DUNMUNKLE HEALTH SERVICES

Annual Report 2011-2012

Compliance Disclosure Index ...... 2

Board of Management Report ...... 4

Responsible Bodies Declaration ...... 4

General Manager’s Report ...... 5

Organisation Structure 2012 ...... 7

Executive Staff ...... 8

Board Attendance and Life Governors ...... 9

Attestation of Compliance ...... 10

Services Provided ...... 11

Occupational Health & Safety (OH&S) ...... 12

Activity Indicators ...... 13

Summary of Significant Changes in Financial Position during year ...... 14

Statutory Reporting Requirements ...... 15

Attestation of Data Integrity ...... 16

Auditor General’s Report ...... Error! Bookmark not defined.

Finance Performance See inserted financial pages

Financial Statements See inserted financial pages

Financial Declaration See inserted financial pages

1

Compliance Disclosure Index

Dunmunkle Health Services is an incorporated body listed under Schedule 1 of the Health Services Act 1988. Dunmunkle Health Services Annual Report is prepared in accordance with all relevant Victorian legislation. The index has been prepared to facilitate identification of the Health Service’s identification of the Health Services compliance with statutory disclosure requirements.

Ministerial Directions

Report of Operations

Charter and Purpose FRD 22C Manner of establishment and the relevant Ministers ...... 5 FRD 22C Objectives, functions, powers and duties ...... 11 FRD 22C Nature and range of services provided ...... 11

Management and structure FRD 22C Organisational structure...... 7

Financial and other information FRD 10 Disclosure Index ...... 2,3 FRD 11 Disclosure of ex-gratia payments ...... FR FRD 15(b Executive Officer’s Disclosure ...... FR FRD 21(b) Responsible person and executive officer disclosures ...... FR FRD 22C Application and operation of Freedom of Information Act 1982 ...... 15 FRD 22C Application and operation of the Whistleblowers Protection Act 2001 ...... 16 FRD 22C Compliance with building and maintenance provisions of Building Act 1993 ...... 15 FRD 22C Details of consultancies over $10,000 ...... 15 FRD 22C Details of consultancies under $10,000 ...... 15 FRD 22C Major changes or factors affecting performance ...... 4,5,6 FRD 22C Occupational Health and Safety ...... 12 & 15 FRD 22C Operational and budgetary objectives and performance against objectives ...... 4,5,6 &14 FRD 22C Significant changes in financial position during the year ...... FR FRD 22C Statement of availability of other information...... 3 FRD 22C Statement on National Competition Policy ...... 15 FRD 22C Subsequent events ...... 4,5,6 FRD 22C Summary of the financial results for the year ...... 14 FRD 22C Workforce Data Disclosures including a statement on the application of employment and conduct principles ...... 10, & 15, 16 FRD 25 Victorian Industry Participation Policy disclosures ...... 16 SD 4.2(j) Sign-off requirements ...... FR SD 3.4.13 Attestation on Data Integrity ...... 16 SD 4.5.5 Attestation on Compliance with Australian/New Zealand Risk Management Standard ...... 10

2 Compliance Disclosure Index cont…

Financial Statements

SD 4.2(a) Statement of Changes in Equity ...... FR SD 4.2(b) Operating Statement ...... FR SD 4.2(b) Balance Sheet ...... FR SD 4.2(b) Cash Flow Statement ...... FR

Other requirements under Standing Directions 4.2 SD 4.2(a) Compliance with Australian accounting standards & other authoritative pronouncements ...... FR SD 4.2(c) Accountable officer’s declaration ...... FR SD 4.2(c) Compliance with Ministerial Directions ...... FR SD 4.2(d) Rounding of amounts ...... FR

Legislation Freedom of Information Act 1982 ...... 15 Whistleblowers Protection Act 2001 ...... 16 Victorian Industry Participation Act 2003 ...... 16 Building Act 1993 ...... 15 Financial Management Act 1994 ...... 16

Additional Information (FRD 22C Appendix) In compliance with the requirements of the Standing Directions of the Minister for Finance, details in respect of the items listed below have been retained by Dunmunkle Health Services and are available to the relevant Ministers, Members of Parliament and the public on request (subject to the freedom of information requirements, if applicable):  A statement that declarations of pecuniary interests have been duly completed by all relevant officers;  Details of shares held by a senior officer as nominee or held beneficially in a statutory authority or subsidiary;  Details of publications produced by the entity about itself, and how these can be obtained;  Details of changes in prices, fees, charges, rates and levies charged by the entity;  Details of any major external reviews carried out on the entity;  Details of major research and development activities undertaken by the entity;  Details of overseas visits undertaken including a summary of the objectives and outcomes of each visit;  Details of major promotional, public relations and marketing activities undertaken by the entity to Develop community awareness of the entity and its services;  Details of assessments and measures undertaken to improve the occupational health and safety of employees;  A general statement on industrial relations within the entity and details of time lost through industrial accidents and disputes;  A list of major committees sponsored by the entity, the purposes of each committee and the extent to which the purposes have been achieved; and  Details of all consultancies and contractors including: o consultants/contractors engaged; o services provided; and o expenditure committed to for each engagement.

3 Board of Management Report Mr Stephen Thomas-Chair In accordance with the Financial Management Act 1994, I present the Report of Operations for Dunmunkle Health Services for the year ending 30 June 2012. Reflecting on this past year as Our Medical Practitioners, Dr the announcement that president, I am very pleased that Lindsay Swalwell, Dr Chris Foord funding has been approved to Dunmunkle Health Services has and Dr Chris Wimbury continue to seal the car park at Rupanyup continued to strive to support the provide a high standard of care and provide additional needs of our community. and the Board extends their storage. appreciation to both Lindsay and I am satisfied that as per our Chris. The level of service I extend my gratitude to our Statement of Intent that compares well and often exceeds dedicated Board Members Dunmunkle Health Services is in a that available to the rest of the who give so freely of their time strong position to continue to lead State. Dunmunkle Health Services and energy, motivated only by in the delivery of high quality continues to seek an additional their commitment to the health health outcomes to our general practitioner for the of our community. We regret community. practice. that Jo Bourke has decided not to continue as a Board The Board of Management The Board of Management’s firm Member due to work recognises the commitment of our focus continues to be on the commitments, we thank her management, staff and volunteers provision, improvement and for the valuable contribution to our common goal. expansion of health services to made. The Board has been the people of Dunmunkle. strengthened recently by the The retention and recruitment of However we recognise the need welcome addition of Ann key personnel is essential to the to house those services in Aston to our numbers. ongoing development of the facilities that provide a safe, Dunmunkle Health Services. I accessible and efficient And in closing, many thanks to congratulate all staff for their environment for all. The Board all of the professionals and contribution and commitment and regrets that proposed community partners who have offer a warm welcome to those redevelopment of the contributed, and continue to new members of the Dunmunkle Hospital/Nursing Home in contribute, to the successful team. I particularly commend our Rupanyup is no closer and due to operation and implementation General Manager, Tracey tightening government finances is of the core values of Chenoweth on the diligent and unlikely to advance in the Dunmunkle Health Services professional manner in which she foreseeable future. The Board is has overseen the management investigating various options that Thank you to all for your and operations of our health will allow us to raise the building support. services. to an acceptable standard through

our maintenance program. However, some good news with

Responsible Bodies Declaration

In accordance with the Financial Management Act 1994, I am pleased to present the Report of Operations for Dunmunkle Health Services for the year ending 30 June 2012.

Stephen Thomas Chair : Dunmunkle Health Services Board of Management 6 August 2012-Murtoa

4 General Manager’s Report

Tracey Chenoweth Dunmunkle Health Services is established under the Health Services Act 1988. The Annual Report is a legal document prepared in accordance with the Financial Management Act 1994 Section 45 and 53A(4) for the Minister for Health and Ageing, the Hon, MP David Davis and through him, the Parliament of Victoria and the community.

Welcome to the 2011-12 annual Wimbury, one session per fortnight. necessary. Replacement of report for Dunmunkle Health The year has seen a number of sick leave will only take place Services. Once again we have staff leaving the organization. In for essential staff. had challenges particularly with particular I wish to acknowledge HACC funding has also seen the occupancy of the nursing the years of service by Mrs Helen 2% reduction for the 2012/13 home. Wallace, who resigned after 33 year, with full affect not We farewelled the residents from years. Helen commenced at the coming into being until Johnson Goodwin home in former Rupanyup Hospital where 2013/14 financial year. There November 2011. The residents she worked initially as a cook is a corresponding reduction had been with us since the followed by 24 years in office in targets. January 2011 floods. During this administration in the medical Dunmunkle undertook the time a number of staff from practice. We wish Helen well in her "Organizational Readiness Johnson Goodwin worked along semi retirement. Tool for Governing for quality side the Dunmunkle staff which This year has seen success with a in public sector residential was a great experience for all. number of funding submissions aged care". Three key Occupied beds numbers have which were announced in the latter improvements are as follows: fluctuated between13 to 21. We half of the financial year. introduce person-centered had, however, a significant . HWA - Australian Catholic care into aged care, number of requests for respite, University & University of Ballarat - implement a staff handbook which resulted in full utilization of infrastructure to increase and continue to seek funding 365 days at Feb 2012. We Dunmunkle's capacity for students to rebuild, renovate or applied for a further 150 days and from these two universities. refurbish the Rupanyup fully utilized these by May 2012. Nursing Home Hospital. Again, we still had further . Dept of Health, Rural Capital Support Fund: This project funding This coming year will be used requests and applied for further as a gap year in relation to our days, which has resulted in is to provide increased storage space and seal the car park at integrated health promotion Dunmunkle having 730 respite plan. We will be working quite bed days available for a financial Rupanyup and line the ceiling in two sheds at Minyip. closely with the other year. Wimmera Primary Care Dr Swalwell continues to provide . Dept of Health through the Clinical Partnership member a well patronized full time service Placement Networks: Funds to agencies, local partners to from Rupanyup. Dr Swalwell upgrade what is fondly known as align our plan with the continues to manage all residents the nurses quarters at Rupanyup to municipal public health for and patients at Rupanyup increase capacity for student Yarriambiack Shire. accommodation. nursing home & hospital as well Dunmunkle will over this year as most of the residents at . HWA - have partnered with Rural undertake planning and in the Dunmunkle Lodge. He continues North West Health to introduce interim continue the work as to provide our after hours service person-centered care into all aged planned in our current plan as well. We thank him for his care areas in Dunmunkle over the around social connection and wonderful service. next 18 months. physical activity. Doctor recruitment is ongoing. Funding remains tight with Wimmera Southern Mallee We have been very fortunate to occupied beds in the nursing home Health Alliance appointed a have Dr Chris Foord consulting below break even, high rate of project worker for 12-months for two sessions per week at sick/family/carer leave. We are to advance a number of Murtoa. As well, Dr Franciose working with staff to bring this recommendations in the Petorious, for a short time, has figure down. Wimmera Southern Mallee provided one session per week Positions as they become vacant Service Plan of which and more recently, Dr Chris will be reviewed and only filled if Dunmunkle is one of the 5 partners. As part of the Alliance chronic disease management This program over the last 6- the Board Chairs & CEO's of committees. months has been funded by each health service are meeting Two other projects of note: We two anonymous donations. bi-monthly. have been and will continue to As you can see we have a We continue our significant work with our partners on a review busy year ahead with many involvement in Primary Care of transport options and Improving ongoing challenges. Partnerships with particular note, Liveability of Older People across To this end I want to commitment on the State Wide the Yarriambiack Shire. congratulate all staff who with Chairs Executive, Wimmera At the time of writing this report we their passion and commitment Executive, health promotion, are waiting to hear if we have been continue to work hard for service co- ordination and successful with our submission to Dunmunkle Health Services. DEEWR for funding for child care.

Tracey Chenoweth

6 Dunmunkle Health Services Organisation Structure 2012

Board of Management President: Steve Thomas Sub-committees: General Manager Chief Executive  Executive Tracey Chenoweth Chris Scott  Finance & Capital Works  Audit  Professional Appointments

 Personal Assistant to GM

Chief Finance Officer

 Maintenance & Garden

 Environmental & Food Services

Nursing Staff -Minyip CHC

-Murtoa CHC

Residential Care Manager  Nursing staff-Rupanyup  Administration Support-Rupanyup

Quality Manager  Activities-Aged Care  Administration staff  Day Activity Programs  Massage Therapist  Social Workers  TAC program

HACC Manager  District Nursing  Post Acute Care

General Practitioners

Contracted:  Allied Health  Aged Care Assessment

7 Executive Staff

Board of Management:

Mrs Joanne Bourke Mr Steve Thomas - President (Vice President) Mrs Delwyn Tyler Mrs Anne Edgerton (Jnr Vice President) Mr Lloyd I Milgate (Treasurer) Mrs Andrea Weidemann

Community Advisory Committee:

Mrs Loris Arnold Mrs Verda Loats Mrs Elinor Caris Ms Janelle Petering Mrs Mavis Crome Mrs Margaret Tepper Mrs Stephanie Funcke Mrs Bernice Edwards Mr Thomas Murphy Mrs Mary Tyler

General Manager: Principal Officer: Mrs Tracey Chenoweth, Chief Financial Officer: Mr Chris Scott Cert.HS Mngmt., MRCNA Mr Kell Duncan, B Bus, CPA

Residential Services Manager HACC Manager: Quality Manager Hospital/Nursing Home: Acting: Mrs Clare Petering Mrs Christine Mc Callum Mrs Joyce Byrne (Maternity Leave 2/2012) Acting: Mrs Janet Hall (2/2012)

Medical Officers: Dr L Swalwell, MB, BS, DG

Bankers: Bendigo Bank Auditors: Auditor General Victoria Solicitors: Power & Bennett

8 Board Attendance and Life Governors

Board of Management Meeting Attendances 2011/2012 Mrs Joanne Bourke 70% Mrs Anne Edgerton 70% Mr Lloyd Milgate 60% Mr Stephen Thomas 90% Mrs Delwyn Tyler 100% Mrs Andrea Weidemann 70%

Life Governors:

Mrs Loris Arnold Mr Gerard W Murphy Mrs Mary Rabl Mrs Olwen Cowan Mr Thomas J Murphy Mrs June Walsh Mrs Mavis Crome Mrs Verda D Loats Mr Ian Westerland Mrs Gordon Gellatly Mr C Stewart Petering Mrs Alison Marie Wood Mrs Alison McKinnon Mr Raymond J Petering

Vale: Mrs Jean Crouch deceased in May 2012 Jean joined the ladies auxiliary in 1962, followed by the Murtoa Hospital Board in 1974. She was awarded a Life Governorship in 1985 and in 1988 Jean joined the Board of Management for 3-years. She also served on the Maintenance & Planning committee for many years. In 2006, having given more than 40 years of service, she was further awarded a Certificate of Appreciation. Not long after this Jean’s health began to fail and she stepped down from her position on the ladies auxiliary and eased back on her voluntary commitments. Jean later became a resident at Stonehaven, Rupanyup taking much interest in events around her, receiving many visits from friends and family until her recent death.

Life Governors-Deceased

Mrs Bernice Arnold Mr HJ Grigg BEM Mrs Joan F Niewand Dr NCT Brito- Babapulle Mr John L Graham Mr HL Niewand Mrs Charlotte Baker Miss B Hateley Mrs Olga Niewand Mrs Verna Baker Mr HL Hateley Mrs Christina V Nunn Mrs R Bignall Mrs Patricia Keel Miss Anna Purwins Mrs Molly Boschen Mrs Daisy Kelly Mrs Margaret Rutherford BEM Mrs Alice Cordes Mrs Marian King Mr William W Schodde MBE Mrs Jean M Crouch Mrs M Liersch Mrs Rosalie Slattery Mr MB Delahunty Mrs Margaret McKenzie Mrs Sylvia Starbuck Mr JJ Drum Mrs Isabel McRae Mr John R Teasdale Mr Murray Dunlop Mr Alec W Milgate Mr Patrick T Tobin Mr Jack D Emmett Mrs Lyla Maddern Mr JH Gawith Mrs F Newall Mrs I Gellatly

9

Attestation of Compliance

I, Stephen Thomas, certify that Dunmunkle Health Services has risk management processes in place consistent with the Australian/New Zealand Risk Management Standard and an internal control system is in place that enables the executive to understand, manage and satisfactorily control risk exposures. The Audit Committee verifies this assurance and that the risk profile of Dunmunkle Health Services has been critically reviewed within the last twelve months.

Stephen Thomas Chair : Dunmunkle Health Services Board of Management 6 August 2012-Murtoa

Labour Category June June Current month FTE * YTD FTE ** 2011 2012 2011 2012 Nursing 311 28.3 313 29.7 Administration & Clerical 6.3 6.6 6.6 6.7 Medical support Services 0.9 0.8 0.9 0.8 Medical Officers 2.3 1.0 2.4 1.0 Hotel Allied 13.7 13.2 13.8 13.7 Ancillary Staff 2.1 2.1 2.1 2.1

Acute and Residential Care 2011 2012 Total Number of beds Acute 2 2 Nursing home 23 23 Number of patients treated Acute 21 5 Number of bed days Acute 335 91 Nursing home 7391 6537 Occupancy rate Acute 46% 12% Nursing Home 88% 78% Average length of stay Acute 16.0 18.2 WEIS 44.83 10.89

10 Services Provided

Objectives, Functions, Powers and Duties of Dunmunkle Health Services Dunmunkle Health Services is a public Agency established under the Health Services Act 1988. It is authorised to provide public health and ancillary services as authorised under the Act, and operate Residential Care Services under the Aged Care Act 1997. The Board of Management consists of persons appointed by the Minister for Health under the Act who is empowered to provide strategic direction for the organisation. Whilst the Board provides direction for the Agency and determine what must be done, the responsibility for determining how services are delivered is invested in the Executive.

Our History On 2/03/1987, by order of the Governor in Council the Minyip & District, Rupanyup & District and Murtoa Annex hospitals were amalgamated to become Dunmunkle Health Services. The new corporate entity comprised an Acute hospital at Murtoa, nursing home at Rupanyup and a community health centre at Minyip. Further changes took place in June 1994 when the Acute services at Murtoa were relocated to Rupanyup which then became known as the hospital/nursing home and resulting in Murtoa converting to a medical centre. In May 2008, 2-flexible beds at the hospital/nursing home were converted to high aged-care beds. In 2007, the Board was advised that the State Government had allocated 2.5 million dollars to rebuild the out of date medical centre at Murtoa. Finally, in March 2009, Minister for Health the Hon Daniel Andrews opened a new community health centre on the corner of Marma & Mc Donald St. This spacious, attractive, functional building now provides more accessible services to the community and the local pharmacy is co- located. Hospital/Nursing Home, Rupanyup Community Health Centre’s Murtoa . 2 Flexible Acute & Minyip . 23 High care bed licenses . Adult Activities . Referral & Advocacy . Out-patient services . Aged Care Assessment services . Carer Support . School Health Programs . Children’s Activities . Social Worker Surgery Rupanyup . Community Health Nursing . Speech Therapy . TAC Personal Care . Medical Practitioner . Community Transport . Dementia specific day activities . Volunteer Transport . Pathology collection . Warm Water Exercises for . Key Safe . Diabetes Education . District Nursing Arthritis . Educational Resource Material . Women’s Health . Exercise Programs . Health Education . Health Promotion . Healthy Lifestyle Programs . Key Safe . Medical Practitioner . Medical Practitioner . Men’s Program . Occupational Therapy . Out-patient services . Pathology collection . Physiotherapy . Podiatry/ Toe-nail Cutting . Post-Acute Care . Primary Care Nurse

11 Occupational Health & Safety (OH&S)

Dunmunkle Health Services runs several risk prevention programs which include No-Lift, Manual Handling, Return to Work, Safety Inspections and Risk Assessments. OHS Committee members attend OHS Refresher Courses and the Quality Manager is a member of Wimmera Safety Committee.

Incident Reporting The OH&S incident reporting is run in conjunction with the clinical reporting system. In November 2010 we introduced an electronic incident reporting system that utilized by all staff across all sites. Reports that are available from this system allows trending on incidents over time and has the functionality to identify where a particular incident/s are occurring. Managers are alerted to incidents as they occur and actioned accordingly. Reports are regularly reviewed by the General Manager and the Quality Manager and consolidated reports provided to the OH&S Committee, Risk Management & Quality Committee and to the Board of Management. Where appropriate, remedial action is implemented or further action is taken to reduce/ eliminate risk where possible.

Meetings The OH&S Committee continues to meet each second month and work group representatives from each area and site attend on behalf of staff where possible. Our appreciation is extended to the staff involved who attend these meetings and provide valuable input.

Staff Training Training in various aspects of safety forms part of the continuous educational activities within Dunmunkle Health Services. Throughout the year training has been made available and include: . Orientation for all new staff-manual handling, fire and evacuation, OH&S and clinical risk respectively. . No-lift training. . Annual mandatory fire and evacuation drills for all staff. . Office ergonomics/Manual handling via E-Learning portal. . Education training for new equipment.

Safety Initiatives . Employee return to work & rehabilitation . Safety inspections & reviews by OH&S Officer . Hazardous Substances . Worksafe Audits

Aged Care Quality Indicators: 2010-2011 2011-2012 1. Pressure Ulcers 25 13 (stages 1-4) 2. Falls & 41 67 Fractures relating to Falls 1-fracture from fall 0-fracture from falls 3. Physical Restraints List A = 40 List A = 0 List B = 0 List B = 0 4. Polypharmacy (residents administered +9 16 22 medications) 5. Unplanned/Significant Weight Loss U/P weight loss-3 U/P weight loss-2 Significant-0 Significant-0

12 Occupational Health & Safety (OH&S) cont…

Incidents 2012-2011 2011-2012 Number of incidents recorded 117 138

Falls 41 67

Outcome resulting in fracture/dislocation 1 0

Skin tears 33 25

Medication errors 9 12

Medication errors-process 3 2

Staff injuries-Lifting machines 0 0

Staff Injuries Minor-6 Minor-8 Serious-0 Serious-0 Needlestick injuries 1 1

Activity Indicators

Community Health 2011 2012 Nursing 4699 4862 Accident & Emergency 153 Physiotherapy 250 175 Speech Therapy 327 227 Toe-nail Cutting 313 381 Occupational Therapy 59 30 Social Work 2748 2286 Aged Care Assessments 85 36 Community Health Programs 8917 5599 Adult Activities 866 976 Marma Lake Activities 437 435 Diabetes 57 57 Gentle/Chair Based Exercises 202 201 Kinderygm 141 167 Men’s Matters 293 351 Take-A-Break Child Care at Minyip & Rupanyup 334 359 Walking & Exercise group 269 157 Warm Water Exercise for Arthritis 517 514 Weight Maintenance 180 208 Screenings for Blood Pressures & Bloods Sugars 3014 3179 Transport 2143 1535 Podiatry-HACC 33 177

13 Activity Indicators cont…

District Nursing 2011 2012 Individuals 36 53 Hours 1919 2015 Contacts 4081 5961 Dunmunkle Health Services, District Nurses visit clients across the townships and outlying areas of Minyip, Murtoa, Rupanyup, Jung, Marnoo, Wallaloo, Lubeck, Boolite, Wal Wal, St Helens Plains and Laen. The Service negotiates with other health providers to pick up clients living on the outlying service-area boundaries to ensure maximum care for all.

Medical Practitioners 2011 2012 Total contacts 8946 5043

Number of WorkCover Injuries Recorded 2011 2012 Nursing (includes TAC program) 4 1 Administrative & Clerical Nil 1 Medical Support Nil Nil Food & Environmental Nil Nil Medical Nil Nil Dunmunkle Health Services Worksafe Premium is below the state average.

Comparative Financial Results for the Past Five Financial Years:

2008 2009 2010 2011 2012 Total revenue 5,284,952 6,883,506 5,247,427 5,372,982 5,404,835 Total expenses 4,865,958 5,051,360 5,555,632 6,033,519 5,764,316 Operating surplus/(deficit) 418,994 1,832,146 (308,205) (660,537) (359,481) Retained surplus/(accumulated (227,921) 1,676,715 1,359,173 698,636 339,155 deficit) Total assets 3,588,252 6,064,068 5,776,326 5,145,357 5,040,475 Total liabilities 1,003,515 1,084,933 1,114,733 1,144,301 1,398,900 Net assets 2,584,737 4,979,135 4,661,593 4,001,056 3,641,575 Total equity 2,584,737 4,979,135 4,661,593 4,001,056 3,641,575 Other (list) - - - - -

Summary of Significant Changes in Financial Position During the Year. "Dunmunkle Health Services reports a Net Operating deficit of $86,426 before capital and specific items. This surplus was largely due to increased operating expenses. The ability to meet a balanced budget is further impacted by under utilisation of our Residential Aged Care facilities. This can largely be contributed to people remaining at home for longer and competition from private providers in the region with more up to date facilities."

14 Statutory Reporting Requirements

Pecuniary Interests Freedom of Information Members of the Board of Management are There was 1-request under the Freedom of required under the Hospital’s By-Laws to declare Information Act 1982 regulations and access to their pecuniary interest in any matter that may be information was granted. discussed by the Board or Board Sub- Committees. Dunmunkle Health Services continues to promote a policy of giving staff, patients and the general public access to information. Minutes Building and Maintenance and agendas of Board of Management and sub- All building works have been designed in committee meetings are circulated throughout accordance with the Department of Human Dunmunkle Health Services to keep all Services Guidelines and comply with the concerned or affected abreast of all matters. Building Act 1993 and the Building Code of Dunmunkle Health Services has a statutory Australia 1996. obligation to report legislative compliance status on a range of matters.

Complaints Merit & Equity/Equal Opportunity (EEO) Policy Dunmunkle Health Services believes the In Victoria the Public Authorities (Equal addressing of complaints is an important process Opportunity) Act was proclaimed in July 1972. in improving the quality and standard of care. Dunmunkle Health Services supports and Feedback forms are readily accessible in all actively endorses the Act by: areas of the Health Service. All formal complaints are directed to the General  Implementing equal employment opportunity Manager and are dealt with according to the programs designed to eliminate guidelines laid down by the Health Services discrimination against and promote equal Commissioner. opportunity for women. In 2011-2012 Dunmunkle Health Services  Observing sound human resource practices. received 2-complaints. The General Manager is the EEO Co-ordinator responsible for the overseeing of the EEO. National Competition Policy Under the Victorian Industry Participation Policy Occupational Health & Safety Act 2003, Dunmunkle Health Services complies The multidisciplinary Occupational Health & with all government policies regarding Safety Committee initiates and co-ordinates competitive neutrality with respect to all tender development of workplace safety policies and applications. procedures, identifies workplace hazards and provides for relevant education and training.

Consultancies No consultancies were undertaken during the Publications year which exceeded $10,000. Dunmunkle Health Services makes available to One consultancy was undertaken during the year all interested persons any of its publications and at a cost of $2,781.63. produces a range of brochures aimed at informing the public of a range of services available. Fees All fees charged by Dunmunkle Health Services are regulated by the Commonwealth Department Adverse/Sentinel Events of Health and Aged Care, the Commonwealth No Adverse/Sentinel events occurred during Department of Family Services and the Hospitals 2011-2012. and Charities (Fees) Regulations 1986, or as otherwise determined by the Victorian Department of Health.

15 Reporting Compliance Whistleblowers Protection Act This Annual Report is prepared in accordance The Whistleblowers Protection Act 2001 came with the Financial Management Act 1994, the into effect 1 January 2002. The Act is designed Directions of the Minister for Finance and the to protect people who disclose information about Australasian Annual Reporting Awards for open serious wrongdoings within the Victorian Public disclosure about this Service to our communities, Health Sector and to provide a framework for the Government and other stakeholders. investigation of these matters. Dunmunkle Health Services has appointed a Protected Disclosures Officer. The following can also be contacted:

The Ombudsman Victoria Level 22, 459 Collins St, Melbourne Staffing Profile 3000 A total of 116 persons were employed by Ph: 9613 6222 or toll free: 1800 806 314 Dunmunkle Health Services, EFT 54.1. No disclosures under the Act relating to Dunmunkle Health Services were received during 2010-2011.

Workcover Victorian Industries Participation Policy The premium cost for the 2011-2012 year was Dunmunkle Health Services abides by the $105,020. principles of the Victorian Industry Participation Policy. In 2010-2011 there were no disclosures Training sessions aimed at reducing workplace commenced or completed by Dunmunkle Health accident and injury, early return to work Services under this Act. strategies and equipment upgrades are held on a regular basis.

Attestation of Data Integrity: I, Tracey Chenoweth, certify Dunmunkle Health Services has put in place appropriate internal controls and processes to ensure that reported data reasonably reflects actual performance. Dunmunkle Health Services has critically reviewed these controls and processes during the year.

Tracey Chenoweth Accountable Officer-Minyip 6 August 2012

16

Dunmunkle Health Services Quality of Care Report 2011-2012

Contents: Page Strategic Plan ...... 2-6 Human Resources & Service Awards ...... 7 Ladies Auxiliaries & Stonehaven Support Group ...... 8,9 Quality of Care Report ...... 10-14 Infection Control ...... 15 Social Work ...... 16 Health Promotion Priorities & Data ...... 17 Nursing Home Activities ...... 18 Attendant Care Program ...... 19 Marma Lake Activity Centres ...... 19 District Nursing ...... 19 Kindergym ...... 20 Transport ...... 20 Walking Programs ...... 20 Adult Activities ...... 21 Men‘s Matters ...... 21 Health Promotion Reports ...... 22,23 Education ...... 24 Students ...... 25 Customer Survey ...... Please complete and return

1 Dunmunkle Health Services - Quality of Care Report 2011-2012

Strategic Plan

Goal: Promote a state of well-being in our community

Objectives: Promote a state of optimal physical, mental and social well being, not merely the absence of disease, in the community Create an awareness within the community of health (and wellbeing) and ways of preventing illness Advocate in order to protect and/or promote the health of the community Benchmark with like agencies Strategies: Engage in collaborative networks with other health and community based services Provide a range of health promotion/education programs relevant to the needs of the community Seek opportunities to implement recommendations from the Service Plan Provide regular planning and evaluation of health promotion programs

Goal: Provide the highest quality health care to meet the needs of our community

Objectives: Comply with, and exceed where possible, all relevant regulations, standards and practices in all areas of care delivery Encourage clients and families to take an active role in their own care Strategies: Ensure compliance with relevant legislation and standards Provide clients with an appropriate assessment that ensures current and ongoing needs are identified Ensure that care is planned in partnership with the client, and where relevant, the carer, to achieve the best possible care outcomes Ensure care is evaluated by health care providers with the client and when appropriate, the carer Ensure processes for discharge/transfer address the needs of the client for ongoing care Ensure systems for ongoing care are coordinated and effective

Goal: Provide health services for all people on the basis of need

Objectives: Ensure equity and accessibility for clients by providing services close to where people live and work without financial, geographical, cultural and other barriers Provide opportunities for people to achieve their best level of health, to encourage the community to actively plan, participate and evaluate programs that enhance wellbeing Strategies: Provide information to the community on health services and care appropriate to its needs Provide access to health services and care appropriate to the needs of the community Ensure systems are in place to provide access and admission to care which is prioritised according to clinical needs Provide health care and services that are appropriate and delivered in the most appropriate setting Provide opportunities for people to participate in, and achieve, their best level of health and wellbeing

2 Dunmunkle Health Services - Quality of Care Report 2011-2012 Strategic Plan cont…

Goal: Ensure/promote awareness across the community of consumer rights and responsibilities and encourage client participation

Objectives: Ensure all clients are aware of their rights and responsibilities Ensure clients privacy and confidentiality is maintained Obtain regular feedback from clients in the planning, delivery and evaluation of the health service Strategies: Ensure provision for clients from culturally and linguistically diverse backgrounds and clients with special needs Promote client engagement and participation in Community Advisory Committees Encourage client and community feedback in all aspects of the service Ensure systems are in place and monitored regarding complaints and compliments as part of the ongoing quality program

Goal: Promote ongoing improvement in performance in all aspects of the organisation

Objectives: Promote a quality focused culture Ensure the flow of communication between the Board of Management and staff Ensure that decisions include consideration of environmental impacts Promote student placements in all relevant areas within the organisation Strategies: Ensure ongoing organisational planning Continue to meet, or exceed, all of the accreditation requirements Ensure appropriate ongoing resources are made available to the Quality Improvement programs Ensure the continuous quality improvement system demonstrates its commitment to improving the outcomes of care and service delivery Ensure Managers report on Dunmunkle Health Services activities at regular staff meetings Support benchmarking at all available opportunities Review, and where appropriate, address recommendations from any surveys or audits Ensure that health care incidents, complaints and feedback are managed to ensure improvements to the systems of care Educate staff in latest health practices Continue IT management services, including an integrated approach to the planning, use and management of information and communication technology (I&CT) Ensure ongoing review of health records to ensure they meet medico-legal and statutory requirements Ensure records management systems support the collection of information and meets the organisation‘s needs Ensure that information and data management and collection systems are used to assist in meeting the strategic and operational needs of the organisation Ensure that data and information are used effectively to support and improve care and services Support the General Manager‘s role in ensuring two way communication between the Board and staff Encourage involvement of students through student placements

3 Dunmunkle Health Services - Quality of Care Report 2011-2012 Strategic Plan cont…

Goal: Human Resource practices ensure a competent workforce within a professional and respectful working environment

Objectives: Support and encourage staff in pursuing education and training to enhance their skills Provide leadership and direction for staff Provide a safe, professional environment in which staff can develop and use their skills, whilst providing a high level of client care Ensure adequate staff/patient ratios Plan for the current and future staffing needs of the agency Encourage student placements within the organisation Strategies: Provide adequate time and resources for training and education Provide effective, appropriate and clear communication channels between staff and management Ensure an organisational structure is in place that assists the organisation to achieve its goals Ensure General Practitioner services in the area Maintain/enhance staff to ensure the best possible outcomes for clients Ensure participation of Board of Management and senior staff on committees and forums seeking to address issues of staff shortages in rural and remote areas Ensure that the recruitment, selection and appointment system ensures that the skills and competence of staff and volunteers meet the needs of the organisation The continuing employment and performance management system ensures the competence of staff and volunteers Ensure credentialing and privileging of all health professionals Develop and implement a succession plan for the health service Encourage formal and informal links with tertiary and training institutions to promote student placements

4 Dunmunkle Health Services - Quality of Care Report 2011-2012 Strategic Plan cont…

Goal: The Board leads the strategic direction of the organisation to ensure the provision of quality, safe services in a financially responsible manner Objectives: Value the merit of partnerships and acknowledge these relationships Foster and nurture relationships with other organisations and all levels of government Provide strong leadership through effective strategic planning Support the ongoing review of Management Policies and procedures Meet the relevant accounting standards and use sound budgeting practices Provide ongoing education to Board members and executive staff in relation to governance Strategies: Ensure appropriate management of corporate and clinical risk Ensure that the risk management policy and system identify, minimise and manage corporate and clinical risks Review the progress of the Strategic Plan on a regular basis Ensure Board of Management monitoring of finances through regular reporting Establish a system of analysis and review/operationalise all processes to address strategies and objectives of this plan Address any recommendations from surveys, audits and to respond as appropriate Ensure Policies and Procedures are relevant to legislations and regulations, governing health service provision in the state of Victoria and the Commonwealth of Australia Actively seek opportunities for increased/additional Department funding Assess annual performance and benchmark against like agencies Meet health service targets within financial limits Ensure ongoing implementation of the organisational wide Risk Management System Seek opportunities to attend governance education programs Ensure governance is assisted by formal structures and delegation practices within the organisation Ensure processes for credentialing and defining the scope of clinical practice support safe, quality health care Ensure external service providers are managed to maximise quality care and service delivery Document corporate and clinical policies that assist the organisation to provide quality care

5 Dunmunkle Health Services - Quality of Care Report 2011-2012 Strategic Plan cont…

Goal: Provide a safe and professional environment that is appropriate to community needs

Objectives: Provide appropriate infrastructure which is responsive to community needs Ensure Occupational Health and Safety Standards are complied with at all times Maintain the Risk Management System Ensure that buildings, plant, equipment, utilities, consumables and supplies are managed and operated to support safe practice and a safe environment Strategies: Provide education and review of Risk Management System to all relevant stakeholders Provide a Capital Works program for end-of-life asset replacement requirements Review and improve the Asset Management Plan Provide safety management systems that ensure safety and wellbeing for clients, staff, visitors and contractors Ensure buildings, signage, plant, equipment, supplies, utilities and consumables are managed safely and used efficiently and effectively Ensure waste and environmental management supports safe practice and a safe environment Ensure emergency and disaster management supports safe practice and a safe environment Ensure security management supports safe practice and a safe environment Ensure the infection control system supports safe practice and ensures a safe environment for consumers/patients and health care workers Ensure that medications are managed to ensure safe and effective practice Ensure the system for prescription, sample collection, storage and transportation and administration of blood and blood components provides safe and appropriate practice

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Human Resources

Staff Recognition 40 Year Service Award 10 Year Service Award Pam Pay Glenda Boschen Sandy Hatcher

Pam Pay - 40 Years Glenda Boschen – 10 Years Sandy Hatcher -10 Years Adult Activities based at TAC Care Program. TAC Care Program and Minyip Community Health Glenda first worked with the Activities. Centre Minyip Community Health Sandy commenced at Murtoa Pam commenced at Minyip & Centre as a driver and as a causal cleaner on 2001 District hospital in 1972 as a assistant in the Adult then gained a permanent nurse attendant. When the Activities program between position in 2003. In 2007 hospital closed and became a 1988 and 1995. Following the Sandy gained the shared Community Health Centre birth of her two sons, Samual position as assistant in the Pam became the bus driver in and Jack Jnr, Glenda Adult Activities Centre at 1987. After a short time Pam returned to work in 2002 in Minyip and has worked in the returned to nursing, the Take-A-Break Occasional TAC care program since transferring to the nursing child care program. Glenda 2003. Sandy and husband home at Rupanyup. In 1995 currently works as a carer in Mark are proud parents of 4- Pam returned to the driving the TAC program. sons, Jesse. Jayden, Caleb position balancing her and Kobe. Sandy‘s main nursing duties with the driving interests are the boys and role. In 2006 Pam gave up their activities and in her her nursing role to spare time enjoys gardening, concentrate on the Adult renovating and scrapbooking. Activities program and the driving. At this time she trained in foot-care and toe- nail cutting to meet the needs of those who slipped under the podiatry radar. Pam continues this service today but no longer drives the bus.

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Ladies Auxiliaries & Support Group

Ladies Auxiliary, Minyip Ladies Auxiliary, Rupanyup Ladies Auxiliary, Murtoa President: Margaret Murphy. President: Marg (Chappie) President: Cheryl Bryan. Vice President: Verda Loats. Lingham. Secretary: Carmen Vice President: Julie Schultz. Secretary: Evelyn Wright. Isbel. Treasurer: Pat Faulkner. Secretary: Mavis Crome. Assistant Secretary/Treasurer: Members, Loris Arnold, Helen Treasurer: Jeanette Grigg. June Walsh. Members: Pat Baker VP, Jenny Boyd, Gwen Morris, Ellen Niewand, Olwen Barker, Aura Ballantine, Bev Members: Joan Furfari, Billie Cowan, Ann Watterston, Janelle Brumpton, Helen Davison, Lois ‗Patricia‘ Mc Kenzie and Mary Petering and Stephanie Funcke. Johns, Margaret (Chappie) Rabl. Mr Geoff Coutts-Auditor. Through the Silver Circle Lingham, Del Tyler. The auxiliary mourn the passing competition, monthly bingo It is my pleasure to present the of Jean Crouch, foundation and raffles and catering the auxiliary Annual Report of the long-term member of the has been able to purchase an Stonehaven Ladies Auxiliary for auxiliary. Jean held the position Automatic External Defibrillator, the year 2011-2012. I would like of treasurer for many years. pulse oximeter, body fat to thank the members of the We had a successful financial analyser, Doppler, scales, BP auxiliary for their work over the year with street-stalls, raffles cuffs, cholesterol and blood past 12-months. The auxiliary and catering being very sugar testing units. has worked continuously profitable raising over $1800. catering for monthly doctor‘s Monies raised assisted with the lunches, funerals when asked, purchase of an Automatic and hosting the fashions day. We External Defibrillator for the have also served morning teas Murtoa Community Health over the winter months. The Centre. Rupanyup LIONS donated $500 The auxiliary also assists with and we have funded 6-easy-glide catering for the Dunmunkle chairs, a defibrillator and Titans bike riding team in the numerous gifts for the residents, Murray to Moyne and delivers doctor and staff at Rupanyup. meals-on-wheels in the community.

Our AGM saw us return all office bearers to the same roles with Acknowledgement the exception of Secretary. Billie McKenzie will now take over this Dunmunkle Health Services is role from Mavis Crome. very proud of the support, time and care that these individuals volunteer to this community. They work together on projects when required, often at short notice. Their care and concern for the sick and frail of our community is part of why Dunmunkle Health Services is so successful in its provision of services. They are often our eye, ear and voice for transferring the needs of our residents, clients and community to further the outcomes and improvements in our facilities. Murtoa Ladies Auxiliary-AED Automatic External Defibrillator 8 Dunmunkle Health Services - Quality of Care Report 2011-2012

Hospital/Nursing Home Support Group President: Mary Tyler. Secretary/Treasurer Marg (Mrs Ron) Lingham. Members: Debbie Colquhoun, Dancers, Vesper and Allan, Residents continue to enjoy Jean Wray, Bernice Edwards, dressed in their ballroom outfits- the fortnightly ‗Lucky Shirley McRae, Faye Hayes, all appreciated the beautiful royal Numbers‘ game and look Rhonda Carter, Bev Folvig, Loris blue ball gown. forward to winning and Arnold. Residents, family and friends receiving a prize. We have enjoyed a very busy enjoyed listening to Norm and We sincerely thank all who year of activities and appreciate Marlene Mc Lean from Horsham. have contributed to our the organisation and support Norm commented on how all Easter and Christmas raffles from the Activities Coordinator, participated in the sing-a-long with donations, sales of and Wendy Pickering, Residential and promised they would return purchase of tickets. This Care Services Manager Joyce in the future. A delicious finger financial support covers our Byrne and staff. food luncheon concluded a ‗Bingo‘ expenses for the year. Successful grants from FRRR, lovely morning with friendships Volunteers assist staff when Yarriambiack Shire and Gary renewed and plenty of chatter. requested, taking residents to Howden, Horsham Telstra have The Family Christmas dinner special outings including local enabled volunteers to continue was great success with the meal venues and functions. The organising a stimulating Music supplied by volunteer, family and volunteers also assisted staff project. We certainly appreciate friends for more than 80 during the floods when their generosity. participants. Rupanyup was isolated and A great crowd attended the We certainly appreciate the staff unable to drive through Open Day and enjoyed listening financial support of the Bendigo floodwaters. to talented pianist Leo Tellefson Community Bank for their Thanks to Bernice for and vocalist, Sandra Loats. sponsorship. It is of great representing our group the Volunteers, ladies auxiliary and assistance with the expenses as Community Advisory friends provided a beautiful we endeavour to bring families committee meetings while afternoon tea. Other stimulating together to celebrate Christmas. Mary is recuperating. musical activities included Neil We are very grateful to Santa Many thanks to all who have Thornton and Christine Johnston David for his visit and supported our group in any from Stawell. Dance band contribution of gifts to all way allowing us to continue organist Carmel Phelan residents. the valuable support and accompanied Old Time friendships with our residents.

Rupanyup Ladies Auxiliary-Morning Tea’s

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QUALITY OF CARE

‗Quality Is A Journey, Not A Destination‘ The Quality of Care Report is a community report. It provides details of the quality and safety systems, processes and outcomes within our organisation. It describes the areas that Dunmunkle Health Services is committed to improving and those that the Service wishes to celebrate. This is done in partnership with the community and in response to what ‗our community‘ want us to provide. As a community health organisation Dunmunkle Health Services is extremely conscious of the needs and wishes of the community. Consumers provide feedback on our services which help us to improve. A survey of targeted community members across all age groups indicated that the Report is of interest to the general population, is easy to read and understand; provides a good and adequate explanation of activities; that opportunities for feedback and complaints was provided.

Quality Quality System Customer satisfaction is The Continuous Quality  Incident reports- ultimately required to ensure the Improvement system comprises of implemented electronic long-term viability of this health systems that assess the quality of system-1st Nov 2010 service. We are committed to resident/patient/client care, (Riskman) has improved offering quality health care for Governance, Legislative reporting. our consumers. Dunmunkle Compliance, Risk Management,  Opportunity for Health Services definition of consumer participation, primary Improvement forms. quality is ‗Quality consistently care programs and services, meeting the negotiated Human Resource Management,  Audits-annual audit expectations of our consumers Infection Control, Occupational schedule-reviewed and optimising their health Health & Safety and Information annually outcomes, in a safe and cost Management. The results from the  Staff and management effective manner‘. Continuous below processes allow us to meetings Quality Improvement is ‗the assess the quality of our services.  Recommendations from continuous search for the  Resident/patient/clients/staff/ opportunities for improvement in each Accreditation and Board of Management Spot Visits in Aged Care. processes and outcomes to surveys. strive for Best Practice‘.  Best Practice  Patient/client correspondence including compliments,  Legislative Requirements complaints and suggestions.  Community Advisory Information is gathered Committee meetings-main through the above processes consumer focus group. and placed on a central Continuous Improvement (CI)  Key Performance Indicators- Plan and discussed at the these are bench-marked appropriate meetings. against other Group E Hospitals. Results are acted on depending on variance.

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Mandatory Police Checks In Small Rural Health Services Committees Aged Care Sector (Group E Hospitals) Our committees are effectively It is now a mandatory The Quality Manager attends led by dedicated community requirement that all employees quarterly meetings with similar members. Consumer and volunteers working sized organisations. The participation is welcomed onto unsupervised in the Aged Care knowledge and ability of relevant committees. The sector have a current Police members within this group Community Advisory Check. Therefore, no person will provide a solid foundation for Committee is our major be employed in either a paid or problem solving and offer each community focus group. volunteer capacity in the Aged other great support. Care sector unless they have Should any community member undergone this process. An Dunmunkle Health Services has like to be involved in one of our ‗alert‘ process is in place to representation on this committees, they would be advise Management when committee. welcome and encouraged. updated Police Checks are From this forum there have been The Medication Advisory pending and staff are advised in many positive changes made Committee (MAC) was formed a timely manner. overtime. There is great early in 2007. The function of Dunmunkle Health Services is networking opportunities for all this committee is to oversee 100% compliant with Police that attend. Medication Administration and the processes around this Checks across the Aged Care Dunmunkle Health Services is within the Hospital/Nursing sector of both paid staff and one of the two founding health Home. volunteers. services who continue to maintain an attendance. This The Medication Administration further demonstrates our committee involves Dr commitment to improving Swalwell, Pharmacist Debbie healthcare in our local Norton and nursing staff. We have recently had interest from communities. a resident‘s family at Rupanyup

to go on this committee.

This committee is run in Electronic Risk Management National Health Standards conjunction with Dunmunkle System Mandated Lodge and we currently have a hostel resident participate in In June 2012 we implemented There will 10 new Mandated Health Standards being this committee. an electronic Risk Management introduced nationally as from 1 System which is supported by The ResourceSmart Committee VMIA. Our entire risk January 2013, with Victoria was formed in late 2010. This includes an additional standard Management System is Committee has the in Nutrition which has been available electronically, has the responsibility to seek ways in functionality to run several delayed for 12-18 months at this which to save money and stage. Dunmunkle Health relevant reports. Our Quality energy where possible. It has Services Quality and Education Manager has received some representation from training and is confident in using Managers are on the working management and staff. party for this Standard. These the system. This will make the A Dementia Resource are clinically focused, with some Risk Management process Committee was formed in 2011 Clinical Governance inclusion. easier to manage and will be to better meet the demand and more relevant in our everyday Some education has been provide appropriate care for attended by Quality Manager but running of the health service. hospital/nursing home still a lot more need to be residents with Dementia. Once accessed before implementation. again our staff demonstrate a We are currently in the process broad representation on this of conducting a Gap Analysis on committee. the 10 standards. Our Accreditation process may future will change due to these standards, that is yet to be decided once more information is known.

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Committee Meeting Frequency Board of Management Monthly Community Advisory Monthly Quality Improvement (QI) 2- Monthly Occupation Health & Safety (OH&S) 2- Monthly No-Lift 4- Monthly Falls 2- Monthly Wound Care 2- Monthly Medication Advisory (MAC) Quarterly Resource Smart Quarterly Dementia Quarterly Residents & Relatives Support 2-Monthly RPC 2- Monthly Executive Monthly Finance Monthly Doctor‘s Monthly

Audits & Surveys Accreditations Dunmunkle Health Services undertakes an We underwent EQuIP 5 Accreditation, annual Audit Schedule. This is reviewed each (organisation wide survey) on 16 & 17 August year in June/July. Audits are conducted across 2011, this involves 3 sites. It is the first time we all areas within the health service & this involves will be accredited under EQuIP 5, an updated a number of different staff. We are increasingly system from EQuIP 4. Although we have not benchmarking data with other health services received an official report as yet the process was and this is reflective in some of the data we very positive and we expecti a favourable collect. There are eighty three (83) audits outcome. Our self assessment is due to be collected and relevant data is fed into a submitted 13 August 2012. Continuous Improvement Plan on an annual On 21 March 2012 we received a Spot Visit in basis. Some of the general audited areas Aged Care at Rupanyup and the 4- minor include: recommendations received have since been  Environmental Services implemented. The visit was a very positive  Infection Control experience and highlighted what great care our  Waste Management nursing team provide. As a HACC review is due within the next 12-18 months new standards will  Housekeeping be implemented in this process. Accreditation  Laundry Services not only gives the health service an opportunity  Maintenance to test current systems but the direction to  Residential Care implement new ones.  Acute Care  Outpatients  Medication Administration  Lifestyle in Aged Care  Staff Satisfaction  Consumer  Quality  No-Lift Results are collected by various staff members and evaluated by either the Quality Manager, then discussed at relevant Meetings before recommendations are made and actioned.

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Consumer Care / Community Cultural Diversity Participation Some demographics: Community Advisory Committee is made up of Under the SEIFA index, Dunmunkle Health community members who meet monthly to Services catchment is in the lower 50%. receive and provide feedback. From data collected from the Yarriambiack Shire, The General Manager and a Board persons born overseas living in the Shire is representative attends and chairs the meeting. 4.9%. During the year the membership has been 18% of those aged between 15-65 years are undertaking a review of pamphlets/information employed in the agricultural industry. sheets produced by the health service, which are Over the past year education has been provided given out to community members. to staff to ensure they are trained and proficient There are a number of surveys which include: in accessing interpreter and translation services.  Resident survey Dunmunkle Health Services has a 3-year  District Nursing and Cultural Action Plan in place which is undergoing  Day Centres review. Feed back from surveys is directed to the Quality Dunmunkle Health Services has signed a letter Improvement committee. Where appropriate of support committing to be an active participant action is taken and the result fed back to in the Wimmera PCP project, Towards Cultural consumers, staff and Board through a variety of Security, working through Wimmera PCP, to avenues. reflect and build upon our existing service Dunmunkle sent out 100 surveys for the 2011- practice to appropriately provide for Aboriginal 2012 Consumer Survey through the medical clients. This work will include taking part in an practice. The response indicated the community audit of cultural competency, as well as capacity were satisfied with the Services but raised building for staff around both CALD practices concerns regarding the difficulties in securing and working with Indigenous Australians. medical practitioners. Dunmunkle Health Services staff attended Dunmunkle Health Services has a Complaints HACC Indigenous specific workshops for HACC and Compliments program. This year two formal clients. complaints were received and were dealt with in Of the 0.76% Indigenous population within the a timely manner. Yarriambiack Shire, no Dunmunkle Health There are also other opportunities for Services clients were identified as being of engagement with consumers, eg. the General Indigenous background in the year 2011/2012. Manager meets with a young mothers group twice a year and receives their feedback. Opportunity for Improvement forms are available at each campus and areas of the Service where they can be used by consumers and carers. These are fed back to the QI committee who action appropriately. There is also an opportunity for the person completing the form to receive a response if desired.

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Service Co-ordination Dunmunkle Health Services has participated in the State-wide Service Co-ordination & Integrated Chronic Disease Management Survey 2010. Overall, the results indicate Dunmunkle Health Services has performed extremely well in this area. For example:  Service co-ordination practice standards and  When ‘urgent referrals‘ are received, a program requirements are integrated into referral acknowledgement is sent within 2- policy, work plans and position descriptions working days. where applicable. Dunmunkle 100% Dunmunkle 100% The major area for improvement:  Consumers have been provided with  Where there is a Care Co-ordination Plan, information about services available in the consumer‘s GP has been provided with a response to their enquiry or as part of an copy. outreach approach. Dunmunkle 100% Dunmunkle 100%

Aged Care Quality Indicators: 2010-2011 2011-2012 1. Pressure Ulcers 25 13 (stages 1-4) 2. Falls & 41 67 Fractures relating to Falls 1-fracture from fall 0-fracture from falls 3. Physical Restraints List A = 40 List A = 0 List B = 0 List B = 0 4. Polypharmacy (residents administered +9 16 22 medications) 5. Unplanned/Significant Weight Loss U/P weight loss-3 U/P weight loss-2 Significant-0 Significant-0

Incidents 2012-2011 2011-2012 Number of incidents recorded 117 138

Falls 41 67

Outcome resulting in fracture/dislocation 1 0

Skin tears 33 25

Medication errors 9 12

Medication errors-process 3 2

Staff injuries-Lifting machines 0 0

Staff Injuries Minor-6 Minor-8 Serious-0 Serious-0 Needlestick injuries 1 1

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Infection Control

Jan Spencer Infection control plays an important role in any health The Rupanyup Hospital and An external auditor conducts service. Dunmunkle Health Nursing Home continues to cleaning audits with the Service (DHS) contracts an participate in the VICNISS results reported to the Infection Control Nurse from the program. Reports are submitted Department of Health, a score Wimmera Health Care Group who each three months on the number greater than 85% must be manages the Infection Control of patients diagnosed with an achieved to meet the required Program. She visits once a infection caused by a multi standard. The external audit fortnight to provide education, resistant organism, having a result for March 2010 was support, staff immunisations and bloodstream infection, 93.2% and compares well to advice and to conduct surveillance occupational exposures, surgical the external audit result for activities. infections admitted to the hospital July 2012 of 87.6% the As Hand Hygiene is the single and the number of staff who average overall score for most important activity to reduce receive the annual influenza facilities in the Grampians the transmission of infections in vaccine. There were no infections region has not yet been any setting, all staff of Dunmunkle reported again during 2011-12 and calculated as the audits were HS receives education often and 32.2% of staff have received later this year. are tested annually for influenza vaccinations to date for The acute care was again competence with the Five (5) 2012. successfully accredited in Moments of Hand Hygiene. Hand 2011 with no Hygiene compliance audits are not recommendations made for submitted to Hand Hygiene Infection Control. Australia as in other facilities because the number of acute beds in the facility does not provide enough activity for audit purposes. Infection Control Risk assessment/compliance audits are conducted annually. The results of these audits are compared to regional and state scores. The audit results for 2012 are: Organisational audit: 93% compared to 93.8% the previous year. The Regional aggregate was 94.5% The nursing home participated in a Victoria wide point prevalence survey of infections and antibiotic use in July 2012. The results of this survey are not yet available. The rapid emergence of Antibiotic Resistant Micro-organisms is of great concern in healthcare. Dunmunkle Health Services has audited antibiotic use in the Nursing Home for a number of years and is pleased with the Minyip Festival-the Climbing wall results.

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Social Work Jacqueline Zakhary & Maxine Tepper Our mission is to promote, protect, and provide for the health and wellbeing of the people of Dunmunkle catchment area and work toward continuous improvement in the quality of patient care and delivery of services which is consistent with the goals of the health service. In our busy environments the Social Work Department continues to deliver services to all client groups including children, youth, families, people with physical or mental health issues, those who are homeless or unemployed, and victims of domestic violence. It is recognised that these groups of people can benefit from the type of supports that a social worker is trained to deliver. Collaborative with Dunmunkle HS multi- disciplinary team we also provide services for older people experiencing health issues. Practice in health care settings involves multiple methods, including clinical and macro approaches, as well as policy and advocacy. As part of the process of continuous improvement and securing best value relevant to our clients policies have been reviewed and updated during 2011-2012. This reflects our commitment to accountability to the people of Dunmunkle. To promote health and well-being for the people of Dunmunkle we run health promotion programs and assist people to take personal responsibility for healthy lifestyle decisions; protecting people from abuse, violence, preventable disease and unsafe environmental Conditions; caring for and/or counselling people when they require support for social or health issues; and treating people when they are sick or suffering from physical, emotional or mental problems.

The past year has been a very Homelessness continues to be a personally delivered to 55 busy one in the Social Work significant problem in the families; child, youth and Department as we continue to see surrounding area, with quite a adult. Due to the generosity a wide variety of clients of all ages number of people seeking help to of the local community there is with many differing needs and find accommodation. The lack of always a wonderful selection circumstances. appropriate and affordable rental of gifts to be distributed. This report provides an overview properties is of major concern. We wish to thank the Lions and highlights some of our major Financial constraints mean that Club of Murtoa who most accomplishments for 2011-2012. many families struggle to manage. generously donated to our As Social workers we wear We have many calls for food Social Work Department multiple hats—case manager, hampers and financial aid in funds. This has meant that patient navigator, psychotherapy assisting with utility accounts; now we are able to assist and community outreach particularly in winter when heating those presenting in crisis coordinator promote health and is a major problem. situations without the problem wellbeing awareness—to name a It is here that the ― No Interest of trying to locate the few. Loan‖ scheme (NILS) has been of necessary funding. Mental health is a huge issue, with great benefit to the community. We encourage all people in depression being very prevalent This enables clients accessing a our community to seek across all age spectrums. Centrelink income to purchase professional help when Identifying this need we are goods up to $1,500.00. needed. We also accept running a series of workshops with Repayments are very affordable referral through strategies aimed at reducing and no interest is charged. Often https://www.connectingcare.c anxiety levels, and coping with this is the only way that families om but not limited to. We can everyday living. can replace essential items such be contacted Monday – as a washing machine or Thursday. It is noted that the number of refrigerator or pay for car Our services are free and clients with drug and alcohol maintenance and registrations. problems has risen significantly. confidential. We are here to Isolation and the distance from Our annual ―Christmas Giving help you. If we are unable to large cities exacerbate this Tree‖ ensures that every family help, we will refer you to problem. Treatment options are enjoys a hearty Christmas someone who can. impeded to some extent with the luncheon, and everyone receives nearest Detoxification and a gift from the Tree. Hampers Rehabilitation facilities being come from the Horsham Christian located in Ballarat and Bendigo. Emergency Food Centre and are

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Community Health Activities The 2011-2012 Health Promotion Priorities were  Social Connectedness  Physical Activity

From the above Dunmunkle Health Services initiated the following programs:

2011-2012 Programs Sessions Contacts AAC 10c day & games 1 90 CPR 14 70 Make Exercise Part of Our Day 19 258 Kinder nutrition 2 55 Ladies health ―Its all about me‖ 1 30 Men‘s Healthy Breakfasts 3 76 Health Check for primary students 1 30 Osteoporosis 1 5 Puberty 5 90 Vision Health ―The eyes have it‖ 1 24 BP & BSL Screenings-all events 39 3272 Youth Activities 1 16 Minyip ‗Fools Festival‘ 1 200 Know Your Numbers 2 52 Anti-Cancer Biggest Morning Tea 1 7 Water for Wellbeing 1 24

Community Health 2011 2012 Contacts Contacts Nursing 4699 4862 Accident & Emergency 153 150 Physiotherapy 250 175 Speech Therapy 327 227 Toe-nail Cutting 313 381 Occupational Therapy 59 30 Social Work 2748 2286 Aged Care Assessments 85 36 Community Health Programs 8917 5599 Adult Activities 866 976 Marma Lake Activities 437 435 Diabetes/Healthy Lifestyle 57 57 Gentle/Chair Based Exercises 202 201 Kinderygm 141 167 Men‘s Matters 293 351 Take-A-Break Child Care at Minyip & Rupanyup 334 359 Walking & Exercise group 269 157 Warm Water Exercise for Arthritis 517 514 Weight Maintenance 180 208 Screenings for Blood Pressures & Blood Sugars 3014 3179 Transport 2143 1535 Podiatry 33 177 Playgym - 263 Make Exercise Part of Your Day for Seniors - 109

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District Nursing 2011 2012 Individuals 36 53 Hours 1919 2015 Contacts 4081 5961 Dunmunkle Health Services, District Nurses visit clients across the townships and outlying areas of Minyip, Murtoa, Rupanyup, Jung, Marnoo, Wallaloo, Lubeck, Boolite, Wal Wal, St Helens Plains and Laen. The Service negotiates with other health providers to pick up clients living on the outlying service-area boundaries to ensure maximum care for all.

Medical Practitioners 2011 2012 Clinics 727 448 Total contacts 8946 4204

Activities - nursing home, Rupanyup Wendy Pickering leads the team We are now able to offer individual We have been fortunate to with the support of Mary Howell, Aromatherapy programs to each have our Residents & Karen Adams & Jag Singh. The resident which staff have been Relatives Support Group be program is overseen by Chris trained to do. successful in submissions McCallum in her role as a Children from OLHC (Our Ladies which has enabled us to have Diversional Therapist. Help of Christian) school continue quite a bit of entertainment at The program is certainly very their monthly visits, with the the home. This has facilitated popular amongst the residents and residents looking forward to these the opportunity for the Murtoa there is no activity too big or too days as much as the children. It is Day Centre clients & staff to small that the staff won‘t consider evident that this program is attend also which has been if it will benefit the residents or is beneficial to both groups as wonderful. An Open Day suggested by them. Resident‘s relationships develop between the including entertainment and complete an annual survey to see residents and children whose morning tea was so well what activities they would like & confidence is building with each received more are planned. the same ones are mentioned visit. Without such a supportive and every time. Activities vary, and may include but hard working group, we would These include: are not limited to singing, reading to have such wonderful opportunities. Their bingo  Massage the residents or having a general chat. We share lunch the last visit program is well supported and  Footy tipping each year and this is very inter enjoyed by participating  Sensory Box active. residents.  Craft Making Mary Howell visits each  Bingo Our monthly church service is well supported by resident‘s and Tuesday and offers massage  Feeding Chickens & budgie community member‘s. therapy to those residents‘ who  Gardening wish to have it. There are  Music Therapy BBQ‘s, pizza and fish ‗n‘ chip days many benefits in this therapy  Local Outings remain as favourite Special Event for the residents including  BBQ‘s Days for the resident‘s, families and relaxation and a reduction in staff.  Gentle Exercises pain.

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District Nursing Attendant Care Program Marma Lake Day Centre- District Nursing is a Home and Chris Mc Callum-Quality Manager Dementia Specific Community Care (HACC) funded Many thanks to our client, the Activities program which provides nursing family and the team of dedicated Deb Delahunty, Debra Russell. services primarily to older frail, staff that work within this The Marma Lake Day Centre younger disabled persons, and program. continues to deliver varied their carer/s. The aim of the activities and outings for service is to keep these people in Without the commitment and dedication of the staff involved in people affected by a dementia their homes, and to maintain as type illness. The Marma Lake much independence as possible. this program it would not be the success it is. It is very rewarding Day Centre, based at Murtoa Living at Home Assessments and to see there are people who are Community Health Centre the Active Service Model is used prepared to go beyond what is offers specialised day care for to assist the client to have a required of them and to do it so people from the local proactive approach towards their willingly. So thank you to all our communities who have some own health care, to remain as wonderful carer‘s and keep up the form of dementia. autonomous and independent as good work. Program leaders plan possible within their own homes. interesting and meaningful Online education continues District Nurses are trained to work activities to allow each person across all sites. SDLP (Self to participate at his/her level of through Living at Home Directed Learning Packages) is Assessments and Enduring Power independence, thereby an option that is offered within promoting self-esteem and of Attorney. They have expertise in this program and the staff are Diabetes in Palliative Care and dignity, and also respite time supported in this as well as for carers. attend Wimmera Regional Wound internal training. Staff achieved Care meetings and in-services. A variety of activities and 100% in mandatory education for outings continues to promote They also participate in annual the year, excellent result. competencies which include CPR, their individual self esteem and medication and fire emergency We hold 4 meetings per year, maintaining social contacts training. which are very well attended. This within the local communities. is an opportunity to brainstorm We have enjoyed outings to District Nursing hosts student and offer ideas and support to local areas for lunches, picnics placements of RN Div 1 & 2 ensure better outcomes for our and afternoon teas. In house nurses and medical students to client and her family. activities include a variety of give them insight into the aims and Thank you to all the staff for their games such as chair table achievements of working in tennis, hookey, golf, bowls, community nursing. input into aspects of running this program, without you the program quoits, bingo, jigsaws, quiz‘s, would not be the success that it proverbs, reading, music, is. movies, music concerts, reminiscence, football tipping, pet therapy and family visitors.

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Kindergym Transport Walking Programs Dunmunkle Kindergym has been Volunteer transport aims to meet Walking is a very safe and very successful in providing the needs of people who have healthy form of exercise and is physical activity for pre school specialist medical appointments encouraged for 30-minutes aged children for over 10 years. away from their hometown, who per day, around 4-times a The children take part in do not have any means of week. With this in mind, structured physical activity which transport such as family, friends or walking groups continue to is dependent on parental Veteran Affairs and who cannot grow and thrive in Rupanyup, participation. access public transport. Minyip and Murtoa. Surveys are distributed yearly to This service caters for the One particular group has been ascertain the needs of the transport requests of those who meeting for one day per week parent and child in relation to need to attend appointments as for many years now at Minyip. program content and equipment; close as Horsham or as far away Some venture out in all times suitable to individual as Ballarat. Dunmunkle Health weathers while others walk to family needs; activity and Services or Shire of Yarriambiack a 2-mile tape/DVD indoors. equipment suggestions from cars are used and a small fee is Some also like to weigh parents. charged to contribute to fuel costs. themselves weekly as a Kindergym continues on a It is envisaged that the service will weight maintenance measure Tuesday morning. Held continue to be well utilised for whilst some endeavour to lose fortnightly during school term many years to come. For small a little. with attendances increasing the country towns such as those in On the first Tuesday of the children excitedly look forward to Dunmunkle, isolation can become month participants enjoy a each session. an issue for those who don‘t have fruit smoothy. the comfort and support of family Michelle Sonego was farewelled and friends to depend upon. This group is one where as Kindergym leader in early participants can join in, talk 2012 and the position is This program relies on the and walk and enjoy other expected to be filled shortly. generous services of volunteer people‘s company. Anyone is drivers, who make an invaluable welcome to join in. contribution to our community and Regular participants of this who must be acknowledged. program, some aged in their Without these people this service 80‘s, report they are able to would not be possible. maintain their daily activities Toni Martin was farewelled as for longer. Transport co-ordinator in June and we thank her for the management of the program.

Wimmera Machinery Field Days

20 Dunmunkle Health Services - Quality of Care Report 2011-2012

Adult Activity Centre Men‘s Matters Gail Jackson, Pam Pay, Sandi Judy Hazelden, Pam Pay, Hatcher. Robert Jackson. This program is designed to Client B wrote ―You have very Men‘s Matters is a reduce social and physical caring staff in Gail, Pam and socialisation program in the isolation and to allow and Sandy. They looked after us at the form of a bus trip for senior encourage participants to join in motel, making sure we were ok in men every second Friday. Its stimulating and enjoyable our rooms, lugging walkers in and format is morning tea on the recreational, individual and out of the bus each time they were way, followed by a visit to a group activities. They have needed. We are one very happy place of interest for men and enjoyed a wide variety of group and we all get on well then enjoying a social lunch activities such as visits to other together. God willing we can look together, usually a counter groups, outings for shopping, forward to another one next year.‖ meal. The day is all about fun movies, beading, craft, games, a and good company and Client C wrote ―They helped me trip away and our ever popular learning something new in a get out and encouraged me to join monthly favourite meal day. casual and enjoyable way. in (I even had the use of a The men are picked up from The group enjoy making, selling wheelchair). My life has changed their home or closest town and donating items they have and now I have lots of things to and the cost is minimal. handmade and are always on look forward too. Thank you Gail, the lookout for new ideas. Pam and Sandy‘‖ Men‘s Matters continues to thrive; we have now reached One highlight for the participants Client D wrote ―The staff were well th our 11 Anniversary. This of this program is the 3-day trip organised which made it possible means we have facilitated 250 away. This year the trip was to to visit many interesting locations, outings for the men to enjoy Hamilton. AAC staff visit the the less able were very and we have continued to proposed venue to ensure that professionally cared for.‖ accommodation and places of receive great feedback from interest will be affordable, We have welcomed the assistance the men as to how special this attractive, convenient and of work experience, nursing and program is to them. medical students who, as part of accessible. Some of the mens` their placement with the Service comments: Appreciation of the program and have enjoyed the interaction with the importance of the group in the group. ―Instead of wallowing in my their lives is indicated in the own self pity and descending notes received following the trip. into depression I have found a Client A wrote ―I was very new purpose and joy in my pleased to be able to go away existence.‖ for 3-days on our holiday. We ―Mens Matters has opened up had a very good time while we a whole new area of were there and stayed in a good friendships for me and has motel. It was very comfortable increased my knowledge of and we were taken to lots of things going on in the places interesting places, the food was we have visited; a pleasant good too. It was nice to be able change from being on my to go away with friends at AAC. I own.‖ don‘t get the chance to go away Examples of our outings: very often.‖ Trojan rocking horse business in Elmhurst, Carrot farm in Kaniva, Innovative Hydraulics in Donald and community garden in Beaufort. This is a friendly group and if anyone is interested in finding out more, they can contact the Community Health Centre Minyip.

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BP & Diabetes Screenings Community health staff attend the talked about how they are The Eye‘s Have It local 3-day Wimmera Machinery managing on medication or how People with vision impairment Field Days event, each local A&P they went to hospital for a few have twice the risk of fall, three Society show, market days, days. Some have asked about times the risk of depression community get-togethers and the other health issues and we have and 8-times the risk of a hip local shopping centres to offer free been able to direct the client to fracture, plus they are likely to blood pressure and diabetes appropriate medical practitioners. be admitted to a nursing home testing. This has proven to be a Health related articles are 3-years earlier. very worthwhile venture with regularly placed in the local However, 75% of vision numbers steadily rising. At the papers. impairment can be prevented shopping plaza between 60-100 or treated. The aim of this persons are screened weekly, of program was to reduce the which 20% of people require incidence of low vision and follow up. Usually the client Biggest Morning Tea therefore the burden of eye returns the next week and has health conditions. Our goal their levels rechecked. About 8% With most of our community was to firstly raise awareness of people require a referral to a GP affected in some way by cancer, of the need for regular eye or other service, and the CHN will our goal was to encourage testing to prevent development phone them at an appropriate time socialisation, fundraise and of eye conditions and afterwards introduce new tea flavours after diseases. Encourage early contacting Nerada Tea in Men in particular ensure they pop treatment and to increase Queensland who generously in at the local shows and field days people‘s awareness of donated several tea varieties. as there is no pressure to attend at services and aids to assist with a particular time or place. It also Those who attended made a vision impairment. provides an opportunity for a donation, picked up some general We enlisted Vision Australia to casual chat about other issues that information about cancer and talk about low vision aids, may be of concern. These can be were able to discuss cancer and equipment and services addressed there and then or other health issues. available. Participants in the program referred on to other appropriate services. included people who attend our diabetes group, the adult Follow up care of clients found Minyip Fools Festival activities, staff and several with abnormal readings are Facing the possible loss of the community members. actioned with a client record A&P Society Show, a group of Five people spent one-on-one commenced and a follow up people approached us for time with the Vision Australia phone call a week later. This assistance. Since the health presenter talking about their allows monitoring of abnormal service has previously organized personal experiences and readings thus allowing nursing well attended community picnics issues, including one with a staff to improve their care of over the past 3-years it was new diagnosis and another individuals. This change in follow agreed that this project would who is facing severe vision up care has been a positive step incorporate local people, impairment in the future. One towards the overall effectiveness volunteer groups and services. learned that she was eligible of this program. This community festival is for a home visit to assist with The screenings are popular designed to be affordable, fun strategies to manage her because people want to know if and entertaining with the aim of deteriorating eyesight. they have unhealthy blood reducing social isolation and pressure and blood sugar levels. If improve community morale and there are any problems, where cohesiveness. In response to required, the nurse can advise community interest and the them to consult their doctor. availability of activities, the focus People with previously has been on physical activity and undiagnosed diabetes and blood entertainment funded by grants. pressure have been picked up including some younger people who were unaware of any problems. Some have been back to thank the nurses and have 22 Dunmunkle Health Services - Quality of Care Report 2011-2012

Know Your Numbers Linking to Better Health Men‘s Exercise Cardiovascular Disease is a We took this approach to the local Diabetes type 2 and obesity serious problem in the Wimmera. machinery field days targeting rates are above average in this One in six people will suffer a primarily farmers, male and catchment. It was noticed that stroke in their lifetime. female. very few male‘s attend The aim on this program is for We booked the Sunsmart Skin exercise programs. What did people to recognise and Scanner for 3-days and BP, we want to achieve? To inform understand their risk factors and to Cholesterol, COPD & BSL men of the benefits of exercise take steps to reduce their risk. screenings were also offered. in relation to their everyday To achieve this goal we provided Our target was to screen up to health and wellbeing. We blood pressure checks in various 100 people per day which was approached two local Men‘s locations in each town ensuring well and truly achieved. Sheds and targeted some we screened a minimum of 50- The program also focused on community members, inviting participants. mental health so a social worker them to take part in a short Attendance was double that and was also available. exercise program with a male 50% had their BP checked after 5 clients from the COPD tests exercise physiologist. We the presentation, discussing stroke reported their father‘s death from deliberately used as little and its link to blood pressure, what emphysema. equipment as possible so that to do when a person has a stroke; One talked about his daughter‘s the participant could do the people who live alone and calling death from cerebral aneurysm; same exercises at home. The the ambulance. Others talked another talked about his participants showed interest in about their personal experience depression which resulted from the exercises, asked many with stroke. his many regrets after the sale of questions and thought they his farm; a female farmer asked could manage the exercises at for advice on preventing diabetes home. Some took home some as there was a family history with Theraband tape to work on a proven genetic link. Others strength resistance exercises. talked about the affect of Our next approach will be to caffeine/energy drinks and the encourage the men to choose affect on a person‘s blood own topic choices and hold the pressure; natural methods to program in the Shed‘s. manage elevated cholesterol; Feedback was positive with the management of food men saying they would ‗give it allergies/intolerances; recognition a try at home‘, ‗It was and management of ceoliac and enjoyable‘, ‗Learned new Crohn‘s disease. These people information‘. were able to go away with written information and referral to other services for management and Water for Wellbeing advice. The rationale of the program was More About Me to promote adequate intake of Due to the popularity of water in older people in the lead previous programs the ladies up to the summer months and to were very enthusiastic for increase the understanding for the another. Our goal is to offer an need to adequate hydration. inspirational evening learning Attendance at the presentation about legal aid services with was good and focussed on the socialisation opportunities and role water has in the body; the building of self-esteem. The importance of daily water intake; second speaker, a local to recognise the risks and sings of community member, told her dehydration; identify food with high story as a live kidney donor, fluid content and practical ways to giving her kidney to her introduce water into the daily partner. This presentation has routine. the capacity to prompt others to think about organ transplant.

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EDUCATION 5 Moments of Hand Hygiene i-Care Aboriginal & Torres Strait Islander Health Infection Control-Gastro & C Diff ACFI i-Soft Acute Documentation Know Your Food Safety Policy Aged Care Nursing Know Your Routine Antibiotic Resistance & Respiratory Tract Infections Managing Challenging Behaviour Asthma & Anaphylaxis Managing Occupational Violence & Aggression in Awards & EBA‘s Health Care Balancing the Benefits & Harm of Antipsychotic Managing Skin Tears Therapy Manual Handling Basic Life Support-practical Medication Administration Competency Basic Life Support-theory Mental Health Referral Pathways Blood Product Practical Competency Night Nurses conference Bowel Management No-lift / Smart Lift - refreshers & Annual Burns Management Competency Chemical Handling Safety Nutrition & Hydration for Elderly People Preceptor workshops Office of Public Advocate Chronic Illness & Diseases Open Disclosure Cleaning & Laundry training Oral Health Part 1,2,3 Clinical Waste Handling Pain Management/Opioids in Hospice Care Code of Conduct Palliative Care Communicating Information Patient Assessment Compression Bandaging Person Centre Care CPR & AED Pressure Areas Dementia Behaviour Management Pressure Ulcers Dementia Mapping Prevention & Control of Infection-basics Depression in the elderly Prevention & Management of Elder Abuse Diet and Nutrition in Residential Care Preceptorship Diversional Therapy PUPPS Elder Abuse RCNA 3LP Emergency Management Resource Smart Encouraging Best Practice in Dental Health-1,2,3 Risk Factors & Identification Falls Prevent ion Principles & Program Implementation Safe Medication Management Fire & Evacuation Skin Integrity Food Handling Syringe Driver Train the Trainer Gastroenteritis / Salmonella Urinary Catheter Care Gluten and Coeliac Dietary Venepuncture Harassment & Bullying Visi Trak Hand Hygiene Woundcare Health Promotion

24 Dunmunkle Health Services - Quality of Care Report 2011-2012

STUDENTS Medical, Nursing & Work Experience

Dunmunkle endeavours to take a cross section of students to offer them the opportunity to work in a rural and remote area where they are introduced to rural life and its differences from the metropolitan experience. It raises their awareness of rural issues such as the distances and difficulties which rural people have in accessing health care and the diversity of situations that a professional may encounter. It has the potential to highlighting to students the benefits of living and working in a rural area on completion of their studies.

Students are provided with accommodation where required, sometimes placing them with farming families and visiting a working farm during the placement. Students are rostered into every available program, in as many sites as possible. At the end of their placement the students are requested to provide brief report.

Each year Dunmunkle welcomes students from the following.

 Medical Students from University of Melbourne  Nursing students (1st, 2nd & 3rd year) from La Trobe  Ballarat University, Horsham based.  Work Experience students from Murtoa Secondary College.  Division 2 Nursing Students & Medication Endorsement Students.

Secondary College Students Medical & Nursing Students Dunmunkle Health Services provides an opportunity Uni Melb Medical Students have a for Secondary College students to undergo work compulsory component of placement in a experience and student placement with each of our rural/small town as part of their studies. The campuses each year. They are able to take part in goal is to experience life in a rural setting most of our health promotion programs, general office and to see health as more than just major administration, adult activity and catering areas to hospitals. allow them some idea of what is available in the medical and health area as they work toward their future career path.

Medical Students Reports Student Assessment of Clinical Experience at Dunmunkle HS The staff were approachable, treated me as part of the team, created opportunities for my learning and valued my contribution. They shared their experiences, were very friendly and keen to involve us. They work on health promotion programs that focus on primary prevention and respond to the community needs: students get opportunities to become involved in and experience a community based health care model. The varied activities gave good rural experience. The patients were approachable and care is taken to maintain their confidentiality. Staff are extremely dedicated to their jobs despite being overstretched on many occasions. The amount of health promotion coming out from this small town is amazing. The placement project kept me motivated and interested. There was little medicine in this placement due to a shortage of doctors in rural areas. For future students we would highlight taking part in all the health promotion events and programs like warm water exercises. Getting qualitative data on the impact of the floods have made on a previously drought ridden area would be interesting and possibly a look at what the effect the recent floods have had on mental health going into the future.

25 Dunmunkle Health Services – Quality of Care Report 2010-2011

DUNMUNKLE HEALTH SERVICES Consumer Survey – Annual Report

Dear Consumer Please take the time to complete this survey, the purpose for which is to improve our Annual Report which we present to the public each year.

What is your age group? □ 0-19 □ 20-39 □ 40-59 □ 60-79 □ 80-99

Are you: □ Male □ Female

Content of the Annual Report/Quality of Care Report:

Do you find the Report easy to read? □ Yes □ No Comment:

Do you find the Report of interest? □ Yes □ No Comment:

Do you feel it provides a good explanation of the activities undertaken? □ Yes □ No Comment:

Do we explain the purpose of the activities undertaken adequately? □ Yes □ No Comment:

Do you think Dunmunkle Health Services provides enough opportunity for feedback about its services? □ Yes □ No Comment:

Do you have any suggestions as to how Dunmunkle Health Services could improve its Annual Report?

Please return this survey to: Dunmunkle Health Services Quality Improvement Manager c/- 23-25 Church St, MINYIP Victoria 3392