Residential aged care findings ‘horrendous’, says GP

Only 1.3 per cent of residents are in facilities with ‘best practice’ staffing.

Aged care findings ‘horrendous’: GP

Only 1.3 per cent of Australian aged care residents are in facilities with ‘best practice’ staffing levels, a new report reveals. And the aged care royal commission says the government needs to spend an extra $20 billion per year – in addition to the $27 billion it currently spends – to give the system a safe, secure and sustainable future.

Australia’s ageing population has long been forecast to swell and now that the future is here, the outlook for many people requiring residential care appears to be grim.

The Royal Commission into Aged Care Quality and Safety commissioned research into staffing levels in Australian residential aged care facilities based on a five-star rating system used in the US.

It found that 57.6 per cent of residents were in care with inadequate (one or two stars) staffing levels.

Slightly more than one quarter (27 per cent) reside in three-star facilities, 14.1 per cent in four-star homes and only 1.3 per cent in facilities assessed to have five-star or ‘best practice’ staffing levels.

In a report analysis from the Royal Australian College of GPs (RACGP), Dr Ken McCroary, a GP with a special interest in aged care, said the findings were “horrendous” and the study was “a really correct representation of what’s actually going on”.

“This information needs to become widespread, seriously,” he said.

“I really support all of the recommendations related to encouraging staff numbers, both allied and nursing. But the deeper picture is that it’s probably even worse than what the star rating indicates, particularly with regard to the work nurses are actually given the opportunity to perform.

“Most of it’s just paperwork and giving out medications and pills, so patients are lacking quality nursing time as well.”

The aged care royal commission has proposed a dedicated levy – similar to Medicare – or a 1-2 per cent increase in personal taxes to pay for reforms to a system it says is in a “shocking state of neglect”.

Other options included a system where people pay for aged care as they need it and mandatory personal contributions similar to Medicare and superannuation and being used in Germany, Japan, Korea and the Netherlands.

In a paper released by the commission this week, an estimate of the cost of an overhaul has been provided for the first time.

“Fundamental reforms” would very likely cost double the $27 billion spent by government, it said.

“With the changing age profile of our working population, and the growing number of people aged over 85 years, the pressure on aged care spending will only increase,” it said.

The Age and Sydney Morning Herald report that about 75 per cent of funding for aged care comes from the federal government and the remainder from users.

The commission’s discussion paper noted the general reluctance of the population to assess aged care needs and planning for the future.

“We tend to think that bad things can’t happen to us and we put things off,” it said.

Chief executive of the Councils on the Ageing (COTA) Ian Yates said the paper provided the first indication on the cost of reforms and also floated changes to income and means testing of payments, which he described as “inconsistent, incoherent and unfair”.

Dr McCroary told GPNews that the high number of deaths – 60,000 per year from a total cohort of around 180,000 permanent residents – means residential facilities should almost be considered an extension of the hospital system.

“Staff are underfunded, undereducated, under-resourced and under-supported by their managers. That causes them to be demoralised and it decreases the attractiveness of a career in aged care,” he said.

“Unfortunately from my anecdotal experience, what seems to be the most important thing for management is filling out the forms for funding, which is so distressing for human beings who are in these facilities and deserve a lot more than that sort of de-personalised quantification.”

GPNews says an estimated 200 Australian aged care providers are experiencing financial distress.

“There obviously needs to be an increase in funding and an increase in efficiency of funding, and then a directed concentration on patient and quality care, not paperwork and administrative tasks,” Dr McCroary said.

The commission is due to provide its final report at the end of the year, but has identified several urgent needs:

  • reduce the wait time for higher level care at home
  • prevent the reliance on chemical restraints in aged care facilities
  • prevent younger people with disabilities going into care
  • provide more and better qualified staff for aged care facilities.

Are you concerned about the adequacy of age care services? Does the government spending during the pandemic suggest assistance in the aged care sector will be some way off?

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    COMMENTS

    To make a comment, please register or login
    mogo51
    26th Jun 2020
    10:23am
    My mother was in aged care facilities for 30 years with Alzheimers and Dementia etc. Mostly they ere ok but obviously understaffed and workers stressed and pressured.
    My partner has been trying to get a job in Aged care for 12 months plus but can never get a start because she has no 'experience', fully qualified in every respect academically. How does shexget experience if they won't give her a jon, catch 22. Would they rather hang onto those 'dodgy' we have seen in action?
    Dabbydoos
    26th Jun 2020
    10:57am
    The staff at aged care facilities are stretched to the limit, the managers sometimes have no nursing experience and are there to boost the coffers. More and more are pit on the aged care nursing assistants who are on the front line dealing with residents who can become violent and verbal abuse is just run of the mill. The residents have dementia so are not aware of their actions but the nursing assistants are on the receiving end. More staff are urgently needed.
    Tood
    26th Jun 2020
    4:41pm
    Mandory staffing/patient ratios need to be legislated, proper training for staff in house or out. CCTV in every room, unannounced check visits to facilities. And never forget that these private nursing homes are run for PROFIT! Only need to look at the Moran family in Victoria years ago living the life of Riley !
    panos
    26th Jun 2020
    10:58am
    Really !! I would never have known.... about time for Soylent green solution....
    BrianP
    26th Jun 2020
    11:08am
    Meanwhile Government needs to make big changes to help people age at home.
    Ted Wards
    29th Jun 2020
    1:49pm
    They all ready do
    tisme
    26th Jun 2020
    11:24am
    i worked in aged care 40 years ago , seems things havent improved
    jan
    26th Jun 2020
    12:14pm
    I notice some age care staff have no compassion or respect. Some don't even understand you or speak English. It's just a job for some carers. I've notice if you visit your aged relative they get more care. If you go on holiday make sure some one visit them. Believe me I have worked in a lot of age care centers. Some patients need bathing more etc
    JoJozep
    26th Jun 2020
    12:15pm
    The Royal Commission has come up with rubbish and ill thought out recommendations. Their first one (from above article), is that residents needing care should be encouraged to stay at home, offering a reduced waiting time for home care to be approved.

    I have first hand experience why this didn't work and caused terrible repercussions along the way. Firstly my wife developed a disorder of balance, no specialist could properly define or find a cause. She visited a cardiologist, a Geriatric Specialist, a Neuron Specialist, and two or three other specialists as well as the hospital specialists. None could pinpoint the cause of her falls.
    As I could not physically care for her, I thought it worthwhile to seek the home care help. We qualified after waiting 15 months.

    The first week, a nurse turned up and being kind to her we sat down for an hour and she explained what field nurses do and what she was going to do for my wife. At that point I was unaware the nurse would charge $50 or so per hour. So I forked out The money for one hour and I would get back a $20 rebate from the DHS Department. $30/week didn't sound much. but I needed help 7 days a week, up to four hours per day. Do the maths, this came to $3,360/month. Then the following week, i called for another nurse that would actually do something, and a scruffy male nurse turned up (around 26 years of age) who looked like someone who slept on a park bench.

    I asked what was he going to do, and after he told me he was a masseur and wanted to massage my wife's legs, I said to him, not on my watch, piss off, I can do that myself. What I wanted was a handyman person, who could keep my garden clean,clean the house scrub toilets, showers,kitchen sink and appliances and other menial tasks. That would relieve me of enough time to look after my wife myself.

    So care at home is expensive, and not always the right people attend. The idiots at the Royal Commission must have imagined home care was free. I finally managed to find an excellent care home in Camberwell after a terrible few weeks in Vermont South, but it was pricey, but compared to the other place, was well staffed, well run, and a high staff to resident ratio of around 5 to 1, compared to 30-1 at the first place. Anyway, this was a life changer, requiring I purchase a unit in Camberwell and sell our long term house in the previous suburb to make ends meet, plus a considerable temporary loan from the bank.
    KSS
    26th Jun 2020
    12:28pm
    The things you wanted doing are not what home help is about, so no wonder you were disappointed. Had you gone to say a gardening or cleaning service you would have had far more success and for a lot less money. Home help is not a general housekeeping service.
    bigpella
    26th Jun 2020
    5:21pm
    My wife and I are in our mid seventies. A couple of years ago I suffered with difficulty walking and pain in most of my body for some unknown reason. All my doctor was doing was to increase the strength of the pain killers. I also suffer from peripheral neuropathy, a side effect from toxic poisoning, so balance was an issue. After a blood test my GP said he thought it was PMR (PolyMyalgia Rheumatica) and gave me a few sample steroid tablets to take and said it might take a couple of days for them to take effect. He was wrong!! I woke up next morning and all the pain had gone but I still have my balance problems and I accept that they will be permanent. After 18 months I'm just about off the tabs.

    In amongst all this we were visiting our son and talking about my ailments and his wife asked me if I had considered getting some home help. At that time she was a surgery nurse and had experience in aged care benefits. She said she would fill out a My Aged Care (MAC) application form for us (all on line), and three days later we had a lady from MAC ring to make an appointment to see us.
    She accessed my disabilities and arranged for rails to be fitted in our en suite and the separate toilet, a raised over the toilet seat and a wheely walker to assist with my walking. An occupational therapist arranged for me to have a six week physio program to improve my balance.
    All this was at what I would call minimum cost to me.

    I have read all the comments below and not once is the MAC service mentioned. I think one needs to know the right channel in the first instance to contact. We were fortunate to have our daughter-in-law who was familiar with the services I could access for assistance.

    I would recommend that anyone needing home help ask their GP about My Aged Care services first and if he doesn't know anything ask until you find somebody that does. So, if you don't succeed try try again.
    Hardworker
    26th Jun 2020
    12:44pm
    There are a variety of scenarios people find themselves in that require a variety of solutions. Don't expect the Government to ever get it right because they won't. One of the issues around aging in place is that not everyone has a suitable property that can be easily maintained. It needs to be affordable, in a safe area, not too big but not too small, low set brick with a level driveway and close to facilities. Is anyone building these? Show me where? Not in my suburb which is where I prefer to live. Regarding the recent aged care and COVID-19 saga, particularly regarding Newmarch House. Sick people need to go to hospital no matter what age they are. The ones who died weren't given a chance because they weren't taken to hospital. Even the CEO of Newmarch House now admits this but it is too late for the ones who died, totally distressed, that they were not taken to hospital even when they requested it.
    ray @ Bondi
    26th Jun 2020
    1:25pm
    there should be criminal charges, that would make them care, about themselves!!!
    JoJozep
    26th Jun 2020
    12:46pm
    The Royal Commission has come up with some rubbish and ill thought out recommendations. Their first one (from above article), is that residents needing care should be encouraged to stay at home, offering a reduced waiting time for home care to be approved.

    I have first hand experience why this didn't work and caused terrible repercussions along the way. Firstly my wife developed a disorder of balance, no specialist could properly define or find a cause. She visited a Cardiologist, a Geriatric Specialist, a Neuron Specialist, a bone specialist and two or three other specialists as well as the hospital specialists. None could pinpoint the cause of her falls.
    As I could not physically care for her, I thought it worthwhile to seek the home care help. We qualified after waiting 15 months.

    The first week, a nurse turned up (under the home care package) and being kind to her we sat down for an hour and she explained what field nurses do and what she was going to do for my wife. At that point I was unaware the nurse would charge $50 or so per hour. So I forked out the money for one hour and I would get back a $20 rebate from the DHS Department. $30/week didn't sound much. but I needed help 7 days a week, up to four hours per day. Do the maths, this came to $3,360/month. Then the following week, I called for another nurse that would actually do something, and a scruffy male nurse turned up (around 26 years of age) who looked like someone who slept on a park bench that night.

    I asked what was he going to do, and after he told me he was a masseur and wanted to massage my wife's legs, I said to him, not on my watch, piss off, I can do that myself. What I wanted was a handyman person, who could keep my garden clean,clean the gutters, clean the house, scrub toilets, showers, kitchen sink and appliances and other menial tasks. That would relieve me of enough time to look after my wife myself.

    So care at home is expensive, and not always the right people attend. The idiots at the Royal Commission must have imagined home care was free. I finally managed to find an excellent care home in Camberwell after a terrible few weeks in Vermont South, but it was pricey, but compared to the other place, was well staffed, well run, and a high staff to resident ratio of around 5 to 1, compared to 30-1 at the first place. Anyway, this was a life changer, requiring I purchase a unit in Camberwell and sell our long term house in the previous suburb to make ends meet, plus a considerable temporary loan from the bank.

    The statement mentioned above that Federal Government contributes 70% is rubbish. In our case, the aged care home charges around 60% of the fee, the government contributes bugger all, in fact imposes another 30% by allowing Residential Aged care Homes to charge an additional 30%. Thus the government pays nothing to the more expensive aged care homes. When we started some years ago, and I couldn't stump up the RAD, I was being charged $7,700 per month. yes, that's $92,400 per annum.

    So someone tell me why the Royal commission has not investigated the real facts of who pays and obviously, ScoMo and Josh can do basic arithmetic because it will cost billions for free aged care. The government has decided the person is means tested. It is not based on the person's condition or need, it's based on means. In fact it means selling your house to make ends meet. Medicare is silent on this one.

    By the way, what's NDIS doing about disabled aged care residents? those over 65? Why can't they qualify for assistance? What has age got to do with it? Please explain.
    JoJozep
    26th Jun 2020
    12:49pm
    Brian P, I have explained in detail below, that after experiencing home help didn't work, you should know better than to make an idiotic statement.
    evemack
    26th Jun 2020
    1:20pm
    It is truly bad and no one seems to have the answers that would fix it. Unless I get dementia I would rather drop dead at home than go into aged care. Also the Soylent Green comment was in poor taste.
    panos
    26th Jun 2020
    3:08pm
    Your drop dead comment is the same as the needle either way needle or drop dead it's still the same, but without the music and lovely looking scenery.

    Really biscuits, the oven or the ground what does it matter.
    ray @ Bondi
    26th Jun 2020
    1:21pm
    never happen especially with our right-wing Orwellian government.
    Fair Dinkum
    26th Jun 2020
    1:49pm
    My mum who is 102 in a few weeks is in Goodwin monash and the care she is receiving is fantastic the last 6 months has been full care unable to do most things for herself. She has been with Goodwin for 20 odd years first in self care cottages then at 98 moved into care facilities except for a period where they had a currupt.and uncaring CEO where goodwins name sunk fairly low thank goodness he was removed under suspious circumstances and now Goodwin has returned to the great place it was before this currupt CEO got involed from my experience i would give Goodwin 5 stars.
    justme
    26th Jun 2020
    2:49pm
    It seems like most of this type of report or comment to government want billions more spent. But no mention of how to fund it.
    A rough estimate would suggest more than double the current cost to those in need.
    Tax increases would be massive.
    Yes, it is a real problem and, yes people are in need.
    But no one seems to be volunteering to pay more to achieve their desired outcome.
    Or offering any funding options.
    Tood
    26th Jun 2020
    4:36pm
    Maybe its a matter of making sure the money that is already being spent, is being utilised properly and effectively, accountability which government seems loathe to do and rorts exist because of it, eg in child care and NDIS recently. Like education, buckets of money keep getting thrown at it and the Australian standard keeps dropping.
    jan
    26th Jun 2020
    3:17pm
    It's a shame today families are not what they use to be, caring, supportive and commited towards a older family member. My family looked after their older parents, my mother looked after her mother, my grandmother looked after her mother who died at 99yrs. I intend to look after my mother who as dementia if my dad passes. My dad 88yrs looks after my mum, yes he stresses and no he won't put her in an age care facility. He does not get any help or support off the UK government because he as exceeded the asset test. Shame families don't support each other anymore, if they did we would not have to rely on the government.
    panos
    26th Jun 2020
    3:27pm
    The old days/ways are dead and gone in first world countries, yes we all might miss the old days those that remember them. But times have changed for the better or worse.

    But good on you if you have the time, energy and strength to look after someone with dementia, who is no longer the person you knew and loved, the body maybe there but that is all.
    MJM
    26th Jun 2020
    3:25pm
    I worked in the industry. Everyday a staff member would call in sick. The managers were bullies and never listened to our grievances or ideas advocating for residents. It was the worst place I have ever worked. To not be bullied some staff reported on other staff. So with all this rubbish going on residents were not being cared for like they should. And I lost all hope. All the decent staff left and now they are young inexperienced and impatient. My kids have been warned ... try and put me in one and the RSPCA gets ya inheritance ... haha .... no really !!!!!
    jan
    26th Jun 2020
    3:57pm
    I know what you mean. People can be so cruel. Let's hope you keep healthy just incase the RSPCA gets your inheritance. Guess we all have to look at our diet and exercise to stay healthy. My dad is quite fit as he walks a lot and still cooks, no processed food. Whiskey and wine most nights....
    JoJozep
    26th Jun 2020
    5:58pm
    Just Me.

    All you worry about is where will the money come from. If it was your wife in her predicament, would you have the guts to tell her she's too expensive to go to an aged care home and needs to stay at home. I bet you don't, and if I was her, I'd slap your face so hard you wouldn't bring up the topic again.

    To Bigpella,

    Yes I did the MAC thing as you call it, and all the help you mentioned was offered to us. In 12 months waiting and correspondence, site visits and explanations, not one word was mentioned that it could cost us up $3,360 per month to provide 4 hours care per day. Not even till our application was approved, and a nurse turned up did anyone mention fees apply. Not till the nurse was about to leave.

    You would think she would say before the interview, there would be a charge for her interview. After much thought and working out the sums, I decided to give it a go a week later and they sent a scruffy young male nurse. I was horrified to learn what he was going to do to my wife. I kindly told him where to go. I had no further correspondence with DHS or the "MAC" since.

    How did you manage this help with hardly any cost?. As I explained before I don't mind paying for good care and a place I can feel my wife is being looked after, and also that she is happy to be there. So you know our background, I've known my wife for 68 years and have had our 50th anniversary several years ago. She was responsible for eight beautiful and respectful grandchildren, the eldest of whom got perfect scores in all subjects in final college year and is now doing a free scholarship at Melbourne University course in Biomedical Science. Do you think I wouldn't do my best for her?
    Jenny
    26th Jun 2020
    6:23pm
    I don't know why you were treated this way by the MAC organisation. Did you not qualify for a care package? When a package starts, there is a cost to pay, but that would be for the whole year. For instance, a level 4 package would require you to pay somewhere between about 3 and 10 thousand dollars for the year of services, that being your contribution out of the approximately 55 thousand dollars worth of services in that year. Your contribution is variable according to your income and assets. I know it is very complicated, it took me ages to work it all out!

    While awaiting the package, I have been allowed a relatively small amount of services which help, and for these I pay what you would call peppercorn rates ($5 per hour). It amounts to 5 and 1/2 hours per week. So I don't know what happened to you, or why. Maybe you need to take it up with some relevant authority, or speak to someone from ACAT. You need and deserve help.
    Jenny
    26th Jun 2020
    6:01pm
    Unfortunately after waiting for over a year for our Aged Care Package level 4, and looking like having to wait another year. I am going to have to admit my husband into one of these residential facilities. Caring for him alone has become too much for me to deal with, and is not safe for him either. He is 83years old with dementia plus Parkinson's disease, and now is so disabled by both these conditions that he is unable to do much at all for himself. He is at high risk for falls, and is a dead weight when I try to help him. It would seem that as self-funded retirees we are going to have to put up all the funding for his care, which is considerable. I am not complaining about how much it will cost us, but I sincerely hope that we get value for money, and don't end up with the neglect which so many have complained about. Had the promised package arrived, I could have managed for longer at home.
    jan
    27th Jun 2020
    10:33am
    Sorry to hear about your husband. Please go and see your local mp or make an appt to see the mayor. Hope you are ok
    panos
    27th Jun 2020
    12:26pm
    Hmm what experience do you have with contacting your local do nothing MP and your rate increasing local Mayor of all things.....
    As this is unusual advice please explain
    Nika
    18th Jul 2020
    3:31pm
    Nursing homes are popping up all over, big money in it. I'd go after those making huge profit and taking from those who need it most