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The coming of age: Aged residential care nursing in Aotearoa New Zealand in the times of COVID-19

The Nursing Leadership Group (NLG) is the recognised voice of aged care nursing. The following article written by the NLG which includes HCSL’s very own Director, Gillian Robinson BN, RN has been published in the Nursing Praxis – Journal of Professional Nursing Special Issue: Nursing response to COVID-19 in Aotearoa New Zealand

The coming of age: Aged residential care nursing in Aotearoa New Zealand in the times of COVID-19

For years aged care nursing has been largely overlooked and marginalised from mainstream healthcare. COVID-19 brought both aged residential care and nursing into sharp focus for Aotearoa New Zealand. This paper provides a commentary on the work of executive nurses within the Nursing Leadership Group of the New Zealand Aged Care Association as COVID-19 spread into some ARC facilities in early 2020 and threatened the health and wellbeing of many residents and nurses. The group influenced the agenda and implementation of policies for Aged Residential Care and brought the voice of nursing and residents of aged care to the forefront at national and regional levels.

CLICK BELOW TO DOWNLOAD THE FULL ARTICLE.

Aged residential care nursing in Aotearoa

Frances Hughes, PhD, RN, Clinical Director, Oceania, Auckland
Anna Blackwell , PGDip, RN, Nursing Director/Owner, Cook Street Nursing Care Centre, Palmerston North
Tanya Bish, MN(Hons), BCom, RN, Clinical Director, Metlife Care, Auckland
Cheyne Chalmers, MMgt, RN, Chief Operating Officer, Ryman Healthcare, Christchurch
Katherine Foulkes, PGDip, RN, Clinical Services Director, Bupa, Auckland
Lynda Irvine, RN, Head of Clinical Services, Summerset Group Holdings Ltd, Auckland
Gillian Robinson, BN, RN, Director, Health Care Compliance Solutions Ltd, Christchurch
Rhonda Sherriff, RN, Managing Director, Chatswood Retirement Village, Christchurch
Virginia Sisson, PGCert, RN, Operations Manager, The Selwyn Foundation, Auckland

Reference:  Hughes, F. A., Blackwell, A., Bish, T., Chalmers, C., Foulkes, K., Irvine, L., Robinson, G., Sherriff, R., & Sisson, V. (2021).  The coming of age: Aged residential care nursing in Aotearoa New Zealand in the times of COVID-19. Nursing Praxis in Aotearoa New Zealand, 37(3), 25-29.

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Moreh Home

Thank you, Gillian, for all your support. The Healthcare Compliance Solutions Ltd (HCSL) aged care program gives a structured clear pathway through the obstacle course of Certification.

The HSCL program was extremely user friendly and appears very nicely laid out and easy to locate care plans and patient’s information. The general feedback from the staff has been positive.

The policies and procedures were easy to follow, and well presented. We appreciated how thorough these policies were, and how much work had gone into developing them.

We all felt well supported throughout, and it was so nice knowing that you were on the end of the phone/email or zoom. Even when we met in person, you were incredibly positive and encouraging, thank you!

We would recommend this system to anyone needing assistance with the challenge that is Certification.

Barbara Adams

Board Chair-person /Acting Manager.

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Bench-marking – Aged Residential Care

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his New Zealand designed web based (on-line / in-the-cloud) Bench-marking and quality management system from Healthcare Compliance Solutionhttp://www.hcslqms.co.nz/s Ltd allows you to:

  • Bench-mark in real-time – specific to resident type, event type, date and time of day.
  • Have automated default reports to save you time analysing your data trends and patterns
  • Drill down into your data easily to identify opportunities for continuous improvement
  • Complete your internal audits online and have the corrective actions auto-populate into a corrective action log
  • Log and manage adverse events
  • Bench-marking of adverse events against other aged care providers
  • Support evidencing an active Health & Safety programme is in place
  • Log and manage infections – automatic outbreak registers
  • Bench-marking of infections against other aged care providers
  • Log and manage your complaints with time-frame, investigation and response prompts
  • Dashboard view options for level of care and any chosen 3 monthly time-frame review
  • Dashboard view option of adverse events or infections
  • Logs (event registers) appear with individual events in one colour when open and change to another colour when the event is closed. This allows you to see quickly the status of events. 
  • Use in conjunction with your current policies / procedures or update to the HCSL site specific created policies and procedures. 

Your organisation policies and procedures and related documents (if created by HCSL) are also accessible through the Facility Documents tab on the left of the screen for remote anytime, anywhere access.  The keyword search option on the policies and procedures in addition to precise indexing and coding of documents makes it very quick and easy to locate information for staff to reference.

You can also upload your own documents for confidential safe storage.

This is what Rhonda Sherriff, NZACA Clinical Advisor says about using the HCSL QA system:

“I am very happy to endorse your system as the information is invaluable for CNMs to analyse the data/information and make informed decisions on best practice and innovation to decrease hazards, improve outcomes, and mitigating factors for resident welfare. I’m pleased you are delving into the data to the level you are, as it’s time saving for sites in many respects, and so easy to dice and slice the information to get the trends. CNM’s used to spend hours just writing up the collective information before the analysis, so hugely time saving”

To view a brief video explanation of the system click here. This programme has been operating in NZ Aged Care since mid 2016 so now has many thousands of pieces of data to compare yourself against.  

To find out more contact us here.

 

Making monitoring your service remotely in LIVE time easy!

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Quality Management Systems

The below question and answer were published in the New Zealand Aged Care Association industry ‘In-Touch’ newsletter (19th February 2016).

Question: A member asks “if we purchase a comprehensive quality management system from a provider how assured are we that the system will meet full compliance, come certification and surveillance audit time, as requirements and compliance expectations change frequently?

NZACA Clinical Advisor Answer: “You should be purchasing a complete quality management system that will comply with the Health and Disability Standards specifications, health and safety requirements and meet DHB/ARRC contractual requirements.

The provider of the system would normally initially tailor the full quality management package to reflect accurately the site specifications, H.R. component, and best practice guidelines, after consultation with the owner and management on site. These documents need to be site specific. The provider will normally contract to the site, which sets out obligations between the provider and the site management.

The contract will include the full review and updates of policies and procedures on a bi-annual basis, unless specified more frequently, to keep documents accurate and reflective of best practice. There may be an educational element provided within the contract as well, to benefit staff knowledge and skills. There is normally a good document control system in place and cross referencing of information where required.

Quality management systems are reliant on the skills and knowledge of the site personnel working with them, the way the system is managed and the outcomes/reviews, content and information extricated from the use of the system to improve quality care provision/outputs. The documentation system is reflective of the people using them, and the depth to which documentation and information is created, analysed and utilised for improvements.

Auditors on site rely on the provision of robust up-to-date policies and site adherence to them. Partial attainments can sometimes result from staff deviating from, or not following, their sites actual policies or processes as outlined in their quality management system.”

Where can you get such a system? 

Here at Healthcare Compliance Solutions Ltd we provide the services described above and noted as being optimal for achieving excellence in care and audit outcomes.   To see a brief video about the Aged Care software update and now in use by over 3,800 users in NZ, click here. 

Request a no obligation consultation here.  

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HCSL Aged Care Software user feedback

We asked a random group of clients for their responses in relation to using HCSL Aged Care Cloud based software. What do you like best about the HCSL software and your current use of it? Below is their responses:
  • I like the layout of the LTCP and being able to load and access documents in the one programme.
  • At the end of the month the stats are all there done without me having to calculate; the system does that itself, love it, I print off the bar graphs for the staff to see each months results with the related information written up to show the story behind the data
  • The advantage of having HCSL software in our facility means enabling quick access to residents records for more coordinated, efficient care and securely share information with residents and other clinicians. Holly Lea is in the process of having most of the documentations online. Moving to electronic significantly improved our archiving processes and the need for physical storage space for paper records is also significantly reduced. Being able to search for a file or document from the computer rather than manually dig through a filing cabinet saves time for all of us.
  • Know it is kiwi made and covers aged care in NZ requirements
  • Analysis of data and logs for complaints and incidents
  • Ease of access and user friendly
  • Log in pages are bright and cheerful.
  • Everything is in one spot and easy to access.
  • Audit system, ease of use, easy access to forms.
  • Its clear and easy to use.
  • The Long Term Care Plan (LTCP) is much more concise, great feedback from the care staff, easy to read and understand.
  • Able to compare to the average when reviewing falls or infection rates.
  • Ability to analyse present the information e.g falls.
  • I like the ease of use – the easy to generate reports – everything being in a logical order that ties in very well with the paper files
  • Used correctly the system does pass audit, meets all the requirements of the MOH Standards.
  • Receiving the continual updates we know we always have the most updated material available to meet our MOH requirements
  • This is a central point for data gathering. We have the potential to have most information on line.
  • The system is new to our team, it is still getting established here. We are finding it quite easy to use.
  • Its web based which means I can look at it anytime and am fully up-to date always with whats happening
  • The audits are detailed, and clear
  • The bench-marking is great and easy – saving time – great reporting
  • All of it, Everything on the website is easy to find and I like the bench-marking.
  • I don’t think we utilize enough of the paperwork some things I am discovering now after 5 years of using it!
  • I like the simplicity of the software.
  • I like that it is integrated with quality documentation.
  • I like that it is cloud based.
  • I like the flat fee for use, rather than a fee the number of devices (tablets).
  • The ease of uploading resident photo and easy layout
  • Ability to easily track trends in adverse events.
  • The straight forward user friendly interface, the data analysis, the way corrective actions populate straight to the corrective actions log,
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HCSL Aged Care Software – Version 2  instruction videos

HCSL Aged Care Software incorporates quality and risk, bench-marking, internal audit management systems as well as clinical functions) and how to use them.  These systems have all been audited numerous times for ARC provider Certification with maximum four year outcomes being achieved where the system is fully implemented. Tried and testing; pre-approved audit compliant.

Please click on the following links (the blue words below) to watch videos which describe the functions of the HCSL Aged Care cloud-based aged care software.

Gives you a general over-view of the key Dashboard and Resident clinical management functions available as at December 2019.

Guides you in how to upload or change a resident photo within their online profile

Guides you in how to add, view or search resident progress notes.

The HCSL system functions are able to be used in their entirety or some care providers use only the policies and procedures with the dashboard for quality and risk management; while others use the full system including the care planning and progress notes.

We have several care provider sites currently who have become paperless using the HCSL system in conjunction with Time-target, Medimap or 1chart and InterRai. The mix of paper based and IT based depends on your site, the IT skills of your staff and their access to computers.  There are a range of service options available depending on what suits your current circumstances.  To find out more about the service level options available click here

We continue to add features to evolve the system in response to changes in clients and industry needs. This evolution is intended to be an ongoing process and we look forward to your feedback and ideas.  Each change is considered on the basis of how it can be used by clients to ease their workload, streamline and save time while giving useful information.

HCSL Aged Care software systems are created by Healthcare Compliance Solutions Ltd through Version 1 or for version 2. Access codes are provided to clients with a current service agreement in place.

If you would like more information on the services which are available click here.

If you would like to receive our HCSL Aged Care newsletter which is published every 6-8 weeks, email us on gill@agedcarecompliance.com with your contact details.  This is also the email address if you have any further questions on HCSL software and services.

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Risk Managing Contractors On-site

It’s easy to forget to check contractors staff changes and ensure your risk managing contractors on site is ongoing. Recently I was on site at a care facility when a sub-contractor was working there.  When spoken to, he appeared to speak very limited English. He left empty boxes, a Stanley knife in the main hallway and wet glue and loose carpet at the entrance to a resident’s room. No signage, no clean-up.  I couldn’t help but ask the provider what the contractor knew about health & safety legislation, his responsibilities and risks to residents as a result of his work practices.

The Health and Safety at Work 2015 increased the responsibility on PCBU’s in relation to risk management in the workplace.  When using the services of contractors, there are likely to be overlapping responsibilities. While residents reside in residential care facilities and therefore it’s their home, the legislation defines residential care as a workplace.  As such, contractors coming into your environment must provide evidence of following a health and safety policy and processes which reflects current legislation.

A copy of their document should be kept on file along with verification of contractors (and sub-contractors) orientation to site and confirmation of their acknowledgement of health & safety responsibilities.  These documents are included in the Safe and Appropriate Environment policy manual for services using HCSL in hardcopy and in-the-cloud online. Documents should be re-signed by contractors annually or when changes to the environment occur or a contractors personnel have changed.

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Bethsaida Resthome, Hospital and Retirement Village Testimonial

We are very pleased to have recently been granted 4 year MOH Certification! No corrective actions and three Continuous Improvements.

This follows on from a fully attained Partial Provisional Audit that was required prior to opening our two new wings earlier this year with no corrective actions.

Make no mistake!  HCSL policies, software and support have played a major part in these accomplishments.  The HCSL software we use means we have easy access to information in real time.

I started working with Gillian of HCSL shortly after I took on the role of Facility Nurse Manager at Bethsaida Retirement Village six years ago. The facility was not using Healthcare Compliance Solutions policies at the time and perhaps this was reflected in the previous audit results.

Gillian is always responsive to emails and phone calls which is critical when timely advice is required.

The HCSL regular newsletters are interesting with relevant and up to date information on issues affecting aged care.

Gillian is a lovely person to deal with. She is thoughtful, professional, pragmatic and I have always found her to be keen to help, with practical advice on any issues that might arise in the management of a retirement facility.

I thoroughly recommend HCSL to all aged care facilities.

Tracy Holdaway RN BN

Facility Nurse Manager

Bethsaida Retirement Village

August 2019

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Home and Community Support Standards audit

Hi Gillian

Just passed our two day audit – NO NON COMPLIANCES; NO PARTIAL COMPLIANCES !!!!!!!!!!!!!!!!  –  thank you so much for your efforts.

The auditor praised your system – said it was a really good system – met all the requirements of the standards, is written in plain language, all the documentation relating to my job ie quality, risk management is outstanding and more than meets the standards and is very well used in the context it should be – thanks!

Lois Lash

Quality Assurance

Ascot House – Tainui Village

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Maintaining independence – maximising mobility

When it comes to maintaining functional ability for residents whether in a retirement village setting or in an aged residential care facility, the input for a skilled Physiotherapist is a huge advantage in setting up strengths and balance or falls prevention programmes.

Getting in the support of that type of expertise is certainly going to help residents maximise their potential.  Not all professionals are created equal and physiotherapists are no different to other professionals!  How do you go about choosing a Physiotherapist though and what should you check for when selecting the right person to support physical therapy for your residents.

I asked local well know registered Physiotherapist Jessie Snowdon what she thought on this topic.  Here’s what she recommends:

How to choose a physiotherapist for your aged care facility.

Physiotherapists are a key member of the healthcare team in aged care facilities. Having physiotherapy input can improve quality of life for your residents, improve safety and lessen workloads of your care staff. Many physiotherapists are also able to offer moving and handling training onsite as part of their service.  Physiotherapists who are passionate about aged care are usually very special people – so how can you pick them?

This article is written with contracted physiotherapy services in mind but many aspects will apply to employing a physiotherapist directly.

Ask about their experience

In order to meet the varied needs of residents in aged care, physiotherapists need to have a broad clinical background. I would suggest that your physiotherapist should have experience in most of the following clinical areas.  Because this is a long list you should be seeking a physiotherapist with a minimum of 5 years’ experience – or actively supervised by a more senior colleague.

  • Orthopaedics
  • Neurology
  • Dementia (even if not working in a specific dementia facility)
  • Cardiac respiratory
  • Moving and handling
  • Basic seating and wheelchair assessment
  • Falls prevention
  • Arthritis
  • Chronic Pain
  • Pressure injury prevention

Ask about their professional development

To maintain registration in New Zealand, a physiotherapist must adhere to The Physiotherapy Board Code of Standards which is available to the general public here. They must also have a minimum of 100 hours CPD per 3 years, show evidence of reflective practice and have one professional peer review per 3 years. At On the Go Physio we require a peer review each year and active ongoing engagement with colleagues and professional development.

It is not uncommon for aged care facilities to directly contract a physiotherapist working as a sole trader. This can be an isolating role for a physiotherapist and it is important they regularly engage in professional development and in supervision and peer review.  If you are employing, rather than contracting, a physiotherapist you will need to budget for this as it is reasonable that you meet these costs.

Eight quick questions when choosing a physiotherapist contractor

As well as the right experience and compliance with physiotherapy regulations, contractor physiotherapists are also businesses in their own right (whether a sole trader or employee of a company) and need to operate as such. These are some legal requirements and compliance issues you should consider.

  1. Ask to see and maintain a copy of their Annual Practicing Certificate (APC – a new one will be issued annually and you should have a copy of this prior to 1st April of each year).
  2. Ask for a copy of their professional indemnity and public liability insurance certificates.
  3. Ask to view their (or their employers) health and safety policy.
  4. Ask if they undertake regular supervision or mentoring to help assure their own professional safety.
  5. Ask them to arrange for a colleague to undertake a clinical notes audit within 3 months of starting in the role and annually following this. Ask for a copy. (You may need to negotiate this and if there will be a cost it would not be unreasonable for you to consider paying this).
  6. How will they cover your facility during periods of leave.
  7. Are they a member of Physiotherapy New Zealand – this is not compulsory but demonstrates a dedication to their profession and provides development opportunities.
  8. What moving and handling training experience do they have? Will they be happy to provide training or will you need to contract those services separately.

This article was kindly contributed to by Jessie Snowdon – Director of On the Go Physio. On the Go Physio provide physiotherapy services to over 20 facilities in Christchurch and Moving and Handling training to many more facilities and the CDHB.

A further article will follow on how to set up a Physiotherapy service in your facility.

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