Are they really using values-based care?

Mar 5, 2023 | Advance Care Planning, Australian Aged Care, Carers Advice

Values-based care may be a big selling point for aged care facilities, but that doesn’t mean that it’s an integral part of how a centre runs. Looking beneath the smart marketing phrases and strong claims is part of making sure values-based care is truly on offer.

To help you make sure the claims match the actions, we’ve put together a definition of values-based care for you to use. And some helpful questions to get below the marketing responses.

Here’s how you can spot which aged care centre is going above and beyond in values-based care and make an informed decision for your loved one

Understanding values-based care

Values-based care is about placing the person who is receiving care at the centre of the experience through input into wants, wishes, goals, and future outcomes. It’s about centring on the needs of the individual to promote an overall experience of well-being. One that includes physical, emotional, social, spiritual, and intellectual considerations.

Values-based care incorporates:

·        Keeping clients healthy, goal-orientated and purposeful. This includes meeting individual definitions of what health, safety and purpose as part and parcel of their care. And challenging techniques, policies and procedures that may intentionally or unwittingly reduce a person’s capacity

·        Individual and community engagement to identify what matters and create services that meet the needs of the people as a group and on an individual level, instead of the other way around where people learn to adjust and slot into the systems and procedures of the aged care industry

·        Measuring and evaluating change and progress in tangible and intangible ways. This includes the use of hard data via analytics and assessment, as well as measuring the impact care makes and the overall well-being of those receiving the care. Plus, making the aged care sector more transparent and accountable as a result

·        Innovation, research and an adaptable, growth mindset. Combining the knowledge and research available about ageing, healthcare, inclusion and disability to create solid policies and accessible, person-centred care that is culturally appropriate is key

·        Sector connectivity and collaboration for better outcomes. Working together to ensure the best possible outcomes has to be a key part of the modern image of aged care in Australia. By working together to improve outcomes and provide quality services, we can not only supply values-based care but challenge the stigma related to aged care in this country

·        An understanding that training, culture, people, governance and regulation are at the heart of providing the best possible care. Short-term profit should not come at the cost of long-term failure to provide a fit for purpose workforce that not only exceeds care standards now but also ensures the future of aged care across generations

·        Shifting the focus of funding and purchasing from activity to outcome. Instead of viewing the financial management of aged care as a cost per person, it is about refocusing on an investment in real cultural change. One that sees an increase in wellness, happiness, satisfaction and engagement with aged care by clients and the community

·        Care meets clinical leadership to provide better outcomes. Providing care is an entire team focus. This means managers and clinicians working together to lead evidence-based change through coupling the theory with the practice of continual learning.

It sounds like a lofty ambition to have such an integrated approach to care. However, this is what we ask of the aged care sector as an outcome of the Quality Assurance guidelines.

Questions to ask to ensure the aged care centre you are considering takes values-based care seriously

1)     What does values-based care look like at your facility?

If you’re familiar with the ExSitu blog and/or the Aged Care Quality Standards that resulted out of the Royal Commission into Aged Care, you’ll understand the focus is very much on providing values-based, person-centred care at the facility level.

Every residential and in-home care centre has to implement the requirements. However, implementation is one thing. Using the values-based care model as an opportunity for improvement and cultural change is entirely another.

Listen to the explanation given when asking about values-based care. And don’t be shy about:

·        Challenging any unclear statements or potential waffle with questions like “when you say <their example>, what do you mean by that?” and “how does that translate for my Dad with his daily routine or activities?”

·        Investigating if they approached the List of Reccomendations as an opportunity to improve things, or if they seem like a sore point or an additional burden

·        Asking if implementing the Aged Care Quality Standards is on track to meet milestones and deadlines

·        Using the outline above to form your own questions about values-based care. For example, asking directly about their reporting and oversight, how they meet individual goals, or what clinicians they regularly work with.

You can also demonstrate what you believe a care plan should look like by using our product and helping it create conversation about care plans and the hierarchy of values as a foundation to that care.

2)     Frankie is an extrovert/introvert. How will they fit in at your aged care centre?

Personalising the situation helps introduce you or your loved one right from the get go. Seeing the person within the family and the friend network ensures they know who they are dealing with right from the start.

It’s also important to match a person’s wants, needs and pastimes with the right centre. Frankie, the history studying introvert who is cheerful with a garden and a good book, is probably going to be exhausted emotionally by large and continual group activities. Frankie the extrovert will probably feel isolated if they are left to their own devices – or could overwhelm other residents if infrequent social activities are their only time to shine.

A great idea is to look at the regular and semi-regular activities on offer and match them to what your loved one already does.

 

3)     Have you got experience with diversity and meeting cultural needs for LGBTQIA+, Aboriginal and Torres Strait Islander Peoples, and/or Culturally and Linguistically Diverse (CaLD) people?

Language, culture, belief and heritage all play an enormous role in who we are. They also influence identity, the needs and wants of a person, and the access we enjoy to rituals and activities that help practice culture and belief in entirety.

Seeing yourself reflected in the staff, policies, procedures and activities gives a sense of welcoming safety. This is especially true to people who have faced exclusion, bullying, racism, homophobia, ableism and/or exclusion or persecution because of religious observance.

Look for not only a tolerance of difference but also proof that they meet specific needs in policy, procedure, language, activities and more. And don’t be afraid to ask how the aged care centres on your shortlist deal with incidences of exclusion between residents and/or staff. Stating it never happens or they don’t envisage it happening is different from having a working plan and mediation process in place.

4)     How do you activate the individual care plans of your residents?

Working with a group of people within an aged care centre is one thing. How they will approach the care needs of an individual is another.

What you want is an aged care centre that is goal oriented. They want to maintain the health, fitness, social buoyancy and mental health of their residents with a focus on meeting values and person-centred care.

Ask them about their care plan process. Do they sit down and talk to residents? Can you see the form they use for the care plan? Do they revisit and adjust the information in a care plan after consulting the individual at regular intervals? Do they review individual care plans when there are changes to services, activities and/or a person’s individual capacity?

It’s one thing to have a care plan. It’s another thing entirely to treat it as a living, breathing blueprint of a person’s individual care needs. You can also use ExSitu’s tried-and-true care plans as your care plan of choice as a way of articulating this part of your journey ahead of time.

5)     How do you accommodate for individual care plans for each resident?

ExSitu is in the care plan business – but we have no expectations that every aged care centre will make use of our services. We are, however, experts in care plan creation and know the toll an underweight or not fully formed care plan can have on a person’s care.

Choose aged care facilities that:

a)      Go beyond basics of hygiene, nutrition, and talk of beds to discussing physical, emotional, social, spiritual, and intellectual considerations

b)     Talk about how they define, design, deploy and maintain values-based care plans as an entire individual project rather than a document or information capturing job

c)      Are less likely to bunch every person under the same umbrella. E.g. Promoting activities “for all members” over focussing on options and individual choice or referring to “all the residents” as an indistinct group of people

d)     Listen more than they talk – and ask questions that help you make an informed decision.

Want more advice on what to ask an aged care centre? Check out our blog on the eight questions to ask when choosing an aged care centre now.

 

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