Listening key to culturally safe care, says CEO

Cultural safety is about respect, relationships and listening to people, the head of a central Australian Indigenous care service tells Australian Ageing Agenda ahead of her appearance at a Governing for Reform in Aged Care webinar.

Sarah Brown is CEO of Purple House, which provides culturally safe dialysis through 19 remote clinics and two mobile dialysis units, aged care and support across remote Australia.

This Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Community Controlled organisation has an all-Indigenous board of directors – 12 Pintupi people from the Western Desert – and a model of care based around family, country and compassion.

Ms Brown will share her insights into providing culturally appropriate care for Aboriginal and Torres Strait Islander communities with aged care provider executives and board members at next Wednesday’s webinar.   

Because “our bosses” are the people who receive the organisation’s services and make the decisions about how they want things to run, “we’re in a really good position” when it comes to providing our clients with their unique care needs, she said.

“Our challenge is to make sure that it meets up with aged care standards and the white fella world,” Ms Brown told AAA.

“All people aren’t the same, but the basis is that if you are running a service that engages with your client group and talks to people constantly about who they are and what they need, then the services that end up being created are so much better for the people using the services, but also for the staff. Because the basis of cultural safety is about respect, listening and having an environment where you feel safe and where your opinions and your worldview is trusted.”

“Cultural safety is about respect, listening and having an environment where you feel safe and where your opinions and your worldview is trusted.“

Purple House was established 20-odd years ago with $1 million raised from the sale of four collaborative paintings by Papunya Tula artists from Walungurru and Kiwirrikurra.

Before that, the Pintupi people from the Western Desert of Central Australia were forced to leave country and family to seek treatment for end-stage renal failure in Alice Springs or Darwin, suffering loneliness and hardship.

Today, Purple House delivers 8,000 dialysis treatments in remote communities a year as well as social support, NDIS and aged care services.

The recent expansion into aged care followed the request of the community, Ms Brown said. When it comes to looking after older people, she said the members’ main priorities are helping elders to remain on country and be part of their community.

“There’s a strong sense of importance of people being able to do things culturally the right way – which is to teach their grandkids about their sacred sites, to participate in ceremony and sorry business and all that stuff – and that people will go to extraordinary lengths to make sure that they can do things the right way.”

While the priorities are different in every place and culture “it’s all about listening to people and having a relationship with them so you can be providing the services that are important to them. And that’s not rocket science,” she said.

However, “be careful if your boss offers to cook your lunch,” said Ms Brown on a lighter note.

“One day, the chairperson at the time rang me from out bush to say he was coming in for appointments because he’s on dialysis. And he said he was going to cook us all lunch. And he brought in a great big frozen feral pussycat and he made us all pussycat sandwiches for lunch,” she said. It tasted “like smoky lamb” in case you’re wondering.

Governing for reform program

Ms Brown will join next week’s panel on cultural safety for Aboriginal and Torres Strait Islander Elders as part of the Aged Care Quality and Safety Commission’s Governing for Reform in Aged Care program.

The program aims to ready members of governing bodies and executives to respond to new obligations and opportunities to improve the quality and safety of aged care. It has been co-designed with the sector to strengthen the capability and understanding of good practice governance and leadership and help leaders and governing groups apply these practices in their boardrooms and organisations.

The program is free and available to all members of governing bodies and executives of Commonwealth-funded residential and home aged care providers. It includes free access to regular webinars, a podcast series featuring leaders from within the sector, learning modules, resources and expert-led workshops on key issues such as workforce, governing through challenge and change.

“The board should have some sort of representation from the cultural mix of the people who are using their services so they can provide that support and advice.”

Next Wednesday’s webinar responds to royal commission recommendations for aged care services to acknowledge the diverse and changing needs of Aboriginal and Torres Strait Islander elders and improve the quality of care and support.

Other panellists include Professor Tom Calma who sits on the Aged Care Council of Elders and Ken Markwell, a Mununjhali man and former executive general manager of Indigenous Services at Australian Unity.

The three speakers will draw on their experience to discuss the importance of creating or strengthening culturally safe, inclusive, and accessible services. The webinar is complemented by the following learning activities:

• Inclusive and Culturally Safe Governance online learning module
• Inclusive and Culturally Safe Governance Flip Guide
• Consumer and Stakeholder Engagement Topic Guide.

Consumer representation on board a must: Sarah Brown

On top of the core focus on the governing committee knowing about finances, clinical governance, work health and safety and so on, Ms Brown said “of equal importance at least” is aged care leaders taking their responsibilities for the people who are using their services seriously in terms of their quality of life and cultural safety.

“If you’re going to be true to having more inclusive governance than you need to make sure that the meeting, structure and explanations include everyone.”

That means understanding who the people using the services are, where they come from and what their stories are, she said. “Certainly, the board should have some sort of representation from the cultural mix of the people who are using their services so they can provide that support and advice.”

The next challenge to overcome is helping all board members fully engage with the process, Ms Brown said.

“I’ve been to some awful board meeting over the years where the agenda doesn’t change, it’s very corporate and then there’s one Aboriginal person sitting at the back who can’t understand what’s going on because that’s not their background and he’s fallen asleep up the corner.

“If you’re going to be true to having more inclusive governance than you need to make sure that the meeting, structure and explanations include everyone.”

If organisations can do that, everyone will have “more fun” in meetings, she said. “We’re in people services and people are diverse and come with life experience and superpowers. If you can engage with people, for people to learn and share with each other, then everyone has a better time.”

The online webinar Transforming for an Inclusive Future: Cultural Safety for Aboriginal and/or Torres Strait Islander Elderswill be held on Wednesday 5 October at 12.00pm (AEST). Sign up for the webinar and program here.

Main image: A Purple House board meeting

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