The alignment between Additional Services and Strengthened Quality Standards 3 and 4

In June, we published our first Insight focusing on the alignment between Additional Services (AS) and Strengthened Quality Standards 1 and 2. On July 1, 2025, AS will be replaced by the Higher Everyday Living Fee (HELF), which we view as the next evolution of AS—a key component of a consumer-focused system that supports choice.

A well-designed AS program currently offers the only way to enhance residents' experiences with amenities that exceed minimum standards while maintaining financial sustainability. The rebranding of these services as the Higher Everyday Living Fee emphasises their role as a core part of the system, unlike AS, which was often perceived as optional.

The Insight we shared earlier on AS and Quality Standards 1 & 2, as well as this one, remain just as relevant to the upcoming HELF regime. 

This second Insight in our series on Strengthened Quality Standards and AS explores Standards 3 and 4.

Standard 3: The Care and Services

The Expectation Statement for Standard 3 focuses on optimising quality of life and meeting residents’ goals and preferences. 

While there are core care and services appropriate to all residents, there are services that go to the quality of life and preferences of the individual. To truly deliver on these expectations, a menu of options needs to be available that individual residents can access as and when it suits them. 

Having implemented AS programs in over 25,000 places, we can confirm that capturing and using information from resident feedback and suggestions is key to ensuring that your AS program remains relevant to your residents as their needs, goals, and preferences change. Indeed, the requirement to review each resident’s capacity to benefit from additional services is in line with the requirement to review resident care plans. 

This is why we recommend integrating AS programs into existing care review processes rather than creating a separate AS review process. Embedding AS into the holistic care delivered to residents allows staff to gain a deeper understanding of how the total needs and desires of residents are fulfilled. It also increases staff knowledge of the program and provides valuable insights into what is valued and what can be improved within AS programs.

Quality Care contributes to, but does not ensure, Quality of Life. Among other things, Quality of Life stems from social engagement and experiencing the “things we enjoy.” This highlights the importance of well-designed AS programs that deliver value in enhancing residents' quality of life.

We have seen the introduction of services as a direct result of the implementation and ongoing review of AS programs. This resulted in consultation and an enhanced capacity to deliver on Standard 3.2.1 b). Thoughtfully curated inclusions within AS programs—such as gourmet dining, barista coffee, wellness centres, and beautician services—enhance the living environment, promote social engagement, and provide residents with the experiences they enjoy. Over the past seven years, we’ve amassed a list of around 200 potential inclusions in AS programs. We are currently working through the Consultation Draft Rules to refine our list of inclusions to ensure they are HELF compliant.

Operating AS aligns with the requirements outlined in section 3.2 of the legislation, particularly in supporting the provision of care and services that meet the residents’ needs, goals, and preferences (3.2.1.b), while optimising their quality of life (3.2.1.c). Rather than being an optional ‘add-on,’ AS programs demonstrate a provider's commitment to resident choice and lifestyle enhancement. Prioritising resident preferences and needs fosters a more vibrant and fulfilling community, ultimately leading to enhanced provider sustainability.

A precursor to crafting an appealing package of inclusions involves thorough local market research and competitor analysis. 

The feedback we received from respondents to our recent Additional Services White Paper highlighted eight highly valued inclusions: 

• Coffee
• Fridge
• Happy Hour
• King Single Bed
• Meal Choice
• Outings
• Smart TV
• Wi-Fi
   

With sector staff turnover reaching up to 20% per annum and a median length of stay for residents of 20 months, it’s likely that, in most facilities, there is a varying level of understanding regarding the features and benefits of your AS program. While you may have introduced it to residents upon their arrival and hopefully included it in staff onboarding, this is just the beginning. As life settles into its routine for both staff and residents, the understanding and perception of value derived from your AS program may fade into the background.

It’s even possible that the program's greatest visibility lies within the monthly billing process. If this is the case, then it’s likely that residents are more focused on cost than on value. In the HELF regime, where continued participation will be voluntary, there is a significant risk that this essential contribution to quality of life and sustainability will be underappreciated.

We have found gaps in communication where providers fail to actively promote services that are part of their AS program and, as a result, are also included in resident contract agreements. For example, events or enhanced menu choices that are covered under the contract for a daily fee are often not mentioned in relevant communication tools such as menus, Lifestyle Programs, or brochures.

While not exhaustive, you might consider the following as elements of critical communication in relation to your AS program:

• Adding AS to your resident and relative engagement opportunities such as surveys and meetings
• Including AS information and updates in newsletters
• Enhancements and upgrades to your program
• Monitoring resident participation and interest in the offering
• Consulting with residents who don’t seem to avail themselves of highly valued program elements
• Communicating to residents’ families about ongoing aspects of the program
• Promoting bespoke AS service offerings of any AS program 
• Clearly articulating when and why fees are adjusted/waived
• Simple, and clear billing 
• Clear brochures that highlight the features and benefits of your program

Clear communication not only informs residents and their families about the specific services utilised, but it also facilitates discussions between staff, families, and residents about ongoing needs and preferences. By ensuring that all relevant stakeholders have access to this information, providers can effectively coordinate services and make timely adjustments as necessary.

Standard 4: The Environment

Under AN-ACC and the Quality of Care Principles 2014, providers are expected to provide the equipment necessary for the delivery of care to residents at no extra charge. This equipment is typically shared amongst residents in the facility. Examples include hoists, lifters, and wheelchairs for communal use. While this approach meets the requirement of Standard 4, it may well fall short of the preferences of individual residents. For example, a resident may prefer to have exclusive use of equipment or may want a higher standard of equipment. 

Under AS, we have typically recommended a package approach to programs. While we are yet to see whether a package approach will be part of the HELF regime, it might be that packages are designed with more optionality in relation to equipment and aids. For example, you might wish to offer a dedicated hire of motorised wheelchairs as an alternative to manual wheelchairs and walking frames, or you may have alternatives for in-room furniture. Where these alternatives are of a higher quality than standard devices, they can be part of your AS inclusions.

The Transition Pathway to HELF

As we previously listed in our previous insight focusing on the alignment of AS and Strengthened Standards 1 and 2, in our experience, successful AS programs include the following seven essential elements: 

At Pride Aged Living, we have developed the following resources to help providers transition from AS to HELF:

We are also finalising our HELF Implementation and Ongoing Support services. 

Webinar - Unpacking HELF 

Looking for more information on HELF? Join our upcoming webinar with Inside Ageing, Unpacking HELF, on the 17th of October.

To learn more about the webinar and register, click here.