• DISCLOSURE OF RELATIONSHIP

    DISCLOSURE OF RELATIONSHIP

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    Skymac and Australian Quality Care act with integrity and honesty, prioritizing your best interests. We support your right to make informed decisions about your life, including disclosing any conflicts of interest that may impact our services. A conflict of interest arises when personal relationships, such as family or friends, could influence official decisions.

    This form declares that Skymac Pty Ltd, operating Avalon Village and Thornfields, shares a Director with Australian Quality Care, which runs Alora Living and our support services. This potential conflict of interest is disclosed to you. If you choose another provider due to this, Skymac will respect your decision.

    We record any service issues and resolutions, explain your right to complain without fear, seek continuous feedback, clarify the differences between accommodation and support, and explain your right to change providers.

  • ENTRY AND PRIVACY

    ENTRY AND PRIVACY

  • CONSENT TO ENTER ROOM TO CONDUCT STANDARD LINEN CHANGE

    Included in your accommodation rent fee is a once per week bed linen change (not personal laundry). In order for us to do this, you consent to our staff entering your room to conduct this service. This service is usually conducted Monday to Friday between the hours of 9:00am and 4:00pm. We will liaise with you establishing a routine day and time but times may vary in certain circumstances.  

     ADDITIONAL PERSONAL CARE SERVICES*

    If you have engaged additional personal care services, either through Skymac or Australian Quality Care, you consent to our staff entering your room in order for the services to be conducted.

  • MEDICATION

    MEDICATION

    Personal Care Services – Level 3 Approved Accreditation – Additional Fees and Charges Apply
  • ASSISTANCE WITH MEDICATION CONDITIONS

    • Australian Quality Care will adhere to the seven ‘rights’ for safe medication administration as per Section 8 of the Residential Services (Accreditation) Regulation 2018:
      • Right person
      • Right medication
      • Right dosage
      • Right time
      • Right route
      • Right to refusal
      • Right documentation
    • This includes assistance with non-prescription and alternate medications as directed by my medical practitioner or pharmacist.
    • Webster-pack medication will be provided by Albion Day & Night; staff will not assist with any other medication.
    • Australain Quality Care is authorised to safely store my medication in a locked area.
    • My prescriptions may be given to the pharmacist as needed.
    • If I am not present for my medication, management/staff may attempt to locate me, including contacting third parties such as family, friends, or emergency services. If unfound, they may report to appropriate parties.
    • If I choose to take my medication to my room, I do so at my own risk, and staff may notify my medical practitioner.
    • If I miss a dose or refuse medication, I do so at my own risk, and staff can notify my medical practitioner.
    • I must inform staff if I have any swallowing problems.
    • If I have acute or persistent swallowing issues, Australian Quality Care may contact my GP or health professional for an assessment, which may include a Mealtime Management Plan.
  • SELF-MANAGING MEDICATION DECLARATION

    My responsibilities in managing my own medication:

    • Ensuring all medications are within their expiry dates; any expired medications will be discussed with staff.
    • Reporting any difficulties in self-administering medications, including swallowing issues.
    • Maintaining an adequate supply of medications as prescribed.
    • Informing staff about non-prescription medications like Panadol used on an as-needed basis.
    • Providing an updated list of all current medications, including complementary and over-the-counter medications, and notifying staff of any changes.
    • Seeking assistance from staff for medication administration or questions.
    • Keeping medications securely stored in my room at all times.

    Note from Australian Quality Care and Skymac:

    We support residents' independence while ensuring safe medication management. As a Level 3 Supported Accommodation and registered NDIS Service Provider, we have a duty of care. We may periodically assess your ability to manage medications and may inform your doctor accordingly. Skymac reserves the right to secure your room if medications are found insecure, and to notify your doctor if medication misuse is suspected. Residents managing their own medication do so at their own responsibility.

  • BGL MONITORING

    BGL MONITORING

    Personal Care Services – Level 3 Approved Accreditation – Additional Fees and Charges Apply
  • ASSISTANCE WITH BLOOD GLUCOSE MONITORING CONDITIONS

    • Australian Quality Care has given me the NDSS Blood Glucose Monitoring fact sheet explaining the monitoring process.
    • I must provide Australian Quality Care with my Diabetes Care Plan from my doctor or diabetes health professional, if available.
    • Australian Quality Care is authorised to store my blood glucose equipment securely.
    • Australian Quality Care will maintain and operate my blood glucose equipment as per the manufacturer's instructions.
    • Australian Quality Care will record my blood glucose levels as directed by my doctor or as stipulated in my Diabetes Care Plan.
    • If my blood glucose levels fall outside the recommended range, Australian Quality Care will follow my Diabetes Care Plan's directions.
    • Australian Quality Care will monitor the expiry dates for test strips, lancets, and needles, and reorder them as needed.
    • Australian Quality Care may remind me to get blood tests and other specimens as advised by my doctor or diabetes health professional.
    • Australian Quality Care will not administer injections but will observe me if necessary.
    • If I miss or refuse to take a reading as specified in my Diabetes Care Plan, I do so at my own risk, and Australian Quality Care may notify my doctor or diabetes health professional.
  • SELF-MONITORING BLOOD GLUCOSE LEVEL MONITORING DECLARATION

    My responsibilities in managing my own blood glucose levels:

    • Monitor expiry dates for test strips, lancets, and needles; reorder as needed.
    • Record blood glucose levels as advised by my doctor or in my Diabetes Care Plan.
    • Follow my Diabetes Care Plan if blood glucose levels are outside recommended ranges.
    • Get blood or other specimens taken as advised by my doctor or diabetes health professional.
    • Inform my doctor or Australian Quality Care staff of any difficulties in monitoring blood glucose levels.
    • Maintain and securely store blood glucose equipment according to the manufacturer’s instructions.
    • Do not share equipment or supplies with others.

    Note from Australian Quality Care and Skymac:

    We encourage residents to maintain their independence safely and effectively. As a Level 3 Supported Accommodation facility and registered NDIS Service Provider, we ensure your blood glucose is managed safely and seek your cooperation.

    • Australian Quality Care may inform your doctor if you manage your own blood glucose levels.
    • If your room is left unattended and unlocked with unsecured equipment, it may be locked immediately.
    • Misuse of equipment or failure to record/monitor as per doctor's orders may be reported to your doctor.
    • Skymac and its staff are not responsible for those residents who manage their own blood glucose levels.
    • Missing a reading at specified times is done at your own risk, and Australian Quality Care may notify your doctor or diabetes health professional.
  • CONSENT TO SHARE AND OBTAIN INFORMATION

    CONSENT TO SHARE AND OBTAIN INFORMATION

  • I understand that Australian Quality Care and/or Skymac may share my information with:

    • Australian Quality Care and Skymac related entities for internal business purposes
    • Commonwealth and State departments/agencies which provide funding for services (e.g., NDIS, NDIA, auditing, Public Guardian, Public Trust)
    • Contractors/agencies working on behalf of Australian Quality Care or Skymac
    • My NDIS registered Support Coordinator and/or Plan Manager
    • NDIS service providers (e.g., Centacare, Endeavor)
    • Health and Allied Health professionals (e.g., GP, physiotherapist, hospitals)
    • Third parties, including Queensland Police Service, for identification in case of missing persons
    • Emergency medical and ancillary staff in emergencies.
  • CONSENT TO OPEN MAIL

    CONSENT TO OPEN MAIL

  • By giving my consent, I also understand the following:

    • Management/staff can open, view, and read all mail I receive and file securely in my personal documents folder.
    • I will be notified of all mail that I receive and each document will be stamped in my presence to acknowledge that I have received it.
    • Management/staff will respond to any mail as required and inform me if anything needs to be actioned.
    • Should I choose to leave Skymac, I will be given all my documents and letters that have been received through the post.
  • I understand that all mail containing details of appointments, legal matters, instructions or other important information will be my responsibility to manage and Skymac Pty Ltd will not be involved.

  • PHOTO CONSENT AND MEDIA RELEASE

    PHOTO CONSENT AND MEDIA RELEASE

  • Australian Quality Care and Skymac uses residents' photos and videos for promotional and educational purposes on its websites, printed materials, and social media. Since identifiable images are personal information, Skymac requires your consent to use them.

  • By giving my consent, I also understand the following:

    • Photos or videos of me can be used on Australian Quality Care and Skymac's website, printed materials, and social media pages.
    • Australian Quality Care and Skymac will securely store photos and videos of me in a safe electronic file.
    • All photos and videos remain Australian Quality Care or Skymac's property and may be cropped or altered for Australian Quality Care and Skymac may duplicate images for future educational and promotional materials without my prior approval, unless I withdraw my consent.
    • I can withdraw my consent at any time by completing a new copy of this form indicating my withdrawal in writing.
  • CCTV USAGE

    CCTV USAGE

  • As part of our ongoing commitment to ensuring the safety and security of Avalon Village, Thornfields and Alora Living homes we would like to inform you that Closed-Circuit Television (CCTV) cameras are in operation on the premises.

    These cameras are strategically placed throughout the property to monitor common areas, entrances, and other key locations. Cameras are not installed inside any private living homes nor private rooms. The primary purpose of these cameras is to enhance security measures, deter criminal activity, and promote a safe environment for all residents and visitors. The purpose of CCTV is not for the purpose of restricting residents’ movement in to, out of, or around any of the properties.

    By residing at Avalon Village, Thornfields and Alora Living homes, you acknowledge the use of CCTV for security purposes. Please be assured that any footage captured by these cameras will be used solely for security and safety-related matters. Access to this footage will be restricted to authorised personnel only, and it will be handled in accordance with applicable privacy laws and regulations.

    We understand the importance of maintaining your privacy while ensuring a secure living environment. If you have any questions or concerns regarding the use of CCTV on the premises, please do not hesitate to contact our office.

    Thank you for your cooperation and understanding.

  • RENT PAYMENT METHOD

    RENT PAYMENT METHOD

  • Centrepay Deduction Authority

  • I authorise Services Australia to make a Deduction of   $   each fortnight from my Disability Support Pension commending   Pick a Date   .
    I request to pay this amount to Skymac Pty Ltd T/A Avalon Village and Thornfields, 555-114-425-L, for Private Rent.

    Option 1
    I request that this deduction of  $   continue until the target amount of  $   is reached.

    Option 2
    I request that this deduction of  $   continue until   Pick a Date   is reached.

    Option 3
      

    Australian Privacy legislation protects your personal information. I give permission for Skymac Pty Ltd T/A Avalon Village and Thornfields to disclose my information to Services Australia for the purpose of checking my account number, billing number and amount I want to pay, and reconciling my payment Deduction details. 

    I understand that I can change or cancel my Deduction at any time, and further information about centrepay can be found online at servicesaustralia.gov.au/centrepay.

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  • Please note: Direct Debit Request Form will need to be completed.

  • Please note: 1.9% transaction fee is charged for all Eftpos payments.

  • SIGNATURE OF RESIDENT

    *Or signature of person acting on authority under Guardianship Administration Act 2000 or Powers of Attorney Act 1998 for the person named below, OR an Informal Decision Maker (must have an Informal Decision Maker Details Form signed) for the person named below.
  • By signing below, I hereby confirm my understanding, agreement and consent of the information contained in this document.

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