A Platform of Change
There is a disconnect between the calls for innovation and the action being taken, NATASHA CHADWICK tells NATASHA EGAN.
It’s hard to make a change in the Australian aged care sector because you won’t necessarily get support from either your own industry or the government, says Natasha Chadwick, CEO and founder of NewDirection Care and managing director of Synovum Care.
“There’s a lot of fear in our industry,” Chadwick tells Australian Ageing Agenda. “We have a government and a whole industry that says that it wants change and that it needs
change, but in actual fact it isn’t really prepared to accept change.”
Chadwick was named Telstra Australian Business Woman of the Year in May and also the winner of the 2019 Medium & Large Business award. It follows her picking up the same accoladaes at the Tesltra Queensland women in business awards in March.
Chadwick says she is particularly happy about the win because it allows her to promote positive aspects of aged care along with her beliefs around dementia care, which she says are not always in tune with others in the industry.
Chadwick is challenged by common practices around the world including in Australia that “almost criminalise people that are living with dementia by putting them in a secure or a locked unit,” she says.
“We think we are making someone safe when in actual fact from what I have seen from all the stats on incidents and accidents and everything that happens, it doesn’t necessarily make anyone safer. It actually reduces lifespan and creates depression and lots of other issues for a person living with dementia.”
NewDirection Care’s so-called Microtown in Bellmere takes a different approach. The community, which opened in 2017, includes 17 houses on six streets across two hectares. It has a town centre with shops and services including a cinema, corner shop, café and beauty salon as well as a GP, dentist and wellness centre.
“We call it a microtown because we wanted to demonstrate that it is a small town in its own right.
“It was pretty confronting to realise that after 18 years spent in this industry, all of the things you thought you were doing to innovate and to make it better are still not good enough.”
We have all the services that support a community to live within that small town,” says Chadwick.
“Residents are able to come and go freely from their homes. They are able to visit other people just like you would in your own community, suburb, and neighbourhood and go to the café, corner store and the gym. They are independent and that independence is being promoted as well as that freedom of being able to move around.”
Rather than being dementia specific, Chadwick says NewDirection Care’s point of difference is they are a fully-inclusive residential aged care community. “I mean inclusive on the basis of diagnosis, not just race, religion, sexual orientation. It is a truly inclusive environment.”
Chadwick piloted the NewDirection Care small-scale model in two houses built in late 2014 at a Tasmanian facility of Synovum Care, where she has been managing director since 2011. The two organisations are separate companies with NewDirection Care operating as its own brand.
Chadwick began working in the sector in the mid 90s at the then national association of nursing homes and private hospitals. “I came into aged care and absolutely fell in love with it [and] the fact that the industry needed change. For me it has always been about that platform of change and innovation,” she says.
She says like most others she was innovating around the edges of the industry when after almost two decades she stopped and thought about what she would want for her Mum if she needed care.
“It was pretty confronting to realise that after 18 years spent in this industry, all of the things you thought you were doing to innovate and to make it better are still not good enough. That’s when I realised that if I wanted to see the kind of care and services that I wanted for my mum then I had to do it myself.”
NewDirection Care is now looking at licensing its model in the future so other providers can implement it with the support of their learnings, says Chadwick. The organisation is also planning to build a mid-rise microtown on the Sunshine Coast next.
However, NewDirection Care did not get any new bed licenses in the most recent Aged Care Approvals Round, but Chadwick says they will apply again. She says it is disappointing they missed out when you consider that government says it wants change in the industry.
“This is where there’s that disconnection around policy and all of those kinds of things. If we want change then we should be supporting operators and providers that are striving for change.”
Another recent area of contention for Chadwick is with quality regulation. While the facility is almost full and receiving “incredible support from the residents and their families coming to live in the community,” she says the response from quality and compliance assessors has been less positive.
“I never felt hampered until about five or six months ago when the agency came in and truly could not grasp or get its head around what we are doing. And it’s been a real challenge for a number of months working with them.
“And I do want to work with them because at the end of the day we are not the only ones. We might be the first that are doing this but there are more coming. There are more that are currently developing and there are plenty of people that are interested in what we are doing.”
Chadwick says that instead of being able to sit down, negotiate and work through the service’s approach with the assessors they have had to fight. “It is a lot resources, time, effort, finances. Everything that I have had over the last 20 years in this industry I have put into this so that’s what we have to do.”
You shouldn’t have to go through that if you’re innovating, says Chadwick. “We know that it has amazing outcomes for residents and their families. They tell us all the time and we see it.” This kind of response is one of the things that make people scared to innovate at the same time the royal commission, industry and government are saying providers must innovate, she says.
“We have consumers saying this is no longer good enough and yet the minute you step outside of what people know, you end up having to validate, validate and validate, challenge and re-educate people when really that shouldn’t be our responsibility.”
Chadwick says she is looking forward to the quality indicators program becoming compulsory from July because there will be more objective measures and a way for providers to compare themselves.
“It is about time we started to have far more objective information because there is a lot of subjective- ness right now within the system.”
“It is about time we started to have far more objective information because there is a lot of subjectiveness right now within the system. If one person says something it almost becomes true rather than what should happen in an audit situation when you try and triangulate information. Many assessors at the moment are just taking whatever one person tells them and running with it.”
Chadwick is also supportive of the end of ACAR and believes that aged care will become deregulated in the future. “I do think that will be the right step for the industry because it will become far more competitive and therefore focused around consumer.”
However, she’s not sure this will be something that comes out of the aged care royal commission. “It could go either way. We will either end
2019 Taurus Marketing up with tighter restrictions or there will be a recognition that sometimes you need to open an industry up to make it a better industry.”
Either way, Chadwick is also hopeful the royal commission will help raise greater awareness and also focus on aged care that is doing well. “There are many amazing providers out there doing good things and plenty of consumers that are more than satisfied with their services and that recognition is not there.”
At the time of writing, she is preparing a second submission for the royal commission specifically around NewDirection Care, and says she would like to appear at a hearing.
“I would welcome the opportunity for the commission to come and physically see what happens and speak to our residents and their families because it is them and the way that they see it that matters, not what I might say it does.”
For other would-be innovators wary of going down a new path, Chadwock suggests they build a network. She says she has felt alone at times in in their journey because there haven’t been a lot of supporters around them.
“We have certainly got a much stronger network of people now who want to change or who are changing,” she says. “It is important that we surround ourselves with people who support us because there are lots of doubters out there in any industry but particularly in ours.”
To the doubters, Chadwick has a simple message. “They say they want change well here it is. At least we are doing something. To me there are no longer any excuses. If we have been able to do it so can anyone else.”