Aged and Continuing Care Unit

In March 1997 the Aged and Continuing Care Unit (ACCU) was established, bringing together the State Government Nursing Home (SGNH) Restructure Project, the Home and Community Care (HACC) Program, the Aged Care Assessment Program (ACAP) as well as a number of aged care initiatives under one integrated unit. It has broad responsibility for:

• strategic planning, service development and purchasing for aged and continuing care services;
• operational management of ongoing SGNH restructure projects; and
• management of the HACC Program and Aged Care Assessment Program (ACAP).

An Aged and Continuing Care Executive Committee was established in the Health Department to oversee aged and continuing care policy and planning.

State Government Nursing Home Restructure

The closure of Mt Henry Hospital meant that a number of strategies had to be identified to replace the restorative unit and day hospital places.

• A purpose built 24-bed assessment and restorative care service is under construction, as well as 20 day-hospital places for the Perth inner metropolitan area at the Mercy Hospital in Mt Lawley;
• Ten day-hospital places were permanently transferred to Bentley Hospital;
• Sixteen restorative beds transferred from Mt Henry Hospital were opened at Osborne Park Hospital. These beds are supported by the new therapies block built on the Osborne Park Hospital campus; and
• Twelve nursing home beds at Goline House (Armadale/Kelmscott Health Service) were successfully converted to restorative beds.

Homes of Peace Redevelopment

The Health Department has committed substantial one-off capital assistance to upgrade and redevelop Homes of Peace nursing home facilities.

Land has been purchased by the Homes of Peace at Joondalup, Stirling and Rockingham to establish three new 60-bed facilities as part of the plan to reduce the number of beds at its Subiaco and Inglewood sites that are in relatively "over bedded" areas, and relocate the bed approvals to areas of greater need. During this process the Subiaco and Inglewood sites will also undergo major capital redevelopment.

Old Mt Henry

Mt Henry Hospital was progressively scaled down during the year. This process will continue, but some services will remain on-site until around August 1998.

New Mt Henry

Requests for proposals were sought from the non-government sector to develop a replacement 60-bed nursing home on the Mt Henry Hospital site. This is a key strategy in the rationalisation of the State’s involvement in the provision of residential nursing home care, with 60 nursing home bed approvals to be transferred to the new facility. Following a selection process, Anglican Homes Inc were chosen as the preferred proponent.

The Mt Henry Hospital site was subdivided and a separate title provided for the replacement nursing home site. The remainder of the site, exclusive of the Dental Services component, has been sold to Landcorp for residential development. The disposal of the land has resulted in substantial revenue to be used to support the various projects and initiatives currently being developed and new initiatives planned.

A new $750,000 therapy centre at Osborne Park Hospital will help elderly patients regain their independence.

Redistribution of Nursing Home Bed Approvals

The restructure of SGNHs is enabling a redistribution of nursing home bed approvals which have become available for transfer through the:

• transfer of bed approvals from Mt Henry Hospital;
• re-allocation of under-utilised bed approvals in country SGNHs;
• redistribution of bed approvals held by Homes of Peace Inc; and
• allocation of new Commonwealth nursing home bed approvals.

Nursing home bed approvals will be transferred to relatively "under bedded" locations, with an emphasis on country area nursing home needs. For example, Commonwealth approval was sought to transfer 10 bed approvals from Mt Henry Hospital to Baptist Homes in the Vasse/Leeuwin area.

The development of the joint State/Commonwealth Multi-Purpose Services (MPS) program is enabling access to residential aged care in rural and remote communities, rather than using acute hospital beds or relocating the elderly to regional centres or to Perth. Agreement was reached with the Commonwealth to transfer 20 bed approvals to the Eastern Wheatbelt MPS and a further 18 bed approvals to the Central Great Southern MPS.

Young People in Nursing Homes

There are 95 young people with disabilities to be relocated from Mt Henry Hospital and Homes of Peace nursing homes to more appropriate accommodation of their choice as part of an agreement between the Health Department, Disability Services Commission and Homeswest. During 1996/97 four young people were relocated. Building has either commenced or been completed by Homeswest for 19 of a total of 60 places. Homes of Peace also purchased a site which will house 12 young people in a group home setting.

Chair in Geriatric Medicine

A Chair in Geriatric Medicine to be established at the University of WA will contribute to improving standards of care for the aged; consolidating the academic aspects of teaching and research, and improving the profile of geriatric medicine. The position was advertised internationally.

Palliative Care

Palliative care services are largely directed to people with terminal cancer and accounts for 90 per cent of all referrals. Projections in the trend in cancer deaths indicate a 60 per cent increase in the number of people dying from cancer over the period 1994-2006.

The Health Department continued to purchase extensive community hospice services through Silver Chain in the metropolitan area and Silver Chain and other providers in non-metropolitan centres. It is estimated that 70 per cent of people with terminal illnesses are in receipt of home-based services. This will continue to be an area of high growth in the coming years.

Sandalwood House, the Nursing Home component of the York District Hospital was officially opened after being refurbished with $480,000 Health Department WA funding and $100,000 from the Shire of York.

A palliative care plan for Western Australia was developed which draws together many of the issues related to the provision of palliative care and demonstrates a commitment to advancing palliative care services in this State.

The plan puts forward 25 key initiatives which aim to enhance the range of service options and choices available for terminally ill people and to assist and support families and carers. These key initiatives include:

• commissioning research to identify the number of people with terminal illness requiring palliative care and their care needs;
• professional education in palliative care;
• purchasing a range of palliative care options;
• increasing investment in rural and remote areas;
• palliative care for Aboriginal people and people from other cultures;
• palliative care for people living in residential facilities; and
• palliative care investment strategies.

Establishment of palliative care and grief bereavement support to the communities of the Central Wheatbelt by the Avon Health Service was progressed by the:

• Grief and bereavement support for carers of patients of Avon Hospice;
• Bereavement support of community members who have experienced a sudden loss;
• Securing of funding to conduct two workshops for Hospice volunteers in the region; and
• Provision of psychosocial support, symptom control and peer support to patients and health care providers.

A 12 week post-acute graduate medical course for General Practitioners in palliative care medicine, developed in conjunction with the Royal College of General Practitioners, was conducted during 1996/97 and similar courses are planned for the future.

Home and Community Care (HACC) Program

The Home and Community Care (HACC) Program enables frail aged people and young people with disabilities to remain in their own home by providing a range of support services, including home help, home nursing, respite care, home maintenance, transport, delivered meals and carer support.

An important initiative during the year was the introduction of the advocacy agency Advocare - consolidating and improving advocacy services for consumers of the HACC Program.

A management training package entitled ‘No Trouble’ was developed for indigenous HACC service providers which shows how complaints can be managed in difficult situations commonly experienced in small communities.

Funding for the HACC program grew by about six per cent in 1996/97 to a total of $75.3M. The availability of new resources enabled a number of new initiatives to be funded, including:

• The Catholic Care ‘Weekends Away’ project to provide respite for the carers of younger people with disabilities throughout the metropolitan region.
• The ‘Take a Break’ project, also to provide respite to carers of younger people with disabilities by taking clients on group holidays in order to give the carer a break.
• A review of transport assets and models of service delivery to be undertaken for HACC funded services throughout the north metropolitan region to identify gaps in service provision.
• A pilot ‘Doorway’ project for the Melville, East Fremantle, Fremantle and Cockburn area to assist and improve eligible HACC clients’ access to the community care sector and improve the coordination and referral processes between providers and referring agencies and other individuals.
• Recurrent funding provided to the Geraldton Day Centre to provide a weekend centre based respite service.
• Funding for a transport, shopping and home help service for Aboriginal people in the Bunbury area.
• Silver Chain started a 24 hour, seven day a week home respite service in Busselton and Capel. Part-time care aides and a clinical nurse provide emergency respite, after hours respite and holiday respite for carers.

One-off funding was also used for improving facilities for HACC consumers. Examples include:

• $75,000 towards building a centre-based respite facility in Bentley for Canning Multicultural Adult Day Centres;
• $250,000 to assist in the construction of an integrated community services complex within the local government of the City of Subiaco. The Home and Community Care Day Respite Centre will be housed in this complex;
• $195,000 to construct a centre-based respite facility in Kingsley/Woodvale;
• $105,000 to construct a HACC facility in Cottesloe; and
• $50,000 to Albany Lions for plans, submission and preliminary site works for a Dementia and General Aged Care building on a block of land next door to the Spencer Lodge Nursing Home.

The Nurse Consultant (Eldercare)

The Nurse Consultant (Eldercare) role was introduced to the Upper Great Southern Health Service (UGSHS) in June 1997. There was a perceived need in the region to identify services pertinent to aged care, for example:

• Health promotion programs including Stay on Your Feet (a falls prevention program), and continence promotion.
• The introduction and support of contemporary aged care programs in existing long term care facilities.
• Co-develop and introduction of a discharge program according to identified need in hospitals within the UGSHS.