cdc duty of care 3 december 2013
TRANSCRIPT
Applying Consumer Directed
Care
Translating the legalities into practice: managing provider risks under CDC
Jeremy McAuliffe, General Manager Community Services
3 December 2013
Overview
• About Villa Maria
• Setting the scene
• Key themes
• Insights
• Conclusion
About Villa Maria
Established in 1907, one of Victoria’s
largest providers of disability,
education, residential, community aged
care and independent living services.
Providing quality services and life
enhancing opportunities for older
people and people with a disability.
60+ programs, supporting 5,000 people
from 42 locations across Victoria &
Southern NSW. More than 1,200 staff
and 300 volunteers.
About Villa Maria
Range of services – carer support
services, day programs, HACC, NRCP,
package care, ACHA, rehabilitation,
Well-being Centre, mental health, young
carers, dementia care, direct care.
CDC “trials” commenced in 2010, some
prior informal arrangements, transition
to Home Care Program underway.
50+ programs, supporting 2,000+
people from 14 locations across
Victoria & Southern NSW.
Setting the scene
When driving a car you encounter various speed limit signs, but these have changed over time and drivers have had to adapt.
Drivers look for signs and adjust accordingly.
CDC is a changed sign on the aged care roadway.
Like a speed sign, if you don’t read it right there are consequences.
Key Themes
1. Managing the practicalities of
duty of care risk
2. How can providers manage and
monitor quality delivery when
services are outsourced.
3. Identifying steps to take when
consumer’s choices conflict with
their assessed needs.
Managing the practicalities of duty of care risk.
Discussion of duty of care often covers a
service arrangement, a consumer’s
situation, planning and decision making,
process and procedure.
Where does the capacity to manage duty of
care come from?
Three organisational practices play an
important role – documentation, risk
management and continuous improvement.
Managing the practicalities of duty of care risk.
“It’s all in the documentation”.
Documentation = operational policies and
procedures, systems to record and maintain
information.
Documentation = communication, training,
review, update, supervision, audit, more
communication, more training.
CDC adds a new dimension to documentation.
Documentation needs to be accessible and easy
to deal with.
Managing the practicalities of duty of care risk.
Risk management - not a new idea, a framework that brings risk, quality and safety together to ensure compliance.
Risk management wants to mitigate or eliminate risk. Consider a risk solution concerned with living with risk, not eliminating it. A CDC environment takes us there.
Risk management should balance duty of care and dignity of risk.
Managing the practicalities of duty of care risk.
Continuous improvement - making sure
that you keep getting things right.
Accreditation and quality reporting
cycles are the start.
You get the culture when you fully
embrace the improvement concept.
Where there is a culture of continuous
improvement less things go wrong.
How can providers manage and monitor quality
delivery when services are outsourced?
Starting point - reflect on recent experiences
in Quality Review or aged care
accreditation.
Contractor management requirements are
quite prominent.
Contractor management is increasingly
identified as an opportunity for improvement
in one way or another.
What is emerging is that the basics are no
longer good enough.
How can providers manage and monitor quality
delivery when services are outsourced?
Sector is adopting contractor management
approaches.
Fundamentals are a Contractor Agreement
and a procedure for annual validation of
contractor credentials.
Contractor Agreement is a legal document,
make sure it incorporates all legislative
requirements that impact.
Annual validation of contractor credentials
extends to seeking evidence that compliance
requirements are fulfilled.
How can providers manage and monitor quality
delivery when services are outsourced?
The best and most challenging approach lies in contractor partnerships.
A good relationship is formed on a “partners in service” approach. A commercial operator finds plenty of value in providing services to older members of the community and because of this will want to be your partner.
A good relationship will make it easier to validate contractor credentials, to initiate site visits, to undertake audits and to get feedback.
How can providers manage and monitor quality
delivery when services are outsourced?
Minimise use of external suppliers that you engage. When administrative burdens are increasing less is good. Preferred supplier arrangements can raise the bar.
There is do it yourself approach, reduce or eliminate the need to outsource through growth of direct care capability.
Use of an external verification service is emerging as an alternative. Contractors register with the service which maintains currency of compliance requirements. One contractor registration can be linked to multiple organisations.
Identifying steps to take when consumer’s
choices conflict with their assessed needs.
Consumer choice conflicting with assessed needs – what are we thinking about?
Is it a risky contractor, breaching program guidelines, an unusual service request or an expression of independence?
Conflict avoidance –
• dignity of risk,
• manage expectations,
• conflict triggers
Identifying steps to take when consumer’s
choices conflict with their assessed needs.
Dignity of risk - the right of individuals
to choose to take some risk in
engaging in life experiences.
Positive view of risk – there is risk in
everything we do, so exposure to risk
is normal.
Is the consumer’s need the problem
or the manner in which it is enacted?
Manage risk positively.
Identifying steps to take when consumer’s
choices conflict with their assessed needs.
Manage expectations from the onset.
Individual choice and control co-exists with
limits and boundaries.
Not setting out to limit or restrict service.
Seeking to understand roles and
responsibilities, to engage with the
consumer and to draw on their experience.
Identifying steps to take when consumer’s
choices conflict with their assessed needs.
Conflict triggers
Preferences change, compete and can be
unknown.
Engage with others but don’t over rate their
inputs.
Organisational requirements vs
responsibility to consumer.
Self determination and who is in charge!
Closing comment
Duty of care is a complex matter but it is quite manageable. We all have the building blocks to get it right. CDC shifts our duty of care focus but does not change the building blocks.
Thank you for your interest and attention.
Contact me: [email protected]
More about Villa Maria: www.villamaria.com.au
Questions