The Future of Aged Care

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-By Claire Suttles

In November of 1984 Florence Padman was a Registered Nurse with an impressive teaching career under her belt. She was also the mother of a toddler and wanted more freedom over her work schedule. Armed with her health care experience, and her husband Viv’s business background, the couple made the leap into the residential aged care industry. “I thought that it would be more flexible for me… working for myself,” Mrs Padman laughs. “But of course it was a lot, lot harder.”

Not surprisingly, the venture was fraught with challenges. “Running a business was new to me,” Mrs Padman admits. “And, we hadn’t much money.” The couple managed to buy the necessary licence and found an ideal 25 bed home on a lovely Adelaide beach. However, just after signing the lease and before settlement, the Padmans discovered a hidden amended clause that would give the landlord ownership of both the building and the business after thirteen years. By this time, Mrs Padman had already quit her job and the couple were wholeheartedly committed to the new enterprise. “We had to make a decision, and we bravely took the plunge as it was our one opportunity to enter the aged care arena.” Fortunately, the risk paid off, and the landlord eventually sold the building to the Padmans.

After successfully running their first home for several years, the Padmans sought to expand the business. They soon learned that the only way to break into the industry more fully was to buy older homes that came up for sale but often required significant improvement. “That’s been our biggest strength, to be able to go in, conduct a thorough assessment of a home that’s underperforming, improve the standards, and improve overall performance,” Mrs Padman explains. In 1992, through tight financial management, and “the courage to go to the bank and arrange loans,” the Padmans were able to purchase a second home, followed shortly by a third.

As the business expanded, the Padmans became increasingly concerned that the aged care industry “had a poor image and not a great name.” The couple quickly realised that they needed to “improve the profile of aged care” in addition to enacting a business strategy that would keep their homes sustainable. “We looked at how we would move forward and get into a position where we would stand out as market leaders,” Mrs Padman reports. The couple believed that the only way to accomplish this was to “look at what the future elderly wanted and what we ourselves would want for our parents.”

After studying the situation, they decided that the key to improving the aged care industry’s name, and to sustainability, was providing better quality homes “that people will want to come to rather than need to come to.” The Padmans also realised that the only way to offset the high cost of new, upscale facilities was to offer Extra Service. “It’s very hard to build homes of that quality if you cannot have some funding that you can get fairly early in the piece that will reduce your borrowings,” Mrs Padman explains. In Extra Service facilities, the client pays a bond that helps towards the cost of building; this enables providers to offer a higher standard of accommodation. Even though bonds are a financial necessity in the Extra Service market, the Padmans are committed to keeping the cost as low as possible. “We’ve set the bond rate at a fairly conservative level so the average home owner can still afford to come in,” Mrs Padman reports.

Because many older Australians cannot afford to pay a bond, Mrs Padman says that “some people philosophically have a problem” with the Extra Service market. In response, she points out that the same accreditation standards apply to all nursing homes, whether or not they are Extra Service. “It’s the same criteria,” she explains. “Every nursing home resident is entitled to high quality care whether they go into a traditional nursing home or an Extra Service home.” Extra Services are not care related, and Mrs Padman describes them as “a package of lifestyle services,” that reflect the same consumer choices made in the broader community.

For example, “In the community now, if you choose to dine in a fancy restaurant or the local hotel, it’s your choice,” she says. “You may wish to pay ten dollars for a meal or fifty dollars for a meal, that’s your choice. Extra Service is just that… you choose to pay for some extra services that you want.” Padman Health Care also provides traditional homes to those who can’t, or prefer not to pay the extra cost. Mrs Padman reiterates that in these homes, “the standard of care is no less.”

Skyline, Padman Health Care’s first Extra Service home, won a national award soon after it opened, honouring it as one of the country’s best aged care facilities. The recognition continued. “A number of our Extra Service homes have won in subsequent years as outstanding homes,” Mrs Padman reports. In general, Padman Extra Service homes attempt to mirror the comforts and luxuries that seniors enjoyed in the outside community. Residents have private rooms and access to more social spaces, including multiple dining areas that can be booked for private parties, a movie theatre room, a spa, a beauty salon, and a ballroom with a grand piano for dances and other events. The Extra Service homes also offer more frequent outings. For example, “We may escort them to the theatre or movies if they wish,” Mrs Padman says. “We make trips to local cafés for coffee and cake or enjoy fish and chips by the beach.” Wine is offered with meals, high tea is served, family functions are abundant, and lifestyle therapists offer more activities. “It’s just a bit more pampering that they can really enjoy,” Mrs Padman explains.

Padman Health Care has been extremely successful, and Mrs Padman gives a healthy portion of the credit to her dedicated staff, some of whom have been with the company for over 18 years. “We’ve got a very good team of senior staff who have grown with us… and have all worked their way up the ranks,” she says. “They are very, very committed.” However, even with a core of committed, long time staff, finding and retaining aged care workers is a hefty challenge. “For us workforce is the biggest issue,” Mrs Padman reports. “We can’t be selective because there are not enough numbers of people to employ. If you advertise you might not get many applicants.” Overall, even among those seeking employment, “aged care isn’t an area that many people choose to work in.” To maintain an adequate number of qualified staff, Padman Health Care has begun employing Registered Nurses from overseas, particularly for homes in remote areas where finding workers is especially difficult.

With so few people interested in an aged care career, Mrs Padman became concerned about the future of the industry and how the needs of the future elderly would be met. To counteract the problem, Padman Health Care launched a registered training organisation in 2008 to cultivate and encourage new aged care talent. The training school has been a huge success, and quickly expanded to offer multiple health care certificates. “We hire most of our own students,” Mrs Padman reports. “We can pick and choose the best from the group. That’s really helped with our expansion of our services.”

Mrs Padman says that her students are also recruited by other aged care organisations. Current Padman Health Care employees also receive regular, ongoing training to ensure that staff and management are all equipped to do their jobs as well as possible. In fact, Padman Health Care has recently submitted an expression of interest to the Dept of Health & Ageing to become a Teaching and Research Aged Care Service. This would involve setting up the organisation as a hands-on teaching facility for university students pursuing degrees in nursing and aged care.

Padman Health Care has a lot to consider as it looks toward the future. Deregulation of the industry is one area to watch, though Mrs Padman says that, for now, “It doesn’t appear that it will happen in the near future.” Regardless, the team is preparing for that possibility. “We’ve been working toward making sure that we are in a position where we can sustain ourselves,” Mrs Padman reports. Conducting at least eight audits on each of its 14 homes every year helps the company meet this goal. Internal audits “give us a certain level of comfort that if we have any gaps in our performance we [will] pick it up ourselves,” Mrs Padman explains. The team is also embracing new technology and software in order to ensure that the business is run as efficiently as possible.

Another new step is partnering with upscale retirement villages so that, should the need arise, a Padman nursing home is ready to receive village residents. Perhaps most importantly, the company is considering new models of health care that will better fit the future elderly. “We are looking at the demand for palliative care, and dementia care, and support for those with mental health disorders,” Mrs Padman reports. “We also have to look at culturally sensitive services for people from multi-cultural backgrounds, as well as services for people who are transgender, homosexual or bisexual.” Padman Health Care understands that the next generation of seniors “will want a different kind of support and care,” and that identifying and providing this service is vital to continued success. Much of our services may well happen in the community and in people’s own homes. “We are always looking at what’s out there on the horizon,” Mrs Padman says. “We need to ask ourselves what the needs will be and try to meet them at the highest level.”

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December 19, 2018, 9:23 AM AEDT