Implementing consumer directed care

Implementing Consumer Directed Care

13 April 2023 Implementing Consumer Directed Care Copyright Carrie Hater Consulting 1

Western Sydney

Community Forum, Sydney, NSW

30 September 2014

About Carrie Hayter Consulting

13 April 2023

• Personalising Care – Research, Evaluation & Translation– A Handbook for community care services , Empowering People,

enhancing independence, enriching lives with Alt Beatty Consulting for NSW Government

– Education, coaching and mentoring– Person Centred Practice and Thinking– Cultural Diversity and cultural competence– Ageing and Sexuality (managers)– Ageing and Sexuality (frontline workers)– Consumer Directed Care (Managers)– Coaching and mentoring programs

Implementing Consumer Directed Care Copyright Carrie Hater Consulting 2

Workshop Outcomes

• Describe the key principles that underpin consumer directed care;

• Discuss the policy context of consumer directed care for older people & people with disabilities

• Discuss strategies for supporting service users from diverse backgrounds to make the most of consumer directed care

• Apply the principles of consumer directed care to practice;

• Describe the principles in developing individualised budgets;

• Discuss strategies for managing risk in the context of consumer directed care

13 April 2023 Implementing Consumer Directed Care

Copyright Carrie Hater Consulting 3


Highly personal Impersonal

Activity 1 – What is a personalised service?

Why consumer directed care?


Policy

Practice Research

13 April 2023Implementing Consumer Directed Care


UN Convention on the Rights of People with a Disability

Productivity Commission Reports

National Disability Insurance Scheme (NDIS)launch sites from 1 July 2013

Consumer Directed Care Packaged Care from 1 July 2013-2015

Research on consumer directed care models - choice and control for people with a disability and cost savings (Glendenning 2008, Ottman, 2009, Leadbetter, 2004)

Low take up of individualised budgets by older people (Glendenning et al 2008) (Ottmann, G., Carmel, L., & Allen, J. (2012)

Research Policy

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Consumer Directed Care Models

Case Management &

BrokerageIndividualised

Budgets Cash for Care

Self Managed/ Direct Payments

Consumer Directed Care Aged

Packaged Care

Attendant Care

Package

National Disability Insurance Scheme

Service User control of money and resources


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NDIS National Disability Insurance Agency

Assessment

Registered Providers with NDIS

Devika(consumer)

Nominees/ Support Planner

National Disability Insurance Scheme


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National Disability Insurance Scheme Agency – Opportunities

Service Users

Registered Service Provider

Registered plan management provider

My access checkerhttp://www.ndis.gov.au/my-access-checker

Registered Providers Disability Care Australiahttp://www.ndis.gov.au/document/297

Registered Plan Management Providerhttp://www.ndis.gov.au/providers-1


http://www.ndis.gov.au/my-

http://www.ndis.gov.au/my-

Aged Care Policy Developments

HACC & NRCP Program 1 July 2015 Home Support Program• HACC• National Respite for Carers

Program• Day Therapy Centres• All other Commonwealth

aged care programs • Discussion paper on the

Home Support Program

Packaged Care Programs • 1 July 2013 til July 2015

– Home Care Packages – Consumer Directed Care– Individualised Budget Model

• Transition for existing packages


Home Care Packages

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Tiers of Care Subsidy Level (*)

Home Care Package Level 4 $45,500



Home Care Package Level 1 $7500

Source: Department of Health and Ageing (2013: 29) Home Care Packages Program Guidelines, Consultation Draft, Department of Health and Ageing downloaded

from http://www.livinglongerlivingbetter.gov.au/internet/living/publishing.nsf/Content/Consumer-Directed-Care-Home-Care-PackagesImplementing Consumer Directed Care Copyright Carrie Hater Consulting 11

http://www.livinglongerlivingbetter.gov.au/internet/living/publishing.nsf/Content/Consumer-Directed-Care-Home-Care-Packages

Aged CareHome Care Packages

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Approved ProviderBudget Holder

ACAT Assessment

Non Consumer Directed Care Consumer

Directed Care

Centralised Intake Screening

http://www.myagedcare.gov.au/1800 200 422

http://www.myagedcare.gov.au/other-languages


http://www.myagedcare.gov.au/

http://www.myagedcare.gov.au/

Consumer Directed CareHome Care Packages

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GoalsWhat

matters most

Outcomes Independence

Approved Provider

ACATTier 1Tier 2Tier 3Tier 4

Strengths & Needs

Individualised Budget

Outcomes

Amanthi Amanthi


ACTIVITY 2 – Self Assessment


13 April 2023

Service Users Practice

Staff & Volunteers

Budgets

Cost Carers Life story

Direct/ Indirect

Training & Support

Education & Support

Goals and Vision

Creative Culture

Culturally Competent

Consumer Directed

Care

Lau

nch

Pad


Cultural Competence

“Cultural competence is a set of congruent behaviours, attitudes and policies that come

together in a system, agency or among professionals and enable that system, agency or

those professionals to work effectively in in cross cultural situations” (Cross

et al. 1989, cited in National Centre for Cultural Competence 2006)


Cultural competence exists at different levels

Individual

Program

Organisation

State

Nation


AgeEthnicity

Language

Country of BirthReligion

Non-verbal language

Etiquette Notion of modesty

Notions of cleanliness

Individual or group orientation to decisions and/or resources

Gender roles, age roles, caring roles

Notions of ageing, disability, dementia, mental illness etc.Notions of superior and inferior

Values, ethics, notions of ‘good’ and ‘bad’Adapted from the National Centre for Cultural Competence (2005)

Iceberg Concept of Culture

Source: ECC NSW, COPS NSW & DADHC (2006) Cultural Competency & Case Management Training Package13 April 2023 18

Person Centred Thinking

Important to Important for• What is

important for people are the things that help people become or stay healthy and safe, whether it is important to them or not


• What is important to a person is what they say through their own words and behaviours about what really matters to them (eg comfort, happiness).

Source: http://www.helensandersonassociates.co.uk/reading-room/how/person-centred-thinking/person-centred-thinking-tools/sorting-important-tofor.aspx

http://www.helensandersonassociates.co.uk/reading-room/how/person-centred-thinking/person-centred-thinking-tools/sorting-important-tofor.aspx



13 April 2023

What people like and admire about me?What are your gifts and talents? What do others value about you? What are the positive contributions that you make?

About me.Put a photo or describe a few words

What is important to me This tells people in your own words what is really important to you, what your hobbies and interests are, who is important to you and what makes a ‘good’ day for you.

How best to support me……….

What do others need to know to make sure you get the best support possible? ( be specific, the more specific, the more people will understand)

One Page Profile

Source: Scown & Sanderson, 2011, Appendix 3 Implementing Consumer Directed Care



I am happiest when: I am comfortable in my chair or in my bed; Sitting listening to the radio or watching TV or a

movie; Spending time with my family every day; Seeing friends for short periods; I am with people but don’t have too talk too much.

How best to support me: My speech is often slurred, however, I can understand everything you say. Give me simple clear instructions. I need time to process instructions and information. I like my food but need it cut into smaller pieces and sometimes need

assistance. I need to be encouraged to push up from the chair when you are transferring

me. I have strength in my arms. I love doing my exercises but need encouraging and prompting. I need my glasses to be clean so that I can see properly. I like having the door open.

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ACTIVITY 3a & 3b


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Service Users

Co- production

and co-design

Consultative Mechanisms

Hearing the voices of

service users

Power imbalances


People Leading the Way Older PeopleVillage to Village Network BostonBeacon Hill Village • Grass roots movement created by

older for older people• Member basedhttp://www.beaconhillvillage.org

Village to Village Network http://www.vtvnetwork.org/

AustraliaWavertonhttp://wavertonhub.com.au/

People with DisabilitiesMy Choice Matters • Ideas and resources for

people to have more voice, choice and control

• Run my projects• Become a leader http://www.mychoicematters.org.au/


http://www.beaconhillvillage.org/

http://www.beaconhillvillage.org/

http://www.vtvnetwork.org/

http://www.vtvnetwork.org/

Empowering older people and their carers


• Education • Advocacy• Support• Council on the Ageing

– Peer lead education of older people

– http://www.cota.org.au/australia/ (home care today)

http://www.cota.org.au/australia/

http://www.cota.org.au/australia/

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ACTIVITY 4 – Service User Choice and Control


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Developing Individualised Budgets

Area What people need to know

Costs Direct Costs

Indirect Costs

Costs to service users What is a reasonable and unreasonable cost?What does administration costs include?

Educating service users Who can support service users to understand their budget?

Monitoring Systems for monitoring costs and information


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ACTIVITY 5


ACTIVITY 6 13 April 2023 Implementing Consumer Directed Care


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Key Area Questions

Service Users What skills do service users have to be active participants?What structures do we need to put in place to support this transition?

Financial Management Systems How much does it cost to deliver particular services?How can we provide this information to service users and stakeholders in a format they understand?

Staff What skills do our staff need ? How is this different or similar to their current skill set?What support structures do we need for staff?

Consumer Directed Care – Systems and Processes


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Key Area Questions

Risk Management How does our agency work with service users to identify and manage risks?How do our staff balance duty of care with dignity of risk?

Board and Governance What are the strategic directions our organisation needs to take?

Community Engagement Which community partners do we need to engage?How can we engage these partners?What languages do they speak?

Marketing How does our marketing material reflect what we do?What images do we want to portray to service users and the broader community?

Consumer Directed Care – Systems and Processes


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ACTIVITY 7 Implementing Consumer Directed Care


Thank You

Please complete an evaluation

Email: [email protected]:carriehayter

Linked In: au.linkedin.com/pub/carrie-hayter/34/536/517/


http://au.linkedin.com/pub/carrie-hayter/34/536/517/



Implementing consumer directed care

Government & Nonprofit

Transcript of Implementing consumer directed care