Sep 25, 2018

Personal stories reveal depth of failures in our aged care system: Four Corners

Last night’s Four Corners again detailed harrowing personal stories of families and elderly people who have experienced first-hand the failures of the Australian aged care sector.

With mistreatment, incompetence and systemic failure laid bare, the pressure for change is growing.

Yesterday we wrote about the rough handling of Ed Robin’s mother, who was 92 years old and had dementia. Her son secretly installed cameras in her room to try to uncover the reasons why she was bruised and frightened.

The footage revealed that carers were pushing and shoving Mrs Robins, laughing at her, throwing toys at her, and even covering her face with a pillow.

Should cameras be installed in residents’ rooms?

Mr Robins believes cameras should be installed in aged care residents’ rooms.

“There should be cameras in every room as far as I’m concerned so you can see what’s happening,” he told Four Corners last night.

This morning on ABC radio, the Aged Care Minister Ken Wyatt said he is open to the idea of having cameras installed in aged care residents’ rooms to stamp out abuse.

“I can appreciate the families who are very strongly supportive now of cameras within those rooms,” he said.

“None of this [on Four Corners] would have been known without that footage as to how those individual were treated.”

“Rough handling”

Four Corners identified poor training as one factor in causing what the industry calls ‘rough handling’. One of the carers who was charged with Mrs Robin’s assault had received only six weeks’ training and said she was expected to get residents ready for bed in five minutes.

Melanie Whiteley, Personal Care Assistant said, “Rough handling to can be as simple as rushing a resident. If you’ve got a resident that has dementia and isn’t understanding that you’re undressing them to give them a shower, you can’t just be ripping their clothes off. They resist, they fight you, and it’s rough.”

“Some people clearly not suited to working in a care capacity”

Tanya Bosch, Personal Care Assistant, said some people working in aged care were not suited to that kind of work.

“There were some people who were clearly not suited to working in a care capacity. They were lacking in empathy and seemed unable to imagine what it would be like to be in the situation of a frail, dependent person,” she said.

Non-performing operators slipping through Quality Agency’s net

Steve Woods, a former police officer who worked in aged care complaints and compliance for the Department of Health for a decade, said he felt the interests of aged care providers are being put ahead of the interests of residents.

“We hasten much more slowly to take action against providers and we give them more scope to fix things, which perhaps should be fixed earlier,” he said.

We was “highly critical” of the fact that the Quality Agency’s accreditation system granted 95 per cent of operators a perfect score last year.

“I think that’s unrealistic,” he said. “I think that if that’s how you believe that our aged care system is operating at the moment, that’s niaeive. I don’t think it’s not an accurate reflection of how the industry is.”

“There must be more operators and providers out there who are not meeting standards and who are slipping through the gaps in the system.”

He said operators may be able to slip through the Quality Agency’s net for a number of reasons: there is only one unannounced visit a year, there can be long gaps between audits, complaints are not often investigated on site, and investigations can be frustrating for the public.

Complaints system is “useless”

Helen Hackett shared the story of her father, who died one night while in aged care. While trying to get to the bottom of what happened to her father, Ms Hacket asked to hear the recording of the Nurse’s call for an ambulance.

The call was played on Four Corners and it made for harrowing listening. The nurse seemed brutally casual, asking for the ambulance to come within two hours, laughing when she couldn’t remember the phone number and commenting by way of explanation, “We’re all casual staff here.” In the background, Ms Hackett’s father’s moaning and drawn out, laboured breathing can be heard clearly.

When Mrs Hackett contacted aged care complaints they said they didn’t think it was important to listen to the tape, and asked, “Will an apology do?”

Six months later, Ms Hackett received the Aged Care Complaints report, discovering that her father was alone in his “hour of need”.

Aged care complaints allegedly did not visit her father’s home to investigate the claim.

“He was a loving man, he cared for his family, he worked hard his whole life. He didn’t deserve this ending. The worst thing is he died alone. There was no one there for him,” said Ms Hackett.

“Families in the dark”

In the last two years, the number of complaints received by the Aged Care Complaints Commission has increased by 50 per cent to 4,700, yet the 2016-17 annual report says officers made only 50 site visits, according to Four Corners.

Mr Wood said in the previous decade, the Complaints Commission had made over 3,000 site visits a year.

“You can’t get a feeling for what an aged care service is doing over the phone,” he said.

Mr Wood said that because what’s published on the Agency’s web site is so restricted, it’s difficult for members of the public to get a “true feel” for how that service is operating.

“Until the agency make failures public that occur in nursing homes, families will remain in the dark,” he said.

Some operators “a law to themselves”

Alanah Freeman’s mother died in aged care in 2016. Her pressure wounds and broken bones were not properly cared for and she died of sepsis.

Ms Freeman only found out about the pressure sores after her mother dies, and she believes that if her mother had been properly cared for in hospital she might have survived.

Ms Freeman approached the Aged Care Complaints Commision and ten months later was handed down a report which said her mother’s wounds were looked after by untrained carers, and wound specialists or GPs were not consulted.

Again, the Commission did not visit the facility, and three months later, the Quality Agency extended the facility’s accreditation for another nine months with a 100 percent score.

Ms Freeman said she would like to see a transparent process where the general public can view complaints.

Abuse is not being reported, enabling it to reoccur

Jamie Fehon and Libbie Brice’s mothers both lived at a home  on Sydney’s north shore.

But both observed changes in their mothers. Mr Fehon noticed a look of fear in his mother’s eyes, and Ms Brice said her mother appeared “terrified”.

Staff at the nursing home were also concerned about what was going on at The Poplars, and put a hidden camera in the dementia unit.

Within a few hours carer Dana Gray was observed hitting, shoving, and pushing a resident and then hitting her over the head with a full bag of rubbish. The footage is absolutely shocking to watch. The staff member who obtained the film took it to management, who took the matter to police.

Mr Fehon and Ms Brice were informed of the incidents. But Ms Brice said the operator was simply going through the formalities. “There was never a sense of deep regret, compassion, sympathy for families let alone loved ones who had been abused.”

Ms Brice took the matter to Aged Care Complaints, which revealed a year before the camera was installed that Ms Gray had been involved in other cases of abuse and the matter was not reported.

“If this was happening to our children we would be in there. We would be fixing it and solving it. But somehow our elderly get neglected,” said Mr Fehon.

Minister Wyatt told Four Corners the Quality Agency would deal with complaints. But seven weeks after the footage of Ms Gray emerged, the Quality Agency did assess The Poplars but allegedly no action was taken.

Ms Gray was sentenced to 17 months home detention, with a non-parole period of six months.

Mr Wood says the entire complaints and regulatory system is failing. The case of this Sydney nursing home  certainly makes it seem that way: a system with no penalties, no justice, and no accountability.

Improvements in regulatory systems are underway: ASCA

Aged and Community Services Australia issued a statement in the wake of the second Four Corners report, saying there is no excuse for poor or neglectful care.

Pat Sparrow, CEO of ACSA, said, “The stories as retold on Four Corners last night are unacceptable. They fall well short of the standards of care all Australians expect for our elders.”

She said there are already improvements and changes to the safety and quality systems underway, based on recommendations in the Carnell-Paterson Review.

Unannounced visits were introduced from 1 July 2018, a new single Aged Care Quality and Safety Commission will be in place from 1 January 2019, and new quality standards come in on 1 July 2019.

Recommendations have “fallen on deaf ears”: Nurses’ union

“Like the rest of Australia, our members were shocked at the footage aired on last night’s Four

Corners,” said The Australian Nursing and Midwifery Federation (ANMF) A/Federal Secretary, Lori-Anne Sharp.

“What we saw should never be allowed to happen in a civilized society,” she said.

She said that despite ongoing enquiries into the sector, little action had been taken.

“Despite an inquiry into elderly abuse; a damning report and recommendations by the Australian Law Reform Commission (ALRC) and ongoing concerns from our members and the families of nursing homes residents, there has been little recognition or response from our political leaders and aged care regulators. It has fallen on deaf ears,” she said.

“Successive governments have allowed providers to sack highly-trained nurses and reduce hundreds upon hundreds of nursing care hours.”

Ms Sharp called on the government to introduce mandated staff ratios and to ensure adequate training for care staff.

“Sadly, the stories of abuse and neglect will continue unless the Federal Government listens to our concerns and mandates staffing ratios in residential nursing homes.”

“The Federal Government cannot wait for the Royal Commission, it must introduce mandated staffing levels now, to protect our elderly.”

Aged care requires urgent increase in government funding: LASA

Leading Age Services Australia (LASA) CEO Sean Rooney said it was “unacceptable” that Australian seniors have been subjected to abuse.

“Any incident of elder abuse in an aged care setting must be treated with the utmost seriousness,” he said.

But Mr Rooney said the large majority of aged care operators are doing the right thing.

“It is unfortunate that the actions of a small number of staff reflects so poorly on the broader aged care system,” he said.

Mr Rooney said the age care industry is in a period of significant transformation and has introduced changes that he hopes will “drive quality improvements” and “help restore confidence for the community”.

Mr Rooney said LASA is recommending:

  • More effective regulation and standards so that if a provider is not delivering an appropriate standard of care they are quickly identified and sanctioned or shut down.
  • Development of the industry’s workforce to ensure an increased number of staff with appropriate qualifications and skills, opportunities for ongoing learning and advancement, and to ensure staff are appropriately paid.
  • An urgent increase in Government funding.

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