Residential Aged Care

Older People

Country SA PHN funds a range of projects, programs, and resources designed to support residential aged care homes in enhancing the health and wellbeing of their residents.  These initiatives focus on better access to health services, enhanced clinical support and more coordinated person-centred care.

The following activities are being delivered to support residential aged care homes in our region:

• improve cross sector engagement and information sharing through Country SA Residential Aged Care Network.
• support the effective use of after-hours action plans to reduce avoidable hospital admissions.
• promote and support the use of digital tools and system integration.
• support access to services through increased use of telehealth.
• improve the coordination of care, particularly between general practice and residents of aged care homes through the General Practice in Aged Care Incentive.
• support residents and aged care staff to remain up to date with routine and recommended vaccinations, while strengthening vaccine delivery networks across the region.

Country SA PHN facilitates a monthly Residential Aged Care Network meeting, bringing together professionals from across the sector to strengthen collaboration and knowledge-sharing.

This network provides a supportive forum for staff working in residential aged care to connect with peers, share practical insights and innovations, discuss common challenges, and explore new opportunities to improve resident care.

Whether you're looking for fresh ideas, practical support, or simply the chance to connect with others in the field, the Network offers a welcoming space to grow and contribute.

Please contact our team if you would like to be added to our distribution list for these meetings at [email protected].

Access to timely and appropriate after-hours support is a critical component of quality care within Residential Aged Care Homes (RACHs). Effective after-hours planning helps ensure residents receive the right care, at the right time, in the right place, while supporting staff to respond confidently to changing clinical needs outside of regular business hours.

As part of the Australian Government's response to the Royal Commission into Aged Care Quality and Safety, Country SA PHN is working alongside residential aged care providers to strengthen after-hours care across regional South Australia. Country SA PHN supports this initiative by developing practical resources, guidance, and tools that assist residential aged care services in responding to resident health concerns during the after-hours period, when access to regular services may be more limited.

To support this work, Country SA PHN:

• Assists residential aged care homes to develop, review and implement After-Hours Action Plans. An After-Hours Action Plan outlines the processes, key contacts and escalation pathways required to support continuity of care and informed clinical decision-making within each facility.
• Raises awareness of available care and treatment options during the after-hours period.
• Supports collaboration between RACHs, residents’ general practitioners (GPs) and other relevant health professionals.
• Encourages processes that ensure digital clinical records remain accurate and up to date, particularly for after-hours care episodes.
• Provides education and training opportunities to build staff capability and confidence in using After-Hours Action Plans and associated resources.

These initiatives help increase awareness and utilisation of the range of primary health care and health system services available after hours, including general practice, pharmacy services, virtual care options and other clinical support pathways.

A range of online learning modules and practical resources have been developed to support RACHs in implementing effective after-hours action plans. Physical resources are also available upon request. For assistance with your organisation's after-hours planning, access to the online learning modules, or to request copies of these resources, please contact the Ageing Well team at [email protected].

The General Practice Aged Care Incentive (GPACI) is part of the Australian Government's broader efforts to improve healthcare access and continuity for older Australians, particularly in response to the Royal Commission into Aged Care Quality and Safety and the Strengthening Medicare Taskforce recommendations.

As noted by the Department of Health, Disability and Ageing, "eligible general practitioners (GPs) and practices registered with both MyMedicare and General Practice in Aged Care Incentive will be able to receive incentive payments. These incentive payments are for providing regular visits and care planning  to older people living in aged care."

As noted by the Department of Health, Disability and Ageing, "Responsible GPs and practices are required to meet the servicing requirements to be eligible for incentive payments, including delivering:

• "Two eligible care planning services over a 12- month period [and]
• "Two eligible regular visits per quarter, each in a separate calendar month, delivering at least 8 regular services over a 12-month period."

Patient eligibility:

• must "permanently live in a residential aged care home, not including respite care "
• be registered "with MyMedicare and link to an eligible practice and responsible GP"
• "have the General Practice in Aged Care Incentive indicator selected on their MyMedicare profile by their practice. "

How can RACHs assist?

GPACI-registered General Practitioners visiting your RACH may benefit from your assistance in signing up residents, if registration has not yet occurred.

You can assist residents to register for MyMedicare either through their Medicare online services or by supporting the completion of a registration form.  Residents are not required to attend a practice in-person for MyMedicare registration completion.

For more information about GPACI for residential aged care providers, view the Australian Government’s ‘Information kit for residential aged care providers: Understanding, communicating, and supporting the General Practice in Aged Care Incentive’ resource.

Additional Department of Health, Disability and Ageing Resources:

• Frequently asked questions for residential aged care providers
• Residential Aged Care Provider Staff Presentation
• Introduction to General Practice in Aged Care incentive - Webinar

For further information or to understand how this incentive works, please contact the aged care team at: [email protected].

The implementation of digital health tools can assist residential aged care homes in enhancing the quality of care provided to residents through better management of health records, more accurate tracking of health metrics, and streamlined communication with healthcare professionals.

Country SA PHN has received funding to support the following digital health initiatives:

Telehealth

This initiative aims to support timely access to primary health care professionals for residents and better equip residential aged care homes (RACHs) with telehealth capabilities by:

• assisting RACHs with telehealth facilities and equipment to enable virtual consultation with primary health care professionals.
• providing training for RACH staff to support them to have the capabilities to assist their residents in accessing virtual consultation services.
• promoting the use of enablers such as My Health Record to improve the availability and secure transfer of resident’s health care information between RACH, primary care and acute care.
• improve technological interoperability between the aged care and health systems.

Country SA PHN has supported residential aged care homes through a range of telehealth initiatives designed to improve access to virtual care and strengthen connections between aged care, primary care and acute care services.

This work included the delivery of Residential Aged Care Home (RACH) Telehealth Support Grants, which assisted organisations to establish suitable telehealth solutions and increase access to virtual consultations for residents. Country SA PHN also delivered face-to-face workshops, webinars, resources and education sessions to build staff confidence and capability in using telehealth.

As a result of this work, a range of telehealth education and implementation resources remain available to residential aged care homes through the CDM Plus Corporate Membership online portal. These resources include online learning modules, digital and physical resources and practical tools to support the ongoing use of telehealth in residential aged care. The CDM Plus Corporate Membership portal is available to all Country SA PHN residential aged care homes. To access these resources, register via the Corporate Membership Portal using the registration link provided.

For further information or support, or to enquire about available physical resources, please contact the Ageing Well team at [email protected].

Country SA Primary Health Network (PHN) continues to support vaccination awareness and uptake across the region in partnership with the Australian Government Department of Health, Disability and Ageing and the primary health care workforce. As vaccination recommendations change over time, it is important for older adults to remain up to date with routine and recommended vaccinations, including COVID-19 vaccines. Residential aged care homes play an important role in ensuring residents are informed about and offered recommended vaccinations in line with current Australian Immunisation Handbook recommendations.

COVID-19 Booster Recommendations for Older Adults

COVID-19 vaccination is strongly encouraged for residents and staff of aged care homes and remains the most effective protection against severe illness, hospitalisation and death from COVID-19. In Australia, COVID-19 vaccines are free (including for people without a Medicare card).

Current booster recommendations for older adults are:

People aged 75 years and over – Recommended every 6 months.

People aged 65–74 years – Recommended every 12 months, with the option to consider an additional dose every 6 months following discussion with a healthcare provider.

Free Vaccines Available Through the National Immunisation Program (NIP)

The National Immunisation Program (NIP), supported by the Australian Government, provides free vaccines for eligible children, adolescents and adults who hold, or are eligible for, a Medicare card. The NIP recommends and funds the following vaccines for older adults:

Shingles (Herpes Zoster) Vaccine - A free two-dose course of Shingrix® is available for:

• People aged 65 years and over
• Aboriginal and Torres Strait Islander people aged 50 years and over

Pneumococcal Vaccines - Free pneumococcal vaccination is available for:

• Adults aged 65 years and over
• Aboriginal and Torres Strait Islander adults aged 25 years and over

Respiratory Syncytial Virus (RSV) Vaccine - Free RSV vaccination is available for:

• Adults aged 75 years and over
• Aboriginal and Torres Strait Islander people aged 60 years and over

Influenza (Flu) Vaccine – The influenza vaccine is updated annually and is available through government-funded annual influenza programs. Funded influenza vaccination is available for:

• All adults aged 65 years and over
• Aboriginal and Torres Strait Islander people aged six months and over

Country SA PHN receives early intervention funding to support older people to live at home for as long as possible.  This activity aims to provide people with early intervention activities that will support healthy ageing and ongoing management of their chronic conditions, to minimise the effects on functional decline and deterioration as they advance in years.

This activity will commission early intervention activity to support:

• people with chronic condition self-management to minimise health decline and optimise health and wellbeing, and  
• carers, family, significant others, and health professionals in the management of people's care to support healthy ageing and reduce unnecessary transfers from home to hospital.  

The service currently funded under early intervention is:

The Nightingale Program - Dementia Australia

The Nightingale Program is a palliative model of advanced dementia care.  The service is available free of charge and provides strategies and advice to support people living with advanced dementia, their families and care providers, with a focus on promoting choice, well-being and forward planning.  

The program supports people living at home, in residential aged care and community settings.

For further information including how to access the program please visit Dementia Australia or download a brochure.

As noted by the Australian Government Department of Health, Disability and Ageing, "The Royal Commission into Aged Care Quality and Safety identified medication management and safety in residential aged care homes as an essential area for improvement."

The ACOP Measure provides funding to engage aged care credentialed pharmacists to work on-site in RACHs in a clinical role to improve medication management for residents.

Support Available Through Country SA PHN

Primary Health Networks are now able to assist residential aged care homes with engaging on-site pharmacists if required. Country SA PHN's role includes:

• raising awareness of the ACOP Measure across residential aged care homes
• identifying eligible pharmacists that can connect with residential aged care homes wanting to participate

Country SA PHN will not be employing Aged Care On-Site Pharmacists.

To support implementation of the ACOP Measure across regional South Australia, Country SA PHN has commissioned the Pharmaceutical Society of Australia (PSA) to:

• identify eligible pharmacists interested in participating in the ACOP Measure
• support pharmacists to obtain the required ACOP credentialing
• coordinate connections between eligible regional pharmacists and residential aged care homes
• assist aged care homes to understand the ACOP Measure and the benefits of integrating an on-site pharmacist into their existing care team
• support collaboration between aged care homes and pharmacists to develop services that meet local needs
• provide guidance on the integration of pharmacists into medication management, clinical governance activities, and the use of the National Residential Medication Chart (NRMC).

Through this partnership, Country SA PHN and PSA aim to support aged care homes and pharmacists to establish sustainable, collaborative models of care that improve medication safety and health outcomes for residents.

For further information, visit the Department of Health, Disability and Ageing website, or contact Country SA PHN at: [email protected].

Resources

• Aged Care On-site Pharmacist Measure – Pharmacist and Residential Aged Care Home Guide
• Aged Care On-site Pharmacist Measure – Information Flyer for Residential Aged Care Homes
• Aged Care On-site pharmacist | Australian Government Department of Health and Aged Care
• The Aged Care Onsite Pharmacist (ACOP) Program - Country SA PHN and PSA Flyer