Moving ‘mountains’ and people, allied health aims high – After a stroke a resident wanted to walk again, Simon Kerrigan of Guide Healthcare said they’d try

Protecting creativity and time for allied health services is vital

Simon Kerrigan, founder and now managing director of Guide Healthcare came to aged care by accident. Originally, he thought he might hate it. Fate would have a twist for him. Far from hating it, Kerrigan found and unlocked a passion that has impacted thousands of lives. He found that allied health, with creativity, innovation and time, can support seniors to walk again after strokes, provide ablement where client and family members had long given up hope. And most profoundly and realistically, in the grounded reality of limited funds, time and resources, his story shows how allied services can contribute skills that bring the dignity spoken of in the act, into the RAC room. Allied health services is hands with renewed strength, legs to walk around the garden, and through grit and persistence be given the opportunity to try to claim back the desire for ability and self-sufficiency that doesn’t evaporate with age.

Collaboration for innovation

Mums usually know best. Kerrigan wasn’t loving his physio studies at university and was contemplating switching to PE teaching. Mum not only stepped in to firmly encourage that he finish his studies, her wisdom extended to encouraging Kerrigan to work for at least a year. His experience up until working had been at hospital placements which hadn’t been his cup of tea.

At the onset of the year of work he accidentally found an allied health job at an aged care provider, and, “[it] was essentially about 100 meters from the beach and I thought, ‘Hey, I’m going to hate it anyway. I may as well be near the beach.’” What started out as a substantial list of clients to massage under the then programs, Kerrigan found that provider leadership were happy for him to “shift some things around”. He was given freedom to pursue a passion for change to supercharge outcomes for the residents within the home.

“From a very massage driven program, we changed what we were doing to a very rehab driven program.”

Kerrigan notes, “I was fortunate that I had a great space, not a lot of equipment, but plenty of room, and excellent phsio aids, and I said to leadership and the team, we need to get people moving, I had all these ideas from university that I wanted to implement, and they supported me so much.”

Provider choices

The provider leadership team supported innovation. Kerrigan’s story is not just one of allied health creativity and pluck but how collaboration can help lift operations in care excellence.

To see and take a chance on young leaders can have bountiful benefits not only for the comprehensive health of residents but the culture and reputational growth of a provider.

“I got given almost full autonomy and freedom. I had a great facility manager. She actually encouraged me to go and talk to the ACI coordinator at the time to help to learn the system, which allowed us to actually re-jig our treatment list.”

“I was so fortunate looking back.”

Time to create

The excellence of Guide Healthcare started in the well-loved, decades-old, rooms of a provider that was seeking to do their best with the resources at hand. Kerrigan was fresh out of university, as yet untested and unverified. It is from this ingredient base that impactful care change began.

“We very quickly created this great physio program and that’s where my kind of passion for care started, and it was really what I loved about it, that I had so much time. In a hospital role I had been limited to 15 minutes and then next person. While at the RAC provider I still had plenty of people to see, but I could structure the timetable and really spend time with people who needed it.”

“We started achieving these amazing results.”

Seeing the results of strength, joy and satisfaction at clawing back movement and ability, Kerrigan was emboldened.

“It created more passion for trying to find ways to motivate people to move more and break down some of that ‘I’m too old’ attitude.”

What he and his colleagues found is that no one is ever too old for games. Through ‘gamifying’ exercises, and creatively designing them, residents wanted to be involved, residents were able to own the journey to being healthier.

There was no cajoling, forcing or negativity, rather purpose seemed to bring energy back even before the exercises were able to fully get into swing.

Business lessons

Through the years, and starting to build up Guide as a business, Kerrigan has found the vessels of fuel which ‘fill his cup’.

“I realized there were some parts of running a business that were really important to me. Specifically, I really wanted to improve the quality of all health services, which meant investing in education, investing in equipment, providing resources to front-line staff and importantly, putting in a lot of effort into culture building.”

Kerrigan learnt that there was considerable power in shaping, and putting money where his mouth was, workplace culture. If people, particularly front-line staff who were supported and excited, wanted to show up to work, they would do so with bells and whistles on, and that carried through to each and every senior they interacted with.

Making work fun and honouring front-line staff became a no-brainer for Kerrigan, “running games for staff to actively enjoy, events and competitions,” reinforced to him, leadership and staff that learning and activity through games is a hoot for all. It was smart strategy to believe in its power to carry into working with seniors.

“There were a few reasons why I started the business but primarily it was because I wanted to be able to make decisions and invest in the areas that I thought were important. Creating great teams and creating supporting environments, this was making sure that the people we support [clients], the older people, really get great service and hopefully achieve great outcomes.”

Persevering through

Kerrigan is grounded and appreciates a solid foundation. He shares that the foundations of Guide started 13 years ago, and that they needed to be significantly worked through and formulated.

“How we structured programs, the importance of learning about the funding tools, and the requirements of the care standards, and the importance of education and using evidence, research and being creative with our design [was pivotal].”

Kerrigan shares that tenacity was decided early on, “this idea that we can overcome any challenge, that’s something that we try and really embed into our teams.”

“Healthcare is going to throw some challenges but if we use creativity we can overcome those, both at an individual level and across systems.”

Positive voice

The complexity and difficulty facing aged care is not lost on Kerrigan. While there are always areas for improvement, in striving for change he and his team, “really want to be positive, a positive voice and positive influence.”

“Everyone’s a bit stressed, and that can kind of permeate through the industry, and we kind of made a decision early on that we want to be a positive voice.” In operations, in conduct, in tackling challenges, Kerrigan and team have sought to place positivity and over-coming-ness at their north star, to bring in others who may be needing that encouragement.

Kerrigan hopes to encourage workers in aged care to keep placing the next foot down in seeking to make their mark in the industry, to impact lives in the routine, and not in rhetoric.

Leveraging change from all team-members

At Guide, Kerrigan shares that a quarterly competition is run. Eagerly anticipated by all staff, “it’s really important to us, it’s based on our values, and essentially we ask our team members to implement an idea or desired outcomes that’s underpinned by our values to secure sustained improved health for seniors.”

“We’ve won innovation awards and been able to completely rejig our fall prevention strategy that we’ve rolled out to all our sites.”

Kerrigan highlights what may be worthwhile for provider leadership to prioritise, that of seeking solutions to obstacles through seeking the insight and experience of those in the immediacy of seniors and care.

“We’re trying to encourage innovation through giving people the freedom and space, all our teams vote at the end of the competition about what’s the best idea outcome implementation and then we invest.”

The challenges of aged and healthcare are sizable, Kerrigan shows it stands to reason that all should be involved to bring solutions from different perspectives and experiences.

“It might not be perfect but we’ll build on it, and take this something and turn it into something else, perhaps even an app to be used across the sector”, Kerrigan muses.

“If something’s working amazingly, well, why would we not want everyone [the sector] to be able to have access to that?”

Calculated risk must have its place in aged care

Kerrigan fondly looks back on the freedom he had to creatively turn initial expectations and programs around.

He did not do so in a vacuum, he was given the education and insight into the compliance systems and funding programs. From this knowledge, he was able to adjust, innovate and upgrade what had been a massage program into a rehab program where ablement was central, and the results were undeniable and wide reaching for the seniors at its core.

“[Guide’s Current innovation approach] is no doubt based off of the kind of freedom the provider leadership team initially gave me in the early days, and hopefully that’s what our team feels as well.”

Kerrigan notes, “we’re bringing together smart people from different allied health backgrounds, we want to hear their ideas, I can’t come up with everything, allied health delivery is also recognising that your way is not the only way or at times, the only right way.”

“The best way that we can create a great business and service offering, and hopefully ultimately outcomes for the people we support, is getting all these amazing ideas, and providing opportunities for people to share them with us. So we’ll always celebrate and reward that.”

Reduced care minutes

Kerrigan is upfront, the trend is that care health minutes per resident are diminishing for allied health services.

“Primarily what we’re doing is not cookie cutter allied health services provision or physio, we’re trying to make sure that we’re looking at the individual needs and responding with treatment plans that aren’t just ticking boxes but facilitating that a senior can achieve more activity than they thought possible.” However this takes time, “sadly due to limited funding, the time is getting smaller and smaller.”

“Provider are having to increase RN minutes and care minutes, and with increased costs, allied health seems to be getting trimmed which is a shame.”

Multiple experts across provider leadership and allied health question the overhead regulatory framework to effectively secure dignified health. In its current iteration care minutes seek to safeguard medical care but advocates wonder too about the funding for services like allied health. Ablement exercises, which can help facilitate empowerment from being able to achieve much as a senior, for themselves through ownership of rehab is a powerful consideration. Care’s definition must safeguard this, as well as its funding.

Funding driven by outcomes

To see the yield of joy and renewed health from being able to walk again after a stroke is without hyperbole, a wonder to behold, one that Kerrigan is honoured to have been a part of. Kerrigan says of his original approach to allied health, and Guide’s current outcome standard, “we want to be proud of it.”

“This is something that was and is really important to me. When I started Guide, it was about rather working with five homes where I could walk in and be really proud than working with 50 and walking in and thinking, ‘man, we’re doing so bad here.”

Kerrigan treasures outcomes he, Guide staff, and residents achieved together.

“In my early days as a physio, a resident had a massive stroke resulting in dense left sided hemiparesis. She had actually been a nurse. While in hospital she wasn’t given the chance to rehab, once she was discharged to aged care, she was still bed or chair bound and not prioritised for rehab. When we got talking, she talked to me intently and said, ‘I want to walk again’.”

The resident had been passed over for rehab by hospital and aged care personnel, and it was with Kerrigan that she had drawn the gumption to say her piece and state her goal. His response? “I’ll be honest, I looked at it and went, ‘I don’t know but we’ll try’”.

She was so grateful for his attitude, and while both a relief and challenging, after that they had the gift of being able to get to work in rehab.

“I was in this amazing position where I could make sure I could give her time.”

He recalls that they would meet, “at least four times a week in the gym space, we started from the basics, trying to get some activation. We started doing a bit of bridging exercises, and slowly progressed to sitting upright and improving postural stability.” They kept at it, perseverance and pluck from both senior and professional.

“This went on for maybe a three-month period, we went from, ‘you’re never going to walk again, being sling lifted everywhere, to slowly pivoting out of bed and getting up from chairs, to walk with an aid.”

“I look at these types of stories, and [hope] they would be very typical.”

Kerrigan remembers, “We had moments where she was crying [happily]. These are the things that I love about health care. This is what is possible.”

Care is relationship and support to achieve

“To have the time to develop relationships, to be able to be just ‘Simon the physio’, in a personal way, delivering life-changing care, to have that social interaction [is key]”, when working to support his client seeking to walk again, Kerrigan pin-points those moments as critically upholding the quality of care.

“I’d be able to give her a big hug and say, ‘good work’, it’s the relationships that I probably love the most.”

Now at a broader level, Guide seeks to secure incredible outcomes by residents, for residents, with passionate and supported front-line staff.

“At our events now we have residents walking marathons, doing Olympic based rowing or weightlifting or long jump.”

He marvels, “At events we’re looking at close to 2000 participants across 70 homes, they’re walking multiple marathons over the course of a month, these residents are knocking over huge amount of kilometers and it’s live streamed, we give out awards, it’s amazingly encouraging.”

“We are excited to be a part of breaking down this stigma that aged care is a place where people go and its only goal is to keep everyone comfortable, calm and [rigidly] safe.”

Agency, purpose and goal-setting don’t diminish with age. Part of the act’s movement into flesh and flood must be supporting the fullness of health and care.

“I just love that we’re able to give people purpose and empower them to do things and overcome.”