Aged Care

Sydney developer Hyecorp has turned the first sod in their redevelopment of Club Willoughby.

They'll be transforming the transforming underutilised site into a retirement living facility, with the $95 million project 10 years in the making.&nbsp;

Known as the Heart of Willoughby, the redevelopment will see the 52-year old building replaced with a new state-of-the-art Club Willoughby, along with a 126-apartment retirement community and aged care facility, dubbed Hyegrove Willoughby.&nbsp;

A mix of one, two and three-bedroom apartments will be on offer, ranging in size from 55 sqm to 176 sqm internally, each with their own balcony or courtyard.&nbsp;

<img alt="Render of the living room in a Hyegrove apartment" data-entity-type="file" data-entity-uuid="9e5bddef-1fa9-4045-a88c-ec855db17408" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Hyegrove%20Living%20Room.jpg?VersionId=juXej5ye4yu8E3OBmnQMGlWQp4sWQepc" />

Off the plan purchasers will also have the unique opportunity to custom design their apartment with add-ons such as heated flooring, wallpaper, pendant lights, and smart home automation systems.

In addition, 45 luxury care suites will be set up as three small ‘homes’ with kitchens, dining rooms and lounge areas designed to feel like a family home rather than a traditional aged care facility.&nbsp;

The contemporary mixed-use project in the geographical centre of Willoughby will also feature 2000 sqm of open space including memorial gardens.&nbsp;

While the Club will retain ownership of the land, a long-term lease will be granted to Hyecorp who will operate the over-55s village.

<img alt="Render of the entry to Hyegrove" data-entity-type="file" data-entity-uuid="afaacdf0-3f56-4111-91fd-8125bbd1cdd3" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Hyegrove_Entry_4k.jpg?VersionId=Zjb55uxZlXqT3YHrk56t.dA1hhKTbp9L" />

Set over three levels, the new look Club Willoughby will offer a range of dining, function and event experiences under one roof.&nbsp;

Residents of the 126-apartment retirement community will have access to a concierge service, complimentary basic groceries, meal preparation assistance, a laundry service, and an on-site building manager.&nbsp;

A suite of amenities will also be developed for the community, including an indoor swimming pool, beauty salon, cinema, wine-tasting room, gym and pilates studio.&nbsp;

Managing Director of Hyecorp, Stephen Abolakian, said both Hyecorp and the Club shared a common goal for members, future residents and the local community.

<img alt="Render of the lobby lounge at Hyegrove" data-entity-type="file" data-entity-uuid="9cf2d2b3-4715-43b1-8678-9b151e52e011" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Hyegrove_Lobby%20Lounge_4k%5B80%5D.png?VersionId=TTJPcqqOPrfOOgEaCS_slseXZzX6JGUr" />

“Our vision is to create a state-of-the-art showcase for the suburb of Willoughby offering a range of facilities and services for community members of all ages,” he said, adding that the addition of retirement living will cater to residents seeking a hassle-free future.

“As people age and require more services and help, we can provide whatever they need whether it is having the heavy laundry done or meals delivered, that level of care can be dialled up or down. It’s about putting the control into their hands, a characteristic that is too often not available to people living in retirement communities or aged care facilities,” he said.

Club Willoughby President Matt Vertzonis said while the road to discovering The Heart of Willoughby had been long, the result will be a dynamic new premises for members, residents and the greater community.

<img alt="Render of the pool at Hyegrove" data-entity-type="file" data-entity-uuid="801a56e5-a214-4e75-bb28-35ac8f64a1b8" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Hyegrove_Pool_4k%5B40%5D.png?VersionId=TUvB84KzuW95f47acXEhkMKYzXpfoG8v" />

The five-star inclusions at Hyegrove Willoughby are a result of local community consultation, with locals invited to have their say on what services and amenities they wished to see at the site.

Stage one of Hyegrove Willoughby has already sold out, with stage two now selling.&nbsp;

With construction underway, the project is slated for completion by late 2024.&nbsp;

alisonwarters@gmail.com

Hyecorp begin redevelopment of Club Willoughby

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If the only inevitabilities in life are death and taxes, then the economy and government policy will start to reflect it.
This is particularly evident when the baby boomer generation goes through the significant transition to retirement.
In March 2017, an unprecedented value of building work was approved in construction of aged care facilities, totalling $340 million over the month.
Australia’s population aged 65 and over is an estimated 3.7 million people by the Australian Bureau of Statistics (ABS). Approximately 5 percent are living in retirement communities, or some 184,000 Australians. Based on current projections, Australians aged 65 and over will make up over 20 percent of the population in 10 years’ time.
Despite a rapidly ageing population, the reality of developing aged accommodation – particularly retirement villages – is a harsh one. Like many assets, growth in the residential housing market has crowded out capital for aged accommodation.
According to a 2016 joint survey by the Property Council of Australia and Retirement Living, the national average price of a standard, two bedroom independent living unit increased just over 3 percent between 2015 and 2016. In the same period, CoreLogic data shows the national standard dwelling increased 7.3 percent.
Competition for vacant land, age friendly regulation compliance and investment into green technology to reduce long term service fees are factors that can inflate initial investment. This is amplified by the average tenure in retirement villages, which is approximately 12 years.
However, some areas across the country lend themselves to aged care development. Advantages such as relatively affordable land and mild climates make them popular with retirees. New incentives to downsize introduced in the federal budget may further boost these areas.
CoreLogic data of aged care facilities, independent living units and retirement villages reveals the areas most likely to benefit from the ageing population.
Of the states and territories, the most aged accommodation construction is occurring in New South Wales. The state has 113 projects with construction commenced or imminent over the next five years.
Within New South Wales, the highest frequency regions for construction were The Hills Shire, Newcastle, Wyong and Gosford. Between these regions, there are 26 aged care accommodation projects either approved or commenced, with completion expected by 2023. Newcastle, Wyong and Gosford offer lower land prices along the coast. As for the Hills Shire, while its lack of public transport to the city makes it relatively unattractive for young professionals, the area has a quiet, leafy exclusivity for retirement communities.
The number of aged accommodation developments in each state and territory is generally proportionate to population. The exception is South Australia, where there are 56 developments expected to be completed over the next few years. Of these, 10 are located in Onkaparinga Council, and 6 are located in the Port Adelaide Enfield region. South Australia has a higher proportion of 65’s and over to the total population.
Looking at individual council areas, Brisbane City is by far the most popular spot for aged accommodation projects. In the last 5 years, the region has seen over $725 million in aged care and aged living construction, ranging from upgrades of existing facilities to a $60 million integrated care facility at Carina. By 2020, a further 22 projects in the space are expected to be completed. In the same period, a further 11 are planned for the Moreton Bay Regional area, 9 in the Sunshine coast and 5 in Toowoomba.
A common trend in new developments is the blending of care types in the one precinct, such as the three tiered levels of care in The Village Coorparoo, mean that people are likely to stay on the one site for a longer period of time, or, ‘age in place’. The ageing in place model was also adopted in the recently completed Woodlands Aged Care Facility in the Sunshine Coast.
In the residential care sector, the Aged Care Financing Authority estimates that over the next decade, approximately 76,000 new places will be required, compared with just 35,000 established in the previous decade. In addition, much of the existing stock will require a knockdown and rebuild. The forecast investment required over the next decade is $33 billion. While the initial costs make aged accommodation unappealing for the average investor, the boomer retirement transition could represent a further boom for the construction industry.
Cameron Kusher is head of research for CoreLogic. You can contact him <a href="https://blog.corelogic.com.au/about/" target="_blank">here</a>.
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The areas capitalising on an ageing population: Cameron Kusher

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Woodlea has revealed plans for an innovative aged care and retirement precinct within its growing estate.
Located in Melbourne’s western growth corridor and currently home to 7,000 residents, Woodlea sought to redefine residential living from the outset by creating and raising the bar for a new suburb where families can live a better life. 
The area earmarked for the aged care and retirement precinct is co-located within the new $45 million Woodlea Town Centre development.
It has the potential for over 100 Independent Living Units, Retirement Living Apartments and an Aged Care Facility.
Victoria Investments &amp; Properties (VIP) and ASX listed Mirvac, in collaboration with Knight Frank, is seeking an independent project partner to bring this opportunity to life.
Woodlea Project Director Matthew Dean said this offering would effectively close the loop on ensuring every age and demographic is catered for within the Woodlea community.
“There are aged care and retirement units within the surrounding area but there is nothing of this size or calibre that integrates different living options within the same precinct.
“Woodlea is unlike any other master-planned community due to its sheer size and offering and as it continues to flourish and more amenities are delivered, we are continually looking for ways to innovate to ensure it is responding to the needs of its residents and the surrounding communities,” he said.
Spanning 711 hectares, Woodlea is fast becoming a major asset for the west, comprising prestigious schools, destination style playgrounds, parks and sporting facilities and will be home to a large-scale Town Centre with a 3500sqm Coles.
Upon completion, the master-planned estate is forecast to be home to over 20,000 residents.
It will see over 30 per cent of the estate dedicated to open space - including native woodlands and wetlands and pocket parks. 
In addition, two childcare centres, two public schools and Bacchus Marsh Grammar Primary School, as well as an abundance of sport and recreation facilities will be available.
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Woodlea reveals aged care and retirement precinct

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GUEST OBSERVATION
In July 2019, the government introduced <a href="https://www.agedcarequality.gov.au/news-media/commission-media-release-new-aged-care-standards-commence" target="_blank">new aged care standards</a> to “raise the bar” in an aged care system where some nursing home residents have experienced care that is <a href="https://www.propertyobserver.com.au/https://www.abc.net.au/news/2019-10-31/aged-care-royal-commission-report-finds-unsafe-industry/11658328" target="_blank">neglectful, depersonalised, uncaring, unsafe and of poor quality</a>.
We took a close look at <a href="https://www.myagedcare.gov.au/non-compliance-checker" target="_blank">breaches of aged care standards</a> from 2019 to see what effect the new aged care standards are having, and where aged care providers are falling short.
What are aged care standards?
Aged care standards are the minimum standard of care the government expects nursing homes to provide.
They are supposed to ensure people in aged care have access to quality care including competent staff who listen, best-practice clinical care and nutritious and tasty food.
Nursing homes that don’t meet standards are given a notice of non-compliance. If the provider doesn’t fix the problems that made it non-compliant, then it will be sanctioned.
If assessors decide there is an immediate and severe risk to residents, nursing homes can also be immediately <a href="https://theconversation.com/how-to-check-if-your-mum-or-dads-nursing-home-is-up-to-scratch-123449">sanctioned</a>. The nursing home provider must then bring the care up to standard before they can take new residents.
The new aged care standards
From 2014 until the new standards were introduced in July 2019, the number of non-compliance notices and sanctions increased steadily as can be seen in the chart below.
This was likely due to a combination of <a href="https://www.propertyobserver.com.au/https://www.abc.net.au/news/2019-08-11/aged-care-commission-hears-recommendations-ignored/11400026">increasing scrutiny</a> of the quality of residential care as a result of the unsafe care revealed at Oakden in 2017, and the establishment of the <a href="https://agedcare.royalcommission.gov.au/Pages/default.aspx">aged care royal commission</a> in October 2018. A 2018 policy change meant providers <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/FlagPost/2018/February/nursing_home_quality_and_compliance_visits">were no longer warned</a> about upcoming accreditation visits.
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<a href="https://images.theconversation.com/files/318042/original/file-20200302-18295-1fbu84s.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/318042/original/file-20200302-18295-1fbu84s.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt=""></a>
 Chart: Else Kennedy. <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a>
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The new standards, introduced in July 2019, <a href="https://www.agedcarequality.gov.au/news-media/commission-media-release-new-aged-care-standards-commence">focus</a> on “personal dignity and choice”.
They were designed to support the provision of care based on what residents want, rather than penalising providers when they let residents do something that could be considered “risky”, such as allowing someone with mild dementia to walk to the shops, or having a pet in the nursing home.
The number of non-compliance notices and sanctions in the first six months of the new standards decreased. This is likely because assessors visited fewer nursing homes in this period, and may still be learning how to interpret the new standards.
Aged care providers and industry bodies have <a href="https://www.australianageingagenda.com.au/2019/03/22/balancing-act-will-test-transition-to-new-quality-standards/">criticised</a> the new standards for being <a href="https://www.australianageingagenda.com.au/2019/03/01/objective-measures-needed-for-better-quality-regulation-rc-advised/">subjective and vague</a>. They do not measure objective resident outcomes like depression or number of infections.
For-profit companies had a higher rate of non-compliance in 2019
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<a href="https://images.theconversation.com/files/318047/original/file-20200302-18262-1vtgbvj.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/318047/original/file-20200302-18262-1vtgbvj.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt=""></a>
 Chart: Else Kennedy. <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a>
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Some <a href="https://www.aihw.gov.au/getmedia/87fa8d3e-ca23-48e7-905f-57df367f8f14/aihw-age-101.pdf.aspx?inline=true">6% </a>of for-profit residential care facilities failed aged care standards in 2019, some of them multiple times. In comparison 5% of not-for-profit and 4% of government facilities failed standards.
The rate of non-compliance in for-profit facilities was 27% higher than not-for-profits, and 54% higher than government facilities.
This suggests for-profit providers in Australia are more likely to provide lower quality care. An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721035/">international review</a> has noted similar trends in other countries.
Profit margins are <a href="https://theconversation.com/its-hard-to-make-money-in-aged-care-and-thats-part-of-the-problem-103339">slim</a> in aged care, and for-profit providers are under pressure to make profits by cutting costs. This could lead to a lower standard of care compared with not-for-profit or government providers.
Reasons for non-compliance in 2019
The most common reasons for non-compliance in 2019 were in the area of personal and clinical care and the area of governance.
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<a href="https://images.theconversation.com/files/318043/original/file-20200302-18291-1usnscx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/318043/original/file-20200302-18291-1usnscx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt=""></a>
 Chart: Else Kennedy. <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a>
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An example of a nursing home breaching the personal and clinical care standard could be if the home’s practices mean it isn’t giving medication correctly, isn’t managing wounds properly, or isn’t providing dignified help for residents using the toilet.
Homes might also breach the personal and clinical care standards if they don’t have sufficiently skilled staff such as registered nurses to care for residents with complex health needs.
A nursing home might be non-compliant in governance when it doesn’t have the right systems in place to monitor and improve its clinical care, for example in the areas of infection control or restraints. It might also be non-compliant if residents and families don’t have enough of a say in how the facility is run.
The new standards were supposed to place an <a href="https://www.agedcarequality.gov.au/news-media/commission-media-release-new-aged-care-standards-commence">increased focus</a> on dignity and choice, supporting the identity of a person, and increasing their say in the care they receive. This means catering for residents who want to have showers in the evening, stay up late, or make their own lunch. Previously there was much less emphasis on these aspects of aged care.
It is somewhat promising that more breaches of non-compliance in the “dignity and choice” standard have been picked up since the new standards came in. But given we know care is often poor in this area and there is an increased focus on this standard, we could have expected a more significant change.
Based on the first six months of non-compliance and sanctions data for the new aged care standards, we cannot be confident the new standards are ensuring nursing homes provide higher quality care. We await more data.
Until then, aged care residents and their families should monitor the quality of care they receive, know their aged care rights, and <a href="https://www.myagedcare.gov.au/contact-us/complaints">complain</a> if they think there is an issue.
If you or a family member are considering using an aged care provider, you can check whether the provider has breached standards via the <a href="https://www.myagedcare.gov.au/non-compliance-checker">My Aged Care non-compliance checker</a>.<img src="https://counter.theconversation.com/content/131449/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;">
<a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, Associate Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>
This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/which-aged-care-services-near-you-werent-up-to-scratch-in-2019-131449">original article</a>.
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Which Australian aged care services weren't up to scratch in 2019?

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The former site of the Kiandra Residential Care facility, in the Adelaide suburb of Prospect, has been listed for sale.
The property at 20 Alpha Road sits on 4,606 sqm, with a 58 metre frontage to Alpha Road. 
It features a single-storey residential care facility that was fully operational until February 2020, configured to accommodate a combination of single and shared rooms for 50 residents. 
Also included is a communal dining room and lounge, nurse’s stations, kitchen, laundry, extensive staff offices and meeting spaces, consulting rooms and clinical spaces, together with on-site loading and car parking spaces for staff and visitors. 
Justin Hazell and Alistair Mackie, from Colliers International, listed the property.
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Prospect's Kiandra residential care site listed for sale

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GUEST OBSERVATION 
If family members are in a nursing home, it’s difficult to know if they’re getting the care they need. Here are some ways to find out.
If you’ve read the headlines about poor standards in Australia’s nursing homes, it’s only natural to be concerned about your own family or friends in residential aged care.
For instance, there was <a href="https://www.propertyobserver.com.au/https://www.abc.net.au/news/2019-09-12/bupas-aged-care-homes-failing-standards-across-australia/11501050" target="_blank">news in recent weeks</a> that 45 of 72 Bupa nursing homes in Australia had failed to meet all health and safety standards, with 22 putting residents at “serious risk”.
Then there are the <a href="https://www.propertyobserver.com.au/https://www.abc.net.au/news/2019-02-22/first-fortnight-of-hearings-for-royal-commission-wrap-up/10837116" target="_blank">harrowing stories of neglect and abuse</a> coming from the <a href="https://agedcare.royalcommission.gov.au/" target="_blank">Royal Commission into Aged Care Quality and Safety</a>, which is due to release an interim report by the end of October.
So, how do you check if your loved one’s nursing home is really up to scratch? How do you interpret audit reports about residents’ health and safety? And how else could you find out if your mum or dad’s nursing home lives up to the promise of its marketing brochures?
Who keeps an eye on nursing home standards?
Every nursing home in Australia receiving government funding is assessed and accredited by the <a href="https://www.agedcarequality.gov.au" target="_blank">Australian Aged Care Quality and Safety Commission</a>. Assessments are conducted every three years or more often if there are concerns.
Commission staff check if each nursing home meets eight <a href="https://www.agedcarequality.gov.au/sites/default/files/media/Aged%20Care%20Quality%20Standards.pdf" target="_blank">minimum standards</a>. These include whether residents are treated with respect, the nursing home is providing safe and effective clinical care, and staff have adequate qualifications and training to do their jobs.
Commission auditors interview residents, families and staff; observe care; and review the facility’s documentation. Visits can be unannounced to get a better picture of what regular care is like. Auditors then use that information to write a site audit.
It takes about a month after a site audit for the commission to decide on the quality of care. Then there’s up to another month for the audit report to be posted online.
Posting the decision publicly can be delayed further if a nursing home asks for the decision to be reconsidered. We understand this often happens if a home receives a poor report.
What is a bad report?
When a home is judged as not meeting standards, the commission will decide how serious it believes these deficiencies are. In increasing order of seriousness, the report says if a home is:
1. Not meeting standards. Nursing homes can be judged as not meeting one or more of the eight minimum aged care standards. Each standard has three to seven individual requirements. Nursing homes don’t have to meet all the individual requirements to meet the overall standard. The more standards or requirements a nursing home fails to meet, the poorer the care.
2. Serious risk. If a nursing home is given a “serious risk” judgement, the quality of care has placed or may place the safety, health or well-being of a resident at serious risk. An example might be a home not having enough skilled staff, leading to clinical mistakes, such as the wrong medication administered often.
3. Sanctions. Sanctions are imposed on homes when care places an immediate and severe risk to residents’ health, safety or well-being. This might be for multiple organisational problems (such as with clinical care, staffing, wounds not being cared for), leading to multiple poor outcomes (such as assault, avoidable illness, and the dangerous administration of medication). Homes can also be sanctioned if they do not fix continued non-compliance.
Families are notified in writing, and facilities must hold a meeting for residents and families to tell everyone what the problems are and how they will fix them by a certain date.
When a nursing home is sanctioned, it is penalised in several ways, depending on what was poor about the care:
the home is not allowed to receive Commonwealth subsidies for any new resident for a set time (usually six months) and an adviser and/or administrator is appointed to the home to help it comply with its responsibilities and/or the home provides specified training to staff within a set time.
A home’s history of non-compliance, serious risk decisions and sanctions are archived online (see below for details). So it might be worth taking a look when choosing a nursing home, as well as checking on an existing one.
4. Revoking accreditation status. If sanctions are imposed and there is no improvement, the commission can revoke a home’s accreditation status. This means a home cannot take new residents or receive government subsidies. Some of these homes reapply for accreditation, others <a href="https://www.propertyobserver.com.au/https://www.abc.net.au/news/2019-07-11/gold-coast-earle-haven-retirement-village-shuts-homeless/11301050" target="_blank">shut down</a>.
How do I find out? Looking online
The most up-to-date information on nursing homes not meeting standards (non-compliance) and sanctions is through <a href="https://www.myagedcare.gov.au/non-compliance-checker" target="_blank">myagedcare’s non-compliance checker</a>. This allows you to see if an individual home has not met standards, is sanctioned currently or has been in the past. Some archived sanctions on the website go back to 2002.
However, the myagedcare website doesn’t list “serious risk” reports. For those, you have to go to the Aged Care Quality and Safety Commission’s <a href="https://agedcarequality.govcms.gov.au/monthly-register-serious-risk-decisions-residential-services" target="_blank">website</a>.
You can also search the commission’s <a href="https://www.agedcarequality.gov.au/reports" target="_blank">website</a> for audit and consumer experience reports, which provide more detail on the quality of care.
Audit reports can be difficult to understand because their intended audience is aged care professionals, not the general public. Reports before July 2019 are on the 44 old aged care standards. Reports from July 2019 are on the new eight standards.
<a href="https://www.agedcarequality.gov.au/consumers/consumer-experience-reports-residential-aged-care-services" target="_blank">Consumer experience reports</a> show what residents said about their care. That’s from whether staff followed-up when they raised an issue, to what they thought about the food. These reports are easier to follow.
How do I find out? Other ways
It can be hard for family to know if their expectations for care are reasonable, particularly when feelings of sadness and guilt colour those expectations.
So, it can help to consider the aged care standards when making your own decisions about whether the quality of care is good enough.
You can do this by observing what happens day to day. Do residents wait too long for attention, for instance, to be taken to the toilet? Do staff speak respectfully and kindly to residents? Are meals appetising and healthy? What happens when residents are distressed? Is there high staff turnover?
Does the nurse on duty know the detail of your loved one’s clinical needs, for instance, diet, illnesses or medications? Is the manager responsive when you raise issues?
You can also talk to other families about their experiences of care.
What should I do next?
If you find that your loved one’s home doesn’t meet standards or is sanctioned, here’s what to expect.
The commission gives the home a set period of time (usually three or six months) to improve care. Commission staff keep visiting the home until they are confident the home is meeting standards.
You will probably want to visit regularly and keep an even more careful eye on your mum or dad’s care. Speak to the home or commission about any concerns.
You can ask your home’s management:
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about its plan to improve care
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about staff changes and staff ratios — staff often leave or are asked to leave when there are sanctions and lots of new and agency staff are a challenge to providing quality care
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for regular written updates and meetings including actions taken and the outcomes. This could be data on the home’s use of antipsychotic medications, and how often residents have falls, critical incidents or pressure ulcers.
</li>
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As a resident or nominated family member, you have <a href="https://www.agedcarequality.gov.au/consumers/consumer-rights#single%20charter%20of%20aged%20care%20rights" target="_blank">a right to information and to complain</a> about your loved one’s aged care.
When should I consider switching to another home?
The issue of whether to move a loved one to a new nursing home is a difficult one. It’s a personal decision involving weighing up the negative impacts you think the care is having with your own energy levels, <a href="https://www.myagedcare.gov.au/aged-care-home-accommodation-refunds">funds</a> and whether <a href="https://www.propertyobserver.com.au/https://www.abc.net.au/life/questions-to-ask-when-choosing-an-aged-care-home-for-a-loved-one/10302590">you can find</a> a suitable new home.
Government reforms presume market forces <a href="https://www.smh.com.au/business/the-economy/how-market-forces-have-failed-the-nation-20180918-p504f1" target="_blank">will drive up the quality</a> of aged care. In the meantime, we hope the resources in this article will help you make a more informed decision about your loved one’s care.<img src="https://counter.theconversation.com/content/123449/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;">
Lee-Fay Low, Associate Professor in Ageing and Health, University of Sydney.
This article is republished from <a href="http://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-check-if-your-mum-or-dads-nursing-home-is-up-to-scratch-123449" target="_blank">original article</a>.
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How to check if your mum or dad’s nursing home is up to scratch: Lee-Fay Low

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An aged care developer has snapped up a 11,981 square metre landholding in the Melbourne bayside suburb of Highett for $28.5 million.  
The permit-approved site at 32-40 Graham Street has plans for a retirement village for 90 residential apartments, a 122 bed aged care facility and 15 assisted living units together with communal facilities. 
It was sold by Savills agents Julian Heatherich, Benson Zhou and Jesse Radisich. 
Heatherich said the site sold for around $20,000,000 and, with the added value of the permit, has benefited on the revenue opportunities associated with the $20 billion-a-year residential aged care industry.
<img src="https://res.cloudinary.com/dz9xllyip/image/fetch/c_scale,w_580,q_auto:good/https://s3-ap-southeast-2.amazonaws.com/po.images/2019/9/2/Highett%20Development%20medium%20.jpg" alt="">
“The Bayside area is one of Melbourne’s most highly sought inner suburban locations due to its abundance of lifestyle amenity, thriving café and culinary culture and public transportation links,” said Heatherich. 
“The site is only 16 kilometres from the Melbourne CBD.
“The sale also indicates a continuing upward trend we’re seeing in aged care developments, particularly in Inner Melbourne and the Mornington Peninsula.” 
The sale to Ryman follows another recent off-market acquisition to Ryman in Ringwood, also transacted by Savills.
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Aged care developer buys Highett site for $28.5 million 

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GUEST OBSERVATION 
Last week’s hearings at the aged care royal commission in Brisbane looked at regulation in aged care. While rules and regulations are designed to safeguard residents, bureaucratic “red tape” also contributes to the failings in aged care.
The fear among nursing home staff of failing a review visit by an Aged Care Quality and Safety Commission surveyor has been known to shift the focus from care for residents to meeting paper trail requirements.
The best outcome for aged care residents and their families would be new reporting requirements <a href="https://www.researchgate.net/publication/335110268_The_Distinction_between_Process_and_Outcomes_Focused_Governance_and_Accountability_Frameworks" target="_blank">centred on outcomes rather than processes</a>. Their primary focus should be on the mediation of critical incidents – that is, looking at what caused them and how they could be prevented in future – and the maintenance of health.
How did we get here?
The crisis in the aged care sector has emerged over time. At least in part, systemic problems in organisations <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/%28SICI%291099-1735%28199603%2913%3A1%3C13%3A%3AAID-SRES66%3E3.0.CO%3B2-O" target="_blank">arise from interactions</a> among its key players. These interactions must be aligned to achieve its <a href="https://pdfs.semanticscholar.org/e33a/5f696b7af6c2eaa3fdbefe94dbf42234bebe.pdf" target="_blank">common goals</a>.
But the key players in the aged care system pursue divergent agendas. Regulators focus on process adherence, while staff struggle with their limited capacity to manage the complex needs of residents. Meanwhile, proprietors focus on economic viability.
The prevailing approach of dealing with the problem of a particular key player in isolation will not solve the problems of aged care as a whole.
Governance and accountability
Our research suggests the need for a major culture shift in the aged care system.
Around the world, governments are being urged to put less emphasis on <a href="http://johnbraithwaite.com/wp-content/uploads/2016/06/Regulating-Aged-Care-Ritualis.pdf" target="_blank">process measurement</a> and more on <a href="http://www.iqg.com.br/uploads/biblioteca/the_strategy.pdf" target="_blank">outcome transparency</a>.
Peter Drucker, a well-known management consultant, educator and author, once said “management is doing things right; leadership is doing the right things”.
Ticking the boxes of a protocol to demonstrate “regulatory compliance” – that is, doing things right – is no longer an option on its own. Residents and their families expect staff to be attentive to residents’ changing <a href="https://www.propertyobserver.com.au/https://www.ncbi.nlm.nih.gov/pubmed/19674233" target="_blank">physical, emotional, social and cognitive needs</a>; that is, doing the right things.
These insights tell us the aged care system needs to be <a href="https://www.propertyobserver.com.au/https://www.springer.com/gp/book/9783319646046" target="_blank">redesigned</a>.
What would this look like in practice?
Let’s consider two common aged care problems – falls and diabetes – whose management is significantly influenced by the chosen accountability framework. The differences between an outcomes-based approach (that is, adapting care to problems in their context) and a process-based approach (adhering to a protocol) are stark.
The first example: a resident has a fall. Rather than only assessing her for injuries and vital signs (as per protocol), staff would also assess potential reasons for the fall – for example, lack of mobility, pain, low blood pressure, or polypharmacy (taking multiple prescription medications at once) – and involve allied health professionals in preventive and rehabilitative care. This could include muscle strengthening exercises, gait and balance retraining, pain management and medication review. These are measures that could reduce the likelihood of the patient falling again, thereby improving her outcomes.
And let’s take a resident with normally stable diabetes, who one day records an elevated blood sugar reading. Rather than just giving him more insulin, staff would also assess potential underlying reasons for the elevated reading. These could include loss of appetite, an infection, or an episode of <a href="https://www.mayoclinic.org/diseases-conditions/delirium/symptoms-causes/syc-20371386" target="_blank">delirium</a>.
The royal commission should do many things, but adding red tape isn’t one of them
Increasing frailty and/or significant memory decline are the main reasons for admission to an aged care facility. These people are particularly vulnerable as their health changes frequently and rapidly.
Being bogged down by <a href="http://johnbraithwaite.com/wp-content/uploads/2016/06/Regulating-Aged-Care-Ritualis.pdf" target="_blank">regulatory ritualism</a> reduces the time staff have available to spend on residents’ physical, social, emotional and cognitive needs.
True accountability in aged care is achieved by demonstrating how the provided care has impacted a resident’s well-being. In that regard, the Aged Care Quality and Safety Commission should provide leadership and primarily act as an educator, helping facilities to become <a href="https://www.penguinrandomhouse.com/books/163984/the-fifth-discipline-by-peter-m-senge/9780385517256/" target="_blank">learning organisations</a>. If an aged care facility fails to “learn and improve”, then sanctions and penalties become necessary.
More bureaucracy would only serve to perpetuate the current crisis, and would fail those residents and families who have suffered from <a href="https://agedcare.royalcommission.gov.au" target="_blank">the current failings in the sector</a>.
Len Gainsford, a former adjunct research fellow in accounting &amp; governance at Swinburne University of Technology, contributed to this article.

<img src="https://counter.theconversation.com/content/121561/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1">

Joachim Sturmberg, Conjoint Associate Professor of General Practice, University of Newcastle.
This article is republished from <a href="http://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/red-tape-in-aged-care-shouldnt-force-staff-to-prioritise-ticking-boxes-over-residents-outcomes-121561" target="_blank">original article</a>.
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Red tape in aged care shouldn’t force staff to prioritise ticking boxes over residents’ outcomes

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GUEST OBSERVATION
Loneliness is increasingly recognised worldwide as a critical social issue and one of the <a href="https://www.propertyobserver.com.au/https://www.ncbi.nlm.nih.gov/pubmed/25910392" target="_blank">major health hazards of our time</a>. Our <a href="https://www.publish.csiro.au/book/7269/" target="_blank">research</a> shows older private renters are at high risk of loneliness and anxiety. This is a growing concern as <a href="https://theconversation.com/why-secure-and-affordable-housing-is-an-increasing-worry-for-age-pensioners-69350" target="_blank">more Australians are renting housing later in life</a>. By contrast, only a small proportion of the <a href="https://housing.vic.gov.au/social-housing" target="_blank">social housing</a> tenants we interviewed said they were lonely.
The links between housing arrangements and loneliness could have profound <a href="https://www.psychology.org.au/for-members/publications/inpsych/2018/December-Issue-6/The-impact-of-loneliness-on-the-health-and-wellbei" target="_blank">implications for our health</a>. As former US surgeon general Vivek H. Murthy <a href="https://www.washingtonpost.com/news/on-leadership/wp/2017/10/04/this-former-surgeon-general-says-theres-a-loneliness-epidemic-and-work-is-partly-to-blame" target="_blank">said</a>:
"The reduction in life span [for people experiencing loneliness] is similar to that caused by smoking 15 cigarettes a day, and it’s greater than the impact on life span of obesity … Look even deeper, and you’ll find loneliness is associated with a greater risk of heart disease, depression, anxiety and dementia."
What causes loneliness?
The causes of loneliness are multifaceted and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167494305000361" target="_blank">complex</a>. The <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2071.0%7E2016%7EMain%20Features%7ESnapshot%20of%20Australia,%202016%7E2" target="_blank">number of people living alone</a> in Australia is <a href="https://www.urban.com.au/property-observer" target="_blank">clearly a factor</a>. In 2016, just under one in four households (24.4%) were single-person households. That’s up from one in five in 1991.
<a href="https://www.kff.org/other/report/loneliness-and-social-isolation-in-the-united-states-the-united-kingdom-and-japan-an-international-survey/" target="_blank">Research</a> suggests low-income individuals are more likely to experience loneliness. So, too, are people who have a serious mental or physical health condition or have had a serious disruptive event (financial or job loss, illness or injury, or relationship breakdown) in the last couple of years.
The <a href="https://www.urban.com.au/property-observer" target="_blank">impact of housing tenure on loneliness</a> has received little attention. While recognising that there are no definite associations, we interviewed about 80 older (65-plus) private renters and social housing tenants who depended on the <a href="https://www.humanservices.gov.au/individuals/services/centrelink/age-pension" target="_blank">Age Pension</a> for their income. These in-depth interviews indicated that their housing tenure was a critical factor in their risk of experiencing loneliness.
Many older private renters are lonely
Many older private renters have little disposal <a href="https://www.publish.csiro.au/book/7269/" target="_blank">income</a>, because the cost of housing uses up much of their income. They also live with the constant possibility that they may be asked to vacate their <a href="https://www.propertyobserver.com.au/https://journals.sagepub.com/doi/10.1177/1440783317707833" target="_blank">accommodation</a>. Their limited budgets mean they often end up living in a poorly located property. These features, individually or in combination, create fertile ground for anxiety and loneliness.
Their dire financial situation was often an obstacle to social activities. One interviewee told of how she had to choose between food or breaking her isolation by using public transport.
"Well, you sort of think what you can do with $2.50. That’s a loaf of bread type of thing." – Beverley *
A 72-year-old woman living by herself said she could not afford the outings organised by her church.
"There’s quite an active social club at the church for over-55s but I can’t go to any of those … Sometimes I think it would be nice to go on something that appeals to me, yes. And they might have an afternoon at somebody’s home and you’re asked to bring a plate [of food]. You see, I couldn’t afford to do that."
Peter, 67 and divorced, had left the workforce prematurely due to ill-health.
"I’ve become very isolated. I used to, before I had the hip operation, I used to play tennis and I loved to play tennis … but I really can’t afford it. I’ve found a few clubs that I could go and play in. I’d like to get back to it, but they say, ‘Ah, the fees are this and you pay it annually,’ and I can’t come up with $150 or $200 or whatever."
Lack of money and insecure tenure were sources of enormous distress and anxiety, which further discouraged social contact. Brigette (67) was brutally honest:
"You do get depressed and I believe that’s why people suicide … And there have been times when I’ve thought, what is the point to life? I really have thought this can’t go on, you know … I feel sorry for people because it is hard, and once you stay in it’s like crawling out of a slime pit … I have to say, ‘Get up and go out, go up the shops … Pretend you need potatoes or something.’"
Not all of the private renters interviewed experienced loneliness. These interviewees usually had strong family ties or had managed to find affordable and secure accommodation.
Social housing tenants feel less isolated
In sharp contrast, only a small proportion of the social housing tenants interviewed said they were lonely. Almost all were adamant they did not experience loneliness and felt they had strong social ties. Their affordable rent, security of tenure, long-term residence and having neighbours in a similar position meant they could socialise and were not beset by anxiety.
An 85-year-old long-established social housing tenant’s response to the question about loneliness and isolation was typical:
"I do like it around here. I know where everything is and I know all the people, especially around these units you know. I know everyone and they know me. I like it around here. This is my home, you know. This is a community, I think. Like I know all the people and we’ve become really good friends. I couldn’t think of being anywhere else." – Kay
Pam, who had been a private renter before being allocated social housing, reflected on how her life had changed:
"Well, it is changed because I’m happier and I think I’m healthier and I have a lot of new friends. I also have a lot more people around me for support if anything does happen. If I get sick and if they don’t see me for a few days someone will come and say, ‘Pam, are you OK?’ In private housing there was nobody."
The <a href="https://www.propertyobserver.com.au/https://journals.sagepub.com/doi/abs/10.1177/1440783313500856?journalCode=josb" target="_blank">residualisation</a> of social housing meant some tenants were living in what they perceived to be unbearable conditions. However, they generally were able to deal with their situation. Patricia coped with her very challenging neighbours by going to the local community centre.
"No, I hate it [public housing]. I live here [at the community centre] every day. Yes, I’m on the committee here and I do things every day. This is my home, my family. Everybody is friendly with everybody. We have outings and things."
What the interviews indicate is that the housing tenure of age pensioners often plays a fundamental role in whether they are able to escape the experience of loneliness. Older private renters are far more likely to experience loneliness than their counterparts in social housing and that loneliness can be acute.
* All the names used are pseudonyms.
Alan Morris, Research Professor, University of Technology Sydney
Andrea Verdasco, Research Associate, University of Technology Sydney
This article is republished from <a href="http://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-really-have-thought-this-cant-go-on-loneliness-looms-for-rising-numbers-of-older-private-renters-118046" target="_blank">original article</a>.
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Loneliness looms for rising numbers of older private renters

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EXPERT OBSERVER
The latest ABS figures estimate that the total number of dwelling units that commenced construction fell 9.5% in the December quarter. The current decline in Victoria’s residential property development is pushing many developers to look at diversifying.
Restrictions on foreign investment, changes in statutory fees and investment incentives, lending becoming tighter and policy uncertainty with the looming federal election have all contributed to a decline in the Victorian residential property market. As a result, developers are struggling to pre-sell a sufficient number of properties to fund residential development projects in the current environment. 
However, with Australia’s rapidly growing population, the need for new housing will persist and lead to a bounce back in the market in time.
Until then, more and more developers are looking at repurposing their existing residential development sites and transitioning them into commercial sites. Some are looking to capitalise on growing sectors of the market by turning to opportunities in the aged care and retirement living and the up and coming ‘build-to-rent’ sector. Build-to-rent developments are purposely built for rental, rather than sale. This benefits people who want or need to rent for longer periods of time. 
Residential developers frequently discuss rezoning and repurposing sites to a commercial development.
Commercial properties are vastly different from residential property developments in terms of size, function, characteristics and most importantly financial risk. 
While residential developments involve selling off the asset once complete, commercial developments usually involve retaining and maintaining the asset, which is a much longer-term financial model.
The biggest challenge for residential developers who adopt any of these alternatives is understanding market expectations and changing their feasibility from a short-term to a longer-term return with a different model and risk profile.
However, with the right team of consultants leading the transition of a development, traditionally residential developers are presented with the potential to thrive under the current housing climate in Victoria.
Opportunities in the growing aged care and retirement living market
The aged care sector is expected to boom over the next few years as our population ages and continues to live longer. 
Aged care and retirement expectations and offerings have completely changed over the last few years in Melbourne due to our society becoming accustomed to an amenities-rich way of living.
New aged care and retirement living sites are no longer sprawling developments on the suburban fringes. They are now situated in inner city areas and have become high-rise modern developments with the same premium finishes as a luxury apartment development.
Traditional residential property developers are seeing the growing ageing and downsizer population as an opportunity to take advantage of in the current market. In particular, an originally proposed high-density residential apartment site can now present an ideal transition for a modern inner city vertical aged care and retirement living development.
Earlier this year, Lendlease submitted an updated proposal for the redevelopment of the historic Channel Nine studio site in Richmond to include aged care and retirement living precincts.
One caveat is that aged care and retirement living sites have a different set of regulations and requirements which developers will need to consider in terms of feasibility and buildability.
Making moves in the new build-to-rent sector
Some developers are also considering repurposing their residential sites into a ‘build-to-rent-model’. 
While this model is still largely untested in the Australian market, there’s a growing demand for this alternative development scheme, particularly as the issue of housing affordability continues across Melbourne. 
In terms of transitioning residential development sites into a build-to-rent model, the design and construction remains largely the same, but the financial model is completely different. 
Developers will be keenly observing how ‘build-to-rent’ sites, such as UBS Asset Management, Grocon and JLL’s Gold Coast ‘built-to-rent’ site which opened early this year, will perform to see if they should transition their developments over to this model.
The reality is, the Victorian residential property development market as we know it is changing. For developers to stay afloat, they may need to explore different types of developments and repurpose their existing residential development sites. 
James Ford is the National Director at WT Partnership
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