industry & reform
So many of them across the country
describe their workloads now as unsafe.
They’re untenable. They report to us that
that’s why they’re leaving the sector,”
she said.
These shortages affect the ability of
nurses to properly attend to residents in
the mornings during their personal hygiene
routine, during meal times and at handover
between shifts, Butler said.
We heard a particularly disturbing
account of a man, post-stroke and aphasic,
who was experiencing pain in his penis. He
was found to have an indwelling catheter
wound, due to a poor handover.
Counsel assisting Paul Bolster read a
statement from an aged care nurse about
the incident that read: “I am blown away
that the staff did not report the erosion as
it was happening and take steps to prevent
it. More-educated staff had not looked
at the source of his pain. He had Panadol
every night.”
Nurse testimonies from ANMF surveys
also highlighted their concerns about
nurse hours. The federation put forward
their hourly care model and a mandated
skills mix of 30 per cent registered nurse,
20 per cent enrolled nurse and 50 per cent
personal care worker.
“What we think our research clearly
indicates is there’s just a gaping hole in the
Aged Care Act currently in terms of how
you actually staff against genuine care
needs in residential aged care,” Butler said.
DAY 4: RISE IN ‘SERIOUS RISK’
The year after the government stalled aged
care funding, there was a marked increase
in findings of “substandard care that would
impact on the health and wellbeing of a
care recipient”.
During the evidence of the secretary
of the Department of Health, Glenys
Beauchamp, counsel assisting Peter Gray
alluded to a correlation between the two
outcomes.
In 2015–16 the Australian Aged Care
Quality Agency found only two aged
care providers to be a “serious risk”.
The following year, concurrent with the
government’s indexation of the Aged Care
Funding Instrument (ACFI), there were 22
serious risk findings, and the year after a
jump to 61.
Gray asked whether funding levels were
sufficient and if funding freezes impacted
safety standards, but Beauchamp proved
hard to pin down, causing Gray to repeat the
question. Beauchamp suggested that “it is
sufficient for the forward estimates period”.
14 agedcareinsite.com.au
Margot Harker, aged care service
recipient, at the Commonwealth Courts
in Adelaide. Photo: James Elsby, AAP
We also heard evidence (from data
contained in consumer experience reports
conducted in over 1100 facilities) that 98.3
per cent of aged care residents felt safe.
However, when more closely inspected,
those figures are misleading. Gray pointed
out that in fact the survey was broken
down into categories, and that of the 98.3
per cent, 17.21 per cent of respondents
answered that they felt safe only “most of
the time”.
When asked by commissioner Briggs
if she would feel comfortable putting
a loved one in a facility under current
standards, and if these standards reflected
community ideals, Beauchamp was
noncommittal.
“I think the current standards require
a subjective assessment, not necessarily
based on how the client feels and what the
client is experiencing, but I think the new
standards absolutely put the care recipient
at the centre,” she said.
DAY 5: AIR-CON TALK GETS HEATED
The fifth day of the royal commission saw
a set of tense exchanges between counsel
assisting Dr Timothy McEvoy and LASA
chief executive Sean Rooney.
Rooney was taken to task by McEvoy
over a number of issues, in particular
LASA’s views on air-conditioning in aged
care facilities.
LASA’s submission made mention – in
reference to the government’s draft aged
care quality standards consultation paper
– of the need for “comfortable internal
temperatures”, which “may be interpreted
that all services are required to have
air-conditioning”.
McEvoy pointed out that, in fact, there
was no reference to internal temperatures
to be found in the draft, asking: “Is it the
view of LASA that it’s unnecessary to have
heating or air-conditioning in residential
aged care facilities?”
Rooney replied in the negative, only to
be pursued by McEvoy.
“So, if that’s the case, why was it suggested
that reference to ‘comfortable internal
temperatures’ be removed and, indeed, why
was there a concern?” he asked.
When asked repeatedly whether he and
LASA believe that air-conditioning should
be standard across aged care facilities,
Rooney repeated that heating and cooling
should make residents “comfortable”.
Rooney was asked how this issue came
up and if LASA was lobbied by providers
due to a fear that air-conditioning may be
a requirement.
Rooney replied that the question “must
have been raised by a member at some
point”, causing McEvoy to question –
three times – whether LASA would ever
prioritise the needs of residents at the
expense of providers.
“I would suggest that LASA has always
looked to ensure that we are supporting
our members to deliver the best possible
care that they can,” Rooney replied.
This was not the only time Rooney was
pressed during his testimony. He was also
asked why some LASA members wanted
to change the wording of the Single Aged
Care Quality Framework.
LASA’s statement reports that “some
LASA members have suggested amending
Clause 2.3 to remove ‘continuously
monitored’ to replace it with ‘regularly
monitored’”.
The clause currently states that: “Care
and services are implemented and
continuously monitored and evaluated for
effectiveness.”
McEvoy then proposed that the
amendments sought by LASA might serve
to reduce “the standard required because