By Natasha Egan
There should be zero tolerance for the poor care practices depicted in ABC Lateline’s latest story on the aged care sector, says Alzheimer’s Australia CEO Glenn Rees, while provider peak bodies have reiterated the incidences are uncommon in a sector that is chronically under-resourced.
The sixth investigation in 12 months by journalist Margo O’Neil aired on Tuesday evening and featured frontline aged care workers telling their experiences working in the sector.
An over-burdened carer locking dementia patients in their rooms at night, incontinence pad rationing, toileting shortcuts which encouraged residents to urinate and defecate while showering, abusive and poorly-skilled staff, and regulation that promotes box ticking rather than adequate care were key practices and problems highlighted.
Lateline reported that while good care was provided in many facilities it had been given shocking examples of inadequate care in over 100 Australian nursing homes.
Ms O’Neil said aged care workers from around Australia have told Lateline there was just not enough of them to ensure dignified and compassionate care for residents in many nursing homes.
Speaking after Ms O’Neil’s report, Lateline host Emma Alberici asked Mr Rees how widespread these issues were based on the feedback his organisation received following a campaign asking people to share their experiences of poor quality care.
Mr Rees said among the many emails and letters Alzheimer’s Australia received in the last month, some were as disturbing as those aired during the program but added they were not enough to conclude there was systemic failure across the residential aged care system.
“What we can say and I think your program tonight shows it again, is that in some places there is really very, very poor care being delivered which is quite unacceptable and as an organisation we believe there should be zero tolerance for that,” Mr Rees said.
COTA Australia CE Ian Yates made a similar call for zero tolerance on poor quality care last month following the previous Lateline aged care investigation as did Mr Rees in a speech to the National Press Club earlier on Wednesday.
Spot checks and the standards and accreditation agency should be identifying inadequate care practices, but they aren’t, Mr Rees said on Wednesday evening.
“We were promised as consumers that the accreditation agency over time would weed out the bad apples in the industry. And, clearly that hasn’t happened.”
Elsewhere in the Lateline interview Mr Rees said while whistleblowing was difficult for staff because their jobs may be at risk, the notion that nurses and carers would lock up people with dementia, with the risk of fire, was beyond imagination.
“[If] you weigh up the cost of 30 or 40 lives in a fire against exposing that kind of risk then I think that short term action has to be taken,” he said.
Mr Rees said a preferred approach involved transparency around care outcomes, using quality indicators and involved consumers in monitoring and checking, rather than current monitoring, much of which addressed systems and compliance instead of quality of care.
He also highlighted that the current accreditation system did not give consumers a sense of which residential care facilities were doing a better job than others because it lacked scaling even though 95 per cent of organisations got accredited.
“You don’t know within that 95 per cent who are very good, who are moderate and who are just doing a reasonable job.”
Mr Rees said he would like to see the quality agency look at this when it comes into being from January next year.
In separate statements issued on Wednesday the two provider peaks, Leading Age Services Australia (LASA) and Aged and Community Services Australia (ACSA), again expressed concern over the issues raised but reiterated they were rare occurrences in a sector that was under-funded with critical workforce shortages.
LASA CEO Patrick Reid said the vast majority of facilities were providing excellent services and healthcare with scant and diminishing resources.
“LASA condemns neglect and abuse of any kind and the 100 examples cited by Lateline comprise less than 3 per cent of total facilities,” Mr Reid said.
“They also operate in the most heavily regulated industry in Australia, with much of the focus on compliance rather than true quality of care which is unproductive and prevents health professionals from delivering clinical care. When nurses spend up to 75 per cent of their time on paperwork, not caring, something has gone awry.”
Government funding does not match the true cost of care needs and it must be addressed in order to start attracting new staff and remunerating them appropriately, Mr Reid said.
ACSA CEO Adj Prof John Kelly said he was concerned that the emphasis in the Lateline programs could lead viewers to incorrectly conclude that the examples of poor care were endemic.
“I sympathise with the residents and families touched by these incidents, but the public needs to be reassured the great majority of aged care residents and those receiving community care are satisfied with the quality of their care,” Adj Prof Kelly said.
“What we need to acknowledge though is that there is chronic underfunding, a great deal of stress and too much paperwork that takes carers and nurses away from caring from their residents and clients.”
Adj Prof Kelly said there were currently a number of regulations that examined the standards of care provided in Australia’s nursing homes as well as the new My Aged Care website, which contained details of every nursing home in Australia including reports by the Aged Care Standards and Accreditation Agency.
How the ‘Twittersphere’ responded:
@SoggyTiri #Lateline does it again! @margotoneill thanks 4 work’n on this very important story. Quality of Aged Care should interest all of us #auspol
@Kate_Hannon All credit to #lateline for following up on its exclusive of aged care horrors. The dedicated staff are disillusioned & overworked.
@nievesmurray #Lateline #agedcare is an election issue. Get with it. We have parents. We have grand parents. And we vote. Ignore #agedcare at your peril.
@SimonBanksHB Consumer need better info about performance of aged care facilities not simplistic slogans like “less red tape” @tonyabbottmhr #lateline
@murrayn @Lateline #Lateline #agedcare Quality programs to be introduced next year but who will do the caring while staff do the paperwork?