Transcript Visiting Angels Nursing-Towards Formal LTC

VISITING ANGELS NURSING AGENCY
LTD
TOWARDS FORMAL LTC SERVICE
MODELS
2ND IAGG AFRICA REGION
CONFERENCE 6TH - 8TH DECEMBER 2016
Introduction: Background
A
private limited company incorporated
in 2012
 Not a franchise
 Motivated mainly by the passion to start
a business in nursing practice, with a
previous experience of home-based care
as a young girl growing up in the
countryside.
Background…
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Visiting Angels opened its doors to help
address increasing health needs and costs
incurred in treating people with chronic and
debilitating conditions in Nairobi, Kenya
Has widened its scope to other parts of the
country including Kisumu, Mombasa and
Nyeri counties, to meet increased requests for
assistance by more people and families, in
care provision in their own homes.
Description of Broad service
type
 In
general, the package of services
offered by Visiting Angels include home
nursing, rehabilitation, personal care, day
and night care, respite care, assistive
devices.
General service types
 Package
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offered is:
Home nursing; 12 hour shift or 24 hour shifts,
house calls ( wound dressing, IV drug
administration)
General rehabilitative services
Wound care
Specific service types

Home based nursing care comprising
personal care to compensate for functional
limitations (mobility in the home, dressing,
eating, toileting, escort to doctors’
appointments etc.); specialized home
health care and services (medical care,
nursing care
Specific service types…
 Physiotherapy,
 Occupational
therapy
 nutritional advice and psychosocial
services, and supervision of medication);
accompanying client to social places,
spiritual support services
Specific service types…
 Disease
management program for older
people – This aims to make early or timely
diagnosis of potential conditions in the
elderly clients. The program is run and
managed by medical professionals who
ensure that tests, investigations and
medications are done and administered
appropriately, that hospital and clinic
visits are adhered to and that doctor’s
instructions are abided by it.
Specific service types…
 Training
of in-service nurses and patient
attendants
Operation and scope
 The
team consists of an administrative
and care management team that
supervises the care process as
undertaken by staff that are expected to
be available to provide clients with part
time, full time or 24-hour live-in care as
required.
Planning the services
Patient
attendants
Physiotherapy
Patient
Nursing
OT
Planning & management of
care
 Initial
assessments
 Develop an individualised care plan
o These include initial and ongoing
assessment, planning, and management
of care, organising shifts per patient and
supervision of other services as carried out
by the appropriate professional.
Financing
 Cash-paying
clients
 Insured clients
 Must keep expenses / overheads very
low
The provision of quality care
In-depth assessments, caregiver introductions,
ongoing supervision and care management.
 Involving the family in the care plan at the
point of inception
 Continous supervisory visits and monitoring the
care plan, review if required
 Progress reports to family and/or doctors on a
monthly basis or as required.

Provision of quality care…
 The
Agency has established an internal
system of quality assurance, which
includes:


supervision
setting standards to ensure quality is
sustained
and enabling clients and families to
provide feedback on the quality of their
care (through specially designed
questionnaires).
Providing integrated care
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Work with client’s family members and /or
primary caregiver
Home-based rehabilitation
Internal communication; as in emergencies
Family doctors- upon invitation by family
Contract with emergency service providers
Careful recruitment and allocation of staff ;
certificates, police certificates of good
conduct
Ensuring equity in access
 How
do we determine client eligibility to
care services?
 Mainly
plan.
guided by the initial assessment
Ensuring decent & fair working
conditions for workers
 We
have a pool of staff of all cadres
 Each staff signs a short term contract
 All report to the agency for the time they
are working for us.
 Work in shifts to cover about 60 hours a
week
How do families view LTC as
relating to customary norms?
 Family
carers are partners in the service to
their loved one.
 These circumstances require a significant
effort to guide, educate, and inform
clients and their families.
 The broad commitment by Visiting Angels
is to tailor services to individual and family
needs.
Future sustainability of the service
model
o
Financing
 Some
insurance companies buying into the
idea of funding home based nursing care if
the client has the relevant medical policy.
 The challenge is that many older people do
not have health insurance policy and this
affects sustainability because it means the
Agency can only draw on a limited target
market.
Future sustainability….
o
Workforce

Some carers have opted out of Visiting Angels
preferring to start up as individuals on a
freelance basis so as to make more money, be
free of supervision etc. but with the realization
that working under the umbrella of the Agency
is beneficial to them in terms of offering security
from abuse, allowing flexible working hours,
providing credibility etc. they have opted back
in. It is envisaged that with an increase in client
volume, the practice will be able to hire staff on
a longer term or permanent basis.
THANK YOU
ASANTE SANA