Annecto Inc, NSW
Improving accessibility through cultural safety
Annecto Inc, NSW
Home Care - Metropolitan, 30 - 79 places
Leadership and culture, Enablement, Communication and engagement
About the program
“Just another process where we spill out our heart and are told that we don’t fit in.”
The Sydney Aged Care Scoping Study, (Burns and Aldis, 2013) describe cultural safety as the position of the Aboriginal person and their identity within social, economic and political systems. Unsafe Cultural practices in any environment, may lead an older Aboriginal person to believe that it is unsafe and not accessible to them, their family and community.
Annecto Inc’s Western Sydney office provides home care packages in western Sydney. Through our engagement with the ageing Aboriginal community, we developed concerns about the accessibility and function of home care support to older Aboriginal people. Together with our Aboriginal identified organisations that we have partnered with, we observed culturally unsafe practices within the delivery of aged care services, including the current consumer directed model of care for home care packages.
Consequently, the main aim of this project was to explore the ramification of cultural safety as the highest barrier for older Aboriginal people accessing aged care in urban regions, and more specifically in western Sydney. Secondly, it identified a series of recommendations that were then implemented to create a safe cultural space for potential Aboriginal identified aged care recipients.
What we did
We started the project, by establishing the following objectives that we wanted to achieve:
- To have more Aboriginal identified referred assessed by the Aged Care Assessment Teams
- To meet priority access special needs groups as outlined by the department in the aged Care allocation for western Sydney; and
- Give a voice to Aboriginal Stolen Generation Elders and other older Aboriginals so that their concerns fears and needs were appreciated and appropriately responded to.
As a service provider, we identified the need to step back into the community to identify the barriers that restricted those who for whatever reason found the aged care system un-accessible. Though we are not funded to undertake this type of community outreach particularly before the person chose to become a consumer, we nevertheless consider this to be an important work and part of the organisation’s purpose and principles.
Recognising the entrenched social disadvantages, we decided to choose a grassroots approach to meet the objectives that we have set. This was through identifying key community leaders who would share the same concern for Aboriginal Elders and would be able to build bridges and conversations into the community beyond the current health care service system.
Through consultations with Aboriginal organisations that we have partnered with, and consultations with Aboriginal Elders and members of the Stolen Generation, we developed a culturally appropriate space in an Aboriginal identified organisation where we could inform Aboriginal Elders and community members about the different aged care programs and the different eligibility criteria.
Planning and implementation methodology
- Undertaking an Aboriginal Reconciliation Plan (funded by the Provider);
- Employment of an Aboriginal Liaison Officer (funded by the Provider);
- Co-design of marketing materials with suitable Aboriginal Elders and artists so that Aboriginal Elders felt comfortable with both the language and the sensitivity in opening a conversation about aged care questions and needs;
- Identification of partnerships that allowed the cultural credibility of the Aboriginal organisations as a basis for having meaningful conversations with Elders in an environment in which they felt safe and comfortable; and
- Collaborated alongside other grass roots organisations in developing a family fun day to receive valued feedback from social entrenched public housing regions an outcomes where we reported back to the community our findings.
Monitoring and evaluation methodology
- As part of ongoing engagement, we host conversations on a regular basis that identify changes in reforms and what they mean at both an individual consumer level and at the community level;
- Hosted forums with other Aboriginal organisations reflective of direct community concerns including suicide prevention days; and
- Regular evaluation forms that are sent to consumers.
Why we did it
There is ‘not a significant body of knowledge among the general population about how to care for older Aboriginal people.’ (Keleher, 2003:372).
Through our work in Blacktown local government area, which has the highest population of Indigenous Australians living in a metropolitan area of a major city, we found that it was almost impossible to meet the priority access requirements set by the Department for the ATSI special needs group as there was almost no Indigenous ACAT assessment carried out. Further to the above, we found that other local government areas had similar if not worse gaps of ATSI assessments.
In order to understand better the situation, we held conversations with Aboriginal elders to find out if they knew about the different kinds of age care supports available to them and why weren’t they going through the assessment process. The response was that most Aboriginal Elders and/or their family did not know about the Home Care Packages; and the people who knew about it found the assessment process to be culturally inappropriate.
In 2012, the government released national ageing strategies for people from a CALD background and for the LGBTI community. Interestingly, no such strategies currently exists for the Indigenous community that we are aware of, in fact there is very little research carried out to form an Indigenous aged care policy.
The ‘Sydney Indigenous Aged Care Scoping study’ reinforced our findings, and unfortunately almost two years after release of the final report (May 2012), the situation had only worsened.
Who worked with us
Wehave established partnerships with Kinchela Boys Home Aboriginal Corporation (KBHAC) and Babana Aboriginal Men’s Group Sydney.
The partnerships demonstrates the strong commitment to improving the lives of Aboriginal and Torres Strait Islander people through the provision of community based, culturally safe, best practice services, specifically in the areas of aged care and disability. The underlying purpose of these partnerships is to work towards the Aboriginal organisation operating independently and sustainably, demonstrating genuine self-determination, while also improving the understanding and capability of the provider to work with Aboriginal and Torres Strait Islander people and communities.
We have been actively collaborating with Aboriginal and Torres Strait Islander community events on a regular basis to help develop working relationships, which will bring about better outcomes in potential and current care recipients. These include the Sydney West Aboriginal Health Service (formerly known as the Western Sydney Aboriginal Medical Service), Wangary Aboriginal Home Care Service, Kuringai Aboriginal Corporation, The Men’s Shed Mt Druitt, Marrin Weejali and the Baabayn Aboriginal Corporation.
The growth of Annecto Inc. has also provided employment and business opportunities for locals including a Recruitment Information Day in an effort to attract Aboriginal and Torres Strait Islander people to apply for support worker positions. Fifty seven percent of attendees were of Aboriginal background, which was a successful outcome.
We have also taken steps to initiate brokerage agreements with Aboriginal businesses such as a Wiradjuri man and Podiatrist, and an Aboriginal owned cleaning business.
What we learned
We identified that to continuously improve our response to Aboriginal Elders in a culturally safe manner, it is important to have an Aboriginal identified person who knew the basics of access eligibility and care planning available for Introduction through to implementation of care planning (preferably known or trusted person who was present during meetings).
The employment of an Aboriginal Identified Liaison officer made a considerable difference to the care planning and goals of Aboriginal consumers.
Aboriginal identified Elders assessments and take up of Consumer Directed Care packages have increased substantially.
Elders within the community have taken up the discussion and promotion of Consumer Directed Packages particularly amongst the Stolen Generation. An example was the invitation of another Stolen Generation Service Cootamundra Girls.
Marketing material changes saw increased referral base by Aboriginal identified Elders.
Several forums were held including a community event held to lobby Government representatives for the creation of an aged care strategy for older Aboriginal and Torres Strait Islander people. The event was hosted by well-respected Aboriginal man and member of partner organisation Babana Aboriginal Men’s Group, Pastor Ray Minniecon, and two Federal Members of Parliament.
We have attended a number of meetings with the Department of Social Services in July 2015 and Prime Minister’s Aboriginal Cabinet in March 2016 to discuss the current legislation restricting Aboriginal aged people including the current guidelines.
- Do not presume that your models are culturally safe for Aboriginal people
- Create an opportunity for Aboriginal community members to have input into your service engagement, design, feedback and understanding of what they anticipate is a priority as an Aboriginal person
- Celebrate and enjoy Aboriginal culture
- Identify cultural safety as a priority for consumers
- We continue to advocate with the Department of Human Services the Aboriginal and Torres Strait Islander Commissioner Mick Gooda for a National Aboriginal and Torres Strait islander Aged Care Strategy similar to the CALD and LGBTI strategy.
- We identified that attending, participating and supporting key Aboriginal cultural events built a trust with potential and current aged consumers
- We have active involvement in a number of Aboriginal events both at a local level, Aboriginal Grand Parents Day in Glebe for example, through to NAIDOC events in which we support, Sorry Day events, and organising one of the only Aboriginal specific NSW Seniors Festival event in 2016.
- Partnerships with Aboriginal Elders identified the value of supporting Aboriginal identified organisations in a concrete and real manner - this included our partnerships with Babana Aboriginal Men’s Group, and participation in their community events which included a Suicide Prevention Day, Colour Digger (Recognition of Aboriginal ex-service man on ANZAC Day)
- When working with an Aboriginal identified person, a whole of family approach is needed.
- The planning process can take longer than for a non-Aboriginal person, as it is essential to build trust to ensure positive outcomes for the Aboriginal consumer.
- Inter-generation historical fear and trauma has created a number of barriers for the Aboriginal older person to overcome to access suitable and needed health services.
In order for other aged care providers to adopt a similar approach, the following are required:
- A national atrategy identifying cultural safety as a key component to accessibility for Aboriginal Elders in urban environments.
- Clearer understandings and training of aged care services from ACAT to providers on the experience of Aboriginal Elders.
- Clear resources into the participation of Aboriginal identified cultural events by non-Aboriginal Service providers.
- Partnership relationship with Aboriginal identified organisations as a priority for non- Aboriginal service providers.
We have undertaken a Reconciliation Action Plan where we receive feedback and evaluation of our Sydney programs and projects which includes representation of the CEO and at least one Board Member.
A working group has been established to oversee the partnership relationship with Kinchela Boys Home Aboriginal Corporation with representation from the CEO and Management of both organisations monitoring and evaluating changes included building the Capability of KBHAC to develop its monitoring and service evaluation for its Aboriginal participants in its own disability service provision.
Management receives regular review and feedback from the Aboriginal Liaison Officer.
More information on this program:
Michael Hercock, firstname.lastname@example.org or phone 02 8047 0909.