Employee engagement: Transforming aged care through a family model

Twilight Aged Care is a Sydney-based residential care provider with approximately 220 staff providing care for 164 residents across four homes.

Over the past few years, Twilight has been implementing a successful change program to improve the care provided to their residents. Despite the difficulties of a pandemic, this change has been achieved through regularly gathering feedback and empowering staff. 

Twilight worked with Voice Project (now Xref Engage) to run regular employee engagement surveys. In 2020, they also ran a service quality survey to gather feedback from the residents’ families.

Twilight’s transformation has led to excellent satisfaction with services (98%) and strong levels of staff engagement (87%). Watch their story below and see why they are a 2021 Change Challenge Award winner. 

Developing a family focus

In 2018, Gladys Maseko, then the Facilities Manager of the Twilight Hunters Hill home, engaged her staff an innovative collaboration. She asked her staff one simple question: ‘If your parent was to come into aged care, would you place them in this home?’

As staff shared their honest answers, this sparked a conversation about why/why not. This helped identify areas for improvement as they reviewed how they could design a model of care that would be more person-centric.

Consequently, the home implemented a ‘buddy’ system where each staff member was paired with a resident, and empowered to advocate for their needs and interests at staff meetings. 

The buddy became the resident’s voice on relevant committees and within ‘care circles’. Incidents and feedback were discussed openly within a multi-disciplinary approach between medical specialists, recreation staff and chefs.

“We found that staff preferred this model, based on the concept of a family, as work become less task focused and more about helping the residents,” Twilight CEO Neil Wendt said.

Staff self-nominated to be ‘Family Champions’ and enhance the model. Visits to other aged care providers were arranged to learn further from other care innovations. 

Staff began to eat meals with the residents. Buddies also presented updates on their resident at all-staff meetings, which the residents’ families were invited to attend.

“When the buddies did their presentations all about the resident and their interests, the families were blown away - some of the buddies knew mum or dad even better than they did,” Neil said.

“I joined Twilight at about that time,” Neil said, “I saw the model and I thought it was fantastic. I was supportive of rolling it out across our other homes as the new Twilight Family Model of Care.” 

The new approach received validation from a regulatory audit in early 2019, which found the model was well placed to support new care standards that were soon to be introduced across the sector.

Supporting staff to succeed

“We were committed to supporting our staff as we made this change. We held our first employee engagement survey with Voice Project (Xref Engage) in November 2019 to gain a baseline of what staff thought,” Neil said. 

Twilight undertook an initiative to reduce its casualisation rates by revamping recruitment practices and offering staff more permanent roles. It also focused on areas for improvement identified by staff feedback.

To assist with embedding the new model, staff were provided with training in person-centred care.

“You need a great Manager of Learning & Development that can relate to staff and is passionate about seeing their knowledge and skills grow. We have this in Fiona Wallace,” said Neil.

Manager of Staff Services, Emily Hams says maintaining a focus on celebrating achievements and life events together as the ‘Twilight Family’ was important in helping staff weather the difficulties when the COVID-19 pandemic hit.

“We give awards to people who complete training, we also recognise people’s work anniversaries, birthdays etc. Even with masks on, and socially-distant, we felt it was important for them to have something to look forward to, and to celebrate when you can,” Emily said.

Twilight also supported staff through distributing protective equipment and helping them to access vaccinations when available. They also provide mental health resources and reached out to individuals with emotional and financial support where needed.

“Without Emily we couldn’t support the staff the way we do. She is just wonderful at staying in touch with all staff and supporting them when they have issues,” Neil said.

Despite dealing with a pandemic, Twilight’s next engagement survey in 2020 showed significant positive shifts in scores for focus areas including Leadership (+14%), Processes (+10%) and Flexibility (+6%).  Twilight’s survey scores so strongly outperformed peers in their sector and staff engagement levels were so high (87%), that they won a Best Workplace Award.

“When compared to the Aged Care sector we have achieved some significant positive differences in a number of questions, including Recognition (up 45% on sector); Cross-Unit Cooperation (up 38%); Involvement (up 30%); and Progress (up 29%),” Neil said. 

A pulse survey held as a ‘COVID check-in’ with staff in late 2021 showed that engagement levels and wellbeing scores continue to be excellent. 

Meanwhile, a Family Survey held in November 2020 showed that 98% of families had high satisfaction with Twilight’s services.

Emily said they also hear positive feedback from residents: “We hear some amazing stories - like a 90-year-old who didn’t know she was good at art, is now an incredible artist, and she lives for our weekly art therapy class.”

“In the Family Model of Care, staff really share the value of wanting to improve someone’s life.”

As for Gladys, she continues to lead improvements in care as the Clinical Governance Manager at Twilight. She has also published a book that shares the aged care experience through the eyes of an elderly person, titled The Journey of an Aching Heart, Through a New Leaf.