by Dr Sarah Russell
Families are more worried their nursing home relatives will die of neglect than coronavirus, reports aged care researcher Sarah Russell. Aged care operators have hoodwinked the Government into giving them more money – even winning grants to screen visitors when visitors are not allowed. Russell exposes an industry marred by poor transparency and understaffing and calls for an inquiry into the disaster at Anglicare’s Newmarch House.
Several large providers in the aged care sector, including Anglicare, BaptistCare and UnitingCare, have used the Covid-19 pandemic to ask the Federal Government for a funding boost of a $1.296 billion.
Described as a “COVID-19 rescue package”, their request has no information about how the providers came up with the figure, how they intend to spend it or why they need it.
Despite this lack of financial transparency, the Government has just pledged $205 million in additional funding — a “$900 per bed support payment” (or $1350 for aged care homes in residential areas).
An aged care home in a residential area with 100 plus residents received a funding boost of over $135,000. Most larger sized aged care homes are owned by ASX listed companies, private equity firms, foreign investors, and superannuation and property real estate investment trusts. Our government has given them a large taxpayer funded cash injection with no strings attached.
When announcing the extra funding, Aged Care Minister Richard Colbeck, said: “This will contribute to the genuine extra costs that they’re incurring as they manage the COVID-19 outbreak”. Curiously, these “extra costs” include “screening visitors” despite the fact that many aged care homes, particularly the large aged care homes, have locked out all visitors for several weeks.
A lack of transparency is par for the course for aged care providers. They have a long track record of ignoring requests for transparency and the government has a similarly long record of buckling to their demands.
Last year, for example, three critical amendments to the Aged Care Legislation Amendment (New Commissioner Functions) Bill 2019 were tabled. If these amendments had passed, they would have improved transparency and accountability around finances, staffing ratios and complaints in aged care homes. The Liberal and Nationals voted against all amendments.
To garner public support for their “COVID-19 rescue package”, providers took out full-page advertisements in The Age and Sydney Morning Herald on 30th April (at a cost of $54,400 & $70,752 respectively). This advertisement claimed: “The rising costs of keeping residents safe from coronavirus is pushing us closer to breaking point”. But where is the evidence? Where is the transparency of how taxpayers’ money is spent?
For many weeks, all “non-essential staff” have been banned from entering aged care homes. This includes family members who care for their loved ones by helping with feeding, toileting and so on. This was in defiance of the Chief Medical Officer’s advice, which was only ever to “limit” the number of visitors in aged care homes.
Providers claimed a total lockdown was done “to save lives”. However, families who were locked out are afraid residents will die of neglect, not COVID-19. They cite the Aged Care Royal Commission’s Interim Report, Neglect. A daughter who normally spends 90 minutes feeding her father received an email from the provider informing her of the total lockdown. There was no consultation with her. She was worried her father would die of dehydration and malnutrition.
One aged care provider claims the Federal Government had “one or two or a handful of complaints” about the lockdown. This is not correct. The regulatory agency, Aged Care Quality and Safety Commission, has received more than 300 complaints regarding visitor restrictions and lockdowns. As an aged care researcher and advocate, I, too, continually receive pleas for assistance.
One daughter wrote this to me:
“I saw my mother on the 27th of April after nearly six weeks of lockdown. She no longer remembers me. I insisted on the visit as a care support visit after reading the Public Health and Wellbeing Act in Victoria which stated I could visit every day, as long as I had had the flu vaccine and no exposure to COVID-19. My Mum was wearing a broken hearing aid, which I have since had repaired. She was very thirsty and had an extensive rash on both arms and chest. They said they faxed the doctor but he had not turned up, so they took no further action. I rang the doctor who came the next day. No visitors means poor care.”
Another relative wrote:
“The blanket lockdown is unreasonable especially when the same facility is advertising on social media for volunteers to help residents use media to connect with families.”
Aged care providers reacted angrily when the Prime Minister suggested that aged care homes were locking down residents. The Prime Minister has highlighted the low number of coronavirus infections in aged care to put pressure on providers to allow family members to visit. Unlike the providers, the Prime Minister relied on evidence. The official data shows that less than 1 per cent of COVID-19 patients in Australia are in residential aged care.
Despite the evidence and pleas from families, several providers continued to refuse to back down with their total lockdown. The standoff between providers and government demonstrated the ineffectiveness of the regulatory agency, the Aged Care Quality and Safety Commission. It also demonstrated the unequal power relations between providers and residents and their families.
The sector and the Federal Government have now finally released a draft “Visitor Access Code” to provide a “nationally consistent visitation policy”. The guidelines were developed after consultation with the usual government-funded consumer groups. But employee unions and family members were not consulted.
If they had listened to family members weeks ago instead of shutting them out, providers would know that families were not calling for “open house”. Instead, they wanted a “humane lockdown” in which relatives who provide regular care for residents continue to provide that care. Of course, everyone who enters an aged care home – both staff and visitors – must undertake the same infection control measures.
The elephant in the room, of course, relates to the number of aged care homes with more than 60 beds. John Howard’s government proved a turning point for aged care policy in Australia. Under the Coalition’s Aged Care Act 1997, there was an increase in private investment. There was also an increase in size of aged care homes.
Managing around 120 visitors per day (assuming each resident has two visitors as per the guidelines) – and ensuring each visitor follows the correct infection control measures – would be difficult for staff, particularly in those aged care homes with insufficient numbers of staff.
To support their position of total lockdown, providers did not refer to the size of their aged care home or under-staffing. Instead, they referred to the large numbers of aged care residents who have died overseas, many in heart breaking circumstances. The World Health Organisation, for example, estimates half of all coronavirus deaths in Europe were residents in aged care homes.
Providers claim total lockdown prevented a similar catastrophe from occurring here in Australia. However, it is more likely that Australia’s low community transmission rates are responsible for protecting older people in aged care homes. Thankfully our “stay at home” and “social distancing” policies have protected residents in aged care homes.
The statistics speak for themselves. There are 2,672 aged care homes in Australia. Thankfully, there has been zero deaths from COVID-19 in 2,669 of these homes.
For several weeks, the lack of transparency from the Department of Health made it difficult to know the exact number and the names of aged care homes with outbreaks of COVID-19. Finally, the Aged Care Minister has revealed there have been 23 outbreaks, though the names of the homes remain top secret. What is certain, however, is that a staff member, not a visitor, has been responsible for bringing the virus into the aged care homes.
Thankfully, only three aged care homes have recorded a resident death. There have been two deaths in Opal Care Bankstown, six in BaptistCare’s Dorothy Henderson Lodge and thirteen in Anglicare’s Newmarch House.
While several aged care homes were able to contain the virus from spreading, Anglicare’s Newmarch House has 37 residents with a confirmed case of Covid-19 and 14 deaths. This raises the following questions that Anglicare must now answer:
Was the staff member who worked for six days with mild COVID-19 symptoms full-time and therefore entitled to sick leave or working as a casual, which meant no access to sick leave?
What infection control measures were in place at Newmarch House to prevent staff bringing the virus into the aged care home?
What infection control/prevention training did staff undertake?
Did staff at Newmarch House have access to enough personal protective equipment?
Have residents who tested positive for COVID-19 and whose advance care directive indicates “treatment in hospital” been transferred to hospital?
Why wasn’t Newmarch House closed down and cleaned like Burnie hospital?
An inquiry is under way into the 21 deaths from COVID-19 via the Ruby Princess debacle. There needs to be a similar inquiry into the 13 deaths in Newmarch House, especially in light of the sector’s appalling track record on transparency. A public and transparent inquiry is necessary to prevent a similar tragedy happening in other aged care homes.