Realising the ‘capability of the sector’

While research has been the tool of her trade for the past 40 years, Professor Barbara Horner tells Natasha Egan that it is the industry partnerships and the translation of that research into action that lights her fire.

While research has been the tool of her trade for the past 40 years, Professor Barbara Horner tells Natasha Egan that it is the industry partnerships and the translation of that research into action that lights her fire.

The growth in the complexity and maturity of the Australian aged care industry has been the greatest change over the last four decades, says Professor Barbara Horner.

Horner, who has worked in aged care as a clinician, educator and researcher for over 40 years, was speaking to Australia Ageing Agenda weeks after she retired from her post at Curtin University earlier this year.

Horner says that residential and community care providers have had to “step up in terms of their business acumen and processes” so they can be competitive in what is “still a very difficult industry.”

Part of that difficulty is due to the innovation-stifling policy and compliance framework and workforce challenges, including an inability to attract and build strong and innovative leaders, she says.

Horner led Curtin’s Centre for Research on Ageing since its inception in 2000 until her retirement on 31 July this year.

Prior roles have included manager of human resources and staff development at Silver Chain and principal education officer at the Nurses Board of Western Australia, as well as work in private hospitals.

Professor Barbara Horner
Professor Barbara Horner

Although her clinical career has been varied – she has also worked in mental health, Aboriginal health and industrial health – Horner says it always included a focus on older people.

“I always felt that there was a lot of wisdom and experience that we could gain from older people and I found I was quite fascinated by interactions with older people,” she says.

Relationships ‘light my fire’

At Curtin, Horner spent many years building research partnerships with organisations in the sector.

With interests spanning workforce, innovation in models of care, service frameworks and evaluation, quality of life factors in aged communities, organisational leadership and change, and care of people with dementia, Horner’s research is broad, but she says it has a common thread.

“While research is my tool of trade it is the process of doing the research and the engagement and the partnerships and the translation of that research into some action; that is what lights my fire.”

These partnerships have included with WA providers Silver Chain and Juniper, Alzheimer’s Australia WA and the Dementia Collaborative Research Centres.

“The greatest satisfaction of my career has been the partnerships I have formed, the organisations I have worked with and the growth I have seen in individuals and outcomes for organisations and for residents. That for me has made everything I have done worthwhile.”

Horner says her research has often involved mentoring and coaching to help organisations better understand what they are doing, improve their systems and processes and look at different ways of viewing what they have.

Horner says making good use of the information organisations collect is a real challenge within the sector. “There are very few organisations who really know what to do with the data, know how to report on it, know how to analyse it and know understand it. Therefore they don’t get the value out of the data they have collected.”

However, the most pressing challenge is staff development, and this has never really been addressed, says Horner.

“There’s very limited money for training and development and there’s very little expertise within the industry to be able to do that. Rather than making sure people adhere to occupational health and safety, it is about valuing the concept of personal and professional development.”

Another area is aged care’s multicultural workforce, which Horner says it is still viewed by many as a problem rather than an opportunity to have a multi-cultural approach to care.

Hindered by policy framework

Looking to the top, Horner says the sector’s struggles to attract senior professionals, to build leadership capability and recruit innovative leaders, limits the industry’s performance. As does the policy framework, she says.

“I am quite disappointed with the current Federal Government’s approach across a number of spheres. Their indecision has been confusing for the industry,” she says, citing the cessation of the Dementia and Severe Behaviours Supplement as an example.

“They lack vision and insight. They have been really disappointing in their commitment to growing the industry and to recognising what it stands for and I feel that a lot of aged care providers are finding it tougher now than they did even five years ago.”

Similarly, Horner gets fired up about the innovation-stifling compliance system, notwithstanding her strong support of the need to ensure quality across aged care.

“What bothers me most is the inability of the current accreditation and compliance system to shift practice beyond the lowest common denominator,” she says.

“I am constantly frustrated by the fact that it is so difficult to be innovative and try new things and to find a place within the existing accreditation compliance system that encourages you to do that.”

Horner was appointed to the former Aged Care Standards & Accreditation Agency in 2012 and spent nearly two years there before its replacement, the Australian Aged Quality Agency, came into being. Unfortunately, the experience didn’t live up to her aspirations.

“My greatest hope was that I would be able to be a voice for the industry in a forum that I perceived would want to talk about evidence-based practice and the latest research and innovation,” Horner says.

However, she says she was unsuccessful in getting evidence-based practice, research or innovation on the agenda, which she found frustrating.

As a supporter of the Productivity Commission’s recommendation for a compliance body independent of government, Horner does not think the new agency is the best way forward as it will be difficult to maintain the checks, balances and independence that the former accreditation agency was able to.

Horner also raises concerns over bringing home care compliance into the fold, as it is a very different way of delivering care that will not be easily judged by the residential aged care compliance system as it sits now.

“My fear is that it will just dumb down the practice even further by creating many legislative requirements and documentation. The biggest killer of accreditation is the documentation that is required.”

The current system, Horner says, makes it difficult for residential and community providers to be learning organisations because they don’t have the resources or the environment to take risks.

“It is a real pity and I don’t have a solution… While we have this disconnect we will continue to inhibit the capability of the sector.”

For the time being though, Horner is taking a break from finding solutions. She is in the process of “letting things go rather than taking them on” and plans to “hang loose” for the rest of the year spending more time with her four grandchildren and husband of 40-odd years.

She stresses her enormous respect for this sector and its people, and says she will miss the friendships and relationships.

“I have no doubt there will be things that will appear on my plate that I will get involved in, but what they are and how I will do it, I don’t really want to think about just yet.”

Horner’s messages for:

Industry: Try and be less introverted and believe more in your capability rather than your inability. Take calculated risks to seek out innovation and not be siloed into that inward thinking approach of just surviving. There is way more capacity across the sector than we have necessarily seen. Share and learn from each other, be collaborative and seek out ways to make better use of all the data you collect.

Government: Listen to the industry. Engage with them and provide them with opportunities to put forward what they think is best for the industry because it is an industry where the government doesn’t know best. My hope is we will find a better way to reduce this gap between compliance and innovation. There is an urgent need to build capacity and invest in research.

Universities: There is an appalling lack of attention to the care of older people in almost all health professional curricula and that has to be addressed. There is also a chronic lack of knowledge and experience among staff and this has to be addressed… There is capacity for large-scale national studies using mixed methods approach.


Tags: alzheimers-australia-wa, barbara horner, curtin-university, Dementia Collaborative Research Centres., silver-chain,

3 thoughts on “Realising the ‘capability of the sector’

  1. From one Barbara J. to another…. my hand is up Barb to support you where I can. Well done!!!

    Barbara Macleod (Carealot Home Health Services – Perth)

    1998 Teltra Business Women’s Award National Winner (Business category)
    2000 Australian Business Women’s Hall of Fame

  2. Barbara’s commitment to, and level of knowledge of the aged health care sector is refreshing, encouraging and inspiring. It has taught me that there is a lot of work to be done in this area, especially in (Western) Australia. The amount of resistance coming from those who manage to keep the status quo intact, as Barbara points out, is great however, and it will be in the smaller, unofficially recognised or less visible activities of (perhaps less visible) people that will eventually create the changes needed. Barbara’s work has been recognised by many, and perhaps it is especially her less visible activities that have formed a source of inspiration, at least in my experience and that of staff in the aged care sector. Thank you so much for standing strong and your support in this field of work, Barbara.

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