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The industry peak bodies however are on the record as declaring this approach as being a "blunt" instrument, limiting flexibility and responsiveness to changing circumstances. And the Aged Care Act is not helpful in that it does not stipulate staffing levels or qualifications. The Commonwealth's Aged Care Act (1997) requires only that the approved provider 'provide such care and services as are specified in the Quality of Care Principles in respect of aged care,,,, and maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met' . This vagueness can readily interpreted managerial as "whatever you can get away with".
Staff ratios such as those implemented in Victoria are described by the industry, as mentioned earlier, as a blunt instrument and does not allow for flexibility in the face of a heterogeneous population with changing care needs. The inference is that nursing rosters in aged care are dynamic instruments forever in a state of flux responding to variable care needs in real time. The fact is nursing rosters are relatively static tools. By and large the only movement is downwards in terms of hours and downwards in terms of trained staff. This has been a long term trend in spite of an increase in resident's levels of dependency and need.
Instead of embarking upon a meaningful examination of the root cause or causes of these social crimes of neglect the government has decided to merely rejig its current means of oversight. According to the government it proposes to set up a "powerful new watchdog" as part of an overhaul of the aged care industry. The implication is that increased scrutiny will lead to a commensurate increase in the quality of care. Yet there is no evidence to support such an assumption. Furthermore this announcement has seen little response from the industries peak organisations other than a few benign references to streamlining and associated efficiencies that may arise. You would be forgiven if you think that this initiative was taken subsequent to widespread discussions with the captains of the aged care industry.
The industry is already subject to relatively intense scrutiny by the present Aged Care Standards and Accreditation Agency alongside the Aged Care Complaints scheme. These organisations routinely name and shame poor performers, apply sanctions and install interim administrators where warranted. Too often a facility is sanctioned or threatened with sanctions by the Commonwealth with what reads like endemic cultural failings. Usually subsequent audits declare the facility has redeemed itself. Recurrent organisational failings suggest such cultural redemptions are cosmetic at best.
These measures have not, it seems, seen any long term rise in compliance or standards of care. It is implausible to believe increased oversight will, in isolation, turn things around. Without a serious examination of the reasons underlying continuing problems within the industry we can expect nothing to change.
With that in mind the only explanation put forward regarding continued failings within Residential Aged Care that has any validity is linked to staff levels and skill mix. The average allocation of care hours per resident per day in residential aged care is in the order of 2.9. This allocation is designed to deliver and oversee the delivery of medicines, attend to skin care including the management of wounds both simple and complex, personal hygiene, assistance with eating meals, undertake a variety of complex care procedures, provide palliative care, offer companionship together with psycho-social support to assist in the management of behaviours of concern and the issues that may simply arise from living in a shared and communal setting. One can easily add to that onerous requirement of documentation, complying with various audits linked to continuous improvement, various committee responsibilities, education, liaising with families, assisting visiting medical and allied health practitioners and managing any critical events such as a fall, assault, medical emergency or unexpected death.
None of this is meant to diminish the value of the care offered by carers, who, as a rule provide excellent service. The danger however lies in what they do not know in relation to dealing with a deteriorating resident, responding to changes in condition or a clinical emergency or managing complex behavioural issues.
The paucity of care hours can be demonstrated in a variety of ways – the ongoing saga of episodes of neglect and abuse that appear year in and year out should be enough to prompt the average person to outrage – but it is the more mundane events that perhaps might strike home more personally to the average person whose loved one is in care.
Kym Durance is a health professional and has worked both as a nurse and in hospital management. He has managed both public and private health services in three states as well as aged care facilities; and continues to work in aged care.
However, this morning a quick glance at Rep. Broun's page seems to show that the somewhat tense post has been deleted, but regardless, it's a little difficult to pull back a tweet when it's been retweeted or commented on thousands of times already. This whole incident sort of makes me a little nostalgic for last year when Joe Wilson had enough courage to just yell stuff from the audience, instead of tweeting from another room and then pretending it didn't happen.
Fri., April 26, 6-10 p.m.
@ Tucson Music Hall Sun., April 28, 8 p.m. 210 S. Church Ave.
Photo by Staasi HeropoulosJerald Reinford, co-owner of Countryside Woodcraft on Route 20 in Russell.
RUSSELL – When Jerald Reinford moved from the family dairy farm in western Pennsylvania to Western Massachusetts 10 years ago, he came to help build a Christian school for the Ukrainian community in Westfield.
But, Reinford also needed to make a living, so he turned to what he knew best – building furniture.
"I grew up on a farm, and on a farm you're sort of a jack of all trades. I did some woodworking on the farm," he says.
Reinford and two friends, now business partners, created Countryside Woodcraft on Route 20 in Russell. The organization is celebrating a decade in business this year, but perhaps more important than that is its growth.
The company has been able to control it, to stay small and limit revenue. They make just enough to live good, healthy lives, they say.
"It would be easy to grow the business so it does take some effort to control it," said Reinford. "We're not here to be the richest people around. Money doesn't buy happiness."
Countryside Woodcraft makes and markets a range of handcrafted dining, bedroom and kitchen pieces featuring "the simple lines of Shaker to the sturdy slats of Mission furniture."
View full sizePhoto by Staasi HeropoulosThe well-constructed, simple Shaker design of this sample of kitchen cabinetry is part of what attracts customers to Countryside Woodcraft.
The company used to advertise a little, but they've cut back, not because business is down, but because it continues to grow.
First year revenue was $600,000; now it's $2 million. The staff has grown from six to 14 people, and the showroom has grown 25 percent.
"Even though we're way out in the sticks people find us," Reinford said. "Our focus is not to become a national chain. We'd like to stay a small, family business."
Even in a down economy, staying small has become increasingly difficult to do, as people discover this business tucked in the woods, drawn by the pristine pieces made from native New England hardwood and the charm of the people who make it.
"Most people seem to appreciate it. We don't use it as an ulterior motive," said Reinford.
Reinford, his wife and six children are among the founding families of the Pioneer Valley Mennonite Fellowship. Once work was completed on the Ukrainian church, Reinford and his fellow Mennonites built a church of their own in Russell; membership today stands at 14 families.
"We prefer a small church, a small community and small businesses," he said.
The only employees at Countryside are friends and family.
Dan Fox is a carpenter and member of the church.
Photo by Staasi HeropoulosDan Fox is a carpenter at Countryside Woodcraft and member of the Pioneer Valley Mennonite Church that Countryside owners founded.
"Everybody tries to live a life like Christ lived. We try to get along together; it's just an atmosphere of love and caring about each other," he said.
There are Bible passages and scripture passages on the walls. "Amazing Grace" is the background music on the telephone when callers are placed on hold.
Fathers bring their sons to work.
"I want to teach him the practical lessons of life. I enjoy working with him," said Raymond Glick, who builds furniture while his 8-year-old son Sheldon looked on one summer afternoon.
Countryside may not be obsessed with profits, quarterly earnings or the minute-by-minute minutiae that drive gyrations in the stock market.
But the owners do keep their eye on changing lifestyles, consumer trends and modern technology. Built into the simple design of Shaker cabinetry is a retractable computer monitor programmed to display recipes.
And with an eye toward innovation and efficiency, what used to be a decoration-only fake drawer is now re-designed to pull out with a purpose.
Even with a shrinking marketing budget, Countryside still produces slick brochures, has a modern website, does some direct-mail pieces and runs occasional promotions like "tax free" days, chicken barbecues and free lemonade.
The programs have been successful, but it is literally the writing on the walls – the subtle religious messages – family values and tours of the workshop that make this place a spiritual retreat of sorts.
"We're Christians, and we love the Lord and the Lord has given peace in our hearts. We love to share that message with others," Reinford said.
"A lot of unhappy people, miserable people come through our doors, and we love to present hope to them that they can actually enjoy life and the Lord can help them though their troubles and trials."
If the goal here is slow growth, then the business is meeting expectations. The cool economy has helped, but what happens when things heat up again?
"I imagine if it was a super-heated economy it would take a lot more effort to slow things down," Reinford said.
"We're not opposed to any growth. It's more the concept of working with our families that we'd like to preserve."
Abe Wertheimer (Jordan Gelber) is an underachieving schlub. Fat and 35, he lives with his parents (Mia Farrow and Christopher Walken) and stocks his bedroom with fantasy-film posters and Simpsons action figures more suitable for a 12-year-old. Yet when he kisses Miranda (Selma Blair), a fellow chronic depressive, she muses, “Oh God, that wasn’t horrible.” One or two women, including his father’s secretary (Donna Murphy), love Abe, in the way a child may protectively cherish an injured gerbil. Or their affection exists only in one of Abe’s daydreams, which appear frequently and furtively in Todd Solondz’s sweet, neurotic romantic comedy. Some folks see a sadistic, derisive side to Solondz’s earlier films (Welcome to the Dollhouse, Happiness, Life During Wartime); we think they show a daring empathy for ordinary people capable of awful behavior. Any misapprehension about the writer-director’s attitude is erased by watching Dark Horse. Ugly is beautiful in Solondz’s gentlest triumph.
Alexander Mead was the only florist in Greenwich when he built a large home in the Victorian style on Lauder Way before the turn of the 20th century. Alexander, son of Sanford Mead, and grandson and great-grandson of successive Peter Meads, was born in the 18th century Mead homestead that once stood in front of the present house.
William Mead emigrated from England and arrived in Stamford in 1641. His son, John, is considered the founder of the Greenwich Mead family. In 1660, he settled in central Greenwich, buying land in what was called Horseneck from Richard Crabb.
Alexander married Matilda Grigg, and their son, Henry S., was a partner in the floral business whose several greenhouses supplied clients in surrounding towns, as well as in New York and New Jersey. Alexander was said to have brought the first load of building materials to start the Second Congregational Church in central Greenwich and remained active at the church throughout his life, according to The Historical Society of the Town of Greenwich.
Alexander Mead's homestead was restored and greatly expanded in 1991, with architecture by Rutherford Associates in Old Greenwich and construction by Wadia Associates of New Canaan, according to Janice Grijns of Coldwell Banker in Greenwich, who has listed the house at $6.5 million.
Today, it's a 9,000-square-foot, nine-bedroom, five-bath home with two powder rooms. Crafted of stone and shingle, the house is sited on 1.9 unusually level acres that also hold the original carriage house, which now is a guest cottage, with cathedral-ceiling sitting room, kitchenette, loft bedroom, bath and laundry.
A deep, covered porch with ceiling fans runs along the front facade of the main house, distinguished by the huge fieldstones that accent the wall and comprise sturdy pedestals for the single and paired columns that span the first level. Above, another porch with balustrade runs along the second floor of the house, with diamond designs in the windows and a door topped with a lunette window.
On the third floor, there are two mini-turrets, and an oval medallion window with elaborate tracery decorates a gable peak.
The wide main hallway opens to a living room with fireplace bearing an urn-and-floral-garland motif and a porch. The urn motif reappears on the pillars of the second-floor porch and on the white fencing around the property.
Across the hall is the fabric-lined library with window seats, bar, icemaker and refrigerator. The dining room has closets for linens, china and crystal. The large island kitchen opens to a family room with fireplace, both with bleached floors.
The second level has a master bedroom with fireplace and bath, with both shower and a deep whirlpool tub spacious enough for two. There are four additional bedrooms on this level, with Jack-and-Jill baths for each pair.
The third floor has another four bedrooms, a children's computer room and library with a window seat, a large office and one bath, with room for more.
The lowest level hosts a recreation room, powder room, wine cellar and a room dedicated to storage of sports equipment.
The kitchen and family room open to a wide porch overlooking the swimming pool, whose entry is through a rose-covered archway that leads to the rosebush-lined pool with spa. There's even a button in the kitchen to preheat the spa and an outdoor shower for pooltime use.
There are 10-foot ceilings virtually throughout, a perfectly pruned Pee Gee Hydrangea in the front yard, along with a double-entry, gated driveway to the private road.
The Lauders first arrived in Greenwich in 1902, when George Lauder, the Pittsburgh industrialist, engineer and adviser to his first cousin, Andrew Carnegie of Carnegie Steel, married Katharine Rowland of Greenwich. In the engagement announcement, The New York Times said Lauder "has selected a site for a residence near William G. Rockefeller's summer home, not far from Mr. Rockefeller's deer park and farm. He purchased today 25 acres from Alexander Mead, adjoining Rock Ridge."
Perhaps Mead was less interested in farming after a number of his barns were burned in 1884 and his cattle crippled by hamstringing -- cutting the large tendon in the back of the leg's hock.
The property Lauder bought was said to have cost $30,000, and the budget for the house was estimated at a minimum of $100,000. An Internet postcard of the Lauder house shows a large Tudor Revival mansion with steep gables, half-timbering and a red tile roof.
In 1903, Lauder became an original member of the Greenwich Hospital Association, which built the first Greenwich General Hospital on Milbank Avenue in 1906.
In 1908, The New York Times reported that Percy Rockefeller's automobile frightened the horse pulling George Jr.'s carriage down Greenwich Avenue at 8:30 a.m. The horse and carriage were ultimately stopped by colliding with a telegraph pole.
The Lauder family, along with Mrs. J. C. Greenway, are remembered in Greenwich for their 1918 gift to the town of almost-four-acre Island Beach.
The island, once known as Little Captain's Island, then held an amusement park, a dance pavilion and wood-frame summer cottages set along the shoreline. Island Beach was given to the town as a memorial for George Lauder Jr., who died of influenza at the age of 37.
An avid sailor, George Jr. kept his boat "Endymion," a 136-foot black schooner together with its 20-man crew, in New Haven during the weekdays when he attended Yale. On the weekends, they all returned to Greenwich.
George Jr.'s daughter, "Polly" Lauder, married famed world heavyweight boxing champion, Gene Tunney, son of a New York longshoreman. They lived at the 1742 Star Meadow Farm of 400 acres on Erskine Road in North Stamford, where they raised cattle and sheep. A successful New York businessman, Tunney was an executive of the American Distilling Co. and Morris Plan Bank, a unconventional provider of credit to low- and middle-income consumers. Tunney and Arthur M. Starck of the Stamford Building Co. also developed Havemeyer Park in Old Greenwich, designed in 1946 primarily as housing for veterans of World War II.
Improving manufacturing processes by using product lifecycle management, supply chain optimisation and enhancing operational processes will go a long way to adding business value through IT. The biggest gain, however, comes when IT can drive product innovation.
Susan Unger, chief information officer at DaimlerChrysler, has been keen to get the most from new IT. "As a chief information officer you constantly look at how IT can be more efficient. It is important to use IT innovatively for our products."
She runs twice-yearly meetings with DaimlerChrysler's key IT supplier. "We discuss our business challenges and where we want to go as a business," she said. Unger uses a balanced scorecard to assess how each supplier delivers innovation to DaimlerChrysler's business.
Along with the strategic suppliers, DaimlerChrysler's Advanced Technology Group, headed by the chief technology officer, has been tasked with looking at innovation.
Unger said "The Advanced Technology Group looks at interesting technology from both small and large companies, based on specific business deliverables."
Unger, who is speaking in two week's time at the ICT World Forum running alongside CeBit in Hanover from 17-19 March, said IT directors need to look constantly at how they can improve the business.
One example at DaimlerChrysler is an engineering grid that runs crash simulations, a job that would normally be run on a supercomputer. "We have a project in our commercial vehicle division using 160 workstations to run simulations between 6pm, when the engineers leave, and 6am," said Unger.
IT directors should also look at more down-to-earth IT strategies to reap savings, she added.
"We have been working on datacentre consolidation, where we aim to move all our servers into four global datacentres. "It is a long journey but we are seeing a 30% saving [on IT costs]."
To keep abreast of technology outside DaimlerChrysler, Unger is among a handful of CIOs on the board of Ciose, a venture capital fund supported by Kleiner Perkins Caufield & Byers.
For four years, members of New York City's largest janitors' union have picketed outside the Port Authority Bus Terminal to protest its use of a nonunion cleaning contractor.
But the union announced yesterday that it was ending its picketing and its four-year strike because the contractor, Laro Service Systems, has signed a labor contract that will improve wages and benefits for the 170 cleaning workers at the terminal.
The agreement is an important step for the union, Local 32B-32J of the Service Employees International Union, which had for years put up a sporadic fight as many New York building managers turned from unionized cleaning contractors to lesser-paying nonunion ones.
Last year, the local stepped up its fight against Laro after the parent union ousted its longtime president, Gus Bevona, and installed trustees who took a more aggressive approach to labor disputes. Last April, the union organized an anti-Laro rally that attracted 5,000 union supporters, including the Rev. Jesse Jackson and John J. Sweeney, the A.F.L.-C.I.O.'s president.
Local 32B-32J began its strike in 1996, when Laro won the Port Authority's cleaning contract and reduced wages and dismissed many of the building's unionized janitors. Under the new contract, some of those laid-off janitors will be rehired immediately while others will be rehired as openings become available.
The contract, union officials said, also improves health and pension benefits and raises wages for the terminal's cleaners to $16.43 an hour from about $15.
Robert Bertuglia, Laro's chairman, said that all of his company's Manhattan operations would be unionized. Because most Manhattan buildings use unionized contractors, he said, Laro's decision will enable it to obtain more contracts.
The union is battling another nonunion contractor, Golden Mark, which has won cleaning contracts with more than a dozen buildings that once used unionized cleaners.
Michael Fishman, the local's trustee, said the fight against Laro and Golden Mark was part of an effort to reverse the trend by commercial buildings to switch to nonunion contractors.
''In an industry that routinely pays nonunion workers the minimum wage with no benefits, the only thing that separates our members and their families from poverty is their union,'' Mr. Fishman said.
John Mahoney's death was caused by multiple health complications, which included brain disease and lung cancer.
Our sources say the "Frasier" star's official causes of death include brain disease, lung cancer and seizures. We're told Mahoney also suffered from kidney disease and diabetes.
We broke the story ... Mahoney died Sunday in Chicago while in hospice care.
Our sources say Mahoney was cremated.
Mahoney played Kelsey Grammer's cranky father, Martin Crane, for 11 seasons on the hit sitcom. Shortly after John's death, Grammer posted, "He was my father. I loved him."
He most recently had a recurring role starring on the TV show "Hot in Cleveland," which ended in 2014. He's also had appearances on movies like 'American President,' "Say Anything..." and "Eight Men Out" over the course of more than 30 years in the industry.
Whether you have an open-source system or a proprietary one, your original underlying requirement will be the same – as it was in the case of the learning management system we needed at Tesco.
Open source wasn’t on the agenda early on, as it was not a route that had been taken often before. Historically we have always preferred to buy a product from a supplier and therefore have the comfort of knowing someone is accountable for its delivery.
We piloted a proprietary system at the beginning of our journey and quite quickly realised that we would have to radically rethink our approach. It was at this point that open source became a contender.
When we started the discussions internally there were concerns from two main areas - our IT and purchasing departments. For IT, the concerns centred on how to support the system and whether we wanted to host it internally. For purchasing, the real debate was how to hold someone accountable for a system that isn’t owned by anyone.
It became clear that open source was the only viable option from a cost perspective, so we dealt quickly with the concerns raised, by hosting externally and having a supplier look after the development, support and maintenance of our system.

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