Old Fashioned Home Style Cooking and Visible Care Boosts Resident and Relative Satisfaction

Murray Vale Shalem Hostel is a 59 bed (with a 20 bed specific dementia unit) mid level care facility. It is operated by the United Protestant Association of NSW. The facility is located in the NSW-Victoria border town of Albury Wodonga.

"When as Care Manager for Murray Vale Shalem I first viewed the satisfaction results I wondered how such improvement over the years had been achieved. Was it: the fantastic team of staff who provide great care; the excellent activities program; the fact that our meals cannot be beaten; or our efforts to constantly communicate with our residents and relatives? The truth is that each and every one of these factors contributes to the excellent results of a 94% satisfaction rate for residents and 95% for relatives." Jaqui Hastings, Care Manager.

In consideration of these results, the team at UPA Murray Vale Shalem reflected on the fact that all the survey data was either completed by the residents and relatives, or collected by independent third party interviewers (Volunteers and TAFE Students). This helped to achieve a good participation rate. The survey data was then forwarded onto the QPS office to be independently processed. Having the data collected and processed at `arms length' gives both management and staff more confidence in the results.

Given time to reflect on the comments made by the residents and relatives, and the breakdown results provided by the QPS Benchmarking scorecards and Charting tools, the team at Murray Vale Shalem Hostel identified the critical elements for success. The process of thinking through the reasons for the high score was an important exercise as it has helped to identify what should be considered in the planning and building of new services. The facility is currently reviewing plans for a new facility in Wagga and the satisfaction results have helped to guide decisions such as the location of the kitchen.

In building structure terms, the things that are working well for Murray Vale Shalem include:

Homelike kitchen - a kitchen that is central to resident activity and provides a hub for discussion and interaction with kitchen staff. Jaqui Hasting's explains "when we think about our parent's homes in the country we immediately remember all those snacks and conversations around the kitchen table and the occasional wafts of fresh baking. Kitchens and eating are not peripheral to our care program, they should be a central feature."

Key staff front and centre - the Care Manager's and registered nurse's office are front and centre of the entrance foyer and this presence has been enhanced with a staffed reception office this year. The staff can see everyone that comes in and out and the visitors can see the staff. Whether it is for a casual smile or greeting, or taking a serious complaint, there are no physical barriers. Residents and relatives can always see us. "Having an office with limited access to the residents or the community would not work for us", claims Jaqui.

Homely atmosphere - Murray Vale Shalem is not a new facility and does not have the decor that is normally associated with a new facility. It does however have a homely atmosphere, and staff members consider that the creation of a homely atmosphere is much more important.

Structural elements are important but nothing will work unless there is a good team dedicated to the needs of residents. The vision and concepts put in place over the years include:

A team of leaders - It is interesting to see that some modern football teams have elected to have more than one captain on the field to enhance leadership and foster quick decision making. In our situation, we have five key staff members that are empowered to take decisions "on the spot" and to assist residents or relatives with concerns or issues.

Residents must pursue an active lifestyle - Many residents are mobile and at Murray Vale Shalem we endeavour to keep them active. This helps drive their appetite. There has been a focus on delivering the best possible home style food service and both our cooks have over 20 years experience in the facility's kitchen. One staff member, Kaylene Hunt won the 2009 ACSA Aged Care Employee of the Year Award for her dedication and commitment to maintaining a `personal service' to the residents. A little love goes a long way in aged care, and the staff at Murray Vale Shalem `love' the residents enough to do the special little things like buying the one off avocado at the fruit store on the way to work, just because the resident had a hankering for avocado the day before. If you were at home, fit and well, and you wanted an avocado you would go and buy it - our staff see the importance of helping residents to feel `at home'. Turning up for Christmas Day to do something really special is not necessarily on the job description and at times the staff members are not even rostered on but they still turn up with special ideas every year. It is just like going back in time to grandma's kitchen except the age of the kids is a little different. As the staff say, the "the kitchen is the heart of our home".

Visibility - for Murray Vale Shalem visibility is not just about being seen, it is about been seen being active with the residents. This, of course, is easier said than done. Too often when aged care facilities are criticised it is because the resident is left alone and a staff member cannot be found. Building design, involvement of residents, and active thoughtful staff all play a part in achieving `visibility'. We need nurse's stations for our staff to do certain administrative processes, but if they become the dominant or central location it will pose issues for the maintenance of being visible in an active sense. Our staff members are trained to tune into the reactions not only of the residents, but also their visitors - if we are to focus on the needs of our clients we have to recognise that the clients are not only the residents but also their relatives and even the community at large. We rarely see positive stories about aged care in the popular press but our aim is to ensure that when our community reads the `horror stories' that their immediate reaction is `we are really fortunate to have Murray Vale Shalem Hostel for our mum or dad'.

"It should bring us comfort and joy to inspire community confidence in aged care" claims Jaqui and her staff.

The overall benchmarking results are a wonderful reaffirmation of our improvement strategies but when you read comments such as the ones below about our food service it adds validity to the scored results.

Or the comments on the overall views of the home:

To cap it all off we always have a big waiting list of people wanting to come in. Right at this moment we have over 60 people waiting.

It would be nice to be able to build more beds but that is another story.

Jaqui Hastings - Care Manager, Murray Vale Shalem Hostel, UPA NSW.