July 5, 2022

ratios for aged care

Elderly dumped in aged care scandal

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A Queensland nursing home left residents homeless and staff unpaid when it abruptly shut down. The incident highlighted the federal Coalition government’s shameful refusal to act to fix our continuing aged care disgrace.

Almost 70 elderly residents were abandoned and staff were left unpaid when Earle Haven Retirement Village on Queensland’s Gold Coast shut down without warning.

The sudden closure was the result of a contract dispute between the owner of Earle Haven and HelpStreet, the subcontractor running the facility.

According to evidence before the Royal Commission into Aged Care Quality and Safety, about 1 pm on 11 July, staff were told they would not be paid because a financial dispute between HelpStreet and owner Arthur Miller had not been resolved.

HelpStreet removed computer servers with vital patient records and organised removalists to take away beds as residents ate their lunch, the commission heard.

Only then, after some staff had left, did HelpStreet call triple zero asking for ambulances to evacuate residents, including many with complex and life-threatening conditions.

Ambulance supervisor Cary Strong told the commission he arrived to find a removalist truck at the home, with furniture and boxes being removed.

He saw a man in a wheelchair trying to push himself to the foyer with his urinary bag dragging behind him.

Strong also had to comfort a 92-year-old woman with dementia.

“She was very distressed, very disorientated, crying. Her daughter was there; she was crying as well,” he said.

Residents still paying as shutdown proceeds

Relatives said HelpStreet was still withdrawing money from residents’ accounts as the shutdown proceeded.

Elizabeth Brown’s mother, who has dementia, was one of those evacuated from Earle Haven.

Ms Brown told the ABC that on the day of the shutdown, $2,500 was withdrawn from their account early to pay for the following month’s services.

Lorraine Cook, whose husband only arrived at Earle Haven a week before the shutdown, also said payment was taken out of her account early.

“It’s not their money. They won’t be there to do the care so they shouldn’t have taken it,” Ms Cook said.

HelpStreet has since gone into liquidation and the Queensland Nurses and Midwives’ Union (QNMU) is seeking to recover money owed to members.

More than 90 people including about 40 QNMU members worked at the facility and some are still owed wages and other entitlements.

QNMU calls for criminal investigation

QNMU Secretary Beth Mohle said closing an entire aged care facility without an appropriate plan for staff and residents was “an unprecedented and disgraceful situation that should never have been allowed to occur”.

Beth said off-duty nurses and other staff rushed to the facility to help residents as news of the shutdown spread.

She commended the actions of nurses and other staff who helped despite losing their jobs.

At the QNMU’s annual confer-ence, more than 350 delegates voted to call for a Queensland police investigation of any possible offences related to the Earle Haven closure.

However, police said there was no evidence of criminal offences and therefore no charges to lay unless new information came to light.

More than 32 paramedics, nurses, doctors and Queensland Health staff, as well as the state Health Minister, Labor’s Steven Miles, attended the village to organise transfers to about a dozen other nursing homes and to hospital.

QNMU delegates congratulated the Queensland Labor government for its “swift action to address this disastrous system failure, in particular the efforts of Queensland Health and the Queensland Ambulance Service to swiftly relocate affected residents”.

The state government, which had already moved to improve nursing home staffing in Queensland, initiated a parliamentary inquiry into Earle Haven.

Chair of parliament’s Health Committee, Labor MP Aaron Harper, said: “People are deeply shocked by what has happened there, and angry at the apparent failure of the federal agencies that are supposed to protect the safety and wellbeing of the elderly in nursing homes.”

The federal Coalition government’s Minister for Aged Care, Richard Colbeck, also announced an inquiry.

He thanked Queensland Health and emergency services as well as staff who stayed behind to 
help residents.

However, Mr Colbeck did not agree to a QNMU request for emergency federal government payments for unpaid Earle Haven staff.

Queensland Labor legislates for ratios

Minimum staff-to-resident ratios will apply at Queensland’s 16 state-run nursing 
homes under legislation pushed by the state Labor government.

A Labor bill currently before parliament mandates 3.65 hours of nursing per resident per day, with a required skill mix of 50 per cent AiNs, 30 per cent RNs, and 20 per cent ENs.

If passed, the legislation will also require all Queensland aged care facilities and private hospitals to report their staffing levels on a public register.

Labor drew up the legislation after months of consultation with the Queensland Nurses and Midwives’ Union.

Premier Annastacia Palaszczuk said the government wants facilities to publicise their staffing levels “for the sake of transparency”.

“If they choose not to, we won’t be afraid to reveal the identity of those unwilling to do the right thing by elderly Queenslanders,” Ms Palaszczuk said.

Scandalous, but not illegal

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The Earle Haven nursing home scandal is outrageous even by the low standards set by Australia’s aged care providers. However, it reflects the sad state of many aged care facilities.

On the day the Earle Haven nursing home on Queensland’s Gold Coast suddenly shut down, one registered nurse was rostered on to care for 68 residents.

This is not illegal or abnormal in Australian aged care.

Australia has no federal laws that determine how a non-government aged care facility should be staffed, or that even that one RN be on site at all times.

The Queensland Nurses and Midwives’ Union came out strongly after the Earle Haven closure.

At the QNMU’s annual conference, about 300 delegates unanimously called on the federal government to act immediately to address issues arising from the scandal (see box).

“Tens of thousands of elderly Australians reside in private aged care facilities. It is currently not illegal to leave elderly residents without an RN overnight or during the day,” said QNMU Secretary Beth Mohle.

“If issues in Australia’s private aged care industry aren’t addressed now, elderly Australians will continue to die prematurely,” Beth said.

“They will continue to experience unnecessary pain and suffering due to chronic understaffing.

“The federal government needs to act now to protect elderly Australians everywhere.”

Led by the national Australian Nursing and Midwifery Federation, nurse unions have repeatedly called on the federal government to put in place safe staffing ratios in Australia’s estimated 2000 non-government
aged care facilities.

Federal government has power to make changes

Unions also want to see public reporting of how taxpayers’ funds are spent, staff numbers and skill mix at individual facilities and any adverse incidents that result in resident injuries, illness or deaths.

“The federal government has the power to make these changes but has repeatedly refused to do so,” Beth said.

“The public need to be aware this (Earle Haven’s sole RN) is not a shocking number; this is business as usual for Australian private aged care.”

She said the Earle Haven crisis smashed the notion that Australia’s private aged care facilities were staffed like public hospitals or managed by health experts.

“At Earle Haven we saw off-duty nurses and other staff rush to the facility to be with their elderly residents when this crisis occurred.

“This was a crisis not of their making, but once again vulnerable residents and hardworking staff bore the brunt of critical flaws in the regulation of aged care.

“Earle Haven nurses, and aged care nurses and staff throughout Queensland and Australia, should be commended for their efforts.

“Not only do they receive up to $300 less each week than their colleagues in the public hospital system, but they return to work day in and day out in a system that overloads them to breaking point and then blames them when something goes wrong.”

Beth said there would be public outcry if Australian child care centres operated the same way.

Secrecy over taxpayer subsidies

There is no public reporting of how private aged care providers spend the massive taxpayer funds they get.

Private aged care providers often cry poor, said QNMU Secretary Beth Mohle.

She said the nation’s approximately 900 aged care providers receive around $18 billion in federal taxpayer funds every year.

They also receive a deposit of up to $500,000 per resident and up to 80 per cent of each resident’s pension, or up to $800 per resident, per fortnight.

“They do not have to publicly report how a single cent of taxpayer or resident funds are spent or ensure that funding is spent on direct care for residents,” Beth said.

“In the 2015/16 financial year, Australian aged care providers received more than $16.2 billion in federal funding.

“In the same financial year, they reported profits of more than $1.1 billion.”

Residents ‘treated as commodities’

The QNMU’s annual conference condemned the management of Earle Haven nursing home for its “abandonment of residents and staff and the significant failure of their duty of care”.

A conference resolution said the incident showed the “woefully inadequate” aged care regulatory framework in Australia.

“Opaque contractual arrangements present significant additional risks and fundamentally fail to meet community expectations around transparency and accountability,” it said.

At Earle Haven, frail elderly residents had been “treated as commodities, rather than with the dignity they deserve”.

“Action is required now to address the flaws in the regulation of aged care in Australia highlighted by the Earle Haven closure and we cannot wait until the current Royal Commission into Aged Care provides its final report in April 2020 to take action to prevent future such disasters.”

Aged care nurse cuts prompt safety concerns in Parramatta

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Aged care nurses at Thomas Street Lodge in Sydney’s West fear residents’ care and safety will be compromised again, following a restructure to cut overall nursing and care staff at the facility.

Members of the NSW Nurses and Midwives’ Association (NSWNMA) were advised last month of Anglicare’s plan to reduce registered nurse hours by 34 per cent a fortnight and carer hours a further 10 per cent a fortnight.

NSWNMA General Secretary, Brett Holmes, said the aged care nurses immediately expressed concerns over the adverse impacts to residents’ care, their safety and associated workload issues for the remaining staff.

“Thomas Street Lodge is a well-known residential aged care facility in the Parramatta area and provides care for a number of residents with high-care needs, including specialised dementia care and other behavioural care needs,” said Mr Holmes.

“Anglicare’s planned nursing staff cuts would result in a loss of nine minutes of care per resident. It might not sound like much but in a residential aged care setting like this, nine minutes is significant.

“Our members have highlighted that daily showers or bath routines would be impacted, along with residents’ meal times.

“Members have also expressed concerns for those residents who require observations every 15 minutes and others who require assistance to be turned every two hours to avoid pressure sores.

“The highly specialised nursing care provided to these acutely unwell residents cannot be underestimated.

“Anglicare has a duty of care to acknowledge that this is often a challenging care environment, as well as the increased risk of harm to residents and staff that such a reduction in staffing hours would result in.

“At the same time, we note Anglicare has implemented processes to restore care requirements and meet accreditation standards at Thomas Street Lodge, since taking over the facility from Ark Health Care in July last year.

“It would be remiss of Anglicare to compromise those care requirements and standards by drastically reducing nursing and care staff hours.”

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