CDC in residential care model tested

A three-year research project has developed a viable model for implementing consumer directed care in aged care facilities, writes Mark Sheldon-Stemm.

A three-year research project has developed a viable model for implementing consumer directed care in aged care facilities, writes Mark Sheldon-Stemm.

The introduction of Consumer Directed Care (CDC) into the Commonwealth Home Care Program followed by the shift to give the package to consumer rather than provider in February 2017 has put the control of care in consumer’s hands.

These changes in home care pave the way for the introduction of CDC into residential care, which is a natural progression in line with the Aged Care Roadmap.

In 2015, we developed a model of CDC in residential care and presented it at a series of workshops with aged care organisations.

One of the participating organisations funded a series of trials in two of their residential aged care facilities in 2016, followed by another in 2017 at one of the facilities to refine the model to then rollout throughout the facility.

Early this year Minister of Aged Care Ken Wyatt and the Department of Health commissioned a report from us about these trials and how CDC could be introduced into residential care.

Mark Sheldon-Stemm

The trials found the major components necessary for introducing CDC and to ensure its ongoing application include:

  • consulting with residents, or their families or representatives, about their goals and the services required to meet goals and to provide choice on what, how and when services are delivered;
  • organising the workforce to be able to provide the goal-based services set by the residents, or their families and representatives; and
  • setting the cost of the services and providing a system to charge residents for these services and track provider’s accountability for funding.

The engagement and services models is similar to the home care system where individualised services meet the goals of consumers.

However, the financial model was new and required extensive testing to develop a system that could account for funds on an individual basis.

As the financial model was being applied it became evident there has to be a separation of accommodation and care costs.

Therefore, the financial model accounts for care services only and omits accommodation.

The 2017 trial produced a series of parameters required to successfully introduce CDC:

  • an engagement process that promotes transparency about costs and services based on available funds
  • specific staff to work closely with each resident to ensure the goals and needs of the residents are being met
  • a personalised approach to place residents in control of the services they require
  • a service that supports residents after hours applied as a standard charge across all residents
  • clinical and essential living services to residents based on their need for these services with residents charged accordingly
  • residents being able to spend their funding on other services, such as lifestyle activities
  • a software and financial system that tracks services as required to provide funding accountability
  • monthly statements showing funds available and service charges.

The trials also pointed to the importance of effective and educated leadership.

Individual managers need to be the champions of change and make CDC real.

Leadership was a key element in determining the success or failure in the trials. Effective leadership cannot be overemphasized in a bid to successfully implement CDC into residential care.

Two further trials in residential aged care using the final model are underway with the providers using these trials as a lead up to the rollout the model to the remainder of their facilities.

The final report will be released for discussion at the Financial Sustainability in Aged Care conference in Sydney in November.

Mark Sheldon-Stemm is principal at aged care sector consultancy Research Analytics.

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Tags: Aged Care Roadmap, cdc, Commonwealth Home Care Program, consumer-directed-care, department-of-health, Ken Wyatt, mark-sheldon-stemm, Minister of Aged Care, Research Analytics,

6 thoughts on “CDC in residential care model tested

  1. I suggest Mark invests $30,000,000 in a 100 bed residential facility and run it for 10 years using his cdc model, giving good care, without making losses before we give further consideration to this experimental formula. The adoption of cdc in Home care has yet to be proven as a success with funds often being directed to areas which have tenuous connection to real care. Long term analysis may well show that funds have been misdirected because of the changes in 2017.

  2. Thank you Peter for your comment and yes I invested well over that amount over the 20 years experience in aged care across a number of states for different organisations. As for an experimental model. Sorry, but it isn’t. The CDC model is used by a number of providers currently in residential care but the piece that has been missing is accounting for the funds. In regard to CDC in home care. The greatest benefits of the new system have been directed to the clients and a number of smart providers who have adapted. I guess in the end it will come down to – Adapt or die. Your choice.

  3. These changes are never done for the betterment of the resident they are done so that the government can save money.

    Where are the staff in all this will they all become independent contractors so they are only paid when the resident agrees to a 15 minute block of care?.

    If as a resident wants a freshly cooked meal at 10pm who will arrange for this?
    If every resident wants a shower between 7 and 8am how will this occur?
    I have cared for many cognitively impaired residents in Residential Aged Care who have no real family or friends, who will manage their CDC? or do we now introduce a new level of case management for the resident to pay for?

  4. I’m disappointed that Mark has not responded to Barry.
    I am interested in the answers to these questions.

  5. Im interested in the case management of services being directed by the consumer?

    who will the service provider bee accountable to? the homeowner or the consumer?

    who will be in control of the quality and risk if the task service provider isn’t fitting the standard.

    How do you manage a new number of different providers coming into a home?

    who services the need if the consumer wants or demands a service at a time that only suites them?

    who manages the safety and security of the other residents when they are not being serviced by the visiting service provider and there is an incident to address?

    is the funding allocated to the accommodation provider to manage as the case manager?

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