Specified Care and Services Reference Group

SPECIFIED CARE AND SERVICES REFERENCE GROUP
Discrepancies across hotel services, care and services for all, and high care services
September 2012
The tables enclosed line up each care and service type across hotel services, care and services for all and high care services.
/ PART I / PART II / PART III / SCS REFERENCE GROUP COMMENTS / ASSESSED NEEDS /
Item / Description / Hotel Services - to be provided for all resident who need them / Care and services for all - to be provided for all resident who need them / High care services - to be provided for residents receiving a high level of residential care / Issues / Contentious Yes/No? / Services to be provided to all residents / Fee for Service ? /
1.1 / Admin / 1.1 General operation of the residential care service, including resident documentation.
Includes: (residents cannot be charged for)
•registration for placement on a waiting list;
•preparing a resident agreement;
•preparing invoices and statements pertaining to the care of a resident;
•resident handbook and notices of resident and/or representative meetings; and
•administration and/or booking fees for all residents except where a resident enters respite care.
Excludes: (resident may be charged for)
•storage fees if stated in resident agreement;
•television rental, for example, a television fixed to ceiling in multi bed rooms unless the arrangement is voluntary and stated in the resident agreement.
Residents can choose not to participate in such an arrangement.
Residents may be charged for management of resident trust accounts provided:
– the arrangement is voluntary (i.e. residents can choose to handle their personal finances in some other way, without placing their money in a trust account with the Approved Provider);
– the Approved Provider charges no more than an amount agreed beforehand with the resident; and
– the Approved Provider gives the resident an account showing the amount charged. / Terminology / No
1.2 / Maintenance of buildings / 1.2 Adequately maintained buildings and grounds.
Includes:
•gardening;
•maintenance within and outside of the home; and
•any repairs and replacements required due to normal wear and tear.
Excludes:
•repairs and replacements required because of deliberate damage. / Needs clarification
To be cross-checked with the Accreditation Standards / No
1.3 / Accommodation / 1.3 Utilities such as electricity and water.
Includes:
•inspection of Approved Provider’s electrical equipment for occupational health and safety purposes;
•telephone sockets;
•access to pay telephone; and
•the cost of heating/cooling the facility to provide a comfortable environment.
Excludes:
•inspection of resident’s electrical equipment for occupational health and safety purposes. A resident may choose who undertakes the electrical inspection and who they pay for this service, i.e. a qualified electrician on behalf of the service, or a qualified electrician of the resident’s choice.
•if a resident chooses to use an additional personal heating/cooling unit for their individual use (in addition to an effective cooling/heating system provided by the service) then the resident may be responsible for the costs of running the system. The Approved Provider must inform the resident beforehand about the financial policies and arrangements in place regarding personal heating/cooling systems and this should be included in the resident agreement or in a variation to the resident agreement; and
•telephone line rental and handset for the resident’s personal use. / Fridges and personal TVs / No
1.4 & 3.1 / Furnishings / 1.4 Bed side lockers, chairs with arms, containers for personal laundry, dining, lounge and recreational furnishings, draw screens (for shared rooms), resident wardrobe space, and towel rails
Excludes furnishings a resident chooses to provide.
The words “to be provided for all residents who need them” does not mean if the resident cannot provide them. Aged care services are required to supply these
items, unless a resident specifically wishes to bring their own items with them.
Whether the resident can bring their own choice of furniture into the service is at the discretion of the Approved Provider and must meet occupational health and safety considerations.
Includes:
•a comfortable lounge chair for each resident to meet their support and comfort needs.
Excludes:
•specific chair requested by a resident for their own use, as an alternative to a suitable chair provided by the home. / Note: excludes chairs requested by resident / 3.1 Includes Over bed tables / Over bed tables only provided in high care / No
1.5 & 3.2 / Bedding / 1.5 Beds and mattresses, bed linen, blankets, and absorbent or waterproof sheeting.
Aged care services are required to supply these items, unless a resident specifically wishes to bring their own items with them which is at the discretion of the Approved Provider.
Includes:
• beds and mattresses that meet the assessed care, comfort and safety needs of residents; and
• pillows.
Excludes:
• resident choice to have a different type of bed or mattress other than a suitable bed or mattress provided by the service. It would be the responsibility of the resident to purchase such a bed or mattress and pay for any necessary maintenance. The Approved Provider has the discretion not to allow the use of the bed and mattress taking into account occupational health and safety considerations. / 3.2 Bed rails, incontinence sheets, retainers, ripple mattresses, sheepskins, tri pillows, and water and air mattresses appropriate to each resident’s condition.
Bedding materials must meet the resident’s individual needs as assessed by an appropriate health professional. The service must provide pressure relieving items of suitable type and quality.
Includes:
• water, air and gel cushions and ‘comfort chairs’ used for pressure relieving purposes. If a high level care resident is unable to ambulate and cannot use a conventional arm chair, then the Approved Provider should provide the resident with a chair incorporating what may otherwise be known as ‘bedding material’ such as air, water or gel chairs which meet the comfort and skin integrity needs of the resident.
Excludes:
• if a service supplies bedding material, comfort cushions, or chairs which are suitable to the assessed needs of the resident, but the resident wants a different type of item, then this is at the resident’s cost; and
• brand name alternatives to the provider supplied items. / Bedding materials only provided in high care / ?
1.6 / Cleaning services / 1.6 Cleanliness and tidiness of the entire residential care service.
Excludes a resident’s personal area if the resident chooses and is able to maintain it himself or herself.
Includes:
• each resident’s room and ensuite;
• cleaning of floor covering including carpet; and
• cleaning materials including materials for the use of residents who choose to maintain their own personal area.
The home may encourage and support the resident if they wish to clean their own personal area. / Facility policy - not to touch residents personal items (operational matter) / No
1.7 / Waste disposal / 1.7 Safe disposal of organic and inorganic waste material. / None / No
1.8 / General laundry / 1.8 Heavy laundry facilities and services, and personal laundry services, including laundering of clothing that can be machine washed.
Excludes cleaning of clothing requiring dry cleaning or another special cleaning process, and personal laundry if a resident chooses and is able to do this himself or herself.
Includes:
• general laundry includes both washing and ironing of clothing that can be machine washed. Aged care services are not obliged to hand-wash residents’ clothing.
• the home must have in place a system for identification of residents’ clothing and laundry items. However, a resident may choose and pay for their own identification system as long as it is at least of an equivalent standard to the service’s system e.g. woven name tapes rather than laundry marking pen.
Laundry services must be provided frequently enough to ensure that residents have an adequate supply of
clean clothing. Approved providers can request that a resident have sufficient clothing to ensure that laundry services operate effectively. / Ironing
Missing personal items / No
1.9 & 3.3 / Toiletry goods / 1.9 Bath towels, face washers, soap, and toilet paper.
Includes:
• suitable soap, or soap substitute for residents who cannot use soap because of clinical need; and
• reasonable quality toilet paper.
Excludes:
• resident’s personal choice to use alternative items to those provided by the home such as specific brands of soap. / 3.3 Sanitary pads, tissues, toothpaste, denture cleaning preparations, shampoo and conditioner, and talcum powder.
Excludes:
• a specific type or brand of the listed item not normally supplied by the Approved Provider, then the resident can be asked to pay for this. / Additional toiletry goods only provided in high care / ?
1.10 and 2.2 / Meals and refreshments / 1.10
(a) Meals of adequate variety, quality and quantity for each resident, served each day at times generally acceptable to both residents and management, and generally consisting of 3 meals per day plus morning tea, afternoon tea and supper;
(b) Special dietary requirements, having regard to either medical need or religious or cultural observance;
(c) Food, including fruit of adequate variety, quality and quantity, and non-alcoholic beverages, including fruit juice.
Includes:
• quality food in accordance with residents’ individual nutritional needs. Residents should be consulted about menu planning to ensure that menu choices take into account their preferences;
• food appropriate to meet medical, cultural and religious needs as well as special dietary requirements e.g. vegetarian, kosher, halal, gluten
free, low fat and thickened drinks if required by an individual resident; and
• nutritional supplements — for residents who are assessed by an appropriate health professional such as a dietician or a doctor as needing a special dietary
requirement, such as Ensure, Two-Cal, Sustagen etc to ensure they receive adequate nourishment and hydration.
Excludes:
• if a resident who has NOT been assessed as requiring a food supplement requests such a supplement in addition to their full diet, then the resident may be asked to purchase such an item. / 2.2 Special diet not normally provided (excludes food supplements unless specified by HCP).
Aged care services must provide individual residents with medically prescribed special diets or components of special diets they would not normally provide to other
residents if the resident needs a special diet (see Item 1.10).
Additional funding is only available for formula provided enterally. For example, it is not available for the same formula taken orally (refer CH6 of this manual).
An enteral feeding supplement is available on application from the Approved Provider to the Department of Health
and Ageing if this is supported by medical certification of the resident’s ongoing need. Enteral Feeding Subsidies cover the cost of enteral feeding supplements and the resident must be receiving a complete food formula by means of nasogastric, gastrostomy or jejunostomy tube.
Subsidy also covers for flexitaners, giving sets and hire costs of mechanical pumps. / Cultural (special diet requirements)
Language/ clarification : Reword it to 'special diet as required' (friendly to read)
Cost issues / Yes
1.11 & 2.5 / Resident social activities / Recreational Therapy / 1.11 Programs to encourage residents to take part in social activities that promote and protect their dignity, and to take part in community life outside the residential care service.
This care and service item is considered essential for the general health and wellbeing of residents.
Aged care services are expected to consult with residents and/or their representatives in the planning and
development of activity programs and base the activities offered on the needs, wishes and abilities of residents.
While residents may choose not to be involved in social activities, services should discuss the reasons for nonparticipation
with a resident and/or their representative.
Excludes:
• special pharmacy medication packaging for social leave; and
• outing costs e.g. transport costs, entry fees and food; however, many homes may choose to pay for these costs. Residents must be advised in advance of any costs. / 2.4 Recreational activities suited to residents, participation in the activities, and communal recreational equipment.
This item is considered essential for the general health and wellbeing of residents. Services are expected to
consult with residents and/or their representatives so they can provide activities that residents enjoy and include activities that cater to minority interests.
While residents may choose not to be involved in social activities, services should discuss the reasons
for non-participation with the resident and/or their representative (see Item 1.11).
Excludes:
• outing costs e.g. transport costs, entry fees and food; however, many services choose to pay the costs. Residents must be advised in advance of any costs; and
• the Approved Provider is not expected to provide craft supplies at no additional cost. / Not specified
Difference between resident social activities and recreational therapy
Recreational Therapy may be added to the extra care services list / ?
1.12 / Emergency assistance / 1.12 At least one responsible person is continuously on call and in reasonable proximity to render emergency assistance. / Responsible person (definition issue)
Reasonable proximity
To be cross-checked with the Accreditation Standards / ?
2.1 & 3.6 / Daily living activities assistance / Goods to assist with toileting and incontinence management / 2.1
Personal assistance, including individual attention, individual supervision, and physical assistance, with:
(a) bathing, showering, personal hygiene and grooming
(b) maintaining continence or managing incontinence, and using aids and appliances designed to assist continence management
(c) eating and eating aids, and using eating utensils and eating aids (including actual feeding if necessary)
(d) dressing, undressing, and using dressing aids
(e) moving, walking, wheelchair use, and using devices and appliances designed to aid mobility, including the fitting of artificial limbs and other personal mobility aids
(f) communication, including to address difficulties arising from impaired hearing, sight or speech, or lack of common language (including fitting sensory communication aids), and checking hearing aid batteries and cleaning spectacles