Jun 23, 2020

Questions remain for Newmarch families about why residents weren’t sent to hospital

 

Last night’s Four Corners report revealed residents at Newmarch House were prevented from going to hospital in an attempt to contain the virus within the home.

Interviews with families affected by the outbreak follow a timeline of the major decisions made in managing the outbreak, during which 19 residents died.

Families reveal they were mostly cut off from their loved one in care, unable to visit them, with little communication, and allowed window visits only after weeks of isolation. 

Residents were left in their rooms for weeks, they were cold, the food was cold and poor quality and often there were not enough staff to help them eat the little food that was provided.

Despite the tough visitor ban, the virus continued to spread inside the home. For weeks, infected residents continued to live side-by-side with residents who weren’t infected. Residents who had not set foot outside their room for weeks still contracted the virus. 

‘Hospital in the home’ promise broken

As the situation within Newmarch deteriorated, families began trying to remove their loved ones from the home. But promises of a ‘hospital in the home’ program – initiated by NSW Health and backed by Anglicare, the federal government, and the Aged Care Quality and Safety Commission – persuaded them to stay.

But as time went on, it became clear Newmarch House lacked not only the staff but also the equipment to run a true ‘hospital in the home’.

Residents were not able to get x-rays on site, IV fluids, or quick turnaround of urine or blood tests. They were not able to receive ventilation if it was needed.

Stark contrast between hospital infection controls

Nicole Fahey, whose 76-year-old granddaughter was a resident at Newmarch House, went to the media after the resident was found collapsed in her room and tested positive to the virus. Ms Fahey insisted her grandmother be taken to Nepean Hospital.

Ms Fahey immediately saw the difference in infection controls at the hospital.

She told Four Corners, “The infection control at the ICU unit… in comparison to that home and that room. If that wasn’t able to be facilitated at Newmarch, get them out. Why weren’t they at the hospital? Why weren’t they all in those ICU rooms? Give them a chance.”

Hospital transfer basic human and legal right

Council of the Ageing chief executive, Ian Yates, said it was “troubling” the Four Corners showed some residents received improved clinical outcomes after being transferred to hospital.

He said future enquiries into what occurred at Newmarch – which are underway by the NSW Coroner, the Royal Commission into Aged Care Quality and Safety, and the Commonwealth – must focus on whether there was an “early reluctance by the facility, or by NSW Health, to transfer residents to hospital”.

“As a matter of basic human and legal rights, COTA believes that every resident of every aged care home has the right to transfer to hospital if they need it and that is their preference.

“Families of residents shouldn’t be forced to go to the media to get the hospital care the resident needs.”

A statement from the Aged Care Guild echoed that sentiment. “Those living in residential aged care must have the same access to the hospital setting as any other person, particularly given their high-risk due to their age and underlying health concerns,” the statement said.

Requests to leave met with threats of jail, fines

Four Corners revealed the strength of the desire to keep residents within Newmarch House.

The family of one man in his 90s – who had tested negative to COVID-19 – wrote to Anglicare asking if he could leave the facility. Anglicare replied that NSW Health could create a public health order to prevent the resident from leaving. 

They said the man could face fines of $11,000 or six months in prison if he breached the order.

Government’s ‘special considerations’ for pandemic hospital visits

The United Workers Union issued a statement today outlining “little-known” guidelines endorsed by the federal government telling aged care providers if they experience a COVID-19 outbreak, infected residents do not automatically have to be transferred to hospital. 

The guidelines, which were issued to aged care providers by the Communicable Diseases Network of Australia on 13 March outline “special considerations” in the management of residents with suspected or confirmed COVID-19, including “transfer residents to hospital only if their condition warrants” (the Network’s own emphasis).

The guidelines also state, “When a single room is not available, and cohorting of ill residents is not possible, a resident with a respiratory illness may be cared for in a room with a roommate(s) who does not have a respiratory illness”, though it states this is “the least favourable option”.

Four Corners exposed a lack of “federal government accountability” for the outbreak of COVID-19 in the aged care facility, United Workers Unions said in the statement.

“The program exposed a sector where short-staffing, a lack of training in personal protection equipment and an overall lack of funding meant that care for residents was compromised on a regular basis.

“Claims by the regulator, the Aged Care Quality and Safety Commissioner, that there were no ‘profound failures’ at Newmarch House flies in the face of evidence of a failing aged care system.”

Quality Commission should have greater powers to step in

Mr Yates said there are three investigations ongoing into what occurred at Newmarch House, investigations by the NSW Coroner, the Commonwealth and the Aged Care Royal Commission.

He said the inquiries should focus on the clinical care provided to residents who tested positive to COVID-19, the effectiveness of infection control measures and clinical treatment, and whether more residents should have been transferred to hospital.

Mr Yates said the program also demonstrated why the Aged Care Quality and Safety Commission should be given additional powers to take early preventative action, beyond the existing laws that mean they can only step in after major problems have been identified.

“We would welcome the ACQSC having a wider range of powers to step in sooner, rather than later, and with a much broader range of tools in its regulatory tool kit,” Mr Yates said.

Respect for older people

Anglicare found itself in an unprecedented and extremely difficult situation. Managing an outbreak was always going to be a herculean task. Four Corners’ investigation identifies failures that occurred, but still leaves questions remaining. No doubt future inquiries will address these issues, and the aim must be to inform responses for outbreaks of infectious disease in the future.

The program also raises questions about how our society treats older people. This too is something we must tackle.

As Louise Payne, whose mother Yvonne was a resident at Newmarch, told Four Corners, “I’m 100 per cent positive that if this happened to young people, we would’ve had a whole different outcome. 

“There would be people screaming in the streets if anything happened like what happened at Newmarch.”

Image: ivisveta, iStock.

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  1. The whole situation was completely mismanaged right from the start. Starting with the nurse who knew she was unwell but chose to work anyway, right up to the top brass of Anglican Care who allowed the mismanagement to continue long after the media got hold of the story. Everyone involved needs to be removed from their position & find jobs outside of healthcare.

  2. Watched this 4 Corners episode – it made me outraged – this whole dilemma should never have happened and needs thorough investigating – NSW Health and Newmarch both neglectful – the poor old darlings not getting showered for two weeks and another not found for two hours when she had fallen – NOT GOOD ENOUGH – OLD LIVES MATTER TOO.

  3. This situation saddens and sickens me, there really is no excuse for this mismanagement. The use of personal protective equipment should be included in mandatory training of all health care staff, from carers, to nurses, to admin staff, kitchen staff, maintenance staff and cleaners! If the CEO said using PPE is a foreign concept to staff members then that is the first thing that must change. In the case of the resident who was told he could face fines or imprisonment if he left the facility, surely he was misinformed! Whatever happened to personal choice? I understand that the resident and his carers, family members, whoever would be caring for him outside the facility should have, had to sign an agreement to self isolate for the 14 days after leaving the facility. It seems there was a complete breakdown in the care chain for those residents who were infected and those who were not. A Baptistcare facility which also had an outbreak seemed to manage to contain the spread from within the facility by moving residents around to enable those who were unwell to be segregated from those who weren’t. (Sorry I dont have any records of this, but did read it in a newspaper some weeks ago). I work in an aged care facility and we have been fortunate enough not to have any positive cases among residents or staff, but anyone who showed any symptoms of respiratory infection or fever were immediately isolate, swabs were attended and the resident remained isolated until results returned. Staff education is vital for any outbbreak, whether COVID, flu, gastro or any other infective illness. After years of working in aged care I note there has always been a culture of maligning staff who call in sick, they are told they cant be replaced and their team will have to work short. The casualisation of the workforce and low pay rates contribute to the problem because staff feel that they cant afford to take time off if they dont get paid sick leave.
    It is high time for a big shakeup in the aged care sector, and the federal government is responsible to see it happens.

  4. The use of Hospital in the Home is only suitable if you have enough qualified Nurses to carry out the procedures required. I don’t know of any facility with enough registered nurses to undertake this process!!

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