HUNTER AGED CARE SCARE: Residents receiving sub-standard care at six services requiring 'significant improvements'

Investigations have uncovered improper use of chemical restraints, poor management of people with advanced dementia, poor catheter care, poor diabetic management, and unmonitored, risky levels of weight loss.

There are currently six 'non-compliant' Hunter-based aged care residential services requiring 'significant improvements', according to the Aged Care Quality and Safety Commission, including one which has been sanctioned.

Among them, SummitCare Wallsend, which has a wing devoted to people with dementia and cognitive impairment. However, assessors found staff have failed to properly support and manage residents with advanced dementia putting their safety, health and well being at risk, as well as putting staff and residents, who are being "regularly physically assaulted and abused", in danger.

The details are contained in a report following a site visit in April 2021. A spokesman for SummitCare said the department's concerns involved "a particular situation" which was resolved "some time ago", however, the home continues to be listed on the watchdog's website, which is regularly updated, as non-compliant.

"Consumers are not being supported to live the best life they can in an environment free from abuse," the report says.

In another instance, staff failed to follow-up with two residents who self-harmed, despite earlier depression scales assessments indicating 'probable major depression' for both.

One of those residents, who became increasingly resistant to care, was not reviewed by a dementia or geriatric specialist. Then there were delays in notifying a medical officer about a deteriorating wound, and in seeking the opinion of a dietician when the same resident's food intake declined.

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The majority of residents also said the service was understaffed, complaining of delays in answering call bells, being assisted with continence needs, delivery of meals, and with help to eat.

"All staff members interviewed during the site audit indicated that the service is understaffed, and this impacted on their ability to perform tasks and complete assigned duties," the report said.

At the Seventh Day Adventist-run Alton Lodge, in Cooranbong, the assessment team found that residents who experienced falls were not being provided with pain relief, and were not reviewed by a nurse, medical officer or relevant specialist.

The "complex behaviours" of some residents, impacting on the safety of others, "did not result in timely management, implementation of strategies to minimise behaviours and/or referral to specialists", and there was evidence of poor management of diabetes, falls, medication, and weight management.

The BaptistCare Warabrook Centre was found to have problems regarding the management of chemical restraints, catheter care, bowel and behaviour management, weight monitoring, and wounds and pain management.

Staff were unable to demonstrate that chemical restraint was being used as a last resort after drug-free interventions proved ineffective, and five residents were identified as having lost weight, with "minimal or no intervention or monitoring to manage this risk".

In Mayfield, Uniting Irwin Hall has failed to effectively manage high impact/high prevalence risks associated with diabetes, medication, falls management, fluid restriction and skin integrity, with medical directives "not consistently being implemented".

Residents interviewed by the assessment team there said there were not enough staff, and that what staff there were were busy and rushed. They were also waiting long periods for staff to respond to calls for help, in some cases resulting in episodes of incontinence.

Two other homes currently deemed 'non-compliant', and previously reported by the Newcastle Herald, are Anglican Care McIntosh Court at Booragul, which has been sanctioned and identified as posing "an immediate and severe risk" to the safety, health or well-being of its residents; and BUPA Waratah.

At the Waratah facility one resident told the assessment team they were "so lonely they could cry". Another resident there said they didn't get a choice about when they got out of bed, had a shower, or attended activities, and another resident said they would like to get out of bed, but this 'rarely happens'.

In all cases, service providers have made statements outlining ways in which they have planned continuous improvement and remain committed to delivering quality services.

A spokeswoman for BaptistCare acknowledged that the service had 'fallen short'.

"BaptistCare is regretful that despite our best efforts and genuine commitment to the care of residents at Warabrook Centre, the home was issued a non-compliance notice in May 2022 by the Aged Care Quality and Safety Commission," a statement issued on Thursday (November 3) said.

"The care of residents is our absolute priority. On this occasion our standards fell short and this was not the result we wanted."

The COVID-19 pandemic and workforce shortages across the aged care sector "contributed significantly" to their ability to deliver "the high quality of care and services we hold ourselves to", she said.

Steps being taken to address the concerns raised included education and training, and a review of systems and processes followed by a "thorough evaluation to ensure changes in the home meet standards".

David Knight, chief executive officer for Adventist Senior Living, which runs Alton Lodge, said it was "worth noting" changes to the way assessments were being reported.

"The Aged Care Safety and Quality Commission have adopted a binary met/unmet approach to the 42 outcomes under the new standards, and because of this items that may have been notified under additional information in previous accreditations were marked as unmet at that time," he said.

Alton Lodge met "all 44 outcomes (under the old Standards) since accreditation surveys were first introduced in the late 90's" Mr Knight said.

"Having said that the service did ultimately receive unmet outcomes in 8 areas and as a result of this we provided a Continuous Improvement plan to the Aged Care Safety and Quality Commission."

The Aged Care Quality and Safety Commission is the primary point of contact for the quality and safety of aged care services. Part of the process of accreditation, assessment, and the monitoring of services against quality standards involves complaints, as well as feedback, provided by residents, their friends and carers, family members, as well as industry insiders.

Members of the community connected to the aged care sector - aged care recipients, families and carers, providers, workers, and experts - are encouraged to contribute to a public consultation on revised Aged Care Quality Standards which opened on October 17 until November 25, 2022.

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