Carer Recognition - Progressing Compliance

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					                     Government of Western Australia
                     Carers Advisory Council
  GOVERNMENT OF
 WESTERN AUSTRALIA




  Carer Recognition -
Progressing Compliance




Report of the Carers Advisory Council of Western
Australia to the Minister for Seniors and Volunteering
on compliance with the Carers Recognition Act 2004 for
the year ending 30 June 2008.

                                                       May 2009
            Carers Advisory Council -
                 February 2009




      Left to right: Clare Masolin, James McKiernan, Judy Waymouth,
Lois Gatley (Chairperson), Ellen Walker (Deputy Chairperson), Allan Golledge,
          Khim Chooi Teo, Charlie Rook. Absent: Vivienne Hansen
Carers Advisory Council of Western Australia                                           March 2009




                                               CONTENTS
CHAIRPERSON’S OVERVIEW _________________________________________ 2

EXECUTIVE SUMMARY ______________________________________________ 4

1.   INTRODUCTION _________________________________________________ 7

2.   LEGISLATIVE REQUIREMENTS OF THE CRA ________________________ 7

3.   PERFORMANCE OF OBLIGATIONS OF REPORTING ORGANISATIONS___ 8

4.   REPORTING ORGANISATIONS' COMPLIANCE OR NON-COMPLIANCE

     WITH THE CRA SECTION 6 (2) ____________________________________ 10

5.   REPORTING ORGANISATIONS' COMPLIANCE OR NON-COMPLIANCE

     WITH THE CARERS CHARTER____________________________________ 14

6.   APPLICATION OF COMPLIANCE __________________________________ 22

7.   FINDINGS ON PERFORMANCE ___________________________________ 26

8.   RECOMMENDATIONS ___________________________________________ 27

9.   FUTURE WORK ________________________________________________ 27

APPENDICES______________________________________________________ 29

Appendix 1: Definition of "carer" _______________________________________29
Appendix 2: Carers Charter __________________________________________30
Appendix 3: Outline of Health Services _________________________________31
Appendix 4: Carers Advisory Council's Activities 2007/2008 _________________36
Appendix 5: Office of Health Review Report to Council 2007/2008 ____________41

Membership of Carers Advisory Council in 2007/ 2008




Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008
Carers Advisory Council of Western Australia                                                                         March 2009




CHAIRPERSON’S OVERVIEW
Evidence is available from research and enquiry reports 1 documenting that those who
care for someone with a chronic illness, mental illness, or those who care for persons
who have a disability or are frail, and those with multiple illnesses/disabilities, have
themselves critical needs for support to sustain their health and wellbeing due to the
demands of the caring role.

Consistently these documents reflect the need for carers to be heard. In the Carers
Australia 2020 report – Don’t wait 2 , which captured carers’ views on the future, the
first four issues announced were: financial security, recognition and respect, health
and wellbeing, and models of care so that their knowledge, information and skills can
improve services and systems of care.

The estimated quarter of a million people in a caring role in Western Australia are a
diverse population. Often a carer is assisting another who may have multiple chronic
illnesses and a disability. Some care for more than one person in their family. In terms
of ages they may be:-
• children caring for a parent or helping their parent(s) with their sibling with a
     disability or chronic illness;
• parents of children with a disability, chronic or mental illness;
• partners/spouses who care for a life partner with a chronic illness, a mental illness
     or disability;
• an adult caring for a companion, relative or friend who has a chronic illness, a
     mental illness or a disability;
• middle aged carers who provide ongoing assistance to an adult child, as well as/or
     their frail aged parents; and
• seniors caring for a mature aged son or daughter with a disability, chronic illness,
     or mental illness.

Those in the caring role also come from a range of cultures and language groups. An
estimated 20% of carers in this state are from culturally and linguistically diverse
populations and 2% are from Aboriginal communities 3 .

The intent of the Carers Recognition Act 2004 (the Act/ CRA) is to recognise these
carers and provide mechanisms to involve them in those services which have the
most impact on their lives, the health and disability services.

The legislation also leads the way in Australia by making concrete strides to involve
carers in the development of policies and programs and the strategic and operational
planning within the government agencies of WA Health, the public hospitals and the
Disability Services Commission.

How carers are to be treated by both government and community service providers in
the two sectors of health and disability is set out in the Carers Charter (Schedule 1 of
the Act). The Charter also directs that carers are to be included in assessment,

1
  R Cummins, J Hughes, A Tomyn, A Gibson, J Woerner, L Lai. “The Wellbeing of Australians - Carer Health and Wellbeing”. Oct 2007.
2
  Carers Australia. “Don’t wait: Carers say listen and act now.” Oct 2008
3
  Access Economics. “The Economic Value of Informal Care”. Aug, 2005.

Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008
Carers Advisory Council of Western Australia                                           March 2009


planning, delivery and review of services and how their views and needs must be
taken into account when making decisions on services. It also states carers’
complaints must be “given due attention and consideration”.

Another strength of the Act is that carers have a role in the accountability processes to
ensure these practices are implemented across the two sectors. The Act establishes
the Carers Advisory Council and states that it must be comprised of persons who have
knowledge of and experience in the caring role (See Membership of Carers Advisory
Council in 2007/ 2008 on the inside back cover of this report). One of the roles of
Council is to review reports from the government agencies of health and disability and
report, through the Minister, to Parliament on whether they comply with the Act and
the Carers Charter.

In Council’s view this is a significant role for carers, as it role models the intent of the
legislation that carers are to be part of decision making where those decisions impact
on the caring role.

The second benefit of the accountability process is that it has the potential to
encourage both change and growth in practices. The reports from the government
agencies (deemed to be reporting organisations) generate annual statements on their
strategies and initiatives. These in turn are reported by the Council, thereby informing
service providers, carers and those they care for, on good practices. By publishing
and distributing its report Council generates this knowledge to the wider community.

It has been rewarding for Council to be engaged in this important work, to see the
system of accountability develop and to witness after only three years’ reports the
number of promising strategies and initiatives developed and implemented across
health and disability sectors that are being reported.

Council extends its thanks firstly to the carers who have been active on committees,
networks and groups representing carers’ views and needs in both the health and
disability organisations; to the staff who have initiated and participated in the
strategies and initiatives that enhance the caring role over the last reporting year of
2007/2008; to the authors of the reports and to the executives and management
members of staff of both WA Health, public hospitals and the Disability Services
Commission for their work with members of the Council over this third year of
operation.




Lois Gatley
Chairperson
Carers Advisory Council
March 2009




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EXECUTIVE SUMMARY
Under the Carers Recognition Act 2004, Disability Services Commission, WA Health
and public hospitals are required to submit annually to the Carers Advisory Council a
report on their compliance with the Act. In this the 3rd reporting year, the Council’s
audit of these reports has resulted in the following compliance ratings.

The Disability Services Commission (DSC/the Commission) is viewed as having
reported on all matters as set out in Part 2 section 7 of the Act and has complied with
all the requirements established in Part 2 sections 6 (1) and 6 (2) of the Act.

The WA Health and public hospitals have reported against Part 2 section 7 of the Act
requirements. In regards to the compliance, they are viewed as compliant with Part 2
section 6(2) of the Act. In terms of compliance with section 6(1) they are considered to
be working towards compliance.

Findings on performance
In reviewing the performance of the two reporting organisations, Council makes the
following findings as relevant to each organisation.

Findings in regard to DSC:
• The Commission delivered its report by the due date and reported against the
   standards set out in the Council’s Self Assessment Toolkit.
• Good practices were evident within the DSC report.
• The appendices provided relevant and appropriate supporting evidence.
• The Commission has commenced to gain qualitative data via the Consumer
   Survey.
• A Carers Recognition Act implementation committee has commenced work to
   ensure the intent of the CRA and Carers Charter is embedded into practice.
• Undertakings for future strategies/ action made in the first and second reporting
   years are being attended to.

Findings in regard to WA Health and public hospitals:
• The health reports were delivered a short period after the due date.
• The reporting of individual Area Health Services is valuable for compliance auditing
   and shows the varying responses to the requirements of the Act across the health
   sector.
• The reports showed encouraging practices are occurring within individual health
   services.
• The Area Health Services did not universally report against the legislative
   standards.
• No supporting evidence was provided to substantiate statements of compliance.
   Future evidence could comprise examples of existing materials such as: policies,
   materials or information packs targeting carers, forms to identify carers, minutes of
   meetings of the advisory bodies in the hospitals or existing examples from their
   quality and/or accreditation measures.
• There is no evidence of a strategy to gain qualitative data to seek outcomes for
   carers.
• Many of the earlier undertakings by WA Health and the public hospitals for future
   strategies/ action appear not to have been addressed.


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•   There is no implementation plan in place to ensure progress in embedding the
    intent of the CRA throughout operational units.
•   There is a need to streamline procedures and formats for the collation and delivery
    of reports to the Carers Advisory Council to cover the requirements of section 7 of
    the Act.

Recommendations
One of the functions set out in the legislation requires the Council to make
recommendations to the Minister on fostering compliance with the Carers Charter by
applicable organisations (CRA, Part 3 section 9(b)).

Implementation of this legislation into practice is reliant on a shift in emphasis and
attention to the principle of inclusion. This in turn is reliant on applicable organisations
understanding the benefits they will gain by the inclusion of carers in decision making
at both the strategic and operational level. Given the benefit that carers bring to
society, the trends that are announced in research and reports, this matter is
increasingly imperative.

Council therefore makes the following general recommendation:

That the Minister responsible for the implementation of this legislation seek the
support of the Ministers responsible for the applicable organisations to take steps to
ensure ongoing implementation of the CRA and the Carers Charter.

The Council recommends that the reporting organisations:

1. Build into their existing performance and quality management systems
   mechanisms to collect evidence on trends of increased levels of carer
   representation and participation to substantiate compliance.
2. Use such data to identify and articulate the benefits of engaging carers
   systematically and reinforce those benefits with the contracted/ funded service
   providers.
3. WA Health develop and internally distribute an implementation plan to embed the
   objectives of the CRA and the Carers Charter into practice over the next five years.
4. WA Health and public hospitals show evidence in future reports that they are
   implementing the strategies reported as undertakings in the first and second
   reports.
5. Commence/ continue work to gauge the impact of their strategies for ensuring
   practical outcomes for carers.

Future work
The Council is committed to two major streams of activity for the coming years.

Firstly, Council’s ongoing promotional and educational tasks across the two sectors to
ensure understanding of the intent, the benefits and purpose of the compliance
requirements.

Secondly, Council is committed to working with all relevant parties on the issues
raised in the report on the Review of the CRA. In particular, the reporting



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organisations and the department with responsibility to assist the Minister with the
administration of the CRA, (that is the Department for Communities).

Council notes the commentary in the review document and is willing to negotiate the
terms under which compliance is defined and is keen to explore additional means of
improving the reporting procedure.

The review also made a recommendation that a policy framework be developed to
assist in identification and training of carers for involvement in policy and program
development or planning activities as required under section 6(2) of the CRA. Council
sees this matter as imperative to sustain the current initiatives of both reporting
organisations and enable that work to permeate through all levels of decision making.




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1. INTRODUCTION
In the wider community, and to some extent among carers and the service provision
sectors themselves, there is still some confusion around the use of the term “carer”.
Mostly this stems from paid workers employed to provide services being referred to as
carers. Also the term “carer” is frequently used as an add-on, for example, families
and carers. This adds to the confusion as it implies they are a separate population
outside the family.

One of the benefits of the Carers Recognition Act 2004 (CRA) is that it clearly defines
who is and who is not a carer (See Appendix 1). This definition gives direction to
service providers to assist in their identification of those individuals providing ongoing
care and assistance to family members or friends as separate from those employed to
provide care or assistance under contract or in a voluntary capacity.

A strength of the CRA is that it is built on the community engagement principle of
inclusion – that people who are impacted upon by decision making should be part of
the decision making process. The intent of the legislation is that there is a culture
change by service providers that in meeting the requirements of the legislation, carers’
needs and views will be taken into account at a micro level of service provision, and at
the macro level, carers will be part of decision making on the future direction of
services.

Documented in this the third annual report is the performance of reporting
organisations in meeting those requirements and recommendations on fostering
compliance with the Carers Charter into the future.

2. LEGISLATIVE REQUIREMENTS OF THE CRA

2.1 Compliance
Those organisations that are public sector agencies, WA Health, public hospitals and
Disability Services Commission, are defined as reporting organisations and must
comply with the CRA. Under the Act they “must take all practicable measures to
ensure that the organisation and its officers, employees or agents comply with the
Carers Charter in providing a service of that organisation” (CRA Section 6 (1)).

Reporting organisations must report on both their own compliance with the Carers
Charter and on the compliance of those services they contract and fund.

The reporting organisations are also obliged to comply with an additional requirement
of involving carers, or persons or bodies that represent carers, in any –
(a) policy or program development; or
(b) strategic or operational planning,
that might affect carers and the role of carers (CRA Section 6(2)).

The legislation is silent on how compliance is to be achieved. No mechanisms or
benchmarks are set out for the reporting organisations on the expected level of
performance or compliance. The legislation simply states they must take all
practicable measures to ensure compliance with the Carers Charter, (Section 6 (1))
and to include “details of the organisation’s compliance or non-compliance with
section 6(2)”.


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2.2 Reporting
The accountability process established by the Act is that by the 30th September each
year the reporting organisations must provide a report to the Carers Advisory Council
(the Council), on the performance of their obligations under the Act, compliance or
non-compliance with the Act, their compliance with the Carers Charter and the
“compliance or non-compliance with the Carers Charter of any person or body
providing a service to others under a contract with the organisation” (CRA Section
7(1)).

The second part of the accountability process is that Council must report to the
Minister as soon as practicable in each year on:
“(a) the performance by reporting organisations of their obligations under this Act;
 (b) compliance or non-compliance by reporting organisations with this Act; and
 (c) compliance or non-compliance by reporting organisations with the Carers Charter,
during the year which ended on the preceding 30 June” (CRA Section 10).

In turn the Minister is required by the CRA to place the Council’s report “before each
House of Parliament within 14 sitting days of that House after the Minister receives it.”

2.3 Carers Advisory Council’s functions
The Act prescribes two main areas of work for the Council. Firstly the functions of
Council are determined under Section 9 of the CRA as:
“(a) to work to advance the interests of carers and promote compliance by applicable
organisations with the Carers Charter;
 (b) to make recommendations to the Minister on fostering compliance by applicable
organisations with the Carers Charter;
 (c) to provide general advice to the Minister on matters relating to carers; and
 (d) to carry out other functions as directed by the Minister.”

A description of Council’s work to fulfil these functions in the reporting year of
2007/2008 is included in Appendix 4.

The second body of work for Council is the reporting requirements as set out in
section 10 (1) of the Act as described above. The Council is also required under
section 10 (2) of the Act to include details on the compliance or non-compliance with
section 6(2) by reporting organisations that are public sector bodies.

3. PERFORMANCE OF OBLIGATIONS OF REPORTING
   ORGANISATIONS
Section 7 of the Act requires reporting organisations to deliver each year to Council
not later than 30th September their report for the year that ended on the preceding 30th
June. The elements of the reports delivered to Council for the year 2007/2008 in
meeting the requirements of section 7(1) (a) are as follows:

3.1 Disability services
• Disability Services Commission (the Commission) provided one compliance report
   on 25th September 2008 with 15 appendices.
• The report provided clear timelines, gap analysis and goal setting with timeframes.



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•     Undertakings of future action reported in the previous report were methodically
      addressed.
•     There is an excellent standard of supporting documentary evidence and cross
      referencing. This was provided in the appendices.
•     In addition, the report contained information on contracted services and funded
      community service providers (See section 5.3 of this report below.)

3.2 Health Services
The Director General of WA Health provided six reports on the 15th October 2008. The
reports related to the following health services and policy offices:
• WA Health Finance & Health Reform Division
            o Contracted organisations
• North Metropolitan Area Health Service (NMAHS) including:
            o Sir Charles Gairdner Hospital
            o Osborne Park Hospital
            o Swan/Kalamunda Health Service
            o Area Mental Health
            o Ambulatory Care Services
            o King Edward Memorial Hospital for Women
• South Metropolitan Area Health Service (SMAHS) including:
            o Royal Perth Hospital – Wellington Street Campus and Shenton Park
               Rehabilitation Hospital
            o Armadale Health Service
            o Bentley Health Service
            o Fremantle Hospital and Health Service
            o Rockingham Peel Health Service
            o South Metropolitan Area Health Service
            o South Metropolitan Area Population Health Service
• WA Country Health Service (WACHS). This includes seven regions across the
state. It incorporates across those regions 91 Hospitals and Nursing posts; 14 Aged
Care services; 69 Community and Public Health services; 17 Mental Health services.
• Child and Adolescent Health Service (CAHS) including Princess Margaret Hospital.
• Drug and Alcohol Office (DAO).

In mapping the WA Health internal reporting system 4 Council ascertained that within
each Area Health Service (AHS) and specialist division, there are a considerable
number of operational units which have a reporting responsibility to their respective
AHS or division (See Appendix 3).

In examining the reports delivered to Council, it is noted that many operational units of
the health system are not included. The conclusion to be drawn is that a significant
percentage of metropolitan and state-wide services have either no strategies/
initiatives in place related to the compliance requirements, or there is no internal
system for reporting their compliance with the Act and the Charter.

Council found that a number of factors impacted on compliance auditing of the health
reports this year:


4
    Website analysis


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•   Some reports relied heavily on information submitted in the previous reporting
    year.
•   A lack of data as to the timeframes when the programs or strategies were initiated
    or conducted in some of the health services made it difficult to assess relevance
    for the reporting year and to see progress and development in those services.
•   In some instances the public hospitals reported separately by supplying an
    independent report, but were also included in the relevant area health service,
    hence there was dual reporting.
•   No materials or examples of initiatives were provided as evidence. For example,
    references were made in respect to published brochures but there was no
    indication of the relevance of those brochures to carers, the Charter, or outcomes
    for carers.
•   With regard to the reports on contracted services or funded community service
    providers there is no data on the scope or volume of those organisations in the
    reports and again there is some dual reporting.

4. REPORTING ORGANISATIONS’ COMPLIANCE                                                 OR   NON-
COMPLIANCE WITH THE CRA SECTION 6(2)
Standard - Carers or persons or bodies that represent carers, must be involved in any
policy or program development that might affect carers and the role of carers (CRA
Part 2 s6(2)(a))

The Act requires that Council’s report to the Minister must include details on the
compliance or non-compliance of the reporting organisations. Council therefore has
identified those initiatives and actions relevant to 2007/2008 from the documentation
provided and by cross reference to previous reports. Council sets out those initiatives
here to also acknowledge the efforts and work of the staff/ personnel and carers
involved, plus provide examples of good practice.

4.1 Disability Services Commission (DSC / the Commission)
The Commission provided extensive information on strategies and activities in this
reporting period which involve carers in policy and program development. Examples of
those initiatives include:

•   The inclusion of 2 carers on the 8 member Quality Management Framework
    'Transition Reference Group'. This followed a wide ranging consultation process
    including consumers and carers identifying gaps and benefits in existing standards
    monitoring processes leading to development of the new Quality Management
    Framework.
•   A carer representative on the Quality Management Framework Advisory
    Committee.
•   Carer representation on the selection panel for Family Leadership and Initiatives
    Grants.
•   Two day training plus payment to 5 carers to allow them to fully participate as
    effective members of the Independent Priority Assessment Panel.
•   A review of the Consumer Complaints Management Policy and Procedure in
    January 2008 to include carers.




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An example of good practice in program development is outlined below.


The Community Living Plan is an example of comprehensive consultation opportunities for
carers and other concerned parties to inform the project from its developmental stages. A
variety of consultation and feedback methods were offered to encourage participation,
including metropolitan and regional workshops and advertising via Local Area Coordination
networks. Consultation enabled carers to have their say on critical issues such as barriers
currently being experienced and their views on strategies to promote community living. A draft
conceptual framework was developed, circulated among participants' networks (including
carer representative bodies) and posted to the website for wider feedback.


Standard - Carers, or persons or bodies that represent carers must be involved in any
strategic or operational planning that might affect carers and the role of carers. (CRA
Part 2 s6 (2)(b))

Good initiatives and progress has been made by DSC in regards to strategic and
operational planning. In addition, the Commission provided evidence that undertakings
made in earlier years were being considered and implemented.

Some examples provided of strategic activity relating to carers include:

•   The appointment of a carer as Chair of the DSC Board (September 2007).
•   The development of a reference group on the Implementation of the CRA
    comprised of community service providers and Commission staff. The Council has
    acted in an advisory capacity to this group.
•   Participation of and consultation with carers and carer representative bodies in
    Stage 1 of Disability Future Directions 2025.
•   The Board Reference Networks, through a consultative process, garnered a series
    of issues relevant to the role of carers.
•   Evidence of consultations with rural, CaLD and Aboriginal carers.

4.2 WA Health
Standard - Carers or persons or bodies that represent carers, must be involved in any
policy or program development that might affect carers and the role of carers. (CRA
Part 2 section 6(2)(a))

NMAHS report states:
All hospitals within the area service are accredited with the Equip 3 criteria of the
Australian Council on Health Care Standards. The Accreditation survey assesses an
organisation’s commitment to consumers and carers.

NMAHS initiatives reported for 2007/2008:
• As part of continuous quality improvement all hospitals will now self assess against
  Equip 4 criterion which includes partnering with carers.
• Osborne Park Hospital (OPH) has a range of strategies and initiatives in place and
  continues to include carers in program planning.
• OPH conducted a Carer survey. No information was provided on outcomes of the
  survey.
• Swan/ Kalamunda Health Service (SKHS) has developed a carers policy.


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•   KEMH held a review of all hospital committee membership to consider Consumer/
    Carer representation. A consumer representative with a carer focus has been
    appointed to the Quality Improvement committee.
•   Community Advisory Councils (CACs) at a number of facilities continue to be
    involved in policy review and service planning, for example future clinical service
    planning, smoking policy and the Disability Access and Inclusion Plan. Carers WA
    provide representation on those Councils in a number of facilities.
•   NMAHS Mental Health is developing a mental health information pack for carers.

SMAHS states:
The draft area wide policy, Carers Recognition policy, to ensure compliance with the
CRA, has been adopted and disseminated.

The statement of commitment to working with carers is repeated.

SMAHS initiatives reported for 2007/2008:
• Rockingham Peel Group (RPG) and Bentley Health Service (BHS) each have a
  carer representative on their CAC and consumers/ carers have been invited to
  participate in RPG governance committees responsible for policy development.
• BHS has provided the CAC with a copy of the CRA and a member of their Council
  is a representative on the peak Quality and Risk Management committee. Council
  members are paid sitting fees.
• The Armadale Health Service reports that the CAC conduct regular ward visits and
  gain feedback from patients and carers.

WACHS states:
Services comprising WACHS are accredited through the Australian Council on Health
Care Standards Equip 4 which prescribes carer input in all planning delivery and
evaluation of services.

The service’s Implementation Guidelines for the CRA are due for review in 2009. All
regions have systems in place to capture elements of the CRA as part of their policy
review cycle.

WACHS initiatives reported for 2007/2008
• A Corporate Policy and Procedure Development and Review procedure is in place
  for new and existing policy reviews to ensure that consultation occurs with all
  stakeholders, including carers.
• Bunbury District Health Advisory Council (DHAC) has conducted audits on current
  policies.
• The Mental Health Services comply with the Federal Department of Health and
  Ageing - National Standards for Mental Health Services, which requires carer
  participation. Other standards and guidelines in relation to aged care, HACC
  programs and Aged Care Assessment Teams plus the Older Patient initiative risk
  screening, all have elements that require the involvement of carers in planning and
  policy development.

DAO initiatives reported for 2007/2008




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• A policy has been completed to ensure recommendations regarding consumer
issues take into account the Carers Charter.

CAHS reported for 2007/2008
• Policies are referred to the Princess Margaret Hospital for Children Community
  Advisory Council (CAC) and a carer is a member of that council.
• The Family Advocacy Support Service is involved in developing a whole of health –
  Carer Recognition policy.
• The CAC or other carer representative bodies have been consulted at the initial
  point of contact with programs such as Ambulatory Care Coordination program, the
  ‘Hospital in the Home’ and the Paediatric Palliative Care Programs.

Standard: Carers, or persons or bodies that represent carers must be involved in any
strategic or operational planning that might affect carers and the role of carers. (CRA
Part 2 s6( 2)(b))

NMAHS states:
• Members of the Community Advisory Councils (CACs) are involved in the
  redevelopment of a number of facilities across the health service. At KEMH, a CAC
  representative was involved in the strategic planning workshop and the vision,
  mission and values statements reflect a culture of dignity and respect for all
  consumers.
• NMAHS was involved with community representatives and carers regarding future
  planning of cancer services in Joondalup.

SMAHS reports:
• The Bentley Health Service (BHS) CAC has a member who participates on
  ‘Clinical Practice Improvement’ projects and has participated in an environmental
  review of the service.
• Rockingham Peel Group (RPG) has involved carers in ‘user’ groups in relation to
  the development of Rockingham General Hospital.

WACHS reports:
• The service’s Strategic Plan for 2007–2010 includes carer groups as partners.
  Carers are involved in in-depth service planning which has a 5 to 10 year outlook.
• Across the state, the service has 24 District Health Advisory Councils (DHACs),
  which are comprised of consumer, carer and community members. These councils
  have a focus on communication and advocacy, in assisting to improve safety and
  quality measures and in contributing to planning of services. Work plans of the
  DHACs feed into planning decisions of WACHS executive and management.
• Some regions have Local Health Advisory Councils that feed into the DHACs.
• Specific examples are the appointment of a carer to the Consumer and Carer
  Group of the Central West Mental Health Team which is involved in operational
  planning. Planning of new facilities such as the Kimberley Mental Health Unit has
  included carers.
• All regions have been requested to develop a Health Consumer Carer and
  Community Engagement Framework and the Midwest region has completed their
  framework for 2008.




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DAO report no new information on strategic work. However Council notes that the
DAO Next Step program is to consider including carer representation when conducting
key stakeholder focus groups to review services provided by DAO.

CAHS reports that strategic plans are presented to the Community Advisory Council
of the Hospital for feedback and that consumer/ carer representation on committees
and forums is being reviewed. The strategic planning for the Psychological Medicine
Clinical Care Unit included a carer representative.

5.  REPORTING ORGANISATIONS’ COMPLIANCE                                                OR   NON-
COMPLIANCE WITH THE CARERS CHARTER
Standard: The organisation must take all practicable measures to ensure that it and its
officers, employees or agents comply with the Carers Charter in providing a service of
that organisation. (CRA Part 2 s6(1))

The Carers Charter sets out how carers are to be treated by service providers, their
inclusion in service delivery decision making, and the consideration given to
complaints made by carers in relation to services that impact on them or their role (see
Appendix 2 – the Carers Charter).

Evidence on how the two reporting organisations integrate the elements of the Charter
into practice within their own service provision, is set out in detail here to inform
decision makers, service providers, carers and care recipients as well as the wider
community.

5.1 Disability Services Commission
CRA requirements have been incorporated into the Commission’s processes for
ensuring the organisational values and requirements are communicated and
implemented. Measures reported by DSC to demonstrate this are documented below.

Officers, Employees compliance with the Charter
• Internal staff newsletters and other widely distributed publications regularly run
   articles on carer issues and stories, heightening awareness among Commission
   staff of the carer role.
• In May 2008 a paper was developed and endorsed for distribution to the
   Commission Directors, staff and agents clarifying the term 'carer' and emphasising
   the need for correct usage as per the CRA.
• DSC website is easily navigable, transparent and well resourced.

Consultative processes with carers
The Commission refers to the benefits from the consultation with people with
disabilities, their families and carers and service provider agencies. It states these
processes facilitate access to information and participation, raise awareness,
strengthen community education and support capacity building among provider
agencies.

In addition, the annual DSC Consumer Survey conducted in March 2008 for the first
time, included questions for carers directly related to performance against the Carers
Charter - thereby informing and establishing new baseline data in relation to carers


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Carers Advisory Council of Western Australia                                           March 2009


that can be used to track improvements over time. The report on outcomes has been
included in the Annual Report of the Commission and posted to the website.

Funding was also provided to Carers WA under the Strategic Plan Implementation
Grant 2006–2008 to add "Introduction to CRA" to “Workshops for Carers" series.

DSC reports that information sharing is evident via the Commission’s website and
Local Area Coordinator (LAC) newsletters including:

•   call for submissions to the review of the Disability Services Act
•   provision of sponsorship and advertising of the Carers Symposium – Worth of
    Carers 2008
•   posts to internal and external websites encouraging submissions to the Federal
    House of Representatives Inquiry into Better Support for Carers
•   brochures detailing the Complaints procedure available in other languages on
    request
•   'Speak up' workshops designed for specific CaLD carer groups made possible by
    funding under the 'Family Leadership and Initiatives Grants'.

Carers’ views and needs are part of decision making processes
Within the evidence supplied there are a number of statements dealing with the
importance of 'supporting and assisting carers'. The benefits for the Commission in
consulting carers as part of the wider consultative processes are also stated with
given examples including:

•   Consultation in the Kimberley region in partnership with Fitzroy Valley Advocacy
    Group to collate key issues experienced by carers in that remote area to inform
    DSC's submission to the House of Representatives Inquiry into Better Support for
    Carers.
•   DSC submission (no. 1039) to the House of Representatives Inquiry into Better
    Support for Carers with numerous references to the need to support carers.
•   The development and launch of the first State or Territory 'Reconciliation Action
    Plan 2008–2010' which acknowledges carers and the need to assist and support
    them. A statement of commitment to working in partnership with carers as key
    stakeholders is also included in this plan.
•   Eleven public meetings throughout the state within the reporting year of the Board
    Reference Networks – advertised widely through the LAC and other newsletters
    resulting in the compilation of a "Summary of Carers' Issues".

Complaints
DSC advises there has been modification of DSC Complaints form which specifically
identifies the source of the complaint, for example if it is made by a carer. This in turn
allows for trends to be monitored over time.

5.2 WA Health
Standard: The organisation must take all practicable measures to ensure that it and its
officers, employees or agents comply with the Carers Charter in providing a service of
that organisation (CRA Part 2 s6(1))

Officers, Employees compliance with the Charter


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Carers Advisory Council of Western Australia                                           March 2009


NMAHS cite a number of examples in various services of actions to inform and create
awareness amongst employees. For example brochures provided to staff,
documentation including the term “carer”, orientation and induction programs. The
KEMH has placed information on the Carers Charter and Carers Recognition Act on
the hospital internet and intranet site and provided training by Carers WA to hospital
CAC members.

SMAHS states identification of carers in all facilities by nurses and ward clerks is
continuing and carers are provided with a resource pack on information to assist
transition from admission to discharge.

Also continuing is the ‘Prepare to Care’ program at Fremantle Hospital in medical
wards and associated clinics.

SMAHS staff training needs analysis was conducted in 2008. As a result ‘The
Corporate Training Plan’ now includes the compliance requirements of the CRA. Staff
orientation includes a presentation by the service’s CAC.

WACHS report states staff have received one off education sessions in person and
via videoconference on obligations and responsibilities under the Act. There is no
formalised training program. Some regions include information in their orientation
programs for new staff and the Great Southern has included the Carers Charter and
the Act in their training plan for 2008–2009 for all staff.

WACHS aged care intranet site and a number of regional intranet sites include
relevant information.

The report states that a number of codes and standards guide staff approach to
valuing and “respecting and considering others” and that carers are regarded as
valuable and vital contributors to the care of their consumers.

Hospitals within the regions have medical admission forms that identify if a patient has
a carer, ensuring they are included in care plans, assessments and discharge plans.
Some regions include carer information in ‘take home folders’ and the ‘Prepare to
Care’ kits are distributed at the Geraldton Hospital.

DAO states:
Information has been disseminated to service delivery staff and a copy of the Charter
provided via the Staff Development Quality Group. Family Sensitive training is
provided to recognise the needs of the whole family and members who may be
concerned about or affected by the consumer’s drug use.

CAHS reports:
Information on the CRA and the Carers Charter is provided by the Family Advocacy
Support Service at staff orientation training. In addition, the Hospital Executive Group
and Heads of Department are provided with the Carers Charter for circulation to their
staff and the Charter is displayed throughout the health service. The CAHS workforce
and staff development liaise with external training groups and agencies to offer
professional development regarding carer issues to staff.



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Carers Advisory Council of Western Australia                                           March 2009


Consultative processes with carers
NMAHS states that consultative processes are evident at Osborne Park Hospital case
conferences and in care plans while SCGH continues the ‘Prepare to Care’ program in
specific wards with a self assessment process in place at the time of admission to the
hospital.

SMAHS reports:
Services involve carers in patient family meetings throughout wards and departments
for treatment and discharge planning.

A brochure for carers is distributed in wards across SMAHS. It is transcribed into 14
languages.

The Department of Health satisfaction survey includes questions on information given
to the family about patient progress.

Rockingham Peel Group states that a ‘Care Coordination’ Team has been introduced
in the Emergency Department to enhance processes for discharge planning for
patients over 65 years of age and carers are involved in this planning.

WACHS states:
Reviews are marketed through the DHACs to promote awareness and gain carer
input. There are a number of audit tools that include carers on reviews but also in
patient information and education materials.

Carer input is also gathered through invitations to community consultations and
education to consumer and carer groups. Aged Care Assessment Teams (ACAT)
consult with seniors and community groups, and processes are in place to include
carers in care planning and placement options of Nursing Home Type Patients.

Carer representation on the Central West Mental Health Team allows the provision of
carer input into service wide operational planning.

DAO reports examples of consultative work with carers relating to the development of
the service’s Disability Access and Inclusion Plan.

CAHS report states:
Carer feedback forms are provided in the hospital to promote carer input. Medical
treatment and decision making matters plus consent issues are all addressed with
carer/ families. The CRA and the Charter are displayed throughout the hospital wards
and clinical areas and are located on the service’s intranet and internet sites.
Information on the Charter is included in a PMH handbook.

Carers’ views and needs are part of decision making processes
NMAHS in its report provides examples of activity and some are direct support
actions:
• Osborne Park Hospital has a wide range of practices that involve identifying carers
    and adhering to the Charter. It also provides networking opportunities for carers.
• Swan Kalamunda Health Service allows carers to visit outside of visiting hours and
    meals are provided.



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Carers Advisory Council of Western Australia                                           March 2009




SMAHS report states:
The service is committed to meeting the needs of carers and providing whatever
support carers require.

A senior project officer was appointed to the Mental Health service to support carer
networks.

The Bentley Health service reports that for the Department of Health Satisfaction
survey it gained a 91% return.

Rockingham Peel Group have revised their care plans to consider carer involvement.
Staff education has occurred along side the implementation of these care plans.

Armadale Mental Health Service, with ARAFMI, provides support workshops for
carers.

WACHS report states:
All regions have mechanisms in place to gain input from carers/ representative
groups. The report provides a comprehensive outline of strategies, policies and
standards that require that carers’ views and needs are heard.

Examples cited across mental health, HACC and aged care programs include:
• A Consumer and Carer Participation Position Statement by Wheatbelt Mental
   Health service
• The opportunity for carers across the region to be accommodated close to their
   care recipient during hospital stays in Geraldton
• The increase in respite beds in Carnarvon and Meekatharra
• The Kimberley region consultation on respite needs of carers identified areas for
   improvement
• A carer survey in the Midwest region found feedback over all was positive.

The WA Health Networks provide for carers’ input into the development of models of
care.

DAO report states carers’ views and needs are taken into account in service delivery
situations along with those of the multidisciplinary team and the consumer. Treatment
plans are developed and reviewed by the case manager and clinical review team.
There is no statement of carers being involved in that process and the report identifies
that the Consumer Involvement Quality Group should consider strategies and
processes to address the needs of carers within the “Next Step” program.

CAHS states the Ambulatory Care Coordination program, the ‘Hospital in the Home’
and Paediatric Palliative Care Program all address the ongoing needs of children with
complex disabilities and chronic illnesses as well as focussing on the needs of carers.

Complaints
The NMAHS reports that it is guided by the WA Health Complaint Management Policy
which includes carers as a distinct population. The Patient Liaison Service at SCGH



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Carers Advisory Council of Western Australia                                           March 2009


provides a report to the Office of Safety and Quality and to the Community Advisory
Council (CAC) of the service.

SMAHS reports complaint and feedback mechanisms are in place and information is
available in all areas which include the website. At Bentley Health Service, Armadale
Health Service and Royal Perth Hospital, all complaint and feedback mechanisms are
reviewed by members of their CACs.

The Armadale Health Service states that a procedure is in place to record and
consider complaints which specifically involve a carer, then see how these are to be
analysed and incorporated into quality control mechanisms.

WACHS report states that its Complaints policy and procedure is in line with that of
the Department. It reports quarterly to the Office of Safety and Quality of Healthcare
on indicators which include new complaints and the issues and timeliness of
response.

Some regional initiatives include carers being informed of their rights and
responsibilities, how to present a complaint and the mechanism used to address the
complaint.

DAO reports that it has a formal complaints procedure and policy compliant with the
state government requirements. It is available on the internet or in hard copy on
request. Complaints are recorded and changes made if required to policy and
procedures.

There is no indication of ensuring carers know of their right to make a complaint on
matters relevant to the caring role.

CAHS report states the “PMH Family Handbook addresses carer needs/ access to
complaint process.” A feedback form is available to consumers and carers both
electronically and in hard copy. All complaints are documented and stored.

There is no detail provided on how the information is used to address the matters of
complaint.


5.3. Reporting organisations’ contracted/ funded services’ compliance with the
Carers Charter
The reporting organisations of DSC, WA Health and public hospitals are obligated
under the Act to also report on whether or not the organisations and services they
contract or fund, comply or do not comply with the Carers Charter.

5.3.1 DSC
As evidence that DSC funded agencies/ services are aware of the requirements to
comply with the Carers Charter, DSC reports that DSC publications are routinely
distributed to funded agencies.

In addition, DSC distributes a ‘Standard Form – Carers Recognition Act 2004’ to
funded agencies which sets out the four elements of the Carers Charter. Agencies are



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Carers Advisory Council of Western Australia                                           March 2009


required to complete this form by responding ‘yes’ or ‘no’ as to whether or not the
agency implements each of the Charter’s four elements.

The Commission made no statement on the compliance of its funded service
providers but presented to the Council a chart of responses by the 108 responding
agencies. All except one stated that they comply with each element of the Charter.
The exception recorded the questions as not applicable and yet was later cited in the
report as an example of engagement and partnership with carers. This suggests
confusion may still persist around the definition of the term “carer”.

There is no indication that the Commission requires their funded community service
providers to comply with the Charter in their funding agreements as they are renewed
over time.

5.3.2 WA Health
Individual area health services reported on their contracted service providers and their
funded community service providers. In addition, the WA Health Finance and Health
Reform Division (the Finance and Reform Division/ the Division) supplied information
on contracted and funded organisations across the health services.

Examples from within the area health services information are as follows.

The NMAHS states the 2008-2009 agreement with its funded services will include
compliance with the Carers Charter as part of the Service Agreement review. The WA
Country Health Service also reports their agreements will include compliance with the
Charter in the future.

In this year’s report NMAHS provided a summary of activities relevant to carers by the
contracted private health services and funded community service providers. These
included Joondalup Health Campus, Swan After Hours General Practice (a resource
to General Practitioners) plus Palliative Care Cancer support groups and Parkinson’s
services, and the Swan Renal service.

An example of good practice:

Joondalup Health Campus has conducted a carer survey to assess whether carer
needs are being met and areas for improvement. One highlight was the importance of
involving carers to ensure early intervention and effective discharge planning.

A result of the survey is the development of a ‘Carers Status Assessment’ form to
assist in identifying carers. It is to be implemented for patients over 65 years of age or
those with chronic medical conditions. This assessment of carers’ needs will aid the
provision of support during the hospital stay and at discharge.

The SMAHS provided raw data from 31 HACC funded service providers. Some had
reported against HACC standards and some against a CRA reporting template
developed by SMAHS. Whilst some sound practices were recognised amongst these
services, in the main, consumers/ clients were consistently identified as the target
population, not carers.



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Carers Advisory Council of Western Australia                                           March 2009


Council notes the statement that the area health service will “continue to work with its
NGO partners to develop this reporting further”. Council considers that by adapting
these reporting formats to capture information about carers, the area health service
would gain valuable data that would assist their ability to report on compliance with the
Carers Charter of their funded service providers.

WACHS states that service agreements and Memoranda of Understanding with their
funded community service providers have been revised to reflect the need to comply
with the Carers Charter and the Act. WACHs have offered information sessions to
DHACs on the Act, the uptake of which will be monitored over the 2008-2010 period.

DAO reports all its funded community service providers have been informed of their
obligations in regards to the Carers Charter. There is a commitment to ensuring
compliance by funded service providers by including a requirement in funding
agreements to observe all government statutory requirements.

CAHS states that when Memorandum of Understanding Agreements are reviewed
they will include compliance with the Carers Charter.

The Finance and Reform Division have also reported on funded community based
organisations and contracted service providers by the Department of Health. These
included organisations such as Huntington’s Disease Association, HACC services,
contracted public services within Drug and Alcohol Office plus contracted services in
the private health service of Joondalup Health Campus. It states that a number of the
Division’s contracts are with population based state-wide health promotion services
and therefore do not have direct client services.

The report documents how some community organisations 5 have created awareness
of the Charter amongst staff and carers and how the four elements of the Charter are
implemented. For example, one organisation reports carers play an integral role in the
assessment, planning, delivery and review of services. In another instance “it is the
organisation’s policy that all care plans must be approved by the carer prior to
implementation of the service”.

Some organisations are stated to have a range of mechanisms to ensure carers’
views are heard for example, specific carer assessment tools and support plans, or
audit tools to ensure carers are informed of their rights and responsibilities, plus
consumer surveys of carers and care recipients.

The report states that all organisations have formal complaints procedures. Whilst not
specific to carers, “many agencies require their staff to inform carers of their rights
including the right to complain”.

The Division also reported on initiatives to engage carers within contracted services
such as Swan Renal Services, Drug and Alcohol Office. The Joondalup Health
Campus initiatives on carers included the implementation of an “ICU Diary” for coma
patients which was trialled and found to be an invaluable tool for carers, families and
friends.

5
    The Division’s report does not quantify the organisations


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Carers Advisory Council of Western Australia                                           March 2009




Whilst the full scope of contracted and funded service providers across the state is not
stated, the Division’s report has provided valuable insight into the engagement of
carers in a number of those services. There are indicators that across the field of
community based service providers, there is awareness of the Carers Charter and
mechanisms are in place to implement the elements of the Charter. Likewise, there
are indications that contracted services within government facilities show awareness
and have mechanisms to implement the Carers Charter.

Council notes that a contractor within the private sector has instituted practices
congruent with the Charter and sees this as a positive development.

6. APPLICATION OF COMPLIANCE
6.1 Carers Advisory Council approach to compliance
Council relies on four elements in formulating the assessment of compliance.

As in the previous years, Council has been guided by section 6(1) of the Act which
states:
        “an applicable organisation must take all practicable measures to ensure that
        the organisation and its officers, employees or agents comply with the Carers
        Charter in providing a service of that organisation”.

Here Council looks for information on measures taken to create awareness of and
knowledge about the Carers Charter by officers, employees or agents – that is the
contracted and funded service providers.

The second element of compliance relates to section 6(2) of the Act which requires
the government agencies only, that is DSC and WA Health and public hospitals, to
report on whether they include carers in policy or program development, strategic or
operational planning.

Hence Council sees action towards inclusion of carers in strategic work as inferring
compliance with that part of the legislation.

As it is “early days” in the operation of the Act and in the absence of any regulations,
Council continues to take the approach that compliance is a developmental process in
line with the compliance definition:

           “a state of being in accordance with established guidelines, specifications, or
           legislation, or the process of becoming so” 6 .

As a third element of compliance, Council therefore looks for indicators of
development and progress in strategies and initiatives.

The fourth element of compliance encompasses the objective of the legislation to
recognise the carer role and provide mechanisms for carers to be part of decision
making, as set out in the Carers Charter. The test here is do the applicable
organisations consult with carers? Are they heard, does this benefit carers?

6
    http://www.topaccountingdegrees.com/top-five-accounting-careers


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Carers Advisory Council of Western Australia                                                                         March 2009




The four markers for the reporting organisations for each year therefore are:
• have all practicable measures been taken in the relevant reporting year?
• are carers included in strategic work?
• has there been an increase and improvement in the development of strategies
    and initiatives in the reporting year?
• are there useful outcomes for carers?

6.2 Limitations of current compliance mechanisms
There are legislative limitations on compliance testing within the current Act and as
stated above, there are no regulations attached to the Act that would allow for a
comprehensive approach. For example, a regulation could define compliance and set
out performance indicators for the reporting organisations. In lieu of such legislative
instruments, Council has set out standards in line with the elements of the Act and the
Carers Charter. These form the content of Council’s Self Assessment Toolkit which
has been provided to both reporting organisations for their use in reporting on their
own compliance. Compliance reporting of the contracted/ funded services is left for the
reporting organisations to determine.

When it comes to testing whether those standards bring about the expected benefits
to carers, Council has to rely on self reporting by the reporting organisations. This
essentially means only an internal assessment.

Council’s role is to conduct a desktop audit of the reports provided. Without a
validation process there is no capacity to assess the veracity or effectiveness of
documented initiatives, their success, or otherwise, in providing outcomes for carers.

Council believes that compliance legislation is one of a set of tools necessary to bring
about a change in culture in service provision. Additional tools need to be instituted
such as a qualitative monitoring process via either independent external checks or
systematic surveying of the target population possibly every few years to assess
results for carers. Council is hopeful such additional tools will be put in place in future
years as the two sectors realise the benefits of carers’ inclusion.

6.3 Compliance theoretical model
Council’s approach to the implementation of action to afford compliance has been
guided by the theoretical model of the Regulatory Enforcement Pyramid. 7

This framework has three elements: educate and persuade to comply; develop
capacity to comply; and deter non compliance.

Council’s own work over the past year has been once again to address the first two
elements of the compliance pyramid by being active in both sectors of health and
disability, working to educate and persuade them on the meaning and purpose of
compliance with the Act. It has sought to develop the capacity of community service
providers for compliance by adding to their knowledge and understanding of the
implications of the CRA for their practice. Plus, Council has emphasised the benefits


7
    Adapted from the Office of the Public Sector Standards Commission 2005 Annual Compliance Report 2004-2005 p 28



Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008                                        23
Carers Advisory Council of Western Australia                                           March 2009


that will accrue to them if they include carers in decision making. A full description of
Council’s work is in Appendix 4.




As Council has no authority to act as a regulator to deter non compliance, it has to rely
on DSC, WA Health and the public hospitals implementing policies and practices to
embed this legislation as with any other compliance legislation. The only external
checking system as to whether or not compliance is being adhered to is advocacy by
interested parties, that can mean advocacy by community organisations,
representations by individual carers and complaints mechanisms.

The formal complaint mechanisms are internal procedures of both reporting
organisations and their funded community service providers. The external mechanism
lies with the Office of Health Review. Council has no information on the results of the
first two processes however the Office of Health Review has provided valuable data to
Council suggestive of challenges in capturing complaints in respect of the caring role.

The Office makes the observation that “there are often complaints brought to this
office by a person other than the consumer. The complainant may act in a caring role
yet may not identify themselves as a carer.” On this basis the Office concludes only a
small number of complaints are made under the CRA “but many more complaints give
insight into the difficulties faced by carers”.

Of the 406 complaints made to the Office of Health Review in the reporting year of
2007-2008, 354 were from a person described as “a relative of the consumer or a
parent or guardian of a child”. A full copy of the Office report is in Appendix 5.



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Carers Advisory Council of Western Australia                                           March 2009




6. 4 Methodology for applying compliance
• Reporting organisations’ reports were audited against the standards set out in
    Council’s Self Assessment Toolkit 2006/2007.
• The reports were assessed for quality improvements/ increases in actions against
    previous years’ actions.
• The supporting evidence provided was examined.
• Reporting organisations previous years’ undertakings were examined to assess if
    they had been actioned/ implemented.
• Information provided by the Office of Health Review was considered.
• The rating system set out in the Self Assessment Toolkit was utilised -
    o compliance – agency has taken sufficient action in all key areas of
       compliance;
    o towards compliance – agency has taken some action towards complying;
    o non-compliance – agency has outlined some future actions with intent to
       comply; and
    o non-compliance – agency has not taken any action to comply.

6.5 Compliance ratings
6.5.1 Disability Services Commission compliance rating
In this the third reporting year Council’s audit shows that DSC is inclusive with regard
to policy and program development and engages carers in planning activities for the
future directions of the organisation. In terms of the Carers Charter, the Commission is
seen to be compliant.

In relation to compliance of the funded community organisations, from the evidence
provided Council accepts the Commission’s position that their information indicates
compliance by their funded organisations. Council views the information provided as a
willingness of those community service providers to participate and work towards the
objectives of the Carers Charter. On the basis of this self reporting Council interprets
this as work in progress with scope for further improvement rather than a total
compliance on all four elements of the Charter.

The Commission is assessed as having taken sufficient action in all key areas relevant
to the Act and the Charter.

6.5.2 WA Health and public hospitals compliance rating
The Council has found that across the Area Health Services there are sufficient
indicators of progress being made to include carers in strategic and developmental
work. Therefore WA Health and public hospitals are viewed as compliant with section
6(2) of the Act.

Council notes however that there is a lack of information regarding a significant
number of operational units. Council will seek to see progress in this area and in
relation to the factors outlined in section 3.2 of this report in future years. It also sees
the need for an implementation process to be established to embed the Act and the
Charter over the next five years.




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Carers Advisory Council of Western Australia                                           March 2009


Based on the information provided in relation to compliance with the Carers Charter,
WA Health and public hospitals are viewed as working towards compliance with the
Carers Charter.

6.5.3 Commitments to future undertakings
Council notes that a number of commitments have been made across the reports from
the health sector and will seek evidence of their implementation in the next year’s
reports.

7. FINDINGS ON PERFORMANCE
The Council in reviewing the performance of the two reporting organisations makes
the following findings as relevant to each organisation.

Findings in regard to DSC:
• The Commission delivered its report by the due date and reported against the
   standards set out in the Council’s Self Assessment Toolkit.
• Good practices were evident within the DSC report.
• The appendices provided relevant and appropriate supporting evidence.
• The Commission has commenced to gain qualitative data via the Consumer
   Survey.
• A CRA implementation committee to ensure the intent of the CRA and Carers
   Charter is embedded into practice has commenced work.
• Undertakings for future strategies/ action made in the first and second reporting
   years are being attended to.

Findings in regard to WA Health and public hospitals:
• The health reports were delivered a short period after the due date.
• The reporting by individual Area Health Services is valuable for compliance
   auditing and shows the varying responses to the requirements of the Act across
   the health sector.
• The reports showed encouraging practices are occurring within individual health
   services.
• The Area Health Services did not universally report against the legislative
   standards.
• No supporting evidence was provided to substantiate statements of compliance.
   Future evidence could comprise of examples of existing materials such as:
   policies, materials or information packs targeting carers, forms to identify carers,
   minutes of meetings of the advisory bodies in the hospitals or existing examples
   from their quality and/or accreditation measures.
• There is no evidence of a strategy to gain qualitative data to seek outcomes for
   carers.
• Many of the earlier undertakings by WA Health and the public hospitals for future
   strategies/ action appear not to have been addressed.
• There is no implementation plan in place to ensure progress in embedding the
   intent of the CRA throughout operational units.
• There is a need to streamline procedures and formats for the collation and delivery
   of reports to the Carers Advisory Council to cover the requirements of section 7 of
   the Act.



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Carers Advisory Council of Western Australia                                                                        March 2009



8. RECOMMENDATIONS
One of the functions set out in the legislation requires the Council to make
recommendations to the Minister on fostering compliance with the Carers Charter by
applicable organisations (CRA Part 3 s 9(b)).

Implementation of this legislation into practice is reliant on a shift in emphasis and
attention to the principle of inclusion. This in turn is reliant on applicable organisations
understanding the benefits they will gain by the inclusion of carers in decision making
at both the strategic and operational level. Given the benefit that carers bring to
society and the trends that are announced in research and reports, this matter is
increasingly imperative 8 .

Council therefore makes the following general recommendation:

That the Minister responsible for the implementation of this legislation seek the
support of the Ministers responsible for the applicable organisations to take steps to
ensure ongoing implementation of the CRA and the Carers Charter.

The Council recommends that the reporting organisations:
1. Build into their existing performance and quality management systems
   mechanisms to collect evidence on trends of increased levels of carer
   representation and participation to substantiate compliance
2. Use such data to identify and articulate the benefits of engaging carers
   systematically and reinforce those benefits with the contracted/ funded service
   providers
3. WA Health develop and internally distribute an implementation plan to embed the
   objectives of the CRA and the Carers Charter into practice over the next five years
4. WA Health and public hospitals to show evidence in future reports that they are
   implementing the strategies reported as undertakings in the first and second
   reports
5. Commence/ continue work to gauge the impact of their strategies for ensuring
   practical outcomes for carers.

9. FUTURE WORK
The Council is committed to two major streams of activity for the coming years.

Firstly, Council’s ongoing promotional and educational tasks across the two sectors to
ensure understanding of the intent, the benefits and purpose of the compliance
requirements.

Secondly, Council is committed to working with all relevant parties on the issues
raised in the report on the Review of the CRA. In particular, the reporting
organisations and the department with responsibility to assist the Minister with the
administration of the CRA, that is the Department for Communities.




8
  Australian Institute of Family Studies. Family Matters 2008 No.80
Stollznow. Research & Insights Advisory (2006). Market research report: A crisis in caring or a system that Works? Sydney
R.Cummins, J Hughes, A Tomyn, A Gibson, J Woerner,L Lai. “The Wellbeing of Australians- Carer Health and Wellbeing” Oct 2007



Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008                                           27
Carers Advisory Council of Western Australia                                           March 2009


Council notes the commentary in the review document and is willing to negotiate the
terms under which compliance is defined and is keen to explore additional means of
improving the reporting procedure.

The review also made a recommendation that a policy framework be developed to
assist in identification and training of carers for involvement in policy and program
development or planning activities as required under section 6(2) of the CRA. Council
sees this matter as imperative to sustain the current initiatives of both reporting
organisations and enable that work to permeate through all levels of decision making.




Lois Gatley
Chairperson
Carers Advisory Council
March 2009




Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008          28
Carers Advisory Council of Western Australia                                           March 2009



Appendix 1

Definition of “carer”, Part 1 section 5 Carers Recognition Act 2004
5.         Meaning of “carer”
     (1)    Except as provided in subsection (2), a person is a carer for the purposes of
            this Act if he or she is an individual who provides ongoing care or assistance
            to —
              (a) a person with a disability as defined in the Disability Services Act 1993
                   section 3;
              (b) a person who has a chronic illness, including a mental illness as
                   defined in the Mental Health Act 1996 section 3;
              (c) a person who, because of frailty, requires assistance with carrying out
                   everyday tasks; or
              (d) a person of a prescribed class.
     (2)    However a person is not a carer if he or she —
             (a) provides the care or assistance under a contract for services (other
                 than an agreement entered into under the Disability Services Act 1993
                 section 25) or a contract of service; or
             (b) provides the care or assistance while doing community work as defined
                 in the Volunteers (Protection from Liability) Act 2002 section 3(1).
     (3)    A person is not a carer for the purposes of this Act only because —
             (a) the person is a spouse, de facto partner, parent or guardian of the
                  person to whom the care or assistance is being provided; or
             (b) the person provides care to a child under an arrangement with the
                  chief executive officer of the department principally assisting the
                  Minister administering the Child Welfare Act 1947 in the administration
                  of that Act.




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Carers Advisory Council of Western Australia                                           March 2009




Appendix 2

Carers Charter – Schedule 1 the Western Australian Carers Charter

1. Carers must be treated with respect and dignity.

2. The role of carers must be recognised by including carers in the assessment,
   planning, delivery and review of services that impact on them and the role of
   carers.

3. The views and needs of carers must be taken into account along with the views,
   needs and best interests of people receiving care when decisions are made that
   impact on carers and the role of carers.

4. Complaints made by carers in relation to services that impact on them and the role
   of carers must be given due attention and consideration.




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   Carers Advisory Council of Western Australia                                           March 2009




   Appendix 3

   Outline of Health Services Reporting Unit
   (Information from WA Health Website: http://www.health.wa.gov.au)


  NORTH METROPOLITAN AREA                                   UNITS / PROGRAMS REPORTING
      HEALTH SERVICE
                                                   •   Centre for Clinical Interventions (CCI)
                                                   •   Centre      for     Clinical    Research     in
                                                       Neuropsychiatry
                                                   •   Graylands       Selby-Lemnos       Postgraduate
Graylands     Selby-Lemnos                 and         Training in Psychiatry
Special Care Health Service                        •   Mental Health Emergency Response Line
                                                   •   Neurosciences Unit
                                                   •   Selby Older Adult Psychiatric Service
                                                   •   State Forensic Mental Health Service
                                                   •   State wide Indigenous Mental Health Service

                                  •                    King Edward Memorial Hospital (KEMH)
                                  •                    BreastScreen WA
                                  •                    Community Midwifery
King Edward Memorial Hospital for
                                  •                    Sexual Assault Resource Centre
Women
                                  •                    WA Cervical Cancer Prevention Program
                                  •                    Women’s Health Policy and Projects
                                  •                    Statewide Obstetric Support Unit

                                                   •    Osborne Park Hospital and Aged Care
Osborne Park Hospital
                                                        Assessment Team

Sir Charles Gairdner Hospital

                                                   •    Swan Valley Child & Adolescent Mental
                                                        Health Service
                                                   •    Swan Valley Centre
                                                   •    Swan Elderly Mental Health Service
                                                   •    Swan Adult Mental Health Centre
Swan Kalamunda Health Service
                                                   •    South Guildford Centre
                                                   •    Morley Adult Mental Health Centre
                                                   •    Kalamunda Child and Adolescence Mental
                                                        Health Service
                                                   •    Viveash Rehabilitation Centre

                                                   •   Migrant Health Unit
Community & Public Health Service                  •   Joondalup After Hours GP Clinic

                                                   • Joondalup After Hours GP Clinic
Health Clinics



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   Carers Advisory Council of Western Australia                                           March 2009


                                            •           Clarkson Child Development Centre
                                            •           Joondalup Child Development Centre
                                            •           Joondalup Community Health Centre
                                            •           Kalamunda Community Health Office
                                            •           Koondoola Child Development Centre
North    Metropolitan            Population
                                            •           Lockridge Community Health Centre
Health Program
                                            •           Midland Child Development Centre
                                            •           Midvale Community Health Centre
                                            •           Mirrabooka Community Health Centre
                                            •           North Metropolitan Aboriginal Hospital Liaison
                                                        Unit

                                              •        North Metropolitan Adult Mental Health
North Metropolitan Area                Health •        North Metropolitan Child and Adolescent
Service - Mental Health                                Mental Health Service
                                                   •   North Metropolitan Elderly Mental Health

  SOUTH METROPOLITAN AREA
      HEALTH SERVICE                                        UNITS / PROGRAMS REPORTING

                                                   Aged Care Services
Armadale-Kelmscott                 Memorial
                                                   • Armadale Aged Care & Rehabilitation Services
Hospital
                                                   • Armadale Aged Care Assessment Team
                                                   • 'Galliers' Wing and Specialist Centre

                                                   Aged Care Services
                                                   • Bentley Aged Care Assessment Team

                                                   Community & Public Health Services
                                                   • Andrea Way Child Development Centre
                                                   • Manning Community Health Centre
                                                   • Belmont Community Health Centre

                                                   Health Clinics
                                                   • Bentley Community Health Centre
                                                   • Bentley After Hours GP Clinic
Bentley Hospital
                                                   Mental Health Services
                                                   • Bentley Child & Adolescent Mental Health
                                                      Service (The WAY Centre)
                                                   • Bentley Elderly Mental Health Service
                                                   • Jarrah Road Centre
                                                   • Mills Street Centre
                                                   • Mills Street Centre Inpatients
                                                   • Mills Street Centre Outpatients
                                                   • Patricia Street Centre




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   Carers Advisory Council of Western Australia                                            March 2009


                                                   Hospital Services
                                                   • Kaleeya Hospital
                                                   • Rottnest Island Nursing Post

                                              Community & Public Health Services
Fremantle      Hospital       and      Health • Department of Community and Geriatric
Service                                          Medicine
                                              • Department of Infectious Diseases

                                                   Health Clinics
                                                   • Fremantle After Hours GP Clinic

                                                   Hospital Services
                                                   • Murray Hospital

                                                   Community & Public Health Services
Rockingham General Hospital
                                                   • Mandurah Aged Care Assessment Team


                                                   Health Clinics
                                                   • Rockingham After Hours GP Clinic

                                                   Hospital Services
                                                   • Royal Perth Rehabilitation Hospital

                                                   Aged Care Services
                                                   • Royal Perth Hospital Aged Care Assessment
                                                   Team
Royal Perth Hospital
                                                   Community & Public Health Services
                                                   • Royal Perth Hospital Public and Community
                                                      Health Unit
                                                   • Royal Perth Hospital Sexual Health Clinic

                                                   Health Clinics
                                                   • Royal Perth After Hours GP Clinic

                                                   Mental Health Services
                                                   • Department of Psychiatry

                                 Armadale Mental Health Services
                                 • Armadale Adult Mental Health Service
                                 • Armadale Child and Adolescent Mental Health
South Metropolitan Mental Health
                                    Service
Service
                                 • Armadale Mental Health Services for Older
                                    People
                                 • Horizons - Community Mental Health
                                    Rehabilitation Service
                                 • Whitby Falls Mental Health Rehabilitation


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   Carers Advisory Council of Western Australia                                           March 2009


                                                        Hostel

                                                   Fremantle Mental Health Services
                                                   • Fremantle Adult Mental Health Services
                                                   • Fremantle Child & Adolescent Mental Health
                                                      Service
                                                   • Fremantle Seniors Mental Health Services
                                                   • Hampton Road Step Down Unit
                                                   • Melville Seniors Day Therapy Centre

                                                   Peel and Rockingham/Kwinana Mental Health
                                                   Services
                                                   • Kwinana Living Skills Centre
                                                   • Mandurah Living Skills Centre
                                                   • Peel and Rockingham/Kwinana Adult Mental
                                                      Health Services
                                                   • Peel and Rockingham/Kwinana Child and
                                                      Adolescent Mental Health Services
                                                   • Peel and Rockingham/Kwinana Mental Health
                                                      Services for Older People
                                                   • Peel Mental Health Services

CHILD AND ADOLESCENT HEALTH
                               UNITS / PROGRAMS REPORTING
          SERVICES
                               Community & Public Health Services
                               • Child Protection Unit
                               • Rural Paediatric Services
Princess Margaret Hospital for
                               • State Child Development Centre
Children
                               Mental Health Services
                               • Child and Adolescent Mental Health Services

WA COUNTRY HEALTH
                                                   UNITS / PROGRAMS REPORTING
SERVICES
                                                   •   Goldfields
The 7 regions include 91 Hospitals                 •   Great Southern
and Nursing posts plus 14 Aged Care                •   Kimberley
services; 69 Community and Public                  •   Midwest
Health services; 17 Mental Health                  •   Pilbara
services.                                          •   South West
                                                   •   Wheatbelt

DENTAL HEALTH SERVICES                             •   UNITS / PROGRAMS REPORTING
                                                   •   Armadale Dental Clinic
                                                   •   Cockburn Dental Clinic
                                                   •   Hall Creek Dental Clinic
                                                   •   Joondalup Govt Dental Clinic
                                                   •   Kununurra Govt Dental Clinic
                                                   •   Ravensthorpe Govt Dental Clinic


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  Carers Advisory Council of Western Australia                                           March 2009




DRUG AND ALCOHOL OFFICE                           UNITS / PROGRAMS REPORTING
                                                  Clinical Education and Research
                                                  • Next Step Alcohol and Drug Information
                                                      Services
                                                  • Next Step Library Services
                                                  • Next Step Parent Drug Information Service
                                                  • Next Step Professional and Organisational
                                                      Development
                                                  • Next Step Research

                                                  Next Step Clinical Treatment Services
                                                  • Next Step Assessment Line
                                                  • Next Step Community Based Treatment
                                                     Program
                                                  • Next Step Fremantle Clinic

OFFICE OF ABORIGINAL HEALTH                       UNITS / PROGRAMS REPORTING
                                                  • Building Solid Families
                                                  • Healthy Tucker
                                                  • Men's Health and Wellbeing
                                                  • Primary Care
                                                  • Youth Suicide

OTHER SERVICES              WITHIN        WA
                                                  UNITS / PROGRAMS REPORTING
HEALTH
                                                  •   GetHealth
                                                  •   PathWest Laboratory Medicine WA
                                                  •   Seniors Telephone Information Service
                                                  •   WA Seniors Card Centre




  Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008          35
    Carers Advisory Council of Western Australia                                            March 2009



    Appendix 4

    CARERS ADVISORY COUNCIL’S ACTIVITIES 2007/2008

    The Council’s Strategic Plan 2006-2009 describes objectives that are in line with the Council’s
    legislative functions as set out in the Carers Recognition Act 2004. The information below
    relates to the actions and tasks taken by Council from July 2007 to June 2008 in accordance
    with its objectives.

CRA Part 3 s9
(a) to work to advance the interests of carers and promote compliance by applicable
organisations with the Carers Charter

OBJECTIVE 1: PROMOTE AWARENESS AND KNOWLEDGE
      Strategy                                                                                     Outcomes
      1.1 Provide Applicable organisations (Division 1 reporting organisations and         Brochures,
                Division 2 other organisations) with information about the Act and their   bookmarks and
                obligations under the Act.                                                 Carers Charter
                • Council has overseen the development of publications and                 posters have
                  materials on the CRA and Carers Charter and in this reporting            been and
                  period a bookmark and brochures have been republished and                continue to be
                                                                                           distributed to
                  distributed
                                                                                           government and
                • Conducted a Forum for staff of 16 NGOs to provide awareness of           non government
                  and training in implementation of and compliance with the CRA            agencies since
                  and Carers Charter                                                       early 2006
                • The Council’s second compliance report distributed to 1100
                  service providers in the health and disability sectors and to                                .
                  relevant stakeholders
        1.2     Target forums for service providers and carers                                 Outcomes
                Council made presentations on the CRA to:                                  Increased levels
                • CaLD carers group at Ethnic Disability Advocacy Centre                   of awareness of
                • Alzheimers Conference                                                    the intent and
                                                                                           compliance
                • Developing Connections- Rural and Remote Mental Health                   requirements of
                  conference                                                               the CRA by staff
                • PWD Inc seminars (4) “More than the Power of One”                        and executives in
                • Young Carers Discussion Forum                                            the health and
                • Mental Health Standards workshop with community sector service           disability sectors.
                  providers
                                                                                           Increased levels
                • SCGH Carers Forum
                                                                                           of awareness of
                • WACHS videoconference to regional service providers                      the legislation
                • ACAT conference                                                          and its intent by
                • Mental Health Carers Rights Forum                                        carers and their
                • Mental Health Social Workers Symposium                                   representative
                • Mental Health Network Co-ordinating Group                                organisations.
                • Think Respite workshop (Geraldton)
                • Discover Recovery – Mental Health Rehabilitation Symposium
                • Balga Carers Group
                • MS Society allied health workers
                • Rockingham/Kwinana Hospital
                • Murray District Hospital – Pinjarra
                • Children and Young People’s conference



    Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008               36
    Carers Advisory Council of Western Australia                                            March 2009


                • Silver Chain Forum – the Changing Role of Care
                • Finance Division of WA Health – State wide Contracting Unit
                • Australian Accreditation Quality in Healthcare Association
                  Health workers seminar
        1.3     Identify and publicise best practice examples of compliance with the Act   Applicable
                • Council’s first and second compliance reports incorporate models         organisations are
                  of actions that comply with the CRA and that could be adapted by         provided with
                  other organisations required to comply                                   models of best
                                                                                           practice
                • Council promotes the Carers Involvement Framework.

        1.4     Promote inclusion of compliance requirements in all contracts between      Reporting
                Division 1 reporting organisations and Division 2 other organisations      organisations are
                • Council continues to raise this issue in discussions with                prompted to
                  executives from the reporting organisations to ensure over time          develop systems
                  that as contracts are renewed compliance with the CRA and the            to monitor the
                                                                                           compliance by
                  Carers Charter are included in the relevant contract clauses.
                                                                                           their contracted
                                                                                           service providers
        1.5     Implement Communications Plan
                Council continues to utilise its Awareness Raising Strategy according      Website was
                to available resources:                                                    developed in
                • identify key targets for Council actions for that timeframe;             house via
                • focus the Council’s energies to contribute to events, forums,            Department for
                                                                                           Communities
                   publications etc organised by other agencies.
                                                                                           staff working with
                Present information and an outline of the CRA at the forums                external
                continue the website as a means of providing information about the         contractors
                legislation and the Council
                • Commenced negotiations to have website translated to make
                   information available to CaLD communities


CRA Part 3 s9
b) make recommendations to the Minister on fostering compliance by applicable organisations
with the Carers Charter

OBJECTIVE 2: REPORT ON COMPLIANCE AND PERFORMANCE
      Strategy                                                                                Outcomes
      2.1 Assess reports received from reporting organisations                             Reporting
            • In the second reporting year seven reports were received of                  organisations are
               varying lengths and complexities.                                           assisted in
            • Discussions were held with senior executives from WA Health and              developing
                                                                                           compliance
               DSC regarding evidence-based reports from the reporting
                                                                                           reports
               organisations.
      2.2 Identify and analyse barriers to compliance with the Act and Carers Charter
            • None of the reporting organisations commented in their reports
               on barriers to compliance.                                                  Council
            • Council has noted verbal reports on the reporting process and will           continues to raise
                                                                                           awareness of the
               seek resolution in the coming reporting period
                                                                                           benefits to
            • Council has aligned its work and approach in its second reporting            organisations in
               period to the theoretical framework based on the Regulatory                 implementing
               Enforcement Pyramid.                                                        strategies to
            • The second Compliance report included a further five                         engage with
               recommendations to guide the reporting organisations in                     carers
               compliance.
            • Council met with the Office of Health Review (OHR) and provided


    Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008              37
    Carers Advisory Council of Western Australia                                            March 2009


                  training to staff on the means of identifying carers to aid the OHR
                  in assessment of complaints by carers
                • In the reporting period 2007/2008 the Toolkit was reviewed by
                  Council. Some minor alterations were made as a result of input
                  from DSC. The Toolkit was distributed to Reporting Organisations
                  in July 2007

        2.3     Analyse identified performance issues                                      Performance
                • Council audited the performance strategies and initiatives of            issues used to
                  reporting organisations, identified instances of good practice           illustrate good
                  which were highlighted in the Compliance report in order to further      practice
                  educate service providers in the field.
        2.4     Prepare a report to the Minister                                           Report finalised
                •   Council prepared a report and presented it to the Minister on 16       March 2008 and
                   March 2008. The report was tabled in the two houses of                  presented to the
                   Parliament on 14 May 2008.                                              Minister



CRA Part 3 s9
(c) to provide general advice to the Minister on matters relating to carers

OBJECTIVE 3: PROVIDE ADVICE ON ISSUES RELATED TO CARERS
      Strategy                                                                                    Outcomes
      3.1 Record and analyse issues for Carers related to obligations under the Act of      Issues are
            reporting organisations.                                                        recorded in the
            • Council kept the Minister alerted to ongoing issues relating the              Discussion
               obligations of reporting organisations under the Act via meetings            Paper
                                                                                            September
               throughout the reporting year
                                                                                            2007
        3.2     Identify other issues relevant to Carers.                                   Issues are
                • Council has brought to the attention of the Minister matters              recorded in the
                  relevant to young carers and parents of school aged children with a       Discussion
                                                                                            Paper
                  disability in relation to the education system. Those matters have
                  been gained via Council’s participation in forums and events in the
                  sector.


OBJECTIVE 4: OPERATE AS AN EFFECTIVE AND EFFICIENT COUNCIL
     Strategy                                                                                     Outcomes
     4.1 Develop and refine resources for Council members.
           • Council met monthly over the period July 2007 to June 2008                     Presentations
           • The Strategic Plan for 2006 -2009 and Operational Plan provide                 made to Council
              direction for the Council activities                                          by
                                                                                            representatives
           • PowerPoint presentation materials continue to be developed for                 from a range of
              use by members presenting at forums, expos and conferences                    government and
           • Members have participated in 11 internal working groups to                     non government
              complete specific tasks.                                                      agencies

                                                                                            Total of 11
                                                                                            Council Working
                                                                                            Groups have
                                                                                            completed a
                                                                                            range of
                                                                                            specified tasks
                                                                                            and achieved



    Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008              38
Carers Advisory Council of Western Australia                                           March 2009


                                                                                       desired
                                                                                       outcomes
   4.2    Develop and maintain productive working relationships with relevant          Total of 6
          organisations.                                                               Meetings held to
          •    Minister for Seniors attended 2 Council meetings and two meetings       brief Members
               with the Chairperson                                                    of Parliament
          •    Parliamentary Secretary to Minister of Health met Council on 2
               occasions
                                                                                       Strategies to
          •    A series of meetings with senior executives and management of
                                                                                       implement
               WA Health and DSC                                                       compliance
          •    Director General Dr Peter Flett.                                        discussed with
          •    A/CEO Child and Adolescent Health Services, WA health (3                senior officers at
               meetings) to develop an Implementation Plan for the WA Health           executive level
               system;                                                                 and
          •    Office for Safety and Quality in Health Care, WA Health Dr Dorothy      management
               Jones, Executive Director. Council contributed to the Strategic Plan    level
               of the Office of Safety and Quality in Healthcare
          •    Office of Chief Psychiatrist, Tim Rolfe, Jennifer Wall
          •    DSC – 4 meetings were held with the Director General Dr Ron
               Chalmers and Executives
          •    Met with Senior Policy Officer for Aboriginal Affairs DSC
          •    Council has attended forums and workshops on the Strategic
               Directions for the Department for Communities
          •    Council continues to maintain a working relationship with Carers
                                                                                       Initiatives
               WA senior staff and Board members. Council attended Carers WA
                                                                                       promoted for
               AGM and contributed to Carers WA Strategic Planning Workshop            compliance with
               and participated in the organisation of the 2008 Carers Symposium       the Carers
                                                                                       Charter with non
          •    Council holds bi annual meetings with Ministerial Advisory Council      government
               on Disability (MACD) regarding CRA and with MACD Chairperson            organisations
               and Executive Officers                                                  service
                                                                                       providers
          •    To enhance Council’s visibility and influence recognition of the CRA
               Council members have attended launches, events and meetings
               including:
               o Developing Connections – Rural and Remote Mental Health
                   Conference.
               o Mental Health Community Network Forum
               o Discover Recovery – Mental Health Rehabilitation Symposium
               o Driving Change in the Disability Sector seminar
               o World Elder Abuse Day
               o NAIDOC expo
               o Launch of the Young Carers Manual, a publication funded by
                   DSC
               o Disability and Justice Conference
               o Post School Options forum by Delayed Developmental Council
                   and CASA Inc.
               o ABC Radio interview – Albany
                                                                                                        .
               o Seniors and Carers Expo Carerlink. Centrelink office
               o Ethnic Communities Council and the Multicultural Service
                   Centre
               o Advocare
          Continuously improve administration and operating procedures.
   4.3    •    Council has developed systems for recording business. All



Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008             39
Carers Advisory Council of Western Australia                                                   March 2009


               meetings both internal and external are documented.                             Council
          •    Documents and records are retained, archived and disposed of as                 maintains a full
               scheduled in the Department for Community Development’s                         and
                                                                                               comprehensive
               Record Keeping Plan 2003 (now the Department for Communities)
                                                                                               record of its
               and in accordance with the requirements of the State Records Act
                                                                                               activities.
               2000.                                                                           Council
          •    The Policy and Procedure Manual guides Council practice.                        continues it’s
          •    New members are provided induction training                                     commitment to
          •    Developed a protocol for filing relevant emails as part of sound                continuous
               record keeping management                                                       improvement
          •    Developed a complaints protocol in order to have a systematic                   and good
               approach to dealing with complaints received by Council                         governance
   4.4    Refine reporting process following the first reporting period.                       Council
          Council has:                                                                         continues to
          • Developed for the reporting organisations the Self Assessment                      gain
             Toolkit and                                                                       improvement in
                                                                                               the efficiency
          • Compliance Guidelines for the reporting organisations.
                                                                                               and
                                                                                               effectiveness of
                                                                                               the reporting
                                                                                               process.
   4.5    Identify training needs of the Council in areas directly relevant to the functions   Council
          of the Council.                                                                      members are
          •    Training has continued in compliance assessment and                             gaining skills
               development of the Toolkit and Guidelines for reporting                         relevant to the
               organisations.                                                                  Council’s
                                                                                               functions
          •    An Induction Package and process has been developed and
               conducted for new members of Council
   4.6    Develop and recommend a succession plan to ensure effective ongoing                  Information on
          operation of the Council.                                                            Council vacancies
                                                                                               is provided to the
          •    Terms of office for each position on the Council are monitored so               Minister
               the replacement of members can take place in a timely manner

   4.7    Monitor and record issues relevant to the administration of the Act for              Council is
          consideration in the review of the Act.                                              collecting
          •    The Council has identified that the needs of young carers should                information on
               be considered in relation to the education system as well as                    issues to be
               parents of children with a disability                                           considered in the
                                                                                               review of the
          •    There is a need to explore the relativity of public health legislation
                                                                                               CRA
               with the CRA and ensure all service providers are incorporated in
               the compliance requirements of the CRA
   4.8    Negotiate and secure an appropriate level of resourcing.                             Unsuccessful to
          •    Regular meetings have been held with executives of OSIC, the DG                 date
               of Dept for Communities and respective Ministers regarding an
               appropriate level of resourcing for the Carers Secretariat.




Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008                     40
Carers Advisory Council of Western Australia                                           March 2009



Appendix 5

OFFICE OF HEALTH REVIEW REPORT TO COUNCIL 2007/2008
“There are often complaints brought to this office by a person other than the
consumer. The complainant may act in a caring role yet may not identify themselves
as a carer. They are usually more concerned about the level of health care their family
members have received and therefore make a complaint relating to Health or
Disability services, not perhaps recognising it as a carer complaint. Therefore we
usually accept the complaint formally under the Health Services (Conciliation and
Review) Act 1995, or Part 6 of the Disability Services Act 1993.

As a result, there is only a small number of complaints made under the Carers
Recognition Act 2004 each year, but many more complaints give insight into the
difficulties faced by carers.

Our aim over the next year is to have a greater understanding of complaints made by
carers, as they are an opportunity to understand how services can more aptly cater for
their needs. In time we hope to provide a more complete account of the information
that you have requested in your letter, but for now I trust the following information will
assist with your report.

In the 2007-08 financial year 406 complaints made to us were from a person other
than the consumer of the service being complained about. This represents 24% of the
total complaints made to the office last year. Most often it was a relative of the
consumer, followed by a parent or guardian of a child.



                     Breakdown of Complainant other than Number              of
                     Consumer                                     complaints
                     Relative of the consumer                     283
                     Parent or guardian of a child.               71
                     Person appointed by the user.                45
                     Donee of a Power of Attorney                 4
                     A Health Service Provider                    2
                     Another person permitted by the Commissioner 1
                     Total                                        406



The Case Study below aims to put these complaints into perspective. It demonstrates
the relevance of a complaint to carer issues that was made under the Health Service
(Conciliation and Review) Act 1995.




Report to the Minister for Seniors and Volunteering for the year ending 30 June 2008
Carers Advisory Council of Western Australia                                         March 2009



Case Study: Complainant is the parent of an adult child concerned about the care
received in a mental health setting

A woman contacted this office reporting that her son had been taken by his father to a

Hospital’s emergency department after slashing his wrists. Emergency Department staff

discharged him after stitching the wounds, with information about possible accommodation.

The complainant was concerned that she was not called when her son was discharged.

Although she had been told her son was in no danger and was not suicidal she felt unsure as

to how this diagnosis or clinical opinion was arrived at. As he was not even cleaned up before

discharge she felt the standard of care had not been appropriate. When she visited the

hospital separately to discuss her concerns there was a security presence that she felt was

unnecessary.




The conciliation meeting held meant that the complainant was able to explain the situation

from her perspective and express her concerns. The hospital apologised that she had not

been called before her son was discharged. In addition, they were able to provide a detailed

explanation of the psychiatric assessment undertaken. The issues raised in the complaint

were discussed with staff at the Hospital, as a learning and service improvement initiative.



From this case study, it is clear that Hospitals can benefit from complaints made by
carers. As a result of the mother complaining about not being kept informed of her
son’s discharge, and the psychiatric assessment subsequently undertaken, the
Hospital was able to look at how they could improve their service for others in the
same position.

Likewise, the Case Study below has contributed to educating a different hospital of the
importance of carers.

Case Study: Carer not kept informed of patient’s condition

A patient with a complex health history was admitted to a hospital for a routine dental

procedure. English was not his first language and his wife was not only his physical carer but

also translated for him.    His wife had particularly requested of nursing staff that she be




                                                                                               42
Carers Advisory Council of Western Australia                                           March 2009

contacted if her husband appeared to need her. His condition deteriorated overnight and his

wife was not called. When she visited him the next morning he was clearly unwell, and had to

be transferred to a tertiary hospital. He died two days later.




His wife lodged a complaint with our office, one of her concerns being that as her husband’s

carer she was not kept informed of his condition.




Following conciliation, the Hospital agreed to put in place a process to ensure that when a

patient who has a carer is admitted, the Hospital will ensure that if there are any concerns

about the patient’s condition, the carer will be called back in as soon as possible.




In respect to the Carers Charter, this reinforces that the role of carers must be given due

attention and consideration.




                                                                                              43
Membership of the Carers Advisory Council in 2007/2008

            Lois Gatley (Chairperson)
            Carer for the past 29 years for her husband who has three chronic
            illnesses.
            Re-appointed September 2007

            Ellen Walker (Deputy Chairperson)
            Carer for parents who have disabilities as a result of acquired brain
            injury.
            Re-appointed November 2007

            Allan Golledge
            With his wife, carer of a child with a disability; also a service provider.
            Re-appointed November 2007


            Viv Hansen
            Carer for her mother-in-law who is frail aged.
            Appointed to Council February 2007


            Clare Masolin
            With her husband, cares for her teenage son who has Cerebral Palsy.
            Re-appointed November 2007


            Charlie Rook
            Carer for his adult son with a disability.
            Appointed to Council January 2008


            Khim Chooi Teo
            Carer for her adult son with a disability.
            Appointed to Council January 2008


            Judy Waymouth
            Service Provider
            Appointed to Council January 2008


            Jim McKiernan
            Past carer for a relative with a mental illness.
            Retired from the Council February 2009
        CARERS ADVISORY COUNCIL
Established by the Carers Recognition Act 2004 to work to advance the
 interests of carers and promote compliance with the Carers Charter.




       Carers Secretariat
       Dumas House
       Level 7
       2 Havelock Street
       WEST PERTH WA 6005
       t +61 8 6217 8500 f +61 8 9481 0441
       e carersac@communities.wa.gov.au w www.communities.wa.gov.au/carers

				
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Description: Carer Recognition - Progressing Compliance