Gov’t aged care inspections being routinely “gamed”: TriCare staff
The Federal Government is responsible for policing standards in aged care homes, but the system is deeply broken, nurses and carers warn. Management are tipped-off ahead of inspections, staff are instructed to “look happy” and facilities are “window dressed” before government auditors arrive. Anthony Klan reports.
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Federal Government inspectors gave the Toowoomba nursing home at the centre of a growing elder abuse scandal a 100% pass mark following an official audit late last year – and inspected the facility last week but allegedly tipped-off management days beforehand.
Searches show that the Toowoomba TriCare facility has received a grade of 100% each time it has been inspected for “re-accreditation” over the past decade, including last October.
Those re-accreditation inspections are conducted after the management of aged care facilities request them, and they are generally conducted every three years.
Part of the Federal Government’s glowing 2019 TriCare Toowoomba report. Source: Supplied.
Nurses and carers at the TriCare Toowoomba facility say the inspection system is being gamed.
Operators are forewarned about inspections by the Federal Government, allowing management to apply “window dressing” to give a false impression of healthy operations.
The Toowoomba home has been in the spotlight since resident Kylie Kilroy blew the whistle on the facility late last month.
Kilroy said residents weren’t being showered; sheets weren’t being changed for weeks at a time; resident’s calls for help were going unanswered due to a lack of staff; distressed residents were being left in soiled incontinence pads for hours at time; and some residents were being seriously injured – including some suffering broken bones – due to systemic neglect.
(Management removed Kilroy from the facility shortly after she blew the whistle.)
After The Klaxon reported Kilroy’s concerns we were contacted by a group of distressed nurses and carers at the facility, who said dire understaffing has meant a “very poor quality of care is being delivered”.
Kylie Kilroy Tweeted her concerns about TriCare Toowoomba last month. Source: Twitter
They said they had written a detailed letter outlining their concerns and sent it to senior TriCare management on June 24, but had been “completely ignored”.
Almost a month later, on July 20, the staffers sent a copy of that same letter (which we have seen) to the Federal Government’s Aged Care Quality and Safety Commission, the regulator responsible for the sector.
“In a cover letter we suggested that a surprise inspection was needed and mentioned that giving notification of an inspection allowed time for ‘preparation’,” the staffers told The Klaxon.
The TriCare Toowoomba facility was “inspected” on Wednesday last week (August 5) but rather than conducting a surprise visit, nurses said the Federal authorities tipped-off the home’s management, telling them three days in advance that they would be visiting to inspect the home.
“As was expected, TriCare rostered for the day,” the TriCare Toowoomba staffers tell The Klaxon.
“The facility had been cleaned and polished, fruit in fruit bowls etc, and staff had been prepped in a meeting with instructions that they were to ‘look happy’.”
The staffers say the Federal Government assessors interviewed some residents, “but only one or two of those residents did not have dementia”.
“The facility had been cleaned and polished…and staff had been prepped in a meeting with instructions they were to ‘look happy’,” — TriCare nurses
“And one of those without dementia had their interview cut short and was not able to say what she wanted,” the staffers tell The Klaxon.
“They interviewed some of the staff, but they (unfortunately) chose some of the staff that had been scared by the prep-talk given by the Facility Manager.
“The management were so happy with the visit that they put out a box of chocolates and a note to say thanks to the staff for such a great outcome,” the TriCare Toowoomba nurses and staffers said.
TriCare is owned by Queensland rich-listers the O’Shea family and operates via shelf companies it has created on Norfolk Island – a known tax haven – in a complex corporate structure experts say is almost certainly designed to avoid tax.
The TriCare Toowoomba facility received $6.08m from the Federal Government in the year to June last year. In the 2017-18 financial year TriCare received $77m in Federal Government funds.
TriCare management and the O’Shea family have repeatedly declined to respond when contacted by The Klaxon in recent weeks.
We have contacted the Federal Government’s Aged Care Quality and Safety Commission, asking why TriCare Toowoomba management were allegedly told of the August 5 inspection several days in advance.
No response had been provided at the time of publication.
The Toowoomba facility, located on Curzon St in the city’s east, has 81 beds and most of its residents require a “high level” of care, typically because they suffer from dementia and other age-related cognitive conditions.
Among the concerns TriCare Toowoomba staffers raised with senior TriCare management in the June letter were allegations that the facility employs just half the number of nurses required; that unqualified staff are being forced to assist administering medicines against the law; that staff are pressured to “fraudulently” document resident care procedures that never occurred; and that the company has a “policy” of not replacing staff members when they are absent due to illness.
The TriCare Toowoomba facility is no stranger to controversy.
The Toowoomba Chronicle reports systemic abuse at TriCare back in 2012. Source: The Toowoomba Chronicle
Just like the current complaints, they centred around resident neglect and abuse allegedly stemming from “cost-cutting” (profit maximising).
“One resident was left without being fed, bathed or shaved for up to four days, a patient with a gangrenous ulcer left unattended for an inappropriate length of time, a bedridden stroke victim going days without being bathed or showered, and a patient left in their own faeces for up to 18 hours before being changed,” The Toowoomba Chronicle wrote in 2012.
“One source who visited the TriCare Aged Care home described the facility as ‘understaffed and poorly managed’.”
Responding to the newspaper in 2012, the Federal Department of Health reportedly said it had “received complaints regarding care and service provision” at the facility and that “departmental officers” were reviewing the complaints.
“The department will continue its inquiries and if it is found there was a failure to ensure the appropriate level of care, the department will take swift action to ensure the care needs of the residents are being met,” the Federal Government is reported to have said at the time.
However it appears little to no action was taken.
We have asked the Federal Government’s Aged Care Quality and Safety Commission whether any action was taken against TriCare Toowoomba regarding the 2012 allegations – and if so what – but it is yet to respond.
The Aged Care Quality and Safety Commission gave the Toowoomba TriCare home a score of 100% in October last year – and “re-accredited” it for another three years, until November 2022.
TriCare Toowoomba was given a tick for every one of the 50 standards it was marked against: including treating residents with “care and respect”; delivering “best practice” personal care; and operating a “safe, clean, comfortable and well maintained” facility.
The facility had been told ahead of time when the site visit would be occurring.
Searches show the Toowoomba home also received glowing reports – each also giving it a mark of 100% – after audits in 2011, 2013 and 2016. (The reports are here).
“Each home applies for a re-accreditation before its accreditation period expires and an assessment team visits the home to conduct an audit,” the 25-page 2016 audit states.
“Following an audit we decided that this home met 44 of the expected outcomes of the Accreditation Standards.
“The home applies for re-accreditation before its accreditation period expires and an assessment team visits the home to conduct an audit,” the audit states.
The group of whistleblowing TriCare Toowoomba nurses and carers said the inspection system was being easily gamed by management.
The only way inspectors would obtain an “accurate representation” was if they conducted their visits “randomly, without any notice”.
It was also vital that inspectors spoke to “residents of sound mind” and that staff were able to give responses “without fear of repercussions”.
“The quality assessors left a number of notices around the facility with a reference number and contact details for any staff or residents to contact them with any further information,” the group of TriCare Toowoomba staffers told The Klaxon this week.
They said many of the notices “mysteriously disappeared” soon after they had been posted.
“We are planning on reprinting them and positioning them around the facility, but some of us have contacted the number given with complaints from those residents without dementia, and from ourselves,” the nurses and carers said.
“If TriCare does pass this (latest) inspection there there is something absolutely wrong with the system and the safety of the elderly will be severely at risk.
“It will be a strong indictment of the aged care system in Australia.”
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