A couple of weeks ago, we published an article titled ‘Is Six Minutes Long Enough for Aged Care Staff to get Residents Ready Each Morning?’
The article reached nearly 20,000 of our Facebook followers, and attracted nearly 200 comments and shares. One reader, Anton Hutchinson, whose family has proudly owned Canberra Aged Care Facility for over 30 years, provided us with the operator’s view of this debate. Here at HelloCare we always strive to provide balanced commentary. We have published Mr Hutchinson’s comments below.
I greatly appreciate the opportunity to respond to some of the hysteria, I don’t for a second condone mistreatment of any sector but the reality is that, as employers, we don’t know what happens in the private lives of our staff that could cause a melt down and an abuse incident.
Look at, for example, how people today deal with the smallest road situation.
Did you ever expect that someone would get out of their car and bash another driver for perhaps breaking too hard or not leaving enough gap?
Absolutely barbaric behaviour and this lack of understanding and patience certainly hasn’t advanced our society.
There of course is a lot of publicity on Homes failing some of the 44 standards.
We are due for accreditation in the next months and have recently had a pre-accreditation audit done by LASA, we have continued exactly the previously successful policies, procedures and documentation but have found that we would probably fail to comply on a few standards and that is due entirely to the Government moving the goal posts.
I think its also important for the public to understand that Facilities are failing to meet standards like “inventory cataloging”, “out of date flu vaccination signs” and facilities are failing the Privacy standard by having a photo of a resident displayed that regularly absconds and is in danger of being hit by a car.
This is a ridiculous knee-jerk reaction by the Government and all operations are being hounded to the point of throwing their hands in the air.
a) Canberra Aged Care Facility in the ACT has 114 residents with varying degrees of dementia and flexibility of procedure is used every day, while there are tasks to be completed we endeavour to make the routine as relaxed as possible.
Morning staff come on duty at 6.30 and have until lunch time and even later to get our residents bathed and ready for the day.
It would be impossible and unrealistic to expect that everyone would be showered before breakfast. Theres nothing wrong with having breakfast in a dressing gown, we do it at home don’t we?
Upon admission, we undertake an extensive enquiry into our new resident’s likes and dislikes, routines, interests and dietary needs and within a short period of time in residence we establish a routine that fits the individual.
We have residents that prefer a shower before bed and sadly we have others that might require 2-3 showers per day.
With dementia residents, flexibility is the only way forward as we soon learn what part of the day a resident is most compliant and agreeable bringing about a better experience for all involved.
b) After 6 weeks of residence, we undertake a Case Conference with nurses, relatives, management and relevant allied health people.
We get the opportunity to voice our observations and experience since admission and families are more than willing to contribute.
It is not unusual with dementia residents, as they deteriorate, to completely change behaviours, become aggressive, start to swear where they never have, etc… and sometimes this is difficult for families to accept.
We have had residents that don’t recognise their real name for instance and commonly forget their children’s names.
Pretty tough stuff for some families, and some families just can’t be satisfied from time to time.
I give a small example. One resident just loves the corned beef we had on for lunch.
Our staff recognised this and arranged for another the next day… a relative wrote out a complaint that her resident had the same meal two days in a row….
That’s pretty tough for that excellent staff member who supplied personalised care and was abused by the family!
c) Our building is full of family members through the day and they are very vigilant in assuring proper care is being delivered.
They don’t just care about their father or mother but about those around them, which is great. It’s also fantastic to have the extra chat going on.
But of course, as time passes, some relatives, not many, become resentful of how their lives have turned out and just can’t be pleased.
A no win situation for all.
d) The events of abuse in the media are to be condemned but the sad reality is that I too could find myself in the paper due to some sick individual doing something abhorrent to one of our clients.
We are vigilant in our assessment of new staff and rely upon our experience to gauge the suitability of staff.
Some can complete the courses but not have a caring bone in their bodies and they don’t last with us.
Wonderfully our core staff will come forward to point out another staff member’s flaws and we can address this.
My frustration at being thought of as guilty just because of a small percentage of problems and abuses occurring is tiring and quite debilitating at times.
Our industry RACS has suffered incredibly over the last five years to the point that we have zero return on our investment and that is the case for almost half the Homes operating today.
The Government has ripped billions out of RACS, billions not millions, and spent this money in its typically poor manner.
The Home Care and NDIS funding and client expectations are unsustainable.
The very best scenario for a frail and ill person is in a facility that offers 24/7 care around the clock and certainly not just a few very expensive dollars per week.
Home care spent 600 million just last year on consultants alone and the packages don’t in my opinion stack up for the cost, but this will be borne out in the fullness of time.
As an Approved Provider of 35 years I believe RACS do a wonderful job.
The overwhelming majority of staff are the most caring individuals anywhere, but as you would expect they feel like they’re not trusted anymore and that’s bloody sad.
There will always be bad people but I fear that the baby will be thrown out with the bath water! Good operators will get out of the industry and be replaced with a Coles/Woolworths variety of “care” and then you will have something to complain about.
Right now RACS are under attack and a very small few deserve this.
Things will always go wrong but for the most part it is a very good industry and it would be my advice to the public when they read about facilities failing standards to ask “which standards did you fail”.
A lot of the industry believe 19 of the 44 standards are irrelevant in any way shape or form to the care delivered to your loved one.
Staying with standards, it’s expected that each facility operates within the rules but are forced to develop their own policies, procedures and a plethora of documents.
Why doesn’t the Government simply issue a full complement of documents to the industry nationally?
We would all be completing the exact same paperwork in the exact form they want and then we would have a real set of Standards that people could trust.
At this time there is just too much interpretation differences between assessors and that, for the most part, under this system, is unavoidable.
Sometimes the simple solution is the best solution.
great to have another perspective. my only beef is when someone calls a person with the disease of dementia a dementia resident. NO!!! a resident is a person with dementia, like a person with heart disease, or gout or arthritis. Dementia is the disease and NOT the person. therefore we talk about Jim with dementia NOT dementia Jim. OK
Penny,… Really, is that all that occupies your thoughts, my pronunciation? Out of my full and accurate response you’re only comment is that you believe I described a resident with dementia inappropriately! Get a job!
Omg really, Penny is that your only problem here. Have you or do you have a close family member with dementia. Have you been a full time carer of someone with dementia…well I damn have and its agonising and even more so when you have to make the unthinkable decision to put that person that you love immensely into care…and you want the utmost care and respect given to them..I have been fortunate enough to find such an aged care facility and have been encouraged to speak up if I see there are issues, and they can be dealt with…I do love the way the aged care facility in Canberra is organised and is so personally involved with the residents needs and the family’s input as well…after all we are paying for a service that involves a precious member in our lives and we expect the proper care to be given..it should be like home away from home…yes there are some whinging family members that can’t be appeased even if the carers and staff bend over backwards and unfortunately they come out of the woodwork in all walks of life and all businesses are faced with these unhappy miserable souls…working hand in hand with services to give their loved one the best quality of care possible should be the focus of the family, not to cause unnecessary drama…if you want better insight to what goes on in aged care and you want to make residents lives a little more pleasanter do what my grandaughter and I are going to do, sign up and volunteer…
Agree, personally prefer the term person/s living with Dementia
Thank you Anton for giving us an owners view. You make a good point about flexibility being the key to good care for people living with dementia – i’d love to see more extensive training re: dementia. Having standardised documentation could also be of benefit (with some inbuilt flexibility there as well). I would be interested in more specific reference to standards felt to be irrelevant by industry.
So glad this article was written and published…. Thankyou I myself have been very lucky to work in a aged care facility for 20 years , with CEOs and management that recognise the importance of good quality trained staff that generally care. As stated in the article the majority of services are very good, however I agree a generalised set of documentation, policies and procedures would benefit great,y and surely would free up managers and senior staff time away from the endless amounts and tailoring of documentation to the important work of being on the floor to observe, train and assist in the care of residents and supervision of staff and consultation with family and visitors. From a Diversional Therapy background of 20 years I encourage all RACFs and family members to ask the question does the service have a trained Diversional Therapist( degree qualified) that is guiding a team of Recreation Activities Officers ( diploma or certificate 4 trained) this vital area of care is often overlooked but is most important. Diversional therapist or “ lifestyle team” as it is quite often referred to as are the health professionals who assess, program and implement the leisure and recreation programs, outings , special events, cultural events, religious services , concerts, usually runs the R&R meetings, organises the newsletter, voting and the staff social events. All this responsibility and quite often I have heard this vital team is expected to do all this with staff ratios of 1: 30/50 or more or even in one case 1 staff :80 residents.. This area of care if supported well with trained staff , resources that don’t need to be fundraised for and with a better staff ratio provides not only Individual care, a better quality of life for the resident but will quite often see a reduction in falls , maintenance in cognitive abilities and less agitated and wandering behaviours.
I agree. Some of these standards are irrelevant and yet all the time we spend trying to meet them by completing mounds of paperwork is time that could be spent with residents. Homes should be judged on care and time spent with residents that being quality time. The funding model should be changed too. There should be 3 to 4 tiers depending on care requirements and as more care needed the tier increases. Homes spend so much time and paperwork trying to extract the max dollar. Employing people solely to extract max payment whereas this money again can go to direct care of residents. Homes should be judged on their ethics, quality care provided, and needs of all residents being met.
If you think this facility is perfect ask somebody who has a relative who has spent time there It is not about small things but bigger things, ie behavioural responses to treatment and care. My wife had many behavioural problems in the facility mentioned when relocated these stopped. The Standards go toward achieving certain things that as a network produce results. This is culture and if the total package does not achieve it fails P_rivate owners will always be concerned with maximising profit. Where as non profit groups tend to look at outcome and break even. If this is seen in the care given then go ahead and make your profit but not at the expense of residents behaviour and health.
All very good points mentioned above…… but staff to resident ratios for both care staff And Lifestyle team is a Paramount issue that the Royal Commission MUST make a PRIORITY