housekeeping. I encourage you to scan the code on your screen to register your interest in starting monthly care statements from 1 October this year. By sharing your information with us we’ll be able to directly answer any questions you might have and send you additional information and support. 

So with that I’m pleased to introduce my colleague Katy Roberts from the Department. Thanks very much Katy.

Katy Roberts:

Thanks for joining us everyone. Today I’ll provide a brief overview of the monthly care statements project then I’ll get to the main point of encouraging you to start giving them to your residents from the 1st of October 2024.

Monthly care statements are a new transparency measure. A monthly care statement is a written statement that providers give to residents every month. The statement summarises the care the resident has received, changes to the resident’s health or care and other relevant events that occurred during the previous period. The statements are first and foremost for residents. In some circumstances the statements may go to the resident’s representative or family member.

Monthly care statements keep residents, their families and representatives up to date about their care. They also improve communication between providers and residents and their representatives about the resident’s health, wellbeing and care needs.

Each month every resident will receive a statement. The statement includes information in four categories which are wellbeing activities, nutrition and weight, medication changes and appointments. The statements mean results can be tracked over time and give insight on both clinical and wellbeing matters. There are four other information categories that the statements can include when they are relevant to a resident’s care, which are wound management, mobility, falls and summary information. You can also add other information that you think is helpful for the resident and their representatives.

The most important benefit of monthly care statements is that it will give residents important information about their care in one easy to read statement so they can monitor their care. Statements can act as a prompt for further conversations with their provider about whether their care needs adjusting.

In proactively providing this information you give residents confidence that you as their provider have listened and acted on their requests and feedback.

Monthly care statements will also help to increase visibility of residents’ care assessments and planning results which providers must make available to them under the Aged Care Quality Standards. This will also be an expectation under the Strengthened Quality Standards.

During the initial pilot Ingrid mentioned earlier we asked the Nous Group to collect some case studies about participants’ experience during the pilot. This case study shows that monthly care statements have additional benefits on top of care plan reviews. Because they were regular and on hand they helped Janice remember the detail of her care between care plan reviews.

Monthly care statements also offer benefits to providers. They give providers a view of the resident’s care needs in one place. This helps to review and adjust care management plans, improve communication with aged care residents about their care needs, address concerns in a timely way and identify trends in the feedback you receive which can help you to improve care across your home.

This case study came from a provider in a rural area. It shows that without monthly care statements the provider didn’t have detailed information about the number or variety of activities this resident had access to. By collecting activity information this provider was able to enrich the resident’s quality of life.

I’m now going to talk about how we’re implementing monthly care statements. We are encouraging all residential aged care homes to offer verbal or written monthly care statements voluntarily from 1 October 2024. This voluntary period is the focus of today’s webinar.

We released guidance last week to help providers prepare for and give written or verbal monthly care statements. These are available now on our website. The guidance includes advice on things like who should receive the statement and the circumstances when it should go to a representative, the information to capture in the statement and the options for introducing the statements during the voluntary period. In future we expect it will be mandatory for aged care homes to give statements. The Australian Government has not yet decided on when this will occur and we expect there will be lessons from the voluntary period that will assist the mandatory national rollout.

I would also just like to mention that no decision has been made on whether the statements will become mandatory for multipurpose services and National Aboriginal and Torres Strait Islander Flexible Aged Care Program services in the future. There will obviously be consultation before a decision is made on this.

Now as Ingrid mentioned earlier we ran a pilot from October 2022 to November 2023. Two of the key findings from the pilot were that tailored software products to create the statements could deliver efficiencies for providers and that software vendors would need time to develop the required software.

Based on the pilot findings we have partnered with Liquid Interactive to develop and pilot software solutions to help providers incorporate monthly care statements into their administrative processes. Liquid is keen to engage with providers and software vendors for this project. If you’re interested in being involved scan the QR on this slide. Note this is a different code to registering for the voluntary period.

If you’re planning to start giving monthly care statements from 1 October 2024 there are some steps you can take to get ready. The first thing is to familiarise yourself with our guidance and template. The second thing is to assess what information you currently report on and how you can incorporate that into monthly care statements. In other words start to create internal processes for filling out statements and also delivering them.

You’ll need to train and support your staff around the new requirements and think about your internal quality assurance processes and how they can ensure the statements are always accurate and up to date.

It’s important to know that time spent preparing monthly care statements may count towards care minutes. Any clinical review components as well as follow up conversations and activities count towards care minutes when they are completed on site by a registered nurse, enrolled nurse or personal care worker. Administrative tasks like delivering, filling out and distributing the statements do not count, nor does QA of the statements.

There are also privacy requirements around monthly care statements. This is covered in detail in our guidance but important to understand providers have an obligation to protect residents’ personal information. This means you’ll need to consider secure storage for physical statements and may need to consider electronic protection for digital statements.

I would like to turn briefly to how monthly care statements will help providers meet the Strengthened Aged Care Quality Standards which will start at the commencement of the new Aged Care Act. The Strengthened Standards will require providers to communicate critical information relevant to the older person’s care under outcome 3.3. Providers could show they meet this outcome by meeting the actions under this outcome including that provider’s implement processes to provide care statements to older people in residential aged care. And this is action 3.3.4 in the Standards.

Just a note though. Monthly care statements won’t become mandatory until they are included in subordinate legislation under the new Aged Care Act even though they’re listed in the Standards.

That’s the end of my component of the presentation. Before we hear from our guest speakers it would be great to just take a minute for an audience poll based on all the information you’ve heard to date. How likely is it that your service will start giving monthly care statements before they become mandatory?

Okay. We might move on. Lastly from me you can see a quick summary of the resources available to help you start the process. They are all available on our website and we’ll distribute links in this webinar. I’d just like to mention that the template and cover letter are just our proposed format and you can update them with your branding and to suit your needs.

Ingrid Leonard:

Thanks Katy. And thanks very much to everyone who participated in the poll or have submitted questions to our Q&A so far. Just a reminder don’t forget to scan the QR code to register your interest in starting voluntary monthly care statements.

I would now like to welcome Anne Muldowney from the Older Persons Advocacy Network to speak. Anne is a Senior Policy Officer from OPAN and has over 30 years’ experience working with and on behalf of people of all ages with care needs and caring roles. She’s participated in aged care policy forums and elder abuse prevention and response for over a decade and is dedicated to promoting human rights in relationships between older people, families and carers and aged care service providers. Thanks very much Anne.

Anne Muldowney:

Thanks very much Ingrid. And OPAN extends our appreciation to the Department for asking us to participate in this webinar today. We participated in the pilot project and we’re really looking forward to seeing the outcomes of monthly care statements implementation.

So on this slide you’ll see a painting that Uncle Mick Adams prepared for OPAN. And this shows groups of older people sitting together and sharing stories and people around them who are providing support and care for them. It’s about older people teaching and reinforcing the storylines through their knowledge and their wisdom. And as Uncle Mick says we always try to have that connecting them to us. And I’d ask you to bear that in mind as we talk about how monthly care statements can help with connection and sharing with older people.

On the other side of the slide you will see this is our national network. So OPAN is the peak body for the National Aged Care Advocacy Program. And so we’re made up of our state and territory members and you may be much more familiar with the service provider of the Aged Care Advocacy Program in your state or territory. Next slide please.

So in our national network in the previous financial year we’ve had more than 44,000 cases of individual information and advocacy. And as Ingrid or Katy mentioned previously similar to the statistics from the Commission around complaints communication is a consistent key issue that’s raised by older people with OPAN. Next slide please.

So this is a sneak preview of our presenting issues report which will be launched later in the year. So you’ll see with CHSP communication is in the top five. Home care packages, communication and choice and decision making are in the top five. Residential care, communication, choice and decision making are in the top five. And flexible care, yet again. So those other issues that are in the top five do change according to the service type and according to the data collection year but very consistently those issues appear in our presenting issues. Next slide please.

And I’d like to share with you just a couple of case studies taken from our presenting issues report that illustrate some of the communication issues that older people are experiencing and how monthly care statements might help. So in this one I won’t read it out. I’ll let you read that for yourself. But we see some common themes. Someone has moved in relatively recently, only three months ago into residential care, and they’re just not feeling listened to. They are experiencing, in common with a lot of other older people, a lack of staffing continuity. So they feel like they are telling their story over and over again. And we do acknowledge the very significant workforce challenges that the sector is experiencing but we will not shy away from expressing the impact on older people.

They’re experiencing a lack of follow through and that’s very common where there’s lack of staffing continuity but it’s also a communication issue of when changes are made that they’re not communicated and therefore not followed through. In this situation the resident is feeling that they’re not being accommodated with their individual care needs. And as Katy mentioned before around adjustments to care. So they’ve asked for an adjustment to the timing of their shower so they can participate in a valued activity and it’s just not happening for them. So they’re just feeling like they’re not being treated as an individual. They feel that they have to fit in with the way that the residential aged care home runs rather than the aged care home accommodating them and their individual needs.

Next slide please.

And case study number two. A different scenario again but some similar common themes. The older person sought advocacy support because there was just some communication barriers between themselves and the staff. And I’m sorry that picture is obscuring some of the text. So the older person felt as though each time they raised concerns they were minimised or swept under the rug and this had made them become extremely anxious. So they’re having difficulty understanding what staff are saying to them. Staff are having difficulty understanding what the older person is saying to them. That results in the older person feeling dismissed and again not being treated as an individual.

Concerningly in this one is the older person’s perception that because there are a high proportion of people living with dementia that they feel that the staff speak to everyone as though they’re living with dementia. So we could get into a whole discussion around what’s the appropriate way of communicating but the end result is that the older person just feels that there’s a one size fits all approach.

The other thing about this case study is that it does help to illustrate the role of an advocate and how they can help to open up those lines of communication. So a lot of the time people may be concerned about an advocate becoming involved in an issue or complaint that a resident has but we actually find that a lot of the time communication can substantially improve once the advocate can bring the parties together and they can talk about what the communication issues that they’re experiencing are. So don’t be scared about complaints and don’t be scared about an advocate coming in to support the resident. Next slide please.

So this is a collation of the feedback that we’ve received from older people and from our advocates about how to implement monthly care statements so that they’re actually maximising those communication benefits for older people and for your staff. So importantly make sure that consent is given. We know that a lot of the time representatives will be involved in the life of the person but that’s not a given and the person has to always feel that they’re in charge of their information. And then once representatives, families and carers are included make sure that of course the older person continues to be included and at the centre of those conversations. We see that monthly care statements – and the distinction’s already been made between your regular care planning activities and provision of care statements – is an opportunity to sit down, talk about what’s happened in the previous month, make plans for the next month. And so that shouldn’t be rushed or just handed over, ‘Here’s your monthly care statement. See you next month’. It is the importance of both the verbal and the written communication together.

Harking back to the case study examples, that within your service you’ve got clear responsibility and staffing continuity to communicate the care statements and monitor those changes over time. If there’s no changes over time or if there are significant changes over time those patterns should start to emerge after a while.

And that they’re in a language that is an appropriate form of communication for the person. So you’ll see in the template that’s been provided it is about providing it in a very straightforward manner and with the free text to use very plain English and potentially other means of communication. Also important to note to use interpreters when you’re having the verbal discussion with the older person about their monthly care statement if required.

And that importantly those discussions that lead to the changes or adjustments in the care plan are communicated with the frontline staff. We do see that this communication loop often doesn’t get closed. The change has been documented in terms of what needs to happen next but it’s not delivered. And then that places the older person in the situation of having to continually ask for something to happen that’s already been documented and is supposed to be happening.

And finally provide information to the older person on the availability of advocacy. So OPAN advocates are free, independent and provide confidential support if there’s anything that they would like to discuss or if they require support to understand their rights and to address their concerns. We know that it’s an ongoing issue for older people that they may experience barriers to making a complaint or raising a concern and so the advocate is there to help them to do that.

Next slide please.

So finally monthly care statements really provide an opportunity and you’ve got an ideal opportunity to commence the voluntary statements before they are expected to be mandated. So it is an opportunity to sit down. It’s not just about providing the written document. It’s important to involve representatives where the older person desires that. Older people who participated in the pilot said they found it was a really useful way of communicating with their family about their care needs. You can discuss what happened over the last month. You can plan for what is happening for the next month. Check in with the older person. How are they going? Does the monthly care statement represent what they feel has happened for them in the previous month? Are there any concerns?

Find out what their questions are and if you don’t know the answer undertake to come back with the answer. Help to address those issues. Don’t leave people feeling their issues are being swept under the rug as the older person in the previous case study said. Importantly monthly care statements are part of the picture of ensuring that older people’s rights are upheld and that their wishes and preferences are reflected in their care plan. It’s a care plan that they are part of and not something that’s being done to them. Find out if the changes that have been made in the previous month are working or do we need to go back to what we were doing beforehand. These are dynamic documents and changes.

It's also an opportunity – and we did get feedback in the pilot from older people and we saw in that case study that Katy had, I’m getting a bit forgetful these days. I’ve forgotten what I’ve gotten up to in the last month. So this is a really good reminder. It helps to highlight people’s good care experiences as well as highlight issues or things that need to be addressed. It also helps with expectation management. So what are the things that are within your power to do as an aged care provider, what can and can’t be done within the rules and regulations and a little bit of problem solving about where else a person might be able to get those needs that are not addressed within the aged care sector.

And it also helps we would hope to be not just looking at the activities and things that the older person is involved with within the home but that they are also looking at opportunities for the person to engage with their family, friends or other social supports such as spiritual or social groups outside of the residential aged care home. So we’re really looking forward at OPAN to the implementation of monthly care statements and we hope that some of these opportunities can be realised for older people and for your staff to be able to connect and share together. Thank you.

Ingrid Leonard:

Thank you very much Anne and we very much appreciate you highlighting that the consumer voice and the rights of older people remain at the centre of the work that we do. I would now like to welcome Corey Irlam. So Corey is the Deputy Chief Executive Officer for COTA with responsibilities for advocacy, Government relations and he also leads COTA’s policy work on aged care and retirement incomes. Since 2013 Corey has worked through the National Aged Care Alliance’s Aged Care Reform Secretariat housed as COTA as Director of Advocacy and Government Relations. Corey became the Deputy CEO in 2019. He's passionate for the rights of older people and the use of technology to reduce the burden of administration and designing for a future aged care system that improves services. Welcome and over to you Corey.

Corey Irlam:

Thanks Ingrid. And can I also say thank you to the hundreds of aged care workers who are listening to this webinar. It’s a great testament that you’re tuning in during this voluntary period for monthly care statements. I know how busy you are. I know there’s another piece of administration. Please don’t think of these monthly care statements as compliance. Think of them as an opportunity to help improve communication with older people. Next slide please.

And can I also acknowledge the traditional owners on which we all meet today. Next slide.

So I don’t want to really repeat things that have already been said but I just want to reinforce some things. We know from the Royal Commission despite the great work from many aged care providers older people and their families didn’t feel like they know what care was actually being delivered. I can’t tell you the amount of times that older people talk to me and they say “I pay half a million dollars and I don’t even understand what it is that I’m getting” because they don’t even understand the difference between the accommodation charge and their care charges, everyday living versus basic daily care fee. We need to be able to put some things in writing that people can sit with, can absorb, can reflect on, if they choose to to talk with their family, and this will be able to help some of the activities that we saw during the Royal Commission and address those issues.

Yes it is coming down the pipeline that action 3.3.4 of the new Standards hopefully from 1 July 2025 will require you to deliver some form of a care statement. But one of the beauties of you being part of this early implementation is that you’ll be able to talk to your IT companies, the people who design your care software about what you’re experiencing on the ground about the monthly care statements and what you’d like to see out of your IT system in the future so that this can be a more automated and less manual process when it becomes mandatory.

And of course the Department wants to hear from you because they want to learn from the things that you’ve experienced during the voluntary period so we know what works and doesn’t work. And I also reckon there’s going to be question about is it too care focused and not enough service focused. One of the things we’re seeing with older people in the health space at the moment is the beauty of social prescribing. That’s kind of like the wellbeing activities. It’s not technically the care stuff but it’s the activities that improve that quality of life that brings out that care moment. It’s not just necessarily the clinical care definition. So if you think of that broader holistic sense of care I think these care statements are going to be an exciting opportunity to have a conversation with older people. Let’s go to the next slide.

So why are monthly care statements good for residents and their families? Well let’s remember we’re designing them for the older person. It’s an ancillary benefit that is going to improve the representative’s understanding of the care being delivered. But with the new Aged Care Act if it’s like the Exposure Draft and there’s hopefully some improvements we’ll see these supported decision making principles coming on board which helps embolden the older person, empowers the older person, and they’ll be able to make a decision as to who is to receive their care statement. It will be a conversation for you all to have with your residents at the beginning but some older people won’t want it to go to anybody else. They’re going to take it, they’re going to put it in their locked drawer and they’re going to occasionally look at it in privacy when they can’t quite remember what was delivered in that month and they want to look it up. That’s an okay use of a monthly care statement. Other older people are going to take that monthly care statement and say ‘I want you to give it to my son and my daughter and I want them to know what it is that I’m getting in this facility’. That’s also okay. So we are designing one solution that’s going to be used for multiple different ways in multiple different people. 

But most importantly it creates that semi-regular reflection point for you to have a conversation about the care and services with the older people that you’re caring for. We know that older people are apprehensive about making a complaint. They don’t want to say something that offends the people who are supporting them. But creating this opportunity in an informal environment to have a conversation about how things have gone last month, these are the things that we saw, what did you like, what don’t you like, is a valuable tool. One of my challenges for people during the voluntary period is to think about how through that voluntary period you shift from just a verbal conversation into something in writing because it opens up a different conversation. Are you giving that something in writing to the older person before you come and talk to them or are you talking them through it when you first hand it over. Does that result in a different way that people open up their conversation? We want to hear from you to make sure this gets right before it becomes mandatory. Next slide please.

Have a think about how you’re capturing feedback from residents and families about the monthly care statement. Have a think about in a multidisciplinary model of care one of the things older people talk to us about is ‘I’m not really sure who to talk to about an issue’. What’s the message from your organisation? Are you capturing information from the GP, the pharmacist, the allied health professional? Do you want the older person or their family if they’ve got questions about things on the monthly care statement to go back to that health professional or to funnel things through the nurse in charge? I think this will spark a bit of a conversation. Just get ahead of it. Make sure that staff know where to direct the queries to. And don’t forget to notify the Department that you’re participating so that we can make sure we’re capturing your experiences or they can make sure they’re capturing your experiences during the voluntary stage. Thanks very much.

Ingrid Leonard:

Thanks very much Corey.

So now we’ll begin our Q&A session. These include some pre-submitted questions which we will answer some online and I’ll kick off with one now. So one question that we received was:

Q:        We were a provider that trialled the type E prototype. There was follow up for a while and then it all went quiet. The result of the trial was that producing monthly care statements was a labour intensive process.

Katy would you like to respond to that?

Katy Roberts:

Yeah. Sure. Thanks Ingrid. And I think Ingrid mentioned this before but I also just want to extend thanks to all of those providers and the residents and family members who did participate in that pilot. We know that there were 40 aged care homes who volunteered and there were 542 residents and representatives in that pilot. And they tested five prototype statements. And the pilot did provide a really useful basis for the next stage of the project and we’ve drawn on that quite heavily in terms of what we’ve put forward for implementation now, so particularly around the contents of the statement and the target audience for the statements.

But it’s also true to say that pilot did show there are a number of implementation challenges with monthly care statements including the time taken to produce them. And that’s why we’ve really moved towards commencing with this voluntary period so that providers do have time to sort of establish their processes and work towards that mandatory implementation. And it’s also why we’ve been working with Liquid Interactive to get this software development project up and running and the purpose of it is really to get more digital solutions available for providers to use in producing the statements, so getting more out into the market. We know there’s some software already available which is great but making more available so that it’s got a wider reach for providers.

Ingrid Leonard:

Thanks Katy. Thanks very much. I’ll go to another question. 

Q:        Some providers who participated in the pilot advocated for the statements to be quarterly. Why are the statements monthly instead of quarterly?

Anne I might sort of go to you first and then offer Katy the opportunity to add to that.

Anne Muldowney:

Thank you Ingrid. Yes. So I guess this is really an illustration of placing the older people at the centre of their care. So the feedback from the pilot was that older people felt that their statements were a really useful reference point for future care planning. So you reflect on the previous month, you plan for the next month, and that a three month timeframe was just a bit too far. A lot of the items that are recorded in the care plan can change very rapidly for an older person. They also saw benefit in sharing with their families to improve communication about their care. And we note that a lot of the complaints that the Commission receives about communication are from families so increasing frequency of communication can help to address that.

And I’d also just finally note that in the voluntary stage another selling point I think for participating in the voluntary stage is that you can implement them every two months or every three months as you start to embed your systems and work out how to populate those fields. So that’s why they’re monthly.

Ingrid Leonard:

Thanks Anne. Katy did you want to add to that at all?

Katy Roberts:

Thanks Ingrid. And Anne I think you’ve captured it pretty nicely around the thought processes and the decision that needed to be made around quarterly versus monthly. And it’s really about that balance between the administrative burden on providers but also the benefit to consumers. And I think the decision point was really that are we actually washing out the main benefit of the statements if they were only on a quarterly basis.

Ingrid Leonard:

Thanks Katy. I’ve got a question here.

Q:        Who should receive monthly care statements and is it just a power of attorney that should receive the statements?

Katy did you want to respond to that? 

Katy Roberts:

Sure. And I think in my presentation I’ve mentioned that – and this came out of the pilot – that the main audience for the statements is the resident. So first and foremost the starting point is that the statements go to the resident and we consider that all ongoing permanent residents of residential aged care would be eligible to receive the statements. Where there might be an issue around a resident’s cognitive capacity then it might be provided to the resident’s representative. But that needs to be where it’s already known and it’s recorded that that resident doesn’t have the capacity, and also very importantly that the representative is authorised under the relevant state and territory law to make health decisions for that resident and/or to receive the information about the resident’s care. And obviously those arrangements differ from state to state. So sometimes enduring power of attorney or other arrangements.

And I think there was a question around consent which I might just raise in there too is that to empower a resident as well, a resident may well want to share those statements with a family member or with someone else. And so the statements can be provided to another person if a resident has explicitly requested this. And obviously that should be documented as well. It’s probably worth also noting that at the moment we’re working under the state and territory law. We’ve got the new Aged Care Act that’s sort of in the wings but isn’t introduced yet and that we know that there are some different provisions that might make some of those state and territory law issues hopefully a little bit simpler. But I think it’s just worth noting that those provisions may change once the new Aged Care Act comes in and that there might be differing consent processes, noting that we’ve got a category of supporters versus representatives. So just to flag that those might shift a bit as that new Aged Care Act comes to fruition.

Ingrid Leonard:

Thanks Katy. And I’ll just add to that that under that arrangement the Department will certainly provide additional guidance to providers to help them understand the responsibilities and arrangements under the new Aged Care Act. 

Just quickly I note there’s a couple of comments in the chat just about trouble with the QR code. I do apologise for that. We’re working in the background to try and resolve that and hopefully before the webinar concludes we will have that up and running. So thanks very much.

Back to our questions.

So one here.

Q:        Will the implementation of care statements be something the Aged Care Quality and Safety Commission look at if our consumer experience surveys are below benchmark?

Katy?

Katy Roberts:

Thanks Ingrid. I’ll probably just say first up that there’s not an active role for the Commission during the voluntary period. And just in relation to – there was mention of consumer experience surveys. And I think essentially the consumer experience surveys are sort of targeted at capturing the residents’ views about their experience about living in the aged care home whereas monthly care statements sort of have more of a focus around a resident’s health and wellbeing status. So I don’t think it’s likely that there would be a direct link drawn between the monthly care statements and sort of a service’s results on consumer experience surveys. 

And in terms of what the role of the Commission might be moving forward into mandatory we expect that the Commission might request information related to monthly care statements in the course of its monitoring activities. So if the Commission had concern about how a provider might be communicating with older people or their representatives about care and delivery of services then the monthly care statement might be something that the Commission looks at once they become mandatory.

Ingrid Leonard:

Thanks Katy. Corey I might send this question your way. A participant has asked:

Q:        Why should the statements include information about activities funded through additional service fees?

Corey Irlam:

The short answer there Ingrid is that people don’t understand the different buckets of money that they’re paying. They just know they’re paying an aged care provider X dollars and they want to know what care and services their loved one is receiving or they’re receiving for themselves. So trying to ringfence the difference between additional services and everyday living services or healthcare delivered by the aged care provider versus healthcare delivered and the aged care provider playing a facilitating role is going to cause confusion out there with care statements. So if you’ve not sure I would urge you to go on the side of adding the information in, not excluding it out. Because it will just ask questions, what about, what about.

Ingrid Leonard:

Thanks Corey. I think that’s right. The intention of the statements are about providing a summary of the care and services that the resident has received in that previous month. And I think you’re right. It’s often not visible to the resident or family members what may have been additional versus base services. Thank you.

Katy there’s a question here.

Q:        Inclusions. Our three monthly collaborative reports are quite extensive. What would you suggest a baseline inclusive?

Katy Roberts:

Great. Thanks Ingrid. And so from that question I’m sort of taking that around what’s the core information that should be incorporated into the statements. And I mean if you’ve already got resident reports in place then really the voluntary period provides an opportunity to look at how monthly care statements might fit in with your existing processes and potentially customise what you’re delivering. During the voluntary period we’re recommending the statements have those eight categories of information. So wellbeing activities, nutrition and weight, medication changes and appointments plus wound management, falls, mobility and summary information which is all captured in the guidelines, or those last four in terms of where it’s relevant to a resident’s health.

So those ones are really what we consider to be the baseline inclusions. So if you’re providing more detailed three monthly reports to residents there’s options there in terms of using the monthly statement to do a regular snapshot while you still deliver your more detailed monthly report.

Ingrid Leonard:

Thanks Katy. Corey might send this one to you.

Q:        How can aged care homes help people from culturally and linguistically diverse backgrounds to understand the statements?

Corey Irlam:

Yeah. Look it’s a really good question. The first thing I’d say to you is obviously you’ve got the TIS service that you can use to be able to help with translation when sitting down and showing them that statement. But I’d also encourage you to push back on your IT vendors. How easy is it for you to write something in English and for you to press a button and have it printed out with Google translation or whatever might work – it won’t be perfect – and come out the other end in the language of your residents. With the introduction of AI, with modern uptakes of many translation services there are technical solutions. I absolutely acknowledge it is not grammatically correct for every language and every sentence and every scenario. It’s not going to be perfect. But what gesture are you making to meet that person halfway through particularly if you don’t have a worker on site that is a native tongue for that resident’s language?

Ingrid Leonard:

Corey thank you very much. Absolutely reiterate the ability to use those TIS services. Absolutely. Thank you. There’s just a question.

Q:        Will the statements become mandatory prior to the commencement of the new Aged Care Act?

So as we mentioned earlier in the webinar there has been no decision by Government regarding the commencement of mandatory monthly care statements. The voluntary arrangements will apply from October this year. And we’re really keen to work with providers and hear from them in terms of their participation in this voluntary period. And the work that we’re doing with Liquid Interactive which Katy spoke to before is also going to be really important to identify options for streamlining these statements going forward. 

So that is a nice segue to another question that’s been posted which is about the digital solution. So we have a question here.

Q:        If the care statements are for the benefit of the residents and their loved ones is it an option for providers to choose how they provide the statements, from a simple Word document for example, or will the expectation be to use a Departmental tool like My Aged Care? This concerns me from a privacy perspective if a Government organisation can see all of the information about a resident’s health especially if they’ve not registered on My Health Record.

So I’ll kick off there and then I might hand to Katy to also share her reflections. So My Aged Care is not going to be used for the delivery of the statements. Throughout the voluntary period the statements are able to be provided in either a Word form or a verbal capacity and it’s really up to the provider to consider what options might best suit their residents and families. But I’ll hand to Katy to talk further about the work that Liquid Interactive are doing and the participation in the pilot. Thanks Katy.

Katy Roberts:

Thanks Ingrid. Yeah. So it’s a good point and the intention of this pilot or the software development project is really to make more options available for providers within their existing IT environment. So this is not about sort of building new capability within Government systems and there’s no intention that the Commonwealth would receive the data that’s in those statements. We consider these statements very much something between the provider and the resident. So really what we’re trying to do is just build those options, make sure there’s options out there for different providers and the way their business runs and what works for them. So using a simple Word or PDF document if that’s the way that providers want to go ahead with that, then that’s absolutely in line with what we would expect. And we’ve also created a sample template that’s up on our website at the moment that can be used or else modified to suit individual providers’ purposes.

Ingrid Leonard:

Thanks very much Katy. There’s a question here.

Q:        Can you please confirm if the monthly care statements are in addition to or replace care plan reviews?

Katy would you like to respond?

Katy Roberts:

There’s no intention that monthly care statements would replace care plans. I think the way we see them – and I mean they’re voluntary at the moment anyway but when they become mandatory there’s no intention that they would replace care plans. I think the way that we sort of see them is that the monthly care statements could almost be like a regular check in against the care plan and help to identify where there might be changes needed. So we sort of see them perhaps working together as a nice sort of suite of resources about a person’s care and their health status.

Ingrid Leonard:

Thanks Katy. Look we’ve very quickly come to time this afternoon. I want to thank everyone for attending today’s webinar and also for the questions. There are questions that we didn’t get to today and as I said we’ll take those away and put together responses which will be available on our website. Encourage you to access the guidelines. So if you go to the Department of Health and Aged Care’s website and search monthly care statements you will hit the page where the guidelines and a number of other artefacts are there to support you. 

We’d also appreciate it if you could complete a quick survey just to help us improve our webinars. Please scan this QR code and follow the link that we’ve posted in the Q&A. The survey will only take about one minute. It’s just three short questions. So thank you very, very much once again for your time and your participation this afternoon. Thank you.

[Closing visual of slide with text saying ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘Webinar survey’, ‘Thank you for attending today’s webinar’, ‘Please provide your feedback by answering 3 short questions’, image of QR code, ‘agedcareengagement.health.gov.au’, ’29 August 2024’]

[End of Transcript]

Webinar slides

Presenters 

  • Chair: Ingrid Leonard, Assistant Secretary, Quality and Assurance Division, Department of Health and Aged Care
  • Presenter: Katy Roberts, Director, Resident Experience and Food Policy Section, Department of Health and Aged Care
  • Presenter: Corey Irlam, Deputy Chief Executive Officer, Council of the Ageing (COTA)
  • Presenter: Anne Muldowney, Senior Policy Officer, Older Person’s Advocacy Network (OPAN).

About the webinar

A Monthly Care Statement is a statement that providers give to residents and their representatives every month to improve communication about health and wellbeing.  

The statement summarises:

  • the care the resident accesses 
  • changes to the resident’s health or care 
  • other relevant events that occurred in the previous period.

We encourage all residential aged care homes to offer Monthly Care Statements from 1 October 2024.  

Giving statements voluntarily will improve communication, develop processes with your residents and improve your care planning before it becomes mandatory. 

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