Annual Report 2012. To maximise your abilities and life skills

Annual Report 2012 To maximise your abilities and life skills

Our Vision Royal Rehab aspires to be: Australia s leading rehabilitation and disability support provider Respected for our clinical, research and teaching excellence Our Mission To maximise your abilities and life skills Our Values Person Centered - Respecting and promoting the rights, capacities and opportunities of all our people Honest and Trustworthy - Ethical, accountable and acting with integrity at all times Collaborative and Inclusive - Fostering team-ship and participation Innovative and Informed - Committed to learning and development, and continuous improvement Our Strategic Goal To create a secure and sustainable future through the provision of rehabilitation programs and disability services, in a commercially viable manner, that maximise the abilities and life skills of people with disabilities and impairment caused by trauma, injury or disease. Patron Her Excellency Professor Marie Bashir AC, Governor of NSW Providing Care since 1899 Our beginning was due to the energy and compassion of Miss Susan Schardt, a remarkable woman of the late nineteenth century. Miss Schardt recognised the needs of patients being discharged from hospital and labelled as incurable, often without family, money or hope of getting a job. From these small beginnings in a rented cottage in Surry Hills in 1899 as the Commonwealth Home for Destitute Invalids, the work of Ms Schardt became increasingly recognised and valued. Public support for her initiative resulted in Sir Henry Moses M.L.C selling his Ryde property Weemala, to allow the service to grow. Weemala became the NSW Home for the Incurables in 1906, and services have continued to be provided from Royal Rehab s site in Ryde ever since. Coorabel opened in 1967 to provide adult rehabilitation services. Moorong which had opened in 1924 for the care of cancer patients, subsequently housed the Spinal Injury Unit from 1988. The Brain Injury Unit opened in 1992. The new Weemala was officially opened in 2011, and construction commenced on the new Rehabilitation Centre for all other services, and is due for completion by September 2013. The Centre s name has changed over time, from the Home for the Incurables to Royal Ryde Homes in 1954, Royal Ryde Rehabilitation Hospital in 1978 and to the Royal Rehabilitation Centre Sydney in 1990. Royal Rehab An Introduction The Royal Rehabilitation Centre is a nationally recognised organisation that provides specialist rehabilitation and disability services for people who have acquired a disability or impairment as the result of trauma, accident or illness. Royal Rehab engages in extensive education and research to improve the rehabilitation outcomes for its clients, and to improve the independence and quality of life for those requiring long term support. Royal Rehab is a not-for-profit charitable organisation with an independent Board of Directors. Royal Rehab operates as an Affiliated Health Organisation under the NSW Health Services Act 1997, and as an accredited service with the NSW Department of Human Services Ageing, Disability and Home Care (ADHC), and with the NSW Lifetime Care and Support Authority (LTCSA). Royal Rehab also relies on financial support from the general community through the Royal Rehabilitation Foundation to provide the range of services and equipment required by individuals undergoing rehabilitation, and to support its research activities. As a teaching hospital, Royal Rehab has partnerships with the University of Sydney s academic units, including the Rehabilitation Studies Unit, the Centre for Community Based Health Care, and the Centre for Disability Studies, in addition to our own Rehabilitation Nursing Research and Development Unit and the Royal Rehabilitation College. Royal Rehab provides on-site and home based rehabilitation for those with complex and long term health care needs, traumatic brain injury and spinal cord injury, and supports the development of specialist spinal cord rehabilitation services in regional NSW. Royal Rehab also provides a growing number of long term supported accommodation places for people with significant disabilities living in the community, and specialised driver assessment and training for people with a disability. Front Cover 1. Profile image of the new Rehab Centre 2. Recreational Circle 3. Entrance from Recreation Circle ROYAL REHABILITATION CENTRE SYDNEY

Chairman s Report Chief Executive Officer s Report I am most gratified, on behalf of my fellow Directors, to see our wonderful new Centre emerging on our grounds at Putney. The vision of a modern, comprehensively equipped and technologically advanced specialist Rehabilitation Centre has had a long and arduous pathway, but it is finally coming to fruition and it will be a magnificent facility. The wonderful reputation that Royal Rehab enjoys, and the tremendous outcomes achieved with our clients, is owed to our excellent staff. Their work over the last twelve months in particular is even more praiseworthy, in that it has been conducted amidst a construction site, and occupying the very oldest parts of our existing buildings. Yet client satisfaction remains very high, and we continue in partnership with our clients to achieve great outcomes. In achieving this result our CEO, Stephen Lowndes and his Executive team deserve particular mention for their commitment and drive in juggling numerous competing balls to ensure that the construction of the new facility is being undertaken with limited disruption to the Centre s operations. Not an easy task but it has been and is being achieved with an admirable outcome. Our new Strategic Plan for 2012-2015 sets some ambitious but realistic goals to expand our organisational reach to other parts of NSW, and to ensure that we are well placed to meet the requirements of the National Disability Insurance Scheme, as the form and nature of this bi-partisan scheme becomes more defined. Much has also been done and achieved over the year in review to improve the sustainability of our supported accommodation and disability support services in particular, and to expand our home and community based services, in a continuing tight economic jurisdiction. It remains to be seen whether combined Government financial support is adequate to meet the needs and expectations of people with a disability and their carers under the NDIS, but it is a most overdue and welcomed reform. I would like to acknowledge the generous time and commitment provided by members of the Royal Rehab Foundation and their Events Committee, who have raised many thousands of much needed dollars over the year, to help support our clients through the purchase of expensive equipment, and to help fund relevant research in the areas of rehabilitation medicine and disability support. These events also do so much to bring awareness to the community of the important work that Royal Rehab undertakes. Finally, I would like to thank my fellow Directors for their boundless enthusiasm, passion and support for Royal Rehab and those we serve. In particular I wish to express my gratitude to Bronwyn Connolly, and to Professor Trevor Parmenter who have both recently retired from the Board. The future outlook for Royal Rehab is a most positive one, and I look forward to realising our new Strategic Plan over the coming years. Clive N Austin Chairman I am very pleased to report that the past year has been a most progressive one for Royal Rehab in positioning ourselves as a sustainable and independent organisation, positioned strongly for the future challenges we face. Whilst we experienced an overall annual Operating Loss of almost $295k across all of our services, this was against a very disruptive backdrop of major relocation and reduced bed availability, as much of our existing facility was demolished to make way for our new State of the Art Rehab Centre. Construction of our new 60 bed facility, child care centre and community centre is progressing on schedule, with completion expected in September 2013. This really will be a Centre of Rehabilitation Excellence providing the very latest in technology, equipment and environment to assist our clients maximise their abilities and life skills following major trauma or disease. Provisional licence approval was granted during the year to operate a Private Rehabilitation Hospital side by side with our Public services an important step as Royal Rehab seeks to diversify its revenue sources to support its future operations and not for profit endeavours. I am also very pleased to announce that FitKidz Learning Centres won the tender for the management of the new sixty place Child Care Centre being built on our new Recreation Circle. FitKidz operate several Centres around Sydney and will bring a most innovative and professional approach to this important community asset. Amongst many highlights in the year, I was thrilled with the success of Royal Rehab s Return2Sport initiatives, culminating in our second major Expo at Sydney Olympic Park. Sport and physical recreation play such an important part in restoring the confidence, mobility and socialisation of people with a disability, and this program is achieving very strong community support and client participation. I was also very proud that Royal Rehab s Rural Spinal Cord Injury Service was a Finalist in the 2012 NSW Health Awards. This is a wonderful and innovative service which brings expert spinal cord injury specialists to clients and non-specialists clinicians throughout regional NSW. During the year, the Board of Directors endorsed Royal Rehab s new Strategic Plan for 2012-2015 which will see the organisation continue to consolidate and improve on the operational performance and client outcomes of our existing rehabilitation and disability support services, with a renewed invigoration of our research and educational activities. We will also be undertaking major cultural change and workforce reform to ensure that Royal Rehab is well positioned to meet the needs and expectations of people with a disability under the emerging Federal National Disability Insurance Scheme. These are very exciting and challenging times for service providers, demanding an improved and visible market relevance, and demonstrable track record of achieving person-oriented outcomes for people now increasingly empowered and funded to make their own choices. Royal Rehab is looking forward to the challenge. Stephen Lowndes Chief Executive Officer ANNuAL REpORT 2011/12 1

One Year in the Life of Rosie September 23, 2011 was planned as a day of celebration, the final school assembly, followed by an afternoon lazing at the beach. It was less than three weeks before the Higher School Certificate. Rosie Attard would remember this day like no other in her 17 years. As she drove to Wauchope High School s year 12 prize-giving assembly, Rosie s day changed. An animal darted in front of the car, causing her to swerve one way then the other as she lost control. The car ended up across a shallow drain, and flipped over before landing back on it s wheels. September 23, 2012 Rosie is now 18 and an inpatient at the Spinal Injury Unit at the Royal Rehabilitation Centre. Rosie has some movement in her hands and arms, she has learnt to feed herself, brush her hair and teeth and do some of the activities she once took for granted, with the assistance of aids. Rosie will need a lifetime of care. Rosie had just completed a defensive driving course three weeks before the accident. Her terrible accident was likely the result of her inexperience as a driver, suddenly confronted with changed driving conditions. It can happen to anybody, especially young drivers warns Rosie but don t increase your chances by playing with mobile phones or ipods. John Attard came across his daughter s car shortly after the crash while also on his way to the school assembly. It was the scariest thing I d ever seen, he says. The first thing she said to me was, I can t feel my legs. I rang the ambulance, told them she d hurt her neck and used my hands like a collar around her neck until the ambulance arrived. Following surgery, Rosie was transferred to the Spinal Injury Unit at Royal Rehab. John, a single parent, has had to move to Sydney to be a constant companion with Rosie during her rehabilitation program. We just want to let kids know that it doesn t only affect them, he says. Our lives have been changed and she s going to need a lifetime of treatment. Rosie is making good use of her time at Royal Rehab to complete her driving program through the Driving Assessment Centre. With access to Royal Rehab s modified vehicle, Rosie will have much more independence and mobility when she gets her driver s licence and returns home. Launch of Stroke Week: George Cepak a client of Royal Rehab s stroke recovery program and his wife Pauline were guests for the launch of Stroke Awareness Week at Parliament House. The Minister for Health Jillian Skinner hosted the morning tea for the Stroke Recovery Association of NSW. In the photo (left to right): Pauline Cepak, Dr Brian Zeman (Adult Rehabilitation Service), Stephen Lowndes (CEO), Michelle Sharkey (EO Stroke Recovery Association) and George Cepak. Rosie Attard attends Art Class at Royal Rehab, one of the many therapy activities available to clients. 2 ROYAL REHABILITATION CENTRE SYDNEY

The Year in Review 2011/12 was again a year largely dominated, of necessity, by issues associated with the redevelopment. The current construction of a 60 bed inpatient and outpatient centre, the Child Care and Community Centre and extensive grounds which will form an integral part of our rehabilitation campus, is Stage 2 of a major capital redevelopment project funded entirely by Royal Rehab. This project required the consolidation and relocation of most of the organisation s Operational Units, with demolition of many existing buildings and extensive refurbishing of the older buildings where they are temporarily operating from. This was achieved with minimal disruption to client care, but has placed some financial pressure on our annual financial result associated with both the costs of renovation and relocation, but also on reduced revenue from the limited private rooms available in the temporary facilities. The capital funds for construction of the new Centre are linked to the sale of land owned by Royal Rehab for residential development, which is in two transactions, the second of which cannot occur until the old buildings on the site from which we are currently operating are vacated. In the meantime a bridging finance facility was secured with our corporate bankers. A number of fundraising events were also conducted throughout the year, to help raise funds to purchase expensive equipment for the new Centre. Unfortunately, promised funding support from the NSW State Government for Royal Rehab s Driving Assessment & Rehabilitation Service, did not materialise and this service continues to struggle to meet the needs of those clients on fixed government incomes. This service helps people with a disability retain their independence through the capacity to drive. A very competitive tender was conducted to appoint a credentialed and professional operator of the new Child Care Centre. FitKidz Learning Centres were the successful tenderer, with a proven record of successful and innovative Child Care Centre ownership and management. The sixty place child care centre will be a tremendous asset to Royal Rehab staff and the community. Weemala residents and families continue to enjoy their new home, and a number of new residents were welcomed through the year. Overall, the building is performing extremely well but a number of minor design and construction modifications have been made to improve resident satisfaction and improve building maintainability, in light of experience since occupation late last year. Royal Rehab s Community Homes throughout Sydney continue to operate on very narrow, although improving margins. These homes support clients with very complex care and support needs, with generally relatively high staff to client ratios and hours of daily support required. It remains to be seen how effectively the eventual roll-out of the National Disability Insurance Scheme (NDIS) might relieve such funding pressures, and achieve better alignment with client needs and wants. The NSW Rural Spinal Cord Injury Service, a part of our Spinal Outreach Service, was recognised for its effectiveness and collaboration between metropolitan and rural health specialists in the recent NSW Health Awards, which was a very meritorious and deserved recognition. A number of Royal Rehab s medical, nursing and allied health staff again made significant presentations and contributions to various Health seminars, professional exhibitions and published journals in regard to models of care and evidence based practice. During the year, Royal Rehab wound down its own Human Research Ethics Committee and will work in collaboration with the Northern Sydney Local Health District Committee in relation to future on-site research projects. This was an efficiency measure. Royal Rehab contributed significantly and achieved well through its active participation in both the Clinical Excellence Commission s Quality System Assessment Survey, and in the pilot assessment of the Australian Council on Healthcare Standards new EQUiP National Standards. This is a very positive reflection on the substantial focus and efforts made throughout the year to improve further Royal Rehab s clinical governance and quality outcome performance. Enrolment growth in the Royal Rehab College did not quite meet expectations, although registrations in the Allied Health Assistant Certificate Courses remained strong. Recent VET-HELP Fee approval should improve prospects and business performance going forward. Again, a concluding highlight of the year was Royal Rehab s second Return2Sport Expo linking almost 2,000 visitors to the Olympic Sports Centre, including the Australian Paralympic Committee s Talent Search and over 50 disability sporting and recreational associations. The 2012 Wall of Fame participants gathered with other special guests in front of a display of the sixty photos representing the history of the ten years of Wall of Fame. The Wall of Fame A celebration for the 10th Anniversary of the Wall of Fame was held during Brain Injury Awareness Week. The seven participants for 2012 were joined by previous Wall of Fame guests, representing each of the past ten years. The Awards were presented by Dr Clayton King, Jessica Taveira and Jessica Barnes on behalf of the Brain Injury Rehabilitation Service. celebrate ANNuAL REpORT 2011/12 3

The Royal Rehabilitation Foundation The Royal Rehabilitation Foundation supports the work of Royal Rehab. Corporate and individual donations are invested in the improvement of rehabilitation services for people with complex and chronic care needs. The Foundation supports research, education, training, the provision of equipment and services, and to assist in the fit-out of the new state-ofthe-art Royal Rehab Centre and the facilities of the Recreation Circle. Significant support for the Foundation was recognised this year with a presentation made to Brydens Compensation Lawyers and ISS Facilities Services acknowledging their on-going commitment through their Foundation Membership. The Chair of the Royal Rehabilitation Foundation is Board Director, David Piper OAM. The ADCO Cup Concord Golf Club hosted the Royal Rehab annual Golf Day, to support the Royal Rehab Foundation. This is the second year that golfers have competed for the ADCO Cup. The event was booked out, with a full field of players enjoying the opportunity to play on the prestigious championship course at Concord. Popular professional and multi international winner, Craig Parry, presented the trophies at the ADCO Cup. Sharing the Gold Prue Watt Prue Watt s vision impairment has presented many challenges but she has established herself as one of Australia s most successful Paralympians. At the recent Return2Sport Expo, hosted by Royal Rehab, Prue was a mentor to young athletes with a disability and an inspiration to all who met her. Prue shared her Gold medal with a young visitor to the Expo, Harry Clist. Harry s mother Sue Clist wrote: I can t put into words what the Return2Sport Expo has done for Harry - he is all the better for the experience of meeting Paralympians and participating in the range of sports on offer. At school Harry is considered different (yep I hated even typing the word different), but to be a part of a team and no one treats you differently because of the way you look... that is priceless - I thank you from the bottom of my heart. Craig Parry and Richard Carmont, Managing Director of ADCO with the winners of the ADCO Cup 2012, Gladesville Healthcare s Marty McCrae and Peter Lumb. Golf Day Dinner Following the ADCO Cup, dinner was held in the main dining room of the Concord Golf Club. As with golf, the dinner was booked out well in advance, with 160 guests enjoying the dinner, silent auction and special guest speakers. Tony Abraham, Steve Shaw and Keith Todd shared their experiences of Royal Rehab, making everyone aware of the significant outcomes achieved for them personally and for their families, through the care provided by the Brain and Spinal Injury services. Prue Watt, Paralympic Ambassador for the Return2Sport Expo, shares her swimming gold medal with a young Harry Clist and former Socceroo and SBS commentator David Zdrilic. believe 4 ROYAL REHABILITATION CENTRE SYDNEY

Back 2 Life Ball The inaugural Back 2 Life Ball was held in the ivy ballroom. Sponsored by The Trust Company, Tactical Training Group and Brokenwood Wines, more than 230 guests enjoyed a night of dining, dancing and entertainment to support the Royal Rehabilitation Foundation. Special guests included Paralympian Prue Watt and speakers Frank Spiteri and Steve Shaw. The MC for the evening was Tom Williams. The concept for the Back 2 Life Ball was reflected in the speech given by Frank Spiteri. When I arrived in the Royal Rehab Burns Unit, I couldn t stand without assistance, I couldn t feed myself. Fifteen weeks later I walked out they gave me back my life! People s lives are destroyed and these wonderful people at Royal Rehab put back the pieces. The staff perform miracles with what they have got now God, imagine what they are going to be capable of doing with state of the art equipment and facilities. The event was organised by the new Back 2 Life Ball Committee. Board Director, Stella Wong was assisted by Foundation Committee members Ed Riley and Courtenay Poulden, together with Juliet Anderson, Andrew Lewis, James Marsden and Richard Wykes. The Back 2 Life Ball was held in the spectacular ivy ballroom. Guest speakers at the Back 2 Life Ball, Frank Spiteri, Steve Shaw and Paralympian Prue Watt, with a former client from the Royal Rehab Spinal Injury Unit Stuart Hume. Tony Abraham with his family and the angels. The equipment for the Spinal Injury gym, which Tony Abraham is using, was provided through a fundraising project initiated by his son Anthony Abraham. Anthony paddled a kayak 200 km down the Murray River to attract sponsorship for this Paddle for Pop campaign. Miracles, angels and a man walks again Tony Abraham who suffered horrific spinal injuries in a surfing accident says he is walking again because of a miracle. The 79-year-old was hit by a massive wave at Hawks Nest beach, he hit his head on the sand and was left paralysed. I was paralysed from the neck down. Now I can walk again. The miracle was being moved to the Royal Rehab Spinal Injury Unit where I was entrusted to the care of angels. Nothing is ever any trouble to the physiotherapists and nurses - they are angels. miracles ANNuAL REpORT 2011/12 5

Community Services The Community Services Division is an integral part of Royal Rehab, comprising our Disability Services, Community Based Rehabilitation Services and Outpatient Services. Disability Services provide long and short term accommodation and support services, and Attendant Care services to people with acquired disabilities (brain injury, spinal injury), developmental disabilities (intellectual, autistic spectrum disorder), and other degenerative neurological disabilities. We also specialise in supporting people who have extensive additional needs in the areas of complex health care requirements, co-existing psychiatric disability, or significant behaviours of concern. Community Services and Programs: Attendant care Rehabilitation Supported accommodation Person Centred Planning Recreation, leisure and community access Community nursing Complex care management Positive behaviour support Specialist assessments and program planning Respite Emergency/crisis support and accommodation Brokerage services Support is incorporated into each person s life activities-personal, home, family and relationships, and community participation. Disability Services draw upon the extensive resources of a broader organisation dedicated to supporting clients to develop independence and express their individuality. Royal Rehab is an accredited, pre-qualified service provider in supported accommodation with the NSW Department of Family and Community Services - Ageing, Disability and Home Care (ADHC), and is an Attendant Care service provider with the Lifetime Care and Support Authority, and the Victorian Transport Accidents Commission. Its Disability Services are accredited with the Attendant Care Industry (ACiA) Management System Standard Association, and with the Australian Council on Healthcare Standards. In the past 12 months, client and accommodation outlet numbers have significantly expanded; currently providing services to 107 clients across 35 residences in the Sydney Metropolitan area, with these numbers continuing to grow. A major achievement this year is the embedding of person centred approaches and tools within our major systems (Individual Planning; Health Care; Client Risk Management), led by our expert Person Centred Planning team. Within Disability Services this is a whole of life approach ensuring all clients receive services based on their individual personal goals and desires, their strengths, skills, abilities and support needs. We have introduced a range of person-centred tools to assist the clients to identify meaningful goals. This year, a number of Disability Services staff attended the Person Centred Champions Training, led by the Centre for Disability Studies. Their knowledge and experience will further assist in raising the awareness of person-centredness throughout the service. Community Based Rehabilitation Services (CBRS) The Community Based Rehabilitation Service (formally known as Home Based Rehabilitation Service) has undergone significant expansion over the past eighteen months. The service operates across Northern Sydney and the Central Sydney regions to provide therapy and rehabilitation services by an experienced multi-disciplinary team to clients in their own home or in the residential Transition Care Unit located at Belrose. CBRS provides multi-disciplinary rehabilitation services to clients within their home and community environments. Services include Physiotherapy, Occupational Therapy, Speech Therapy, Social Work, Allied Health Assistant, Dietetics, Neuropsychology and a Rehabilitation Medical Specialist. Therapists have significant and wide-ranging experience working with older clients within the community. Programs within the service include: Home Based Rehabilitation (HBR) a six week multidisciplinary, goal based program providing therapy to clients in their own homes Transitional Aged Care Program - therapy for aged clients transitioning (community and residential) from an acute setting Transition Aged Care Unit - a Centre based residential transition care program Referral-based therapy service to Royal Rehab s long term care facility, Weemala and community supported accommodation. Outpatient Department The Outpatient Department at the Royal Rehabilitation Centre Sydney provides a range of goal directed individual and group therapy programs for clients living within Northern Sydney. The Outpatient Department provides services to clients who have experienced a decline in function as a result of an injury or illness and aims to enhance the quality of life enjoyed by all our clients. In addition to providing therapy intervention the team will work with clients and their family/carers to provide education and information to assist with the management of ongoing limitations. Links will also be made to other services as required. A thank-you reunion was organised to bring together two doctors who played a significant part in the life of Jonathon Devenish. Dr Jill Collins was the Good Samaritan who was on the spot to save Jonathon s life when he suffered a heart attack while driving his car. Jonathon was then referred to Dr Brian Zeman for continuing care through the Royal Rehab Outpatients Department. A reunion to celebrate: Jane Devenish, Dr Jill Collins and Jonathon Devenish with Dr Brian Zeman 6 ROYAL REHABILITATION CENTRE SYDNEY

Spinal Injury Unit The Royal Rehab Spinal Injury Unit provides inpatient rehabilitation in a 20 bed Unit, using a multidisciplinary client-centred, goal orientated approach. Clients are followed up post discharge by the Spinal Outreach Service. The Spinal Injury Unit celebrated the 25th anniversary of the establishment of this service, in what was then known as the Coorabel Rehabilitation Hospital. Discussions between Dr Bob Oakeshott and Dr John Yeo led to the establishment of a 10-bed Spinal Cord Unit on 15th September 1987. The following year, in October 1988 the Spinal Injury Unit was moved to the Moorong building. Spinal Outreach Service The NSW Spinal Outreach Service, incorporating the Rural Spinal Cord Injury Service is based at Royal Rehab and provides community based, multidisciplinary support for all clients discharged from NSW Spinal Injury Units (RNS/Royal Rehab and POWH). The team works with the client in the community to facilitate achievement of health and community participation goals, and competencies in self management. Providing spinal specific education and support to clinicians across NSW is an integral component of the statewide service. Brain Injury Rehabilitation Service The Brain Injury Rehabilitation Service is made up of a 16 bed inpatient Brain Injury Unit as well as the Brain Injury Community Rehabilitation Team (BICRT). The aim of these specific programs within the Brain Injury Rehab Service is to restore as much function and independence as possible, while at the same time facilitating adjustment to disability, promoting self determination and enhancing quality of life. All activities/therapies are conducted in as close to home-like environment as possible. A supportive environment exists for ongoing education and the promotion of research based practice within this service. Brain Injury Unit The inpatient brain injury unit offers a state-wide service to clients who have sustained a traumatic brain injury. It is a 16-bed Unit, which offers individually tailored multi-disciplinary inpatient rehabilitation programs. Brain Injury Community Rehabilitation Team (BICRT) BICRT provides rehabilitation services to people living in the community who have sustained a traumatic brain injury. The staff of the team work together to help clients return to a fulfilling lifestyle and maximise their level of emotional, social, physical and intellectual functioning while encouraging independence. The team provides assistance in respect to relationships, health, learning, finances, work and leisure activities. Adult Rehabilitation Service The Adult (CARS) and Aged Care (Dixson) Rehabilitation programs provide rehabilitation for clients following stroke, burns, neurological disease, amputation, and orthopaedic injury. The Adult Rehabilitation program is designed for clients of working age. Dixson clients are over the age of 65 and are part of the Ryde Aged Care Service. Driving Assessment and Rehabilitation Centre The Driving Assessment and Rehabilitation Centre promotes independence in driving for people with a range of disabilities or following a health event. At the Driving Assessment and Rehabilitation Centre specially trained Occupational Therapists and Driving Instructors work together to assess, advise, train and support people through all the necessary steps towards independent driving. The Occupational Therapists have completed post graduate studies in Driver Assessment and Training and are recognised by, and registered with the RTA. Specialist support is also available from an Orthoptist and other health professionals as required. Wheel Chair and Seating Services The Royal Rehab Wheel Chair and Seating Services offer a comprehensive maintenance, modification and cleaning service. A wide range of living aid equipment is also available for hire and purchase on long or short term arrangements. The service offers free quotes on new and used equipment and work with all funding bodies to achieve the best outcome for the client. The service provides loan equipment in the event of any major or long-term repairs. The Wheel Chair and Seating Services can also arrange specialised seating consultancy with a Royal Rehab Occupational Therapist. The Driving Assessment and Rehabilitation Centre has assessed 217 clients this year. Of these clients 82% have regained their licence following their assessment and rehabilitation program. At the Return2Sport Expo staff provided information and displayed a modified car from our Driving Rehabilitation Assessment Centre. A number of other specifically designed and modified vehicles were also on display. ANNuAL REpORT 2011/12 7

Research Human Research Ethics Committee The Royal Rehabilitation Human Research Ethics Committee (HRCC) has been responsible for providing ethical review for single site research proposals; and for monitoring the ongoing conduct of research regarding compliance with the National Statement on Ethical Conduct in Human Research (2007) for the past eighteen years. The first meeting of the Royal Rehab Ethics Committee was convened in 1994. The Committee consisted of nine people and was chaired by Dr Robert Oakeshott, the Director of Clinical Services. One of the earliest proposals considered was research into the identification of risk factors and strategies for prevention of falls with elderly rehabilitation clients. A Scientific Review Subcommittee was also established to ensure the scientific or applied worth of research projects conducted using Royal Rehab s resources or with persons under the organisation s care. Since its inception, the Royal Rehab Human Ethics Committee has considered in excess of 240 applications. Applications for approval were also received from external organisations, such as Northcott Disability Service. With the introduction by NSW Health of Lead Ethics Committees, which approve multiple site studies, the decision has been made to conclude the Royal Rehab HREC. The Committee will continue to administer existing ethics approvals and will conclude when all responsibilities to our current studies are fulfilled. There have been more than 36 members of the Committee. Royal Rehab appreciates all of the past and present members who have given freely of their time. Particular recognition is given to community member Ian Miller who has been with the Committee since its inception. Membership: Professor Ian Cameron (Chairperson); Mr Ian Miller (Deputy Chairman); Mr Ben Brungs; Ms Jane Rothman; Mr Phillip Boorman; Dr Penelope Kearney; Mr Joe Hanna; Ms Elizabeth Drolz (Executive Officer HREC) and Ms Bernadette Nicholl (Research Governance Officer). Following research and testing conducted by the Professional Leader of Physiotherapy, Sarah Fereday and her physiotherapy team, the manufacturer incorporated changes and adjustments to the model of the Sliding Tilt Table. Left: Royal Rehab physiotherapy assistants Sally Edington with the controls and Santina Lopreiato demonstrate the Sliding Tilt Table. Research Governance at Royal Rehab The Research Governance Officer is responsible for assessing all research projects intended to be conducted on site, for risk and impact on the organisation s resources; and makes recommendations to the CEO for approval of the site specific assessments. Nine site specific assessments were conducted during 2011/12 with all being approved for conduct of the research at Royal Rehab. A new risk management system was introduced to document and rate risks associated with individual research projects; and to audit compliance with ethics approvals and risk control measures. Rehabilitation Nursing Research and Development Unit (RNRDU) The RNRDU is funded by Royal Rehab for the purpose of undertaking and developing rehabilitation nursing research and providing leadership in rehabilitation nursing practice. The Rehabilitation Nursing Research and Development Unit is building the research capacity and skills of Royal Rehab based nurses, and strengthening the organisation s commitment to providing evidence based practice and professional development of rehabilitation nurses. The RNRDU is proactively linked to a wide range of organisations, including universities, and provides consultancy services and designs and conducts evidence informed education programs. Rehabilitation Studies Unit (RSU) The Rehabilitation Studies Unit s main focus is injury related disability, particularly disability following motor vehicle accidents. RSU has collaborative links with other university departments, clinical colleagues working in rehabilitation, as well as groups and individuals with interest in injury related disability. The Rehabilitation Studies Unit is one of two academic units located at Royal Rehab. It is an interdisciplinary research and educational unit of the Sydney Medical School Northern, University of Sydney. It is funded by a grant from the Motor Accidents Authority of New South Wales (MAA) and the Lifetime Care and Support Authority (LTCS), and also receives funding from the University of Sydney. Community Based Health Care Research Unit (CBHCRU) The Community Based Health Care Research Unit (CBHCRU) was established in December 2007. The Unit is jointly funded by Royal Rehab and the University of Sydney s Faculty of Health Sciences. The Unit provides critical support to Royal Rehab in the development of its community-based rehabilitation services. The Unit develops research programs that address the effectiveness of community-based health care for people with major traumatic injuries and long-term conditions with complex care needs, concentrating on finding ways in which people with a disability can participate in everyday tasks and be integrated into communities of their choice. The Unit also examines the impact of impairments on activity and life participation, and the development and efficacy of interventions across the lifespan. Members of the Unit are currently undertaking research including investigating the most effective utilisation of therapy services in rural and remote NSW. 8 ROYAL REHABILITATION CENTRE SYDNEY

The Royal Rehabilitation College The Royal Rehabilitation College has undergone significant development since last reported. A comprehensive review of its current courses has been undertaken to better reflect the dynamic nature of the industry we operate in. The College has recently added several new courses to it scope of registration, to improve the offering to students and other stakeholders within the Rehabilitation and Disability communities. The College is also maintaining close links with NSW Health s new Health Education & Training Institute (HETI) to explore opportunities for expansion of its established Allied Health Certificate training courses. Significant improvements to the College s new website have been made. To provide on-line student access to progress reports, receive learning updates, access learning materials and connect directly with their assigned trainer in real time. Students now have the ability to interact and design courses to meet their individual needs. The College, through its expert team of educators and administrators has developed greater ties within its traditional client base but also into new areas of business education as it expands its footprint into the health and disability communities. Students extend a message of welcome from Korea to Royal Rehab during their visit. The Royal Rehabilitation Centre is recognised internationally for it s reputation as a teaching hospital. Throughout the year students and medical professionals visit regularly from China, Korea and Japan. Royal Rehab also hosts visits at the request of the Protocol & Overseas Visitors Program of NSW Health. The most recent being a delegation of twenty from Jia Ding China. Royal Rehab is the preferred rehabilitation facility for many visits, and we now have a program for some Colleges in both Korea and Japan that include a visit to Royal Rehab as part of their student final year study program. For example: Students from the Tokyo College of Medico-Pharmico Technology complete a two day course program covering their specialist interest in Orthoptics and Speech Pathology. Volunteering Royal Rehab is proud to announce the launch of its new and revitalised volunteer program. From big ideas and goodwill comes human power channelled to bring results and reap the benefits from the wealth of talent and time available in the local communities in which we operate. Volunteering roles within Royal Rehab range from being ambassadors; raising awareness in the community about the services provided by our facility, supporting health professionals to improve rehabilitation outcomes for clients by increased access and opportunity for participation in activities and outings, or through increased practice of therapy. Royal Rehab has enjoyed the support of a number of very loyal and long serving individual and corporate volunteers over a number of years. The recent appointment of a Volunteer Manager will bring new impetus and focus to this important area. Gosford City s Volunteer of the Year Brianna Shaw was named Gosford City s Volunteer of the Year. Brianna received the award for her commitment to fundraising efforts for the Royal Rehab Brain Injury Unit. Accepting the Volunteer of the Year award, the excited 20-year-old said: I did it for dad. Like many others I had not heard of the Rehab Centre and had never considered what happened to patients after hospital. Watching my dad start again from scratch has been the most incredible and tough journey. The staff and doctors at the Brain Injury Unit have given him life again. I cannot thank them enough for their wholehearted efforts, their positive spirit and for never giving up. Brianna s father Steve Shaw is now home after almost eight months at the Royal Rehab Brain Injury Unit, recovering his speech and mobility following a head injury suffered in a bicycle accident. satisfaction ANNuAL REpORT 2011/12 9

Pride of Workmanship 2012 Maureen Di Tano, Administration Officer Spinal Injury Unit; Marisa Kotuwegedera, Admin Officer Brain Injury Unit; and Santina Murgida, Admin Officer Adult Rehabilitation Service were honoured with the 2012 Ryde Rotary Pride of Workmanship Awards, at a formal dinner attended by over 200 local business and community service people. Maureen, Santina and Marissa have been serving Royal Rehab and our clients for a combined total of over 58 years, and they were acknowledged for their enduring enthusiasm and pride in their work at Royal Rehab. The Brain Injury Unit staff, including Dr Clayton King and Clinical Operations Manager, Jessica Taveira congratulate Marissa when she receives her Award from CEO Stephen Lowndes. Stephen Lowndes, Jennie Connolly, Gary Paterson (President, Five Dock Rotary), Angelo Tsirekas - Mayor City of Canada Bay. The Rotary Club of Five Dock nominated Jennie Connolly for her Award as the residential Service Supervisor, responsible for the care of residents and staff within the Concord/Five Dock/Ashfield area. Team Colours Green Day an opportunity to celebrate St Patrick s Day. April Fall Day - Staff go orange to highlight the importance of preventing falls in the workplace for both clients and staff. Working Together - in red, working as a team is at the very core of multidisciplinary services to the clients. Hat Day making a fashion statement with a Hat Parade is fun for staff and clients. 10 ROYAL REHABILITATION CENTRE SYDNEY

Corporate Governance Corporate Governance describes the practices and processes adopted by Royal Rehab to ensure sound management of the organisation within the legal and clinical framework under which it operates. The Royal Rehabilitation Centre Sydney is an Affiliated Health Organisation as defined in Schedule 3 of the Health Services Act 1997. It is a public company limited by guarantee with an independent Board of Directors, elected by the Members of the organisation. The Board of Directors is responsible for the overall corporate governance of the Royal Rehabilitation Centre Sydney and believes it has the necessary experience, skills and mix of people to oversee the high standards of corporate integrity and accountability required of an ethical, values based organisation. The Board has delegated responsibility for the operation and administration of the organisation to the Chief Executive Officer and Executive Management. Responsibilities are delineated by formal delegations of authority. Human Resources In 2011/12, Royal Rehab had a committed team of over 600 people working on a full or part time basis. This equates to 400 full-time equivalent (FTE) staff. Work Health and Safety The Royal Rehabilitation Centre Sydney has a Work Health and Safety (WHS) Risk Management System in place that includes the identification, assessment and elimination of all foreseeable hazards in the work environment and ensures safe systems of work. Royal Rehab is committed to providing a safe and healthy work environment for all of our staff, contractors, volunteers, clients and visitors. We are committed to proactive injury prevention and injury management aimed at the safe, sustainable and early return to work of any injured staff. A WHS consultative committee enables staff to contribute to the development of safe systems of work and be involved in decisions that affect their health, safety and welfare in their place of work. Professional Development We have a Leadership and Management program for all current and emerging leaders,to facilitate the team s commitment to client outcomes, ensure best practice rehabilitation and disability services through the ongoing professional development of staff at the Royal Rehabilitation Centre Sydney. This continuing commitment saw 16 leaders within Royal Rehab attend supervision, leadership and people management programs. These programs ensure the continuing proficiency and contemporary skills of our clinical and operational employees and managers is maintained resulting in optimal operational decision making and succession planning within the Centre. Employee Assistance Program (EAP) The Royal Rehabilitation Centre Sydney continues to offer the services of an Employee Assistance Program (EAP) to all staff. The aim of the EAP is to assist staff resolve personal issues at an early stage and avoid situations which might otherwise ultimately affect their work performance or attendance. The EAP covers a wide variety of problems and concerns such as post incident debriefing, balancing family and work responsibilities, career and vocational issues, managing and coping with change, and dealing with difficult situations. Access to the EAP is available to all staff. Food Safety Accreditation We are a registered food business with the NSW Food Authority and maintain a Food Safety Program (FSP) which requires the training of all Food Service staff including successful completion of the Advanced Food Handling & HACCP Principles Training Course. The Food Services Department are audited annually by an independent auditor to ensure that our operation meets all statutory requirements. Accreditation, Risk and Quality Management Royal Rehab established the Quality and Risk Management Service (QaRMS) in February 2012. The primary purposes of QaRMS are: to develop and enhance organisational risk management, quality improvement and compliance frameworks; support the use and effectiveness of the Risk and Quality Management Systems; and coordinate the preparations for all scheduled accreditation programs. In May 2012 the Royal Rehabilitation Centre submitted its latest self assessment to the Australian Council on Healthcare Standards (ACHS). Royal Rehab will have an organisation-wide accreditation survey in April of 2013. The ACHS will conduct this using their new EQuIP National Standards which incorporate the National Safety and Quality Health Service Standards, developed by the Australian Commission on Safety and Quality in Health Care. Royal Rehab recently completed our second self assessment using the Clinical Excellence Commission s (CEC) Quality Systems Assessment (QSA). The QSA assesses the health and adequacy of the organisations clinical safety systems and processes. The CEC surveyors visited the Centre in March 2012 to conduct our first on-site review using the QSA. Disability Services undertook its second periodic survey under the Attendant Care Industry Association (ACiA) Management System Standards in February of 2012. The periodic review identified two minor recommendations. Disability Services will undertake a service-wide accreditation for ACiA re-certification in August 2013. ANNuAL REpORT 2011/12 11

The Board Directors: The following persons were Directors of the Company during the financial year and/or up to the date of this report. Mr Clive Austin LLM, FAICD Chair of Board of Directors since February 2003, Member of Board Nomination and Remuneration Committee, Board Executive, Audit & Risk Management Committee, Planning & Development Committee and Royal Rehabilitation Foundation. Joined the Board in 1993. Mr Anthony Staveley MComm, Grad Dip (Land Econ), FAPI, MAICD, JP Vice Chair of Board of Directors since January 2005. Chair, Planning & Development Committee; Member of Board Executive, Board Nomination and Remuneration Committee, Royal Rehabilitation Foundation and Development Control Group. Joined the Board in 2000. Professor Trevor Parmenter AM, BA, PhD, FACE, FAAIDD, FIASSID, FASSID Member of Planning & Development Committee and Client Outcomes & Participation Committee. Joined the Board in 2000. Retired from the Board in August 2012. Professor Gwynnyth Llewellyn PhD, DipOT, BA, MEd, DipContEd Chair, Board Nominations and Remuneration Committee, Member of Board Executive and Royal Rehabilitation Foundation. Joined the Board in September 2004. Mr David Piper OAM Chair, Royal Rehabilitation Foundation. Member Audit & Risk Management Committee and Planning & Development Committee. Joined the Board in November 2004. Mr Bruce Hatchman FCA, MAICD, JP Chair, Audit & Risk Management Committee. Member, Planning & Development Committee. Joined the Board in February 2006. Retired from the Board November 2011. Ms Bronwyn Connolly LLB, BA (Juris), MAICD Member, Audit & Risk Management Committee and Client Outcomes & Participation Committee Joined the Board in May 2008. Retired from the Board in August 2012. Mr John Cullity Grad Dip Mmgt Member, Planning & Development Committee. Joined the Board in August 2008. Mr John Dakin MEdAdmin, BA, DipEd Member of Royal Rehabilitation Foundation. Joined the Board in August 2008. Retired from the Board November 2011. Professor Richard Madden BSc. PhD, FIAA Chair, Client Outcomes & Participation Committee; Chair, Medical (and Other) Appointments & Credentials Advisory Committee. Joined the Board in October 2008. Mr Brian Hurley B.Comm ACA Member, Audit & Risk Committee. Joined the Board in February 2012. Mr Anthony Wehby FCA, FAICD Chair, Audit & Risk Management Committee. Member of Board Executive. Joined the Board in February 2012. Ms Stella Wong BBus Member of Royal Rehabilitation Foundation. Joined the Board in February 2012. Professor Ian Cameron MBBS Phd FAFRM (RACP) Special Consultant: Director of Medical Studies at the Royal Rehabilitation Centre. Appointed 2009. The Executive Chief Executive Officer Stephen Lowndes Director, Finance & Corporate Services (resigned July 2012) Chris Champ Chief Financial Officer & Director Corporate Services (Commenced July 2012) ChrisThomson Director, Inpatient & Specialty Services/Director of Nursing Elizabeth Drolz Director, Medical Services/Director Clinical Support Services Professor Ian Cameron Director, Community Services /Director, Allied Health Services Delia Gray The Board and management of the Royal Rehabilitation Centre would like to acknowledge and thank the staff, clients, families and supporters who feature in photographs or who have shared their stories within the Annual Report. DESIGN: Edwell Graphic Design Pty Ltd 12 ROYAL REHABILITATION CENTRE SYDNEY

E XPO 2 0 1 2 It was on for young and old in the Murderball challenge with coaching advice from Recreation Therapist Kel Smith. More than 20 different sports were demonstrated either in the Main Arena or in the Hall of Legends. Visitors were able to join champions of the sport on the court, and challenge themselves against the best. E XPO 2 0 1 2 The Australian Futsal Team was presented with their Australian jerseys at the Expo. The team played an exhibition game against the best of the Royal Rehab R2S Team, prior to their departure for France and the world championships. More than 200 school children participated in the NSW Premier s Sporting Challenge on the opening morning of the Expo. The Athlete s Welcome was hosted by Paralympic gold medallist Liesl Tesch and one of the stars of Wheelchair Basketball, Kylie Gauci. The Australian Paralympic Committee conducted their Talent Search over the two days of the Expo, to identify potential elite athletes who may go on to represent Australia at the next Paralympic Games in 2016. Stuart Hume explains the adapted ski that he uses for winter sport. The Disabled Winter Sports display was one of more than 50 sporting associations who exhibited at the Expo. Minister for Sport and Recreation Graham Annesley joined staff and volunteers at the Information Desk, following his official opening of the Return2Sport Expo. The event was supported by the NSW Office of Communities and was staged at the Sydney Olympic Park Sports Centre.

Royal Rehabilitation Centre Sydney ABN 34 000 025 794 227-259 Morrison Road, Ryde NSW 2112 PO Box 6 Ryde NSW 1680 Australia Telephone 02 9807 1144 Facsimile 02 9809 6071 www.royalrehab.com.au To maximise your abilities and life skills