COMMONWEALTHHOME SUPPORT ADVISORY GROUP - MEETING

This paper has been prepared for the CHSP Advisory Group meeting of 15 September 2014. It is designed to generate discussion on the policy parameters of the CHSP and does not necessarily represent a preferred or final position.

15 September 2014Agenda Item No: 9A

AGENDA TOPIC: Wellness and Reablement

Purpose

The feedback to theKey Directions for the Commonwealth Home Support Programme Paper strongly supports the implementation of a wellness and reablement focus in the CHSP. The next steps include developing a plan to put the concepts into practice in the CHSP. The Department is seeking advice from the Group on what the plan should include, in particular with regard to operational issues, resources needed, risks and challenges and ways to overcome any known obstacles.

Background

The Key Directions for theCommonwealth Home Support ProgrammePaper(the Discussion Paper) states that:
“As recommended by the National Aged Care Alliance, the design of the Commonwealth Home Support Programme will be underpinned by a wellness and reablement approach to care that focuses on whole of system support to maximise clients’ independence and autonomy. While improving older peoples’ functioning and independence is a core component of the Commonwealth Home Support Programme, it is not intended that this replaces the range of services delivered for older people by the health system”.

Feedback to the Discussion Paper

Sector feedback to the Discussion Paper includedthe following suggestions/recommendations:

  • While there is some ambiguity in the terms used, stakeholders stated strong support for a greater focus on wellness, reablement and restorative approaches in CHSP.
  • Stakeholders sought education, training, resources and support to better understand and apply these approaches in their services. It was expressed that WA and Victoria are ahead in their understanding of this and other jurisdictions will need support to catch up.
  • A workforce development strategy must be articulated to support the roll out of wellness, reablement and restorative care across the sector.
  • Consideration should be given to the funding of multicultural, ethno-specific and specialist providers of care to Aboriginal communities to deliver wellness and Reablement, allied health and nursing services.
  • The Department could examine funding the Community Services and Health Industry Skill Council to develop a nationally recognised skill set (to sit above Certificate III level) on wellness and reablement to address the competence gap for the vocationally trained workforce.
  • Stakeholders noted the strong leadership and service delivery role that allied health can provide in this area.
  • Stakeholders sought recognition that after restorative care interventions some clients will continue to require ongoing service provision to maintain improvements made.
  • Assistive technologies such as ‘telehealth’ should be considered in order to increase access to restorative services for clients living in rural and remote areas.
  • The reablement and wellness approach should include recognition of cognitive capacity and mental health.

Working definition of terms

In order to progress discussion and work to develop and implement a wellness and reablement approach the Department has drafted a position on the use of these terms for the CHSP and the Regional Assessment Services which proposes three different yet complementary concepts.

Wellness is a philosophy which will be implemented across all service delivery that focuses on client independence and autonomy. It involves a cultural shift from ‘doing for’ to ‘doing with’.

Reablement is the use of timely assessment and targeted time limited interventions that will be overseen by Regional Assessment Services and will help people regain or maintain their function and independence, and may reduce or eliminate the need for ongoing services. This can include practical advice on limiting the need for ongoing care or simple interventions (such as advice to assist the person be more independent in preparing meals, or referral to services for the installation of a grab rail).

Restorative care is a form of reablment that is time limited, allied health led and will focus on older clients who can make a functional gain after a setback.

Next Steps

The Department is now looking to develop a plan for embedding a wellness and reablement approach across the CHSP, building on the good practice and body of work that currently exists in the sector including evidence of what works. This plan would cover:

  • A clear definition of what wellness and reablement are;
  • Implementation arrangements, taking into account the establishment of Regional Assessment Services;
  • Identification of challenges in implementing the approach;
  • Identification of resources needed to equip providers to implement the approach;
  • Options for managing the roll out of the approach; and
  • Options for evaluating and further refining the approach over time.

The work may also examine how best to deliver reablement services through the Regional Assessment Services.

Discussion Questions

  1. Does the Group support the feedback to the paper?
  2. Are the working definitions ‘fit for purpose’ i.e. do they provide a useful framework to embed these elements in the CHSP and the Regional Assessment Services?
  3. a)Are the elements outlined above under ‘Next Steps’ appropriate?

b)What support will be needed to implement a wellness and reablement approach in CHSP?

c)How could we measure successful outcomes in this area?

d) What change management strategy could be required to leverage the existing provider

base’s capacity?

e)What challenges will need to be managed in implementing the approach?

  1. How can the Group best support this work?
  2. Are members able to provide leads on providers and regions demonstrating good practice in these areas? E.g. examples of evidence informed practice, staff development, measurement of success etc.

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