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‘First step’ on consumer-directed residential aged care

An Australian-first training program to implement consumer directed care in residential aged care facilities has been shown to improve resident wellbeing.

The Australian Catholic University’s Institute for Health & Ageing this morning released the findings of a small-scale pilot of the Resident at the Centre of Care (RCC) training program, which provides facilities with a model for implementing CDC.

The researchers say the program has been shown to be “a very effective first step” in helping determine the ideal way to achieve CDC in residential aged care.

The report was launched today

Aged care organisations Mercy Health, Ozcare, Beaumont Care, Carinity and IRT Group participated in the project.

The researchers say it is the first program designed to implement CDC in residential aged care that has been delivered and evaluated in Australia.

While the federal government is expected to mandate CDC for aged care facilities in the “very near future” the sector is currently without the necessary implementation strategies, approaches and costings, the research team says.

Although some facilities have incorporated elements of CDC in areas such as activities and food, no comprehensive approach has been developed or implemented that includes all aspects of care and lifestyle, they say.

“The aim of this study was to support facilities by implementing and evaluating a staff training program that would facilitate the transition to CDC practice in their facilities,” they said.

Training and support for facilities

Delivered onsite by facilitators over six sessions, the program trained staff in communicating with residents and gathering information to devise and implement a consumer-directed care plan.

It also provided training to support the necessary organisational change and leadership.

The program was designed to:

  • increase staff awareness and understanding of CDC
  • educate staff on the use of a ‘resident care form’ to obtain resident choices on care
  • empower leaders to address the organisational barriers to implementing CDC, and
  • support staff in the implementation process.

The program was evaluated in terms of resident quality of life, staff satisfaction, organisational adherence to CDC, and program cost.

It was implemented and evaluated in six facilities in Melbourne and Queensland. Two sites received the training and ongoing support over 12 weeks, two others received the training alone while the final two were a “care as usual” control group.

The training was provided to all staff including nurses, care workers, lifestyle and kitchen staff.

The report released today draws on data from just the three Melbourne facilities but the data from the three Queensland sites will be included in the complete findings, the team said.

The report draws on responses from 32 residents and 32 staff across the three sites.

Results: boost to wellbeing

The evaluation found the program increased resident wellbeing in both training groups compared to the care as usual group.

However, the evaluation of the program found little change in staff satisfaction or organisational improvements. The researchers said:

“Given the substantial upheaval in the operations of the facilities that implemented the RCC program, it is not surprising that three months after the training staff were still experiencing difficulties in changing their ways of working, as well as the operations of the organisation, to accommodate the new model of care.”

With increased time, it is expected that these staff and organisational measures would improve, they said.

Next steps

The researchers say they have applied for funding to implement and evaluate the program in 39 aged care facilities in Queensland, New South Wales and Victoria.

They acknowledged the need to include a greater number of residents and staff in a future study and to measure changes over a longer period of time.

“Future study requires better costing information to more competently assess the program’s cost effectiveness,” they said.

Read the full evaluation report here

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