Manawanui is passionate about making a difference in the lives of disabled people, through providing the resources to control their own funding and hiring of who supports them. But what about older people – who also require home support and the ability to manage their funding?

Manawanui has been running a long-term trial with The Bay of Plenty District Health Board and a Papamoa retirement village to assess how older people either living at home or in a retirement village setting could gain more control and support from individualised funding.

I talk to the project team at Manawanui, as well as Graeme Wilkinson, President of the Retirement Villages Association and CEO of Generus Living, who were a participant organisation on the trial. They reveal some surprising beneficial gains, not only on reliability and cost-savings, but also on mental and physical wellbeing!

Graeme, what were the main objectives of the pilot project for your village residents and staff?

We wanted to allow our village residents to access care that was more flexible, efficient, reliable, and delivered in a way they wanted, compared with the traditional Home-Based Support model. The residents had trust and familiarity with our staff and were able to select not only traditional care support, but also more preferred and tailored outcomes, e.g., evening bed preparation.  At the same time, it allowed our staff to be more closely connected to the residents and ensure a more holistic care focus.

What were the biggest challenges faced during the pilot, and how were they overcome?

Getting some residents to understand how Individualised Funding works was sometimes a challenge if the traditional Home-Based Support was all they knew. This was generally overcome by having a staff member onsite acting as agent, taking the stress away from the resident and their families. Some residents were concerned the pilot might not continue, as they were already receiving some type of assistance from an external provider and were nervous about a change. However, seeing others receive consistent and satisfying care has helped them make their decision and all participants report significantly higher satisfaction and security.

 Initially there was an additional staffing cost for us to ensure sufficient resources existed to be able to provide the various services required and requested by residents. The creation of a new onboarding process for residents took some time and meant operational efficiencies also took some time. However due to the unanimous acceptance, the balance between cost and service meant it was a win-win outcome for all parties and is now a well-managed and easy process.

What were the most significant positive outcomes of the pilot project?

Both anecdotally and through targeted surveys, the project highlighted the high level of satisfaction of all residents and their families. A crucial factor was reliability - the service was always provided as requested, with the days and times of the promised service always being met, and no days/times ever being missed. This provided a level of emotional security that was previously missing, particularly through the Covid period.

Sharla, you are the Manawanui Project lead for Health of Older People. What are your key observations of the project?

The Health of Older People pilot has been running since 2021 and was designed to demonstrate how our services could benefit a new demographic of customers, by providing them with choice and control they did not currently enjoy through the centralised care model. Since the start of the pilot, 145 customers have benefited from the service – being an even mix of those living in their own home and those living in a retirement village setting. A key goal of the service is to allow customers to retain their independence, and the ability to provide support at home is key.

We work alongside the regional Te Whatu Ora health providers, customers living in their own homes and the retirement village, with a focus on bringing choice and control back to customers who have historically been reliant on the use of large-scale home support providers etc.

Customer experience and feedback shows that this form of funding has been working effectively for them and local health funders Spend reports of the past 3 months show that this form of funding is providing both a more efficient and effective service than their prior centrally funded service. Customers have also commented on how they feel more in control through choosing who supports them, leading to improved mental wellbeing as well improvements in their physical health. A win-win for all.

This project embodies the commitment Manawanui have to expanding self-direction and the positive impacts that self-direction has on customers and their families/whānau.

Angela, you are the Manawanui Coach for BOP, so spend a lot of time with the actual customers. What did the anonymised research reveal about the project?

The key feedback from customers was that this service definitely works well, clients and families love the consistency and the option to choose who they can employ and the regular times. This helps clients plan their days and know exactly who to expect on what day and what time to expect them.”

Clients are liking the portal and are finding it easy to navigate once trained up. Having a coach in the BOP who they can reach out to directly was also received well.

• 71% said their health had improved physically and mentally since starting the trial
• 82% claimed their outlook on life had also improved since joining the trial
• 50% surveyed said they are getting more service than their previous provider, for the same or even less.
• 100% of those surveyed said the quality of care they receive now is better than before they joined the trial
• 100% also said that the level of service they receive is more reliable or better than before.

What’s next for this Pilot?

We are working closely with BOP health to investigate ways to expand the service and are building relationships with other regions who recognise the financial and health benefits of self-direction for the care of older people, and wish to also offer an empowering self-directed funding service.