Consumer Directed Care in residential aged care: Evaluation of the Resident at the Centre of Care training program

The 2012 Living Longer Living Better aged care reforms impacted significantly on aged care service delivery for Australians. These reforms encouraged a sector-wide shift to a more person-centred approach emphasising consumer choice and wellbeing. The introduction of Consumer Directed Care (CDC) in aged care homes requires providers to more comprehensively meet the often-complex individual care needs of each care recipient, substantial regulatory burden, and mounting consumer expectations, including residents’ demands for more care choice, and to be treated with greater dignity, autonomy and independence. National and international examples of CDC in aged care homes are limited, with the majority of studies exploring CDC delivery in community aged care (Benjamin, 2001; Eustis, 2000). While some person-centred approaches have been evaluated in the Australian aged care context (Chenoweth et al., 2015; Stein-Parbury et al., 2012), with some positive outcomes, staff training programs where staff are trained to ensure that decision making about care is directed by the resident (i.e. CDC), have not been evaluated in aged care homes. Our project was designed to rectify this gap in knowledge by providing an innovative approach for CDC implementation in Australian aged care homes. Our research (e.g. McCabe et al., 2017) and that of others has identified a range of critical factors for sustainable evidence-based change in aged care practices. Difficulties associated with implementing a resident-directed approach include the lack of staff empowerment to handle the shift towards CDC philosophy, job restructuring, resistance to change, and the need for strong leadership. There is a pressing need for workforce training to implement CDC approaches that include appropriate attention to change management, leadership strategies and the working relationship between carers and carerecipients. Our Resident at the Centre of Care (RCC) training program was developed to address these critical factors in order to drive real and sustainable change towards implementing and embedding CDC in residential aged care.