About residential aged care services

Overview, legislation and accreditation

Residential Aged Care Services provide accommodation and support for those among us who are no longer able to live at home without professional assistance. Residential aged care, by definition, refers to specific aged care facilities that receive government funding to supplement the cost of services they provide to residents.

During 2009 - 2010 federal government funding for aged care facilities in Australia totalled approximately $7.1 billion. This amount was spread over the 3000 government-funded aged care facilities in Australia. Each aged care facility offers varying levels of care and services, including low level residential care (LLRC), high level residential care (HLRC), dementia care, and residential respite.

The Australian Government's Aged Care Act 1997 governs all ageing/aged care programs and services. Aged care service providers must comply with their obligations under this act.

Australia's aged care system aims to ensure that all elderly people receive the necessary support and quality care when they need it most. Government-funded aged care facilities are owned and operated by officially approved aged care individuals or organisations. The government regulates these facilities to ensure they meet high standards of accommodation and of care, and that the rights of their residents are protected.

The government monitors and audits the quality of care and services provided in aged care facilities on a regular basis. Residential facilities have to meet accreditation standards, as well as show continuous improvement in the quality of care and services they provide to their residents.

The Aged Care Standards and Accreditation Agency assesses residential facilities for compliance and regularly monitors them to make sure they comply with the national standards. Residential facilities have to meet accreditation standards, as well as show continuous improvement in the quality of care and services they provide to their residents.

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Low level residential care

Low level residential care is provided for people who need some assistance with the basic activities of daily living (ADL's), but do not require 24-hour nursing care or supervision. Generally speaking, a low care residential facility provides accommodation, all meals, and assistance with activities of daily living. These activities may include bathing, going to the toilet, eating, moving around, dressing, incontinence management, and assistance in accessing therapies and services.

Low care residential facilities are required to provide bedding and furnishings, laundry and cleaning services, some toiletries, as well as also being required to maintain the surrounding grounds and buildings. Residents are generally able to bring some of their own furniture into these facilities, giving their room a more personal feel.

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High level residential care

High level residential care is for people who require 24-hour nursing care and/or professional supervision. A high level care facility is the next step up from a low level care residential facility, and as such must also provide additional care services. These include professional nursing services and equipment (Including mobility assistants, continence aids, basic medical and pharmaceutical supplies, the provision of therapy services and more).

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Secure and dementia care

Facilities may offer a secure environment, or dementia-specific care. In some cases a low care facility will be secure (in essence, it has keypads at all exit points which prevent disorientated residents from wandering out of the residential facility into harm's way).

The level of security provided and the relative behaviour a person displays, will determine the residential facility's ability to care for the resident in question. In many cases however, low care facilities are not secure (potentially allowing circumstances where a secure environment dependant resident may be able to exit a residential facility without being noticed). Therefore a resident who requires low level care and who has a dementia related illness will often need to be cared for in a dementia-specific wing or secure area, usually a separate space within a larger residential facility.

Those residents with a dementia related illness, who demand a high level of care, are best suited for the services of a high care facility due to the additional supervision and secure care services these facilities offer. However, should a resident display challenging behaviours, then they will most likely require a dementia-specific high care facility. Dementia-specific care can therefore be provided in both low level and high level care environments.

Dementia-specific care facilities cater for the special needs of those with dementia in a comfortable, safe and secure environment. The staff will be better equipped to deal with behavioural effects of dementia and the residential facility itself will better provide specific activities and appropriate care targeted to help those suffering from the disease.

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Extra services

Extra services denote that a residential facility offers a higher standard of accommodation, food and services than other facilities are able to. Extra services often encompass bigger rooms, and/or the guarantee of a private room. This can be of particular interest for perspective residents seeking high level residential care, who may otherwise find it difficult to secure a single room. It may also mean a glass of wine with the evening meal, as well as a greater choice of meal options and/or superior residential furnishings/décor.

Extra services should not be mistaken to denote that a higher standard of care is on offer. All facilities must meet the same care standards set by the Australian government. Extra services are a choice that the individual requiring care and/or their family/guardian will determine, depending on their particular circumstances. It is not a level of care, or care requirement, that must be adhered to as indicated by an aged care assessment team.

In high care, choosing an extra service placement will attract a bond, where as a mainstream high care placement will not. In low care, if the resident has sufficient assets, a bond is required regardless of whether or not the person chooses an extra service placement. There will also be a daily extra service fee, which applies to both high care and low care extra service placements. It is important to ask the facility in question what their extra service fees are (as unlike daily care fees, these fees are set by the residential facility and can vary significantly).

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Residential respite

Respite is offered by many residential aged care facilities and is often used to give carers a break. A person will receive 63 days per year of government funded respite, if assessed by an aged care assessment team as being eligible for respite.

Respite is short-term care, intended for individuals that will be returning back to their own community/home. It can be offered for residents who require LLRC, HLRC and dementia specific care. It can also be provided in an extra service environment, although this generally incurs additional fees.

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Transition care

The transition care program is a goal-orientated program, providing short-term accommodation in a residential aged care facility. It provides for individuals that have just experienced a recent hospital admission, allowing 12 weeks time for a suitable long-term care plan to be put in place. Therapy services such as physiotherapy and nursing care are provided to assist, maintain, or improve an individual's current health and mobility.

In most cases the decision has already been reached whereby permanent care will be required within a residential aged care facility following transition care. As finding a permanent place in an aged care facility can be difficult at times, transition care can provide a place for the individual to be properly cared for while the family or guardian makes said permanent care arrangements. The family or guardian will be required to secure the permanent placement within the allotted 12 week period. They may also be asked to sign an agreement stating that the individual needs to be waitlisted at a specific amount of facilities within a certain timeframe.

Transition care also has a community arm for those individuals who are able or may be able to return home with additional supports in place. It allows time for the individual to regain confidence and further improve their health in their own home, with the intention of returning to independent living with or without supports in place.

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