Harrowing testimonies and inadequate staffing: Royal commission begins

Doug Hendrie

11/02/2019 3:26:25 PM

The Royal Commission into Aged Care has heard its first traumatic testimonies, as GPs call out the ongoing crisis in staffing levels.

Barbara Spriggs and son Clive Spriggs speak to media after giving evidence at the Royal Commission into Aged Care. (Image: James Elsby)
Barbara Spriggs and son Clive Spriggs speak to media after giving evidence at the Royal Commission into Aged Care. (Image: James Elsby)

The wife and son of Oakden dementia patient Bob Spriggs, who died in 2016, urged major changes to aged care practice in Australia, including wider use of CCTV.
Barb Spriggs told the Royal Commission into Aged Care Quality and Safety that the Oakden Older Person’s Mental Health Service was like a prison.
‘Bob and other residents were sedated and I believe staff sedated those living in the facility to better manage them,’ she told the Commission, according to an ABC report.
Son Clive Spriggs told the Royal Commission that bruises found on his father’s body had not been explained.
The poor quality of care at the Oakden facility triggered a major investigation by South Australia’s anti-corruption body, Independent Commissioner Against Corruption (ICAC), which found that residents ‘were obliged to live in a facility which could only be described as a disgrace, and in which they received very poor care’.
The Oakden facility was shut down in 2017, but has come to symbolise wider concerns for Australia’s aged care sector.
Queensland GP Dr Kat McLean drew attention to the ongoing crisis in staffing and care last week when she returned from a visit to a residential aged care facility (RACF).

Pharmacist Samuel Keitaanpaa responded.
RACGP President Dr Harry Nespolon last year signed an open letter calling for better aged care staffing levels and praised the appointment of Australia’s first aged care quality and safety Commissioner.
‘For a long time, GPs have been concerned with the lack of investment and the inadequate staffing levels within residential aged care facilities [RACFs],’ Dr Nespolon told newsGP.
‘Due to inconsistent staffing and investment, some medical practitioners have been … placed in a position where they cannot provide the best possible care to their patients.
RACGP Vice President Associate Professor Ayman Shenouda has pointed out that there have been 20 inquiries into aged care over the last decade.
‘[W]e know there are systemic national challenges in aged care and through significant review. We now have the policy answers,’ he wrote on newsGP.
Associate Professor Shenouda outlined a very different model of care, including better training and incentives for aged care workers, individualised care for people with complex care needs, better staffing and a model supporting GP decisions.
Prime Minister Scott Morrison announced the $104 million Royal Commission in September last year, ahead of a major Four Corners expose on failings in aged care.
Commissioner Lynelle Briggs has said in preliminary remarks that there had been a ‘rising torrent of concern’ over the aged care sector, which might no longer be ‘fit for purpose’.
The commission is expected to hand down an interim report by 31 October, with a final report by April 2020.
Ahead of the first hearing, the Prime Minister yesterday announced $662 million in aged care funding, including $282 million for extra home care packages and $320 million for people living in residential aged care.
The move comes after an earlier $100 million cash boost to encourage more GPs to provide healthcare in RACFs.
GPs have been progressively pulling back from providing care in aged care facilities, with a survey last August finding around a third of doctors plan to reduce or end their visits to patients in aged care over concerns around understaffing and low rebates.
New quality standards for aged care will come into effect on 1 July, covering residential facilities, home care, flexible care and the Commonwealth Home Support Program.

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Chris D Hogan   12/02/2019 12:25:54 PM

Aged Care Fiasco
Caught between the pincers of poor funding & increased costs Aged Care has suffered much since the sector was privatised & almost no public residential aged care health facilities were left.
My parents went into Aged Care in 2014 & I worked in 3 nursing homes from 1990 to 2016 where I cared for up to 60 people.
I saw dedicated staff starved of funds & resources while burdened with more & more regulation. As part of a move to encourage computerisation of the Aged Care Sector several of us measured how much time clinical staff spend per shift writing in the clinical record- it was up to 3 hours. We proposed that with redesign of the clinical record & computerisation that it should be possible to save a least an hour per shift of staff time. Computerisation would also give useful data that could be used to improve patient outcome rather than have barely legible hand written notes. Sadly, many aged care specific computerised systems were uninspiring.
In retrospect, we should have published but there were major logistical barriers.
Going thru incident reports, it seemed that some errors were best explained by difficulties with literacy. Indeed, when we included a written component to applications for employment it was obvious that low literacy was an issue in several candidates & most of those were educated in Australia. Several candidates disguised their literacy issues with poor handwriting. There was much less correlation between the quality of care & literacy than expected.
I strongly believe that computerisation can be adapted to cope with literacy issues.
I saw far more adverse effects from underfunding that I did from malicious incompetence.
I saw too many professionals hounded out of aged care by relatives with inappropriate expectations & vexatious complaints to multiple agencies. All complaints were dismissed but the damage was done.

Dr Rodney Paul Jones   12/02/2019 11:39:25 PM

Often expected to undertake end stage palliative care which is one of the most complex nuanced and challenging areas of general medicine to do well and ethically and meet the public expectations of the Hollywood ending.
Underfunded , under resourced and trained , under-expertised and 24/7

Dr.Gnanasegaran Xavier FRACGP N0.519256   17/02/2019 12:43:37 AM

At least you have an aged care center.Here we have none.The aged are chucked into private homes run by foreign worker maids.They are all independently run by private owners.Many are just rented houses where many beds are put to accomodate them.Somehow the elderly are the most neglected lot,specially if there are no family members to care for them.For you all it is the care that is a concern.