four corners - Lamp Online

Substandard aged care is in the media spotlight and the public is getting our message about the need for safe staffing laws. Now, a Royal Commission into the sector looms.

Australians have reacted with horror and anger to media exposure of poor treatment of the elderly in understaffed nursing homes.

A Four Corners television special last month was the result of the ABC’s biggest crowd sourced investigation. More than 4,000 people – including 1300 current and former aged care staff – responded to a request to share their experiences.

Presenter Sarah Ferguson said the program heard many “every day stories of neglect and inattention, poor quality food, lack of personal care, boredom and heart-breaking loneliness”.

There were disturbing accounts of overworked staff and neglected residents.

Hidden camera footage revealed an elderly woman routinely left in a soiled bed for hours on end.

Staff condemned the widespread practice of rationing continence pads to three-a-day – and keeping them under lock and key in order to save money.

Personal care assistant (PCA) Tanya Bosch described aged care as “very confronting and distressing work. It was really frustrating to know that on a daily basis, you were failing to meet the needs of some of the most vulnerable people in our society”.

PCA Melanie Whiteley said she was speaking to Four Corners “because the truth about aged care needs to come out, so it can change”.

“I think families think that they’re getting their loved one looked after. I think that they think that they’re paying for that to happen, and in reality, it’s just not. It can’t happen. There’s not enough staff,” she said.

Facility manager and clinical consultant Tony Northcote said: “I believe our elderly deserve to have better care. We’re going the other way at the moment, we’re reducing the number of skilled staff and increasing the number of unskilled carers.”

One RN and one EN to 72 residents

Enrolled nurse Katrina Legzdins said she and a registered nurse were in charge of 72 residents.

“There’s no ratio, I guess, for number of staff to residents, so they can just get away with bare bones, bare minimum.”

Also interviewed was Sean Rooney, CEO of Leading Age Services Australia, the peak body representing private and not-for-profit nursing homes.

He rejected staffing ratios as “a very blunt instrument” and defended nursing homes spending just $6 a day per resident on food and giving staff five to six minutes on average to get somebody out of bed, toileted, showered and dressed.

Four Corners’ Facebook page drew more than 600 comments in the three days following the program. Many were scornful of Rooney’s suggestion that $6 per day was enough to feed people with “a low nutrition requirement”.

A typical comment read: “Angry and extreme sadness is what I’m feeling after watching this. ‘Older people have a lower nutritional requirement.’ Well, Shaun Rooney let’s see if YOU can stomach some of the muck that is being served up.”

Another wrote: “To say that the elderly don’t require nutritious food is just beyond ridiculous. These residents are people. Food should be a pleasure and a joy for them.”

More than 36,600 viewers voted in a Four Corners online poll in the same period. Ninety-seven per cent said minimum staff to resident ratios should be enforced in aged care facilities.

A day before the program went to air, Prime Minister Scott Morrison announced a Royal Commission into the sector.

However, a Royal Commission will do nothing to fix the crisis in aged care unless the government introduces mandated staffing ratios urgently, the Australian Nursing and Midwifery Federation (ANMF) said.

“Every day that the government fails to act on dangerous understaffing in nursing homes is another day that vulnerable residents are still at risk,” ANMF Federal Secretary Annie Butler said.

“While the current aged care crisis clearly warrants a Royal Commission, we know what the problems are. We have two decades of reports and inquiries outlining the problems. It’s time to take action. Let’s start by introducing a safe staffing law.”

‘I wouldn’t put a sick dog in some of these places’

Aged care registered nurse Maree Wiseman hopes media exposure and the forthcoming Royal Commission will finally force the government to act to improve staffing of nursing homes.

“It was horrifying to see how those residents were being treated – I wouldn’t put a sick dog in some of these places,” she said.

“Congratulations to Four Corners and the staff and families who had the courage to speak out.”

Maree works at a community-owned nursing home in northern NSW. She says most staff members watched the program and many are worried it will contribute to a public backlash against nursing home employees.

“The union needs to continue its campaigning to make the public aware that the fault lies with owners and administrators who fail to provide enough staff.

“We all know more staff are needed to achieve a better working environment that allows us to provide high quality care.”

Maree hopes the Royal Commission will recommend mandatory staffing ratios and employment of more registered nurses.

“There have been plenty of inquiries and the government has done nothing so far – maybe the Royal Commission will make a difference.”

Unusually, her facility currently has a few empty beds. That has given carers more time to sit and talk with residents including some who never get family visits.

“A couple of the team have even had time to take residents for a walk. That’s something that should happen every day.”

Watch the Four Corners special on aged care: http://www.abc.net.au/4corners/who-cares/10258290

Letters to the Editor
Share your thoughts on this article or anything else important to you as nurses and midwives by sending a Letter to the Editor.

Four letters are published in the Lamp each month and the letter chosen as Letter of the Month will win a gift card. Please include a high-resolution photo along with your name, address, phone and membership number. You can submit your letter by emailing the Lamp:lamp@nswnma.asn.au

The state of the aged care sector is a national disgrace and our arguments for change are beginning to gain traction.

Aged care nurses have been campaigning for years to change the abysmal state of our aged care system and their persistence has finally been rewarded with a number of significant developments.

Firstly, the media has finally listened to their concerns and cast a spotlight on the dangerously low staffing levels, the poor practices and the profiteering that is rife in the sector (see pp 8-9).

Last month, Four Corners broadcast a very harrowing account that exposed a major crisis in our aged care homes. The Daily Telegraph also conducted a comprehensive investigation into aged care which revealed a shocking abuse of taxpayers’ money by some major aged care providers.

This has had political consequences with Prime Minister Scott Morrison calling a Royal Commission into the state of aged care.

The Four Corners report was very distressing. It was hard to watch these elderly, vulnerable members of our community suffer due to inadequate care, without proper food and without access to the most basic of needs like continence pads.

The brave family members and staff that spoke out deserve our admiration and support.

For many nurses these revelations were not news.  Aged care nurses, the NSWNMA and the ANMF have worked tirelessly for many years to bring these conditions to light.

We have commissioned research, lobbied politicians, held rallies, run advertising campaigns, taken to social media and talked to the community in a myriad different ways about the terrible state of aged care.

It is a relief that finally these efforts are beginning to stir a response.

The public responds with fury

And the response by the community to the Four Corners report was telling.

The Four Corners Facebook page was awash with caustic comments about aged care providers and their weak explanations for the poor state of care in their homes.

More than 36,000 people voted in an online poll in the first three days after the program went to air. Ninety seven per cent said minimum staff to resident ratios should be enforced in aged care facilities.

This is highly encouraging. The public instinctively understands that the lack of staff is central to the problem and minimum staff-to-resident ratios are an important part of the solution.

The response of the federal government was also telling. Even before Four Corners had gone to air the government preempted the fall out by calling a Royal Commission.

The crisis in aged care certainly warrants a Royal Commission. Society has a moral obligation to stop this neglect and abuse of the elderly.

But there have been decades of reports and inquiries outlining the problems and issues in aged care and any findings of a Commission and the federal government response must go beyond more talk to action.

Addressing the glaring staffing problems remains the overriding challenge.

Aged care providers receive billions of dollars in taxpayer-funded subsidies yet there is no law to guarantee that public funding goes directly to the provision of care.

The NSWNMA and the ANMF have championed a safe staffing law that guarantees safe nurse-to-resident ratios in our aged care facilities. We will remain resolute pursuing that goal.

There is still some way to go to achieve our goals so we must keep up our campaign. The tenacity shown by our aged care members has gotten us this far and we must keep it up.

It is a lesson for us all, in all of our campaigns.

Making substantive change in health and aged care always seems impossible until it is done. But if we show tenacity, resolve and courage we know there is a public out there that supports us and governments that fear that public support.

Anger grows over aged care neglect

Persistence pays