Older Tasmanians are more likely to be impacted by failing aged care services than mainland seniors because the state has the highest proportion of seniors coupled with a small number of services, the aged care royal commission has heard.
This week’s hearing of the Royal Commission into Aged Care Quality and Safety is focusing on the governance of aged care services and the subsequent impact on quality and safety and particularly concerning those operating in Tasmania.
Senior counsel assisting Peter Rozen said Tasmania had the highest proportion of older people in the nation.
“Just over one in five Tasmanians are over the age of 65 or are of Aboriginal and Torres Strait Islander descent and over 50 years of age,” Mr Rozen said in his opening address on Monday.
“Some 37 per cent of older Tasmanians live in a rural or remote location.”
Together these mean that Tasmanian’s aged care workforce is under pressure, Mr Rozen said.
There were 72 aged care services providing just over 5,000 residential aged care places across the state, he said.
“With a number of towns and regions served by a very small number of providers, Tasmania is particularly sensitive to the failure of aged care services,” Mr Rozen said.
Bupa Aged Care Australia South Hobart, the organisation’s only Tasmanian facility, was put under the spotlight at this week’s hearing.
In October 2018, the quality agency found Bupa South Hobart failed to meet 32 of the 44 expected outcomes, and only met four of the 17 health and personal care expected outcomes, Mr Rozen said.
“These failures were found to have created an immediate and severe risk to the safety, health or wellbeing of certain care recipients at Bupa South Hobart.”
Resident took over care roles
The royal commission heard from Merridy Eastman about her parents’ experience of living in the facility.
Ms Eastman’s parents moved into the facility in January 2016. Her father the late Walter Eastman was living with dementia and diabetes and had a history of heart failure and mini strokes. Her mother Berenice Eastman has her head permanently bowed toward her chest due to acute scoliosis and osteoporosis.
Ms Eastman told the commission about a shortage of staff at the facility, which resulted in her 90-year-old mother assisting a 90-year-old blind resident to visit the bathroom.
“On several occasions she’d had to take this lady to the toilet because she was calling out for help going to the toilet and mum had pressed the buzzer and no one had come, so my 90-year-old mother was taking a 90-year-old blind woman to the toilet,” Ms Eastman told the inquiry.
Ms Eastman’s mother was also looking after her husband and taking on roles that staff were expected to do including dressing him, assisting with incontinence, washing clothes and making their bed, she said.
“Whenever a carer was available they did these things, but this was the problem, they just weren’t available on a daily basis so my mother was doing this on a daily basis,” Ms Eastman said.
The commission also heard about staff’s poor response to call bells. Ms Eastman said her parents were often waiting 20 to 40 minutes and in one instance did not get a response at all.
Staff cut due to costs
The royal commission heard that in the 12 months leading up to its sanction in October 2018, Bupa had reduced its staff and particularly the number of registered nurses to reduce costs.
Bupa Aged Care’s former regional director Stephanie Hechenberger and regional manager Elizabeth Wesols agreed with Mr Rozen that this was a “completely misguided strategy.”
The Hobart facility “had always been a challenging home,” Ms Wesols said.
It moved between compliant and non-compliant because of a “constant changes in key personnel, leadership, clinical managers,” she said.
Ms Hechenberger said staff at the facility weren’t adequately supported or guided through learning processes due to high turnover.
“Training was provided extensively but it was not having the impact that was required, and again, the volume of change in the team members meant that the team members didn’t understand deeply and innately the individual care needs of the residents and to be able to provide that person-centred care that was so, so important for the vulnerable residents,” Ms Hechenberger said.
The Royal Commission into Aged Care Quality and Safety Hobart hearing wraps up today. The next hearing takes place 9 – 13 December in Canberra, ACT, and will focus on interfaces between the aged care and health care system.
To stay up to date on the latest about the Royal Commission into Aged Care and Quality go to our special coverage.
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