Leading the Way in Aged Care

The Montefiore Home

With 12 decades of award winning service under its belt, the Montefiore Home certainly stands out. “I think the first thing that really sets us apart is that we have operated with a very successful cross subsidy model,” reports CEO Robert Orie. “That is really the defining difference between us and a lot of other charitables.” The organisation focuses on high end accommodation in order to attract full fee paying customers and create the income stream that the charity needs to support its mission. The model has been a huge success and enables economically disadvantaged residents to receive the exact same level of accommodation and services as the full fee payers. “It is a real win-win situation for everybody.”

The Montefiore Home has carefully invested a good portion of this income stream into its accommodations. “Our organisation always had a lot of foresight in terms of what the demand will be [regarding] the quality of the accommodation,” Mr Orie explains. Staying ahead of tomorrow’s trends has “enabled us to maintain a very high standard of built fabric,” he adds. “So, even though a lot of our facilities were built many years ago, the rooms are all single rooms with ensuite bathrooms and they are all very generous in size.”

Additionally, with every new construction project, the organisation makes it a point to “look at what the current accommodation standards are – and add 50 per cent to the current standard.” As a result, the team believes that Montefiore facilities being built today will still stand up to market demands 30 years down the road. “That has been a very, very strong part of our market appeal,” Mr Orie explains. “We do have very, very high standards of accommodation.” Most recently, the organisation completed a comprehensive refurbishment of its dementia specific unit at Hunters Hill.

The Montefiore Home also has a strong multi discipline approach to services. Clinical services are supplemented with allied health services to ensure that every need – including the spiritual, emotional, and psychological – is met. For instance, The Montefiore Home is one of the few aged care providers with its own social work department to support residents and family members. “We really look at the overall wellbeing of residents,” Mr Orie says. “We are recognised in the market as being a leader in that area.”

Memory boxes provide an additional means of comfort and support. These display cases are filled with personal mementos and are proudly showcased outside of each resident’s room. Each box serves a variety of purposes. It can help guide a forgetful resident back to the proper room; it also helps the staff connect with residents more quickly; perhaps most importantly, a memory box helps residents retain their identity within an institutional setting. Typically, the industry has limited memory boxes to dementia specific care units, but, “we love the concept so much that we have put them throughout all of our areas and throughout all of our facilities,” Mr Orie reports. “We just think that the benefit is so significant in terms of providing good support for our residents.”

The Montefiore home also stands out for offering both residential care and home care – a combination that Mr Orie says is extremely beneficial. “We’ve always believed that the best outcome for the older person is when a professional provider can case manage and assist the care needs of the older person throughout the continuum of their ageing process.” Historically, however, Australia has had two separate aged care streams – one for residential care and one for home care and unfortunately, this model can lead to a conflict of interest. “What you often find is that the home care providers are determined to keep people in their homes for as long as possible, and of course the residential providers want to get people into residential care. Quite often that is at odds with what the actual quality of life requirements are for the older person themselves. I think that if you have a provider that isn’t invested in either home care or residential care, but is really looking at what the best quality outcome is for the older person, than you are ultimately going to get the best outcome for the older person in the long run.”

Not surprisingly, The Montefiore Home’s comprehensive home care services are in very high demand. The only real challenge, Mr Orie says, is securing government funding so that funded packages can be offered to the economically disadvantaged. Currently, the organisation’s home care support is only available via fee for service. “At the moment we are locked out of that [lower income] market,” Mr Orie explains. The Montefiore Home is in the current approvals round, however, and the team is cautiously optimistic. “There has been a bit of recognition by government that there is a need to open up the home care space to other competitors.”

Like everyone else in the industry, the team is unsure how the aged care reforms will affect them. “We will have to wait and see [to] know more details around the pricing arrangements that the government is planning to implement,” Mr Orie points out. One thing that is clear, however, is that “the government is facing a very large budget deficit at the moment. It’s looking at ways of saving money as best as it possibly can. Effectively, it has reduced the care funding being provided to residential aged care providers.” Aged care facilities will be receiving less funding per resident – but will still be required to provide the same standard of care. “We are expected to provide the same services but for less money, and that has put an enormous strain on the industry,” Mr Orie explains. “The industry accepts that the government has a budget deficit and, at the end of the day, the government can only afford to fund what it can afford to fund. But if it is going to choose to cut back on the level of funding provided, then it has got to open up [other means of funding].”

The key, Mr Orie insists, is “to make sure that those people who can afford to pay are chipping in an appropriate amount.” And he believes that the consumer is more than willing to chip in. “Those people that can afford to pay [at Montefiore] are more than happy to pay because they recognise the value in what the services are, and the quality of the accommodation that they are getting. It is not as though the consumer has a problem with paying.” Mr Orie also believes that consumer demands for higher end service – and the willingness to pay for it – is only going to increase. “The baby boomer cohort is going to demand a level of service that the industry needs to be able to provide. And the only way that we are going to be able to meet the needs of the baby boomers is if we have the opportunity to charge for the services they require.”

The industry needs to be forward thinking to stay ahead of these upcoming demands, Mr Orie adds. The newest generation of seniors will expect single rooms with ensuite bathrooms, for example. And, they will expect these rooms to be larger than previous generations’ accommodations. Mr Orie also foresees a rising demand for aged care accommodation and services located inside major metropolitan areas and CBDs. “I think that older people want to access aged care services in and around where they live,” Mr Orie explains. “I think what we will see in the future is a move to more vertical village type developments.”

Meeting the demand for aged care high rises conveniently located near shops, theatres, and restaurants will require a substantial investment in prime real estate. In many ways, the future of the industry rests on government’s approach to new investments like these. “Don’t disincentivise aged care providers by [preventing them from] charging appropriate market rates for accommodation,” Mr Orie cautions. “Because, at the end of the day, the only way that the industry is going to reinvest is if they can see that there is a reasonable return coming back.”

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October 20, 2018, 12:03 PM AEDT

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