Some aged care homes ‘run like a factory’, industry expert claims

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“The way policies are framed around running these [aged care facilities], it is as if they are running a factory.”

That’s the disturbing assessment by University of NSW emeritus professor Richard Hugman, a social worker who specialises in the caring professions.

Prof. Hugman says that when the government responds to the current aged care royal commission, which is due to report in February, it must go beyond providing a significant injection of funds and ensure older people are treated with dignity and care rather than regarded as objects.

“[The government needs to] focus on improvements to the aged care sector that are not reflective of a sense that older people needing care are a burden on society,” he says.

“[Instead, they need to focus on the fact] that older people are part of society and that a good society is one that values all its members.”

Prof. Hugman says there must be an emphasis on positive values and our elderly people must be treated as human beings.

“Frankly, there are some places I’ve visited in the last few years, either because I’ve had friends or relatives who are living in them or I’ve gone to visit for professional reasons,” he says, “[that] I wouldn’t go anywhere near.”

The dramatic increase in COVID-19 deaths in Australia’s aged care homes – more than 580 – lays bare the ethics around our treatment of people in such places, says Prof. Hugman.

“To use a similar ethos in caring for human beings that you would use in producing physical things for sale, I think is an unfortunate way to think about the world.

“… it is as if they are running a factory. I understand good management techniques are transferable across settings, but you also need to understand the content of what you’re managing.”

COVID outbreaks in care facilities have been blamed on a lack of available staff and insufficient training in the use of personal protective equipment (PPE), plus staff working across multiple facilities to earn enough to survive on.

Melbourne’s aged care homes have been the worst hit, with all but five of the 115 aged care homes affected by the virus. St Basil’s recorded 44 deaths, Epping Gardens 36 and Twin Parks Aged Care in Reservoir 21. In Sydney, Newmarch House recorded the state’s highest death toll in aged care with 19 cases.

Prof. Hugman says the alarming death toll at Newmarch and St Basil’s was due to a decision not to transfer patients to hospital – a decision exacerbated by the fact that there are now very few qualified nurses in nursing homes.

“Some nursing homes don’t even actually have a nurse on duty at all times. If they’re looking after 100 people and they’ve got one nurse on duty to supervise other people, then they might have somebody who has a certificate from TAFE administering drugs and medications.

“In a hospital, someone would actually have to be a qualified nurse to be doing that.”

Prof. Hugman says that while the royal commission creates an opportunity for people to speak up, the real challenge will be in how the government responds and whether that produces a positive change in society generally.

Regarding funding, he says there is a lack of transparency in how government funding is spent by management in aged care facilities in comparison to community-based social services where monitoring is stringent.

Claims by some aged care homes, particularly those from the for-profit sector, that they have to spend less on staff relative to residents in order to cover their costs, just don’t stack up.

“And those claims about non-profitability do not explain how or why the [aged care] for-profit sector remains [in operation].”

For-profit aged care homes have reported more cases of COVID-19 than facilities operating on a not-for-profit framework, heightening concerns about staff numbers, training and supplies.

Do you believe a sense of humanity is missing in some aged care facilities? Is it profit first and people second? Do you believe the royal commission will initiate meaningful change?

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Written by Janelle Ward

41 Comments

Total Comments: 41
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    Yes it would be the last place I would ever put an aging parent. Its all about profit at the cost of lives. Enough talk and more action is needed!

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      Same here and for that matter personally would not even consider entering one, appreciate argument re impact on those around you if you elect to stay in your home but anything better than the poor attention, food and medical support some of these so called Aged Care facilities offer. The whole Aged Care Industry needs urgent review and in most cases correction.

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    As a frontline carer the biggest obstacle is everyone above you! Management has to answer to head office. Government gives money in a situation calledACFI. Basically facilities get money from government on top of Basic from client. Things like giving medication To toileting assisting with personal care. So ultimately they take away your ability to be independent For cash.
    They feed them rubbish fish fingers party pies… I saw no summer fruits just apples oranges bananas. They offer independent living….That’s also a crock!
    The place I worked there was rampant bullying by management.
    I really hope it gets changed because the young ones don’t stay young forever!!!

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      MJM you are right about the independence. My folks moved into aged care with physical difficulties yet they were very with it and had been coping well in their own home till heart issues forced them to seek help with day to day living. They were treated as cash cows. The food was as you say party pies and frankfurts on the weekends when there was no cook on site and during the week when they had proper meals the portions were tightly rationed to come under budget. The worse thing though was the loss of dignity. Staff entered rooms without simply knocking and they went through residents drawers frequently. They wouldn’t let mum keep even a panadol in case of need when staff were unavailable and this is a woman who until she moved in was handling all her own medications. The facility was two years old and on the surface looked great but was what I would describe as all fur coat and no knickers. I fought them tooth and nail and won some but got empty promises for most issues. I offered to move the folks out but they had friends there and didnt want to leave. Under staffed because most of the wages budget went on the excessive tiers of management. Your last point is well made. The people able to effect change now are the people who will eventually benefit from that change.

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    The bottom line is, of course, money. Everyone wants to spend as little of it as possible. It’s why our manufacturing industries died – consumers wanted cheap cheap cheap, so manufacturing moved offshore and a lot of consumers lost their jobs in manufacturing. Go figure. Now, of course, the same people want to put nan and pop into a nursing home because they are too busy working three jobs to pay for the next cruise to care for them themselves. But they don’t want to pay much for the nursing home, so the home employs cheap labour, most of whom are barely qualified to breathe. And then everyone complains when it doesn’t work out. But yes, in the end, everyone wants everything as cheap as possible so they have more to spend on the fun stuff. Aged care isn’t fun or sexy so it will never attract serious funds. I don’t have answers to any of this, but please now, tear my argument apart. tell me where I’m wrong!

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      The problem is the Federal Government supply taxpayers funds to aged care facilities but do not exercise proper controls on that funding.
      The State Government aged care homes in Victoria had very few covid cases but they have proper staffing levels whereas the privately owned ones have no mandatory staffing levels, as the article said.
      The Federal Government have responsibility for aged care and all they think needs to be done is throw more money at it without oversight of where that money is being spent.
      The families of the aged people are not the ones responsible for the care provided.

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      Thanks for that, Tanker. Question for you: if state-owned homes provide better staffing, why do people opt for private ones? Just not enough state places available?

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      No need to tear you apart. There are different stages of growing old, the last one is where professional nursing is really needed, this cannot be done in many family’s, if you are 80, your kids could be 60 and not physically capable of doing the work for a multitude of reasons, handling a dementure patient requires training and is a constant job of living your life and someone else’s, some can do it but not many and not for long therefor a nursing home really is required.
      Far too many are placed in care when with help from a carer they could live on at home for many years, homes can be modified to help the ageing, bathrooms, bedrooms, kitchens and ramps and best of all the Government helps with this.
      I live in a village where many in their 80’s and 90’s live happily with professional caregivers, they have a quality of life that is happy, they enjoy living with neighbours that they have known for years, they listen to each others medical news, share the daily paper and importantly care for each other.
      My advice is that as soon as your home becomes a chore move to a village, you will make friends with people of a similar age and with similar interests, you dont have to be old and failing, many ride bikes, go walking, play cards and cook. As they age meals on wheels come in, as do carers who clean, wash and do the tasks that are becoming too hard,
      Villages offer different levels of accomodation and facilities, seek out people who are livng in villages, ask questions, find out about body corporates, there is plenty to learn.
      Lastly dont put it off if your home is unsuitable for living as an older citizen, my experience is that I am the healthiest Ive been for 20 years, have caring friends in the village, no maintenance problems, family come and go, life is great

    • 0
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      Thanks for a very detailed outline, Tarzan – lots of good ideas there!

  4. 0
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    My mum was in Goodwin Monash aged care and the care was excellent. Every little misshap i was notified immediatly. There of coure were a few small things that could have been done better but overall the care was excellent. I am a retired nurse so feel i have the knowledge to make this accessment. Before entering the full care mum was one of the first into the village about 25 years ago and except for a short period when they had a currupt uncaring CEO who left unders supisicous circumstances the village has returned to its once good record.

  5. 0
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    Told my children years ago to never put me in an aged care facility as it’s a death sentence & not necessarily for me.

  6. 0
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    I am familiar with aged care homes having worked in them, as a nurse in the 1980’s 90’s. Nothing has changed from then to now. The three major problems are government funding being inadequate, Private ‘run’ aged facilities where excessive profit comes first and care of residents comes last, and staff training non-existent. Anyone can get a job in a nursing home with no qualifications at all. I could tell you stories of what I have seen in nursing homes that would make you sick. All nursing homes should be government run by professional caring and trained management and staff trained for for one year both in nursing school and ‘on the job’ before being certified and then getting decent pay. But how to get a competent government to organize this is the problem. Our governments still have their ideology locked into the 19th century. But government run they should be but never by Church or private companies never, never, never. By a public non-profit company under strict regulation and overseen by a government minister and responsible for reporting complaints by the public – absolute transparency at all times. Too long has this situation has been ignored by both State and Federal Governments. They are a disgrace and should be ashamed of their failure in the care of our elderly citizens

  7. 0
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    Individual aged care facilities are legally responsible for the safety of their residents, but the Federal Government is responsible for the aged care system as a whole.
    The Government’s primary role is to fund and regulate facilities to ensure they adhere to agreed safety standards. These standards include preventing infectious disease outbreaks.
    Aged care facilities are also subject to the public health laws of their host state or territory, so state governments retain some responsibility for residents.
    However, a state’s involvement only comes after an outbreak takes hold. Under powers not specific to aged care, it can, if necessary, take over facilities.
    In preparation for COVID-19, both levels of government agreed on their roles and responsibilities for helping residential care facilities respond to outbreaks.
    These largely reflected existing legislative arrangements, but they made clear the Federal Government would, in addition to its regulatory role, manage the supply of personal protective equipment and help address staff shortages. State governments were tasked with, among other things, testing, contact tracing and working with hospitals to free up hospital beds.

  8. 0
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    Why should I comment as it would only be for venting my spleen as I can only see the government will only have talk fests as at present, to make us suckers believe that they are doing something. Don’t hold your breath to see any improvement.

  9. 0
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    This government sees the aged as a burden on the economy they did not listen to the last royal commission and they wont listen to the next one. So many have died needlessly the only way to make them listen is at the ballot box this government is corrupt and incompetent paying 10 times the value for land belonging to liberal party dondors and ignoring the aged is criminal.

    • 0
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      Another political rant, why do you bother, no one really takes you seriously.

    • 0
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      Tarzan Its not a political rant its fact

    • 0
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      The vendors also donated to the Labor party.

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      Horace I am not denying the fact that they donate to both parties my issue is corruption and that`s what it is. A royal commission found last October that aged care residents under their watch were neglected undernourished and were left lying in their faeces and they did nothing they should be held accountable

    • 0
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      You probably watch the A B C suggest you take a nap.

    • 0
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      Tarzan what do you trolls get out of personal attacks on other commenters? Two insults in one thread a bit over the top. You may not agree with someone’s comment but they have as much right as you to state their opinion.
      Ollie is correct about nothing being done since the aged care inquiry began.

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      diamond, this whole site has a left wing bias, state your opinion, but don’t try and stop others whose political opinion you don’t agree with.
      The Aged Care inquiry has been ongoing so don’t expect anything for a couple of years, get on with your life and don’t expect someone else to look after you and yours or you will be very disappointed, we have to look after ourselves, take a walk, enjoy a sunset , life is good f you allow it to be

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      ‘State your opinion and don’t stop others from doing so’….quite right Tarzan….but it seems from what you say, this doesn’t apply to everyone.

  10. 0
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    Who has ever heard of someone saying that they can’t wait to get into an aged care place?
    Once people are in there they can’t wait to leave, even though there’s only one way to do that.
    People must be treated with dignity and respect but they should not be kept alive to keep putting money into drug companies coffers. Most medication should cease to be given and nature allowed to take its course. Covid has destroyed the lives of so many in aged care, not by killing them, but by policies that deprive people of seeing their loved ones. That’s about all people have to look forward to and it’s been taken away because governments are afraid that old people may die. Old people do die, so let them be happy.

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      I find your suggestion that medication be withdrawn from the people who go into aged care totally repugnant and horribly unkind and nothing short of euthanasia. If their medications are keeping them alive, withdrawing those medications will kill them. That is murder.
      The idea of assisted dying is by far preferable for those who have had enough, but the instinct to hang onto life is strong and should be respected.

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