One of WA’s largest Not For Profit aged care operators is now focused on building its revenue over the $100 million mark – with the customer as its focus, according to its CEO.
Russell’s name will be familiar to many in the sector.
The former CEO of the Aged Care Channel, Russell returned to his hometown of Perth in 2017 to take up the mantle at Baptistcare after previously working with NSW and VIC based provider Australian Home Care, BaptistCare NSW and ACT and Churches of Christ Care in QLD.
The CEO now oversees a growing portfolio of 760 aged care beds across 10 aged care homes, 260 independent living customers in eight retirement villages, and 196 home care clients – plus their families and around 1,500 staff.
Just one case of COVID-19 in WA’s residential care and home care sector
It’s a considerable task, particularly during a global pandemic.
Russell says the provider has been helped by the different path taken by Western Australia compared to other States and Territories during the pandemic.
Like the ACT, SA and the Northern Territory, WA has recorded no COVID-19 cases in residential care and just one case among its home care recipients.
The State had one early scare in a transitional care program at the start of the pandemic where a staff member returned from overseas and tested positive but was quickly isolated with no other infections.
Relatives ‘panic visiting’ prompted five-week lockdown
Baptistcare put what Russell calls a ‘preventative lockdown’ in place for five weeks from late March and throughout April after what he says was an ‘flood of panic visiting’ as relatives tried to see family members with people even attempting to sneak in and out of homes requiring staff to come off the floor (this measure had 98% support from families and friends, he adds).
With the remaining 2%, Russell says it was simply a matter of talking personally with families.
“They are naturally anxious but once you talk and understand their issues, we have not had any complaints go through to the [Aged Care Quality and Safety] Commission because our team has been active with families.”
Providers supported by State Government’s public health directions
Russell adds that WA providers had an advantage in that the State Government had acted early to put out a public direction mandating one two-hour visit by no more than two visitors per resident per day, which gave them a legal framework when speaking to families.
“It’s been more helpful since we opened up to visitors than it was during the lockdown,” he says.
“We can say to families ‘these are the public health restraints’ and we are doing this to protect your family members.”
Virtual visitors’ program to continue
Like many operators, the provider established a number of ways for residents to keep in touch with families include iPads with voice-activated calls for bedbound residents, and window visits.
Baptistcare also expanded its volunteer program, setting up a virtual visitor’s scheme which drew in people from across the country to speak with its residents via Skype or FaceTime – many of whom never receive face-to-face visits.
Its success means the provider will now keep up the virtual program.
“It’s such a powerful thing for people to do and it’s still continuing today,” he said.
Staff given badges saying ‘I am an essential worker’
Russell says they also focused on supporting their staff, maintaining a register of people deemed to be at risk in the event of a COVID-19 infection at a service.
They also highlighted the importance of workers’ roles by creating badges saying ‘I work in aged care. I am an essential worker’ and encouraging staff to wear them at work and in the community.
“It made staff feel a lot more confident in their roles,” Russell says. “Many still wear them today and are rightly proud of what they do.”
The CEO says the sector also took up the issue of acknowledging aged care workers with the WA Health Minister Roger Cook, who acted on their suggestion and made sure to refer to aged care workers in his wider communications around healthcare workers – helping to boost staff’s confidence further.
No falls in residential occupancy because of lack of beds
A reflection of WA’s unique position, Russell says Baptistcare has seen no fall in its 97% occupancy rate – before or during the pandemic – which he puts on the historic shortage of beds across the state which followed the mining boom.
“It became too expensive to build aged care facilities so we’ve had limited new facilities on the ground for some time,” he said.
“We are undersupplied for beds compared to the East Coast so we still have facilities that are fully occupied.”
No requirement for new residents to self-isolate
They are also still taking on new residents – and have not put in place a requirement for new residents to self-isolate due to the low presence of the virus in the community.
“Hospitals here are only to discharge people who are negative from COVID or have no risk of COVID so we have no need for that requirement,” he said. “It’s not the best for someone’s adjustment to a new site or their emotional wellbeing.”
New residents and family members are also allowed to tour homes – subject to temperature testing, screening requirements and a maximum of two people.
20% fall in home care utilisation – now turning up in EDs
However, Russell says they have seen a 20% fall in Home Care package utiliation in April as people pause services.
Some are returning now, but concerningly WA Health has reported these people are beginning to show up in emergency departments.
$100 million turnover required to achieve sustainability
With numbers now increasing, Russell says the provider is looking to the future – aiming to increase its revenue to the $100 million mark within the next financial year as the first step to achieving long-term sustainability for the organisation and the people it supports.
“What we’re trying to do is position the organisation to be sustainable and start to build out from there,” he said.
Scale essential to growing revenue while reducing overheads
Russell says Baptistcare has done the numbers and found they need to gain scale in terms of their revenue – without growing their overhead costs.
To this end, they have been working toward growing both their home care customers and their residential care services through a steady pipeline of acquisitions and developments.
Baptistcare is about to add another two services to its portfolio on 1 July.
They are also looking to put new facilities on the ground with plans to utilise provisionally allocated ACAR licenses to build a 100-bed aged care home and another 120 ILUs in southeast Perth, with construction starting in the next 12 to 18 months.
New customer-focused model of care on its way
He also points out that being sustainable is not only about your financial performance or number of beds.
“It’s also about how the customer perceives you because if you do that well, everything tends to take care of itself.”
To that end, the CEO says Baptistcare is now focused on challenging their organisation in the next 12 to 18 months by shifting their model of care to one based on individual choice.
While he says he’s reluctant to use the term ‘consumer-centred’, the provider will be focusing on working with their residential care and home care customers to redesign how they deliver care to them.
Next six months future to sector's viability
Russell also has predictions for the future – and says the next six to 12 months will be vital to the sector’s future viability and sustainability.
He points out the sector was under an “extraordinary” amount of financial pressure even before the pandemic.
“As a society, we need to look at how aged care is resourced as it can’t continue to be under this pressure.”
Not just about more Government funding
He forecasts the next year will prove to be the ‘crunch time’ for the sector.
“I don’t think the answer is always for the Government to give us more money,” he stated. “We’ve got to rethink how we’re funding the sector; I think it’s an issue that’s now at crisis proportions.”
Russell says the ‘curve ball’ thrown by COVID-19 has also dampened hopes of a quicker resolution to the sector’s funding woes.
“If we hadn’t had COVID, I would have been optimistic of changes in the Budget process [now delayed to October].
“Now I think there is little chance we will see anything in the next Budget cycle. Ahead of the pending report from the Royal Commission, there could need to be some legislative reform so it could be some time before we see substantial change.”
More providers merging – or shutting down
However, Russell says if there is no change soon, he predicts there will be more providers merging or closing their doors.
“I’m not sure that’s the best for anyone – Government included – so there is a sense of urgency about what’s going on.”
In terms of future consolidation in the residential care market, the CEO believes it will be the mid-sized operators who will disappear from the sector.
Mid-sized operators in the firing line
“We will continue to have smaller community-based operators addressing smaller niches,” he said.
“But operators in the 500 to 800 bed range are going to struggle unless they grow or consolidate.”
Russell argues that once providers are over the 800-bed mark, they can increase their revenue which improves the quality of care to their customers, while keeping their costs down.
He also does not agree that some operators in Australia are ‘too big’, pointing to his time at the Aged Care Channel where they syndicated content to the UK.
He notes that operators considered large here such as Bupa and Opal which would have around the 5,000-bed mark do not compare to large organisations there which have in the region of 30,000 beds.
Less reliance on RADs
Russell does acknowledge that Baptistcare is in a different position to other providers – they target a higher number of concessional residents – around 50 to 55% – which he says has shielded them from the serious decline in RADs seen on the East Coast.
The crash in the Perth housing market following the mining boom has also assisted as most aged care homes do not have the high RADs seen in the Sydney and Melbourne markets.
Closer ties and customers should drive future
His final thoughts on the future?
Russell says while all operators in WA have been working under a lot of pressure, they have been coming together more to support each other during the pandemic – and he would like to see these close working arrangements continue.
“The other challenge is to keep the customer in the front of our minds, doing everything we can to think of new ways of caring for them and support them,” he said.
“Being open to new ways of doing things is probably the biggest challenge for all of us.”
