Small scale dementia care in Australia: an implementation study of innovation in funding, technology and resident-led care

In 2021 the Royal Commission into Aged Care Quality and Safety drew attention to systemic problems in Australian nursing homes, including inadequate funding, inadequate staffing, poorly trained staff and regulatory failures. The final report contained 148 recommendations, and Government responses were predominantly scheduled for mid 2022–24. This study examines one agile and innovative response to the challenges facing Australian aged care, a small-scale residential service for people with mild to moderate dementia. Kambera House opened in July 2021. The home offers enhanced assistive technology targeting resident safety and quality of life, an innovative funding model that sits outside the national aged care system and two trained staff on site 24 hours a day. The implementation of the service from the perspective of managers, staff, residents and their families was investigated using thematic analysis of interviews with staff, clients, and family members. The project began as an evaluation of the acceptability and efficacy of cutting edge radar sensing, vibration and subsonic sound to monitor resident safety while protecting privacy and enhancing independence. However, it was apparent that for staff and residents, the technology was not readily separable from the broader and innovative model of service and the small scale living environment. For the six people living at Kambera House, the focus is on individual choice, privacy and self-determination. Kambera House demonstrates the potential for a bespoke service to lead the way in challenging not merely conventional models of service delivery, but also conventional ways of thinking about those models.