Call for urgent changes to aged care by three Wairarapa rest homes

David Famularo, July 2017

Chris Clarke, Manager at Carter Court Rest Home in Carterton, is not a man given to over-exaggeration.

Never-the-less, the picture he paints of the financial challenges facing Carter Court and other not-for-profit rest homes in the Wairarapa is sobering.

Last May,  Carter Society Incorporated (Carter Court Rest Home in Carterton),  Arbor House (Arbor House Rest Home in Greytown)and Wharekaka Trust (Wharekaka Rest Home in Martinborough) sent an open letter to the Wairarapa’s MPs and candidates in this year’s general election.

The catalyst was the pay equity settlement which saw a significant increase in pay for care workers in rest homes.

While the three rest homes see this as a “significant milestone”, it has had the flow-on effect of creating an imbalance in remuneration, with care workers now earning more than other staff with similar levels of skills and responsibilities,  and close to that of staff with significantly higher levels of skills and responsibilities such as nurses.

Carter Court has addressed this by giving all its staff a pay increase, says Chris.

“The carers’  pay increase threatened the team feeling and co-operation that is essential for our services. We didn’t want to undermine staff morale and goodwill by sending the wrong message to all our staff. We want all our staff to know they are genuinely valued.”

The three rest homes are calling for rapid action by the government to achieve gender equity across all sectors – “through much faster means than a series of employment court battles.”

But there are other issue in play as well, says Chris.

One of these is level of funding rest homes receive and how it is calculated.

Rest homes receive a set amount of funding on a per-resident basis. Healthcare in general in New Zealand is underfunded with aged care the Cinderella of health spending with no significant funding increases for years until the pay equity settlement.

“We got a  1.8 percent increase in the subsidy on July 1st but the CPI in the quarter to March was 2.2 percent so effectively our funding is going backwards.”

Meanwhile costs associated with running a rest home continue to rise.

“Compliance has increased tenfold in recent years diverting valuable resources away from the coal face and annual subsidy increases of up to one percent are totally inadequate.”

To balance their budget, the three rest homes need an almost 100 percent occupancy rate. While this is the situation at the moment, there is never any guarantee that that will remain the case.

“The present funding mechanism doesn’t enable rest homes, particularly in smaller towns and rural areas, to remain viable because occupancy numbers can fluctuate.”

Rest homes like Carter Court need to  be still around in a few years because demand for their services will inevitably increase. In the Wairarapa, the number of residents aged 65 and over is predicted to go from 18.3 percent in 2013 to 23 percent by 2043.

The present government policy is to support elderly people in their own homes for as long as possible. While the three rest homes say this is laudable in their open letter, “our experience tells us that there are elderly who are vulnerable, socially isolated and live in unsafe environments.

“Often there is a huge burden on other family members as well, especially as the elderly person becomes increasingly incapacitated.”

Chris says that while it is great that people are independent for as long as possible, some elderly people need to move into a rest home earlier and there needs to be a better transition process.

“The government needs to take a close look at the provision of care in community and how we support our elderly as they encounter the reality of needing more support – and every part of our community needs to be engaged.

“It’s all about how people are supported into full-time care and how communities can help, so when they move into a rest home they can still be connected to their communities – their church, clubs, friends and family.”

This is one of the reason that the survival of small community rest homes is so important, Chris believes.

“With the loss of Ultimate Care Greytown, for example, residents in the South Wairarapa now have severely limited options and have to move to Masterton and elsewhere.”

Another looming issue is the housing crisis. Not every older person owns their own home or has enough equity in it to sell up and move into a retirement village.

The Carter Society’s low cost rental accommodation is in strong demand and there is always full occupancy, Chris notes.

“Although it has only been small numbers to date, the Carter Society has been approached by elderly who are losing their rental accommodation and have few options on where to go.”

The three rest homes believe the government is not providing leadership on aged care.

“We need to have plans at national and local levels to ensure that we have the right mix of services and resources. The challenge of government is to establish and implement policies that show a commitment to addressing what are very important issues for our communities,” they say in the open letter.

They would like to see immediate action on redressing the funding mechanism so that rest homes are properly supported to remain open.

“We don’t want any more to close, says Chris. “I understand there is a funding revision going to happen but we have no idea of terms of reference or the scope of review – this is a quite serious situation with one of most vulnerable sections in community.”

The rest homes want a fair and equitable scale of remuneration for all aged care staff,  along with an increased recognition of what they do.

“We would like funding to reflect both the real costs we encounter  and reflect skills of staff. Caring for the elderly can be hard work and often staff are working with difficult and complicated health needs,” says Chris.

And they want the government to ensure that smaller locally owned services are valued and supported.

“The biggest tragedy is that we have lost some very important beds in the South Wairarapa and how are we going to get them back.”

Chris says there has been various levels of feedback from everyone who received the open letter.

NB Since this interview Chris has resigned as Manager at Carter Court to join the Red Cross Trauma Recovery Service in Wellington as Manager