Commissioners Richard Tracey and Lynelle Briggs have heard a harrowing array of stories in the last two months, detailing the human cost of the failings in our aged care system. Much of the evidence of the Broome, Perth, Darwin and Cairns hearings has been given via case studies from the perspective of family members and then provider responses.
Broome hearings 17–19 June
In Broome, the focus of the hearings was on the challenges of providing aged care in remote settings and the unique care needs of Aboriginal and Torres Strait Island people. Evidence highlighted the lack of access to aged care services, the challenges of providing distance services and the need for culturally safe care. Providers spoke of the need for increased funding in remote areas- as the cost of all services, including attracting and retaining staff, are all higher. The importance of supporting indigenous Australians to be cared for at home, to provide training in delivery of culturally safe care and respecting elders was conveyed throughout the Broome Hearings.
Perth hearings 24-28 June
The focus of the Perth hearings was person centred care, advanced care planning and palliative care services.
RN and QNMU member, Emma Murphy provided a statement to the Commission about her experience working as an agency and casual nurse and the benefits and challenges of delivering person centred care. Emma was invited to give evidence to the Commission on a panel of aged care workers. Emma described how as a recent graduate she has embraced working in aged care and become passionate about person centred care. Emma explained that as a nurse an equally important part of the role to providing clinical care is being able to look after and nurture residents’ social and emotional wellbeing. She explained that sometimes residents’ emotional needs and personal interests were not met due to inadequate staffing levels in the facilities she’d worked in. When asked what she would like to see in aged care, Emma replied ‘I would like to see a bigger influx of qualified nurses, new graduates coming into aged care, a greater appreciation of the industry and a bigger focus on the emotional side of care.’
Darwin and Cairns hearings 8-19 July
The Darwin and Cairns hearings focussed on aspects of care in residential, home and flexible aged care programs and examine rural and regional issues and quality of life for individuals in care.
The case studies highlighted failings in the system and the lack of quality care through the story of Ms Aalberts who was cognisant, continent and ambulant when she moved into Avondrust on 24 May 2018. On 31 May 2018, the RACF was assessed as meeting all 44 of the accreditation standards. Ms Aalberts had a number of falls and developed a leg wound which was not properly assessed or treated. Importantly, her daughter was not informed of the severity of the wound and only discovered it when her mother was admitted to hospital. Serious pressure sores were also discovered and the combined effect of the wounds resulted in Ms Aalberts’ death on 19 August 2018. Ten days later sanctions were imposed on the RACF for failing to meet standards, with particular reference to the failure to assess and provide appropriate clinical care for Ms Aalberts.
Counsel assisting the Commission confirmed this concession from the provider – at the time Ms Aalberts was a resident, the RACF was staffed to provide only 7 minutes of RN direct care per resident per day, with all residents of the facility having been assessed as high care.
Based on these and other similar case studies, the Commissioners can be in no doubt about the severity of the problems arising from lack of regulatory oversight and the devastating outcomes of inadequate staffing and skills mix in RACF’s.
The next round of hearings, to be held in Brisbane on 5-9 August will focus on regulation in aged care.