Feb 17, 2021

Managers with no medical training or experience: is this the unravelling of aged care services?

Senior man sitting on chair and cross arms
Photo credit: fzantiStock
While this editorial is based on information from sources that are considered reliable, they do not necessarily reflect HelloCare’s views, instead the intent it to highlight topical issues impacting consumers and the sector more broadly. * Warning disturbing content.

Aged care homes are hiring managers with no medical or aged care qualifications or experience, according to the wife of a resident the move is putting the health and safety of residents at risk in the home her husband resides in.

A HelloCare reader reached out to share her story about deplorable management in the aged care home where her husband has lived for the last two and a half years, and the latest development – the appointment of a manager with no medical or aged care experience.

On top of that, the home has appointed 10 managers in the last 18 months.

It was the last straw for Jan**, who is a nurse herself with a long and successful career in the healthcare sector.

“A turnover like that is indicative of major issues,” she told HelloCare – and she has seen these issues play out.

No response to royal commission grilling

The Royal Commission into Aged Care Quality and Safety “took the home to task”, Jan told HelloCare, over its poor clinical governance which they considered to be a “major problem”. 

However, Jan said the home has not implemented any discernible improvements since then. “They don’t seem to have taken the message,” she said, and in fact since then, things have become “much worse”.

“I don’t know if it’s arrogance or stupidity, or both. I know if I’d had such negative feedback at the royal commission, I would do everything possible [to improve].”

“They don’t have the policies, the procedures or the system in place. They don’t have the appropriate staff appointed in relevant roles to provide that support and mentoring that’s needed when new people start.

“The royal commissioners were very clear when they spoke to this organisation about these deficits, so to make a decision to put a non-clinical person into a facility management role is extraordinary.”

“I’m alarmed and I’m afraid”

After a long series of care failures, the last straw came when the home appointed a manager with no medical or aged care experience.

To make matters worse, the home does not employ any senior resident nurses either. The clinical coordinator is a second-year graduate, and most staff are personal care workers new to the industry.

“It’s extraordinary that we can have older people who can have multiple comorbidities in these aged care facilities and you don’t have people who understand those comorbidities or people who understand how to look after the elderly,” Jan said.

“I’m alarmed and I’m afraid for the residents and my husband.”

“It’s really shocking. As a nurse, I can’t believe this is happening in Australia.”

“You have a situation where you don’t have the clinical staff to ensure that the residents are safe, clinically, and you have a manager appointed who has no clinical knowledge.”

Jan believes that if operators employ managers with no health qualifications, they must then have a very strong nursing workforce. “These facilities don’t want to do that because they don’t want to pay for it,” she said.

“I see him screaming”

Jan believes that if she wasn’t a registered nurse, her husband would have died because the care provided at the home is so poor.

He has a terminal illness, but Jan wants him to continue to have as good a quality of life as possible. Cognitively he is the same person, although physically he has serious challenges which the staff do not help with.

Jan provided a harrowing account.

There are no attempts to rehabilitate residents, they are simply in “a holding pattern for death”, she said.

Dehydration has been a recurring problem, both for Jan’s husband and among the other residents. 

“The staff don’t give the residents sufficient fluid and they get delirium,” Jan said. “For those people who don’t have families or know how to advocate, they die prematurely from dehydration. 

“My husband is alive because I have been meeting with these people over and over.”

Jan said she has attended meetings during which the manager was instructing the nurse on clinical practice. “It was totally inappropriate. It’s absolutely dangerous,” she said.

Punished for speaking out

Jan told HelloCare she raised her issues with the Aged Care Quality and Safety Commission and at the royal commission, but the “reprisals” from staff at the home after doing so were “shocking”.

A group of the staff claimed Jan had physically and emotionally “elder abused” her husband when she lifted up his skin to show he was dehydrated. 

“It was the most devastating thing I’ve ever had anyone do to me. I love my husband. We’ve been married for 40 years. He’s a really decent man. And they did this the week before Christmas,” Jan said. 

Jan was forced to hire lawyers, but once police investigated the matter, it was quickly seen there was no substance to the allegation. 

“It’s been the most horrendous journey,” she said.

A cost cutting excercise

Jan believes the reasons aged care homes are not employing skilled and experienced staff is, in this case at least, to cut costs.

While some will argue a good manager does not need to have medical experience, Jan believes that is “a cop out, so they can say ‘these are just their homes, we don’t actually have to give the care’”. 

“People are going to aged care homes in a much more acute state of health… So in fact the skill sets that are required in these aged care facilities have increased,” she noted.

All eyes on the royal commission

Jan lives in a state of sustained trauma and has been diagnosed with traumatic stress syndrome because of her harrowing experiences with her husbands’ aged care home. 

She describes herself as a “very strong person” who is used to coping with stress. She has worked in ICU, open heart surgery and emergency, and through famine, drought and natural disaster.

But she has never before been in a situation of sustained trauma as caused by the experience of having her husband in care.

Rather than stay quiet and powerless, she has decided to speak out.

The royal commission will release its final report and recommendations next week and Jan, as well as others, will be looking closely to see if any recommendations are made about requirements for manager qualifications.

Jan believes that aged care managers should at least have a health, aged care and management qualification, with the appropriate support under them.

What do you think? Should aged care managers have medical or aged care experience?

While HelloCare has chosen not to name the home in question in this article, we have advised Jan of the appropriate channels to seek resolution including the Aged Care Quality and Safety Commission to investigate.

** Not her real name.

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  1. I am now a registered nurse after being a carer at my same work place for 15years. Please don’t put us all under the same umbrella. There are some good nursing homes out there but with all this news about aged care, families only see the worse in nursing homes.At my work place the residents are our family . Some really do care about your family members so please when I say I’m an aged care nurse, don’t think the worst. I really love my job and my residents I treat like their my own family.

  2. The same thing is now happening at glenara lakes Launceston kingsmeadows new facility manager he is all for saving money and not filling shifts his background is hospitality

  3. Jan** this saddens me that I read ‘most’ staff are Personal Care Workers new to the industry…….many aged care workers have years of experience and do mentor and support new staff.

    Jan**what saddens me is that CEO’s order these Aged Care Facilities to operate for profit by cutting costs, putting both residents and care workers at risk.

    Jan**reading this report saddens me that your husband has been in this particular facility for two and half years. Only you have a choice/option to relocate him to another……for the sake of a happier Jan** and husband.

  4. Unfortunately for Aged Care Residents it is pointless complaining to the Aged Care Quality and Safety Commission.
    That is a toothless tiger, poorly lead and constipated by its own paperwork.
    Change will not come until we see effective legal action against the Directors of badly managed Aged Care Service Providers.

  5. Absolutely they should have medical experience and at the very minimum be a Division 1 nurse with extra training in elderly care management. Atrocious that a home for our elderly should have as manager someone with no medical experience! Totally beyond my comprehension how they can do that!!

  6. I have worked in a facility that had an accountant as Facility Manager.
    Technically, it was a ‘not for profit’.
    But if beds were empty, staff had reduced hours, or if they were casual, they lost shifts.
    I understand all ACF are businesses, but some forget that the residents, and their care is paramount.

  7. I whole heartedly agree with Jan and am terribly saddened that this is happening. Why are our elderly so undervalued in society, to be allowing this to happen?
    It is criminal…and it all boils down to money!

  8. I agree with Jan that aged care managers should at least have a health, aged care and management qualification, with the appropriate support under them. Under this qualification, the managers already have knowledge or experience, or gained the knowledge and experience through the studies in medical and aged care.

    The health management is very different from others, it is people-centred, compassion motivated management than others, such as managers with hospitality background, which mentioned by May in comment. People living in an aged care who need health care do not like people living in a hotel who do not need health care. Therefore, it’s obviously that a manager from hospitality will focus on the sales not the cares.

  9. Sadly, because some operators think residential aged care is a “home” they think that clinical care is not as important as it once was. Some aged care providers have drastically cut back on Registered Nurses, employing Enrolled Nurses or carers to filll those roles to cut costs. The same applies to management roles.
    A manager should be a Registered Nurse. They have the expertise to ensure resident care across all areas not just clinical. Non medical managers rely on Clinical Coordinators for support but often, these staff are not even available.
    When will people realise that Aged Care is a specialised area that requires well educated and registered staff to ensure appropriate care for the frail aged with multiple comorbidities???

  10. I worked for an Aged Care place for 5 years, I have some stories to tell. I tried to name things which concerned me and reported a night nurse for physical violence to a woman, they claim it was unsubstantiated. This person had been there for years, retired and was welcomed back with open arms and she dictated were she’d work. Staff some called her mum! Investigated 🤔. I ended up being called to office regularly and claims of to many to mention, it broke my heart ethics morals. The story goes on however I have now found an Aged Care Facility that acknowledges my skills, commitment💖

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