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The many extracts on these pages are from copyright material. They are owned by the reference given or its owner. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of any allegations made. Any comments made are based on the belief that there is some substance at least to so many allegations.

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This corporate web site addresses the issues of corporate health care within a broad framework. A web page describing this broad context should be considered as an introduction to each page on the web site. If you have not yet read it then
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Content of this page
This web page looks at the not for profit sector in nursing homes. It comments on the shift from a caring humanitarian system towards an impersonal service focused on economics. It gives some examples of failures in care.

 Australian section   

From humanitarianism to markets
Not for profit nursing homes
 

  

CONTENTS


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Different operators, different motives

We need to clearly distinuish the spectrum of operators as their thinking and the way they operate differs.

Not for profit church, community and government

As indicated elsewhere the vast bulk of aged care has been provided by church and community groups whose primary focus has been charitable and directed to helping those sections of the community in need. The not for profit sector is not monolithic.

Church and community:- While the church groups dominate there are secular community organizations, ethnic group structures, and isolated communities owning nursing homes. All seek to care for their elderly in the communities where they have support. Community input and interest play an important part in creating the ethos in the homes. More isolated homes and smaller organizations often lack the expertise to meet modern standards.

Government:- Also part of the not for profit sector are government owned nursing homes run by state or local government. Community input is less critical for these.


For profit private, listed and financier driven

The for profit sector comprises private companies and publicly listed companies. A new group is the financier controlled companies.

Private for profit:- A majority of the earlier private for profit providers were motivated by an urge to serve the community. They made their living by doing so. Until more recently most were not primarily motivated by profitability. Part of the private for profit sector still operates as if they were not for profit, but many now operate in an extreme for profit manner. The spread of problems in this group of homes partly reflects this difference.

Publicly listed for profit:- Publicly listed companies in contrast have a fiduciary duty to make profit for shareholders their primary concern. Humanitarianism is embraced as a secondary objective when it is seen to enhance profitability.

Financier driven for profit:- Recently the large banks and financiers actively entered the general marketplace investing in and owning companies. They have targeted the nursing home industry by forming property trusts, sometimes in partnership with other for profit companies. The trusts lease or contract the homes to other for profit operators who manage the homes. These managers have a responsiblity to generate returns for the banks and trusts which are in a position to pressure them to do so. This places pressure on care. How great the problem will be remains to be seen.


Distracters from care

Care is not something with defined limits - the more resources and the more attention given the better will be the care. Profits compete for the money and staff time which would otherwiise go to care. When the primary focus is profitability then there is pressure to take more away from care and this pressure will vary between operators.

While these systems have co-existed for many years the ethos and patterns of behaviour were established by the not for profit sector. Social pressures ensured that for profit operators identified with community values, conformed to them, and devoted sufficient resources to care. A primary focus on making profits out of vulnerable people had a "Yuk" factor and people who thought this way were not welcomed in the sector.

Since that time "wrinkle ranching" by individual entrepreneurs and companies looking for profits has not only been accepted as legitimate but economists and market theorists have seen it as the only way of "reforming" and improving the provision of aged care. Government has turned the sector into a competitive marketplace where the participants compete for profit. The logical contradictions, conflicts, and the evidence that this had not worked elsewhere (with which they were supplied) were ignored.

The not for profit sector does not have the profit distractor. Their mission is to stretch available resources and staffing for maximum benefit and to cooperate with others in the service of the community. But there are some other distracters away from care.

In the churches the primary focus on other worldly and religious beliefs can come into conflict with the requirements of care. They are strongly motivated to care although there was a time when saving souls sometimes took precedence over saving lives.

The priorities of politicians running state and local governments may not include aged care which can consequently be underfunded. Excessive bureaucracy can undermine morale and impede the provision of care. Nevertheless government nursing homes are owned with the primary intention of providing care rather than profit so that the focus within the homes is directed to care.

Church and community groups are dependant on community support and involvement. A waning of community interest can be followed by apathy, disillusionment, isolation and dysfunction. Care is nevertheless the primary motive.

We can ponder whether a lack of community involvement played a part in what happened in the church run orphanages and other shelters where children were sexually abused in the past. Would this have happened if the community were involved in helping to care for those children, rather than simply delegating their responsibilities to church or government then walking away. Is aged care similar?


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A changing world

While the not for profit sector still owns and operates nearly three quarters of nursing homes and hostels the situation has changed dramatically.

Pre-1996:- During the early 1990s right wing economic rationalist governments gained power in almost all states and set about reforming the health system along market lines. While labour held power federally it had shifted away from a strong socialist focus. It introduced a number of important economic changes which were far more tolerant and supportive of market practices.

In most states nursing homes were spared and only in Victoria did the government move to privatise the nursing home system it owned (but lost power before doing so). It encouraged smaller entrepreneurs into the sector. These became and remain the main problem companies.

At that time federal regulations kept a tight rein on all expenditure. The homes had to account federally for the way they spent money and at a state level for standards of care. The whole system was under funded and there was no money for improvement or growth. Physical facilities deteriorated and there were many problems. All found the constraints imposed by government burdensome.

There were already problems in the diversion of money from care to profit. A group of activists led by Ted Quinlan in Western Australia were particularly vocal about this. The system clearly needed a lot of attention. The concern is the sort of attention it got! While it has had some benefits the changes made have compounded the commercial problems and introduced other problems.

After the 1996 election:- Aged care was a federal responsibility. The major change came after 1996 when the conservative federal government remoulded the system to conform to its market ideology. They called this reform. The new government deregulated the market. It abolished the accountability requirements and created a market friendly support system. Not for profit organizations were forced to shift from a cooperative service directed to care to a competitive one directed to economic considerations. To do so they converted to market systems of management. The story of aged care and government's role in radically changing the system is reviewed on other pages.

Humanitarian considerations were replaced with an impersonal commercialism which clashed with their ethos of care. The ambience of the services became more formal and process driven.

On other pages I have described the difficulty which the entire not for profit sector experienced in accommodating to this new commercialism, which clashed so with their traditional mission. In 2003 this dilemma for not for profits in the welfare sector was analysed in an article in The Age.

There comes a point at which the inhumanity of commercialisation becomes intolerable and not for profit organisations find that they can no longer be a part of it. The churches have long assisted the poor and cooperated with government in managing unemployment relief. That system has now become so harsh that the majority of the major churches have withdrawn from their contracts with government. Only an evangelical group strongly supportive of the government remains.

In the nursing home industry the Salvation Army has been a major carer of the elderly, particularly the less fortunate. They have now walked away from the sector and sold all of their nursing homes to Macquarie bank in Australia and New Zealand. The remaining churches walk an uneasy tight rope between identifying with a competitive commercial structure and complaining about what happens there.

Click Here to explore the dilemmas for not for profits forced to operate in a market context.


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Failures in Care

I am not claiming that there are no problems in the not for profit sector. In both the USA and Australia there is a greater incidence of problems in for profit nursing homes than in not for profit homes but they do occur.

I am claiming that the problems in the market model are an integral part of that model - an essential part of its structure so that dysfunction will be recurrent and ongoing in spite of all efforts. The pressures in the system drive it towards an impersonal commercialism and away from care.

In the not for profit sector there are distracters and many factors which impinge adversely on care. These are mostly external to the care situation and can be addressed. Those that are integral are more transitory and can be managed.

Having to operate in a market mode and compete with commercial operators in order to survive is a major factor in driving not for profit services to adopt market style thinking, practices and management so driving them towards dysfunction. This is most readily apparent in health care in the USA.


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A lack of skills

Ethnic communities have been motivated to manage nursing homes for their sector of the population. They have sometimes lacked the expertise and the skills needed to meet modern standards and to cope with the complexities of accreditation. As in other sectors interest and support within the community may wane. Conflicts in the community can impact on care.

Apr 2006 An ethnic home has problems

The safety, health and wellbeing of about 90 residents in the aged care facility at Netherlands Retirement Village at Birkdale in Redland Shire was found to be at risk after an audit by the Aged Care Standards and Accreditation Agency earlier this month.

The risk to residents occurred after the home's senior management resigned -- the CEO, director of nursing and services administrator -- within a six-week period.
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The home, which opened in May last year, also faced sanctions in June last year, and the CEO at the time was fired.

Sanctions were lifted in December but imposed again this year after a spot audit by the federal agency.
Aged care residents found to be at risk The Courier-Mail April 28, 2006

Isolated communities such as those in some aboriginal townships may lack the skills, the staff and the understanding to provide modern care and cope with accreditation’s complexity.

Jan 2001 Small remote communities

The website says the Yallambee Hostel at Millmerran has accreditation to November 24 this year, but its approval might be revoked unless one or more aged-care advisers were employed. Another Queensland home, the Yumba Binda Aged Persons Hostel at Woorabinda, is also listed as facing sanctions over a risk to residents but the website says it has received the full three-year accreditation.
Aged-care audit net spreads. Courier Mail January 2, 2001

A number of older private for profit nursing homes were founded by individuals who provided many years of dedicated caring. These individuals do not have the skills to provide modern care and are quite unable to cope with the concepts and the documentation on which accreditation depends. It is distressing to see the efforts and the worlds of these older citizens who have given so much kindness destroyed as they are vilified by the press for their failures.


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Homes owned by churches

The vast bulk of nursing homes are owned and operated by the large church groups. They have the size, the manpower and the knowledge to identify and address problems in their homes. Although they perform better than the market sector they do have problems in some of their homes.

This group have been under funded for years. Many of their homes and hostels are aging and they have not had the money to refurbish or rebuild as this would have taken money from needed care.

New government regulations and competitive pressures have required that the physical facilities be ungraded or rebuilt and additional funding for this has been limited. The churches acknowledge that they have had to divert funds from care to rebuilding and that this does have an impact.

Other reasons for failures might include under funding, problems between local community and central church, aberrant individuals, the imposition of market forces and management, bureaucratic inertia and apathy, and the migration away from nursing. Perhaps sometimes more care is given to the needs of the soul and the hereafter than the physical and mental needs of the here and now.

The reports below suggest that a major problem is the quality of staff. Perhaps these old and crumbling homes do not attract the sort of staff needed and rely more on immigrant workers.

The pressures of excessive work, and a disintegrating physical environment impact on staff morale and so on care.


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Examples

The extracts illustrate some of the concerns which have been expressed about church operated facilities.

Baptist Community Care

Mar 2000 Disintegrating buildings, poor management and demoralised staff

There are holes in the walls. That much management admits.

There are also, according to photographs taken inside the Church Nursing Home in Brunswick, patches of broken plaster hammered over with boards and bits of exposed plumbing. Angry staff and concerned residents say there have been occasions when residents have been left, wet, in their beds for hours because there are not enough nurses to care for them.

Then there is the case of the Bellview nursing home across town, in Oakleigh, where ``Susan'', another concerned relative, says sadly but bluntly that her elderly father is ``waiting to die''.

It is not just the allegations of neglect, Susan says - the mouldy dentures, the resultant mouth infections, the bed linen left soiled with faeces and vomit, the maggots she says have infested a resident's wounds - although that is the worst of it.

It is also the fact that activities at Bellview, which used to involve a rigorous game of bingo, now consist, she says, of turning the residents' chairs to face a window on to Ferntree Gully Road so they can watch the traffic go by. It is all the nurses have time for these days.

The allegations, which include an elderly woman at the Church Nursing Home being left alone in her room, lying on a wet bed stripped of linen until well after midday, are among a litany of disturbing stories about the condition of Melbourne's aged-care facilities received this week. They were made after The Age invited readers to pass on their experiences in the wake of the scandal involving kerosene baths at Riverside Nursing Home, Patterson Lakes.

A distressed staff member at the Church Nursing Home, a not-for-profit facility with 30 residents operated by Baptist Community Care, said most of the problems stemmed from recent staff shortages. But the director of aged care for Baptist Community Care, Mrs Robyne Tresidder, said the nursing home continued to adhere to nurse-patient ratios, even though they no longer applied to nursing homes.
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``With such large holes and openings it has created a gateway for mice and now rats ... It is inhumane to have a resident or residents sleeping in rooms like this. In one lounge room the skirting boards are missing and there is a large hole that opens up into another resident's room,'' the relative said.
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Staff members told The Age they had been instructed on how to deal with the auditors when they came to inspect the nursing home, and there had been a process of attrition in staffing numbers as nurses succumbed to the pressure of caring for residents with complex needs, with little support from management.

Bellview Nursing Home, in Oakleigh, one of Melbourne's biggest, was one of seven Victorian homes named in a report tabled in Federal Parliament late last year for failing to meet aged-care standards. The proprietor says the home has since complied, but Susan - not her real name, for she fears that her father will be victimised if he is identified by association - says little has changed.

She is adamant that the nurses at Bellview are wonderful; just overworked and overwhelmed by the needs of 110 very old, sometimes sick, usually frail, incontinent, immobile residents. ``The nurses just don't have time any more,'' Susan said. ``He (her father) has gone absolutely downhill ... I think he's just waiting to die. I mean there's nothing to live for apart from when we visit.''
The Sad State Of Aged Care The Age March 4, 2000


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Anglican Aged Care Services

Dec 2000 Staff problems

A NURSING home has sacked at least four care assistants over allegations that they tormented and mistreated residents.

Elderly people at St Anne's nursing home in Hawthorn were alleged to have been slapped across the face, verbally abused and not dried properly after washes.
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The Health Services Union, which is representing the care assistants, strenuously denies the claims and believes the allegations are racially motivated.
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St Anne's is one of 16 nursing homes and hostels run by the Anglican Aged Care Services Group.
Elderly torment alarm Herald-Sun December 2, 2000


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Society of St Vincent de Paul

Dec 2003 Staff problems - language/literacy problems

AN elderly resident of a Melbourne nursing home died after she was allegedly given the wrong heart pills by a carer who could not read the label on her medication.
Medication mix-up Wrong heart pills blamed Herald-Sun December 12, 2003

Dec 2003 Management instability

The Herald Sun has learned the foreign-born employee at Vincenpaul Hostel in Mont Albert North was still being allowed to administer medication as recently as last Monday.
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Concerned staff and residents of the home revealed yesterday that Vincenpaul had undergone senior management changes four times in the past year.
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The Health Services Union said the case highlighted concerns over low-paid carers who are allowed to to do many of the tasks of trained nurses.
Medication mix-up wrong heart pills blamed Herald-Sun December 12, 2003

Jan 2004 Major problems in this home - staffing particularly

The federal aged care home watchdog has detailed a litany of problems at the Vincenpaul hostel, which could be closed over its performance.

Problems listed include:

ALLOWING a woman to rinse out her mother's blocked catheter with Coca Cola;

REPEATEDLY giving residents the wrong medication;

SERVING Catholic residents meat on the first day of Lent.
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The untrained "professional carer" allegedly gave Mrs Barnes the pills about 8.30am on October 27 last year, but did not report the mix-up until three hours later.
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But the Commonwealth agency has attacked the hostel's operator, charity St Vincent de Paul, for allowing the employee to work unsupervised.

The woman is no longer allowed to hand out pills, but residents in pain overnight are forced to wait until morning for relief, when an authorised nurse arrives.
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Agency inspectors claim they found a catalogue of neglect when they visited the 53-bed hostel after Mrs Barnes' death.
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Residents were allegedly constantly given the wrong medication, with a mix-up recorded at the rate of at least once a month since July 2003.

On July 21, a resident was given a double dose of medication and taken to hospital after complaining of feeling unwell.

Relatives also complained to the Commonwealth agency over staff neglect including keeping residents indoors for more than a year.
Hostel loses licence as death investigated Herald-Sun January 8, 2004

Jan 2004 Accreditation results

The report released by the agency showed the hostel only complied with 31 of the 44 expected outcomes of the accreditation standards.
Aged hostel under review Aged hostel under review January 21, 2004


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The Uniting Church

Aug 1997 Church dispute about money for aged care

More than a year after it was hailed as the biggest donation to any religious charity in Australia, mystery surrounds the Wesley Mission's $12 million charitable trust for aged-care facilities.

The mission and its head, the Rev Dr Gordon Moyes, have refused to provide the Uniting Church with details of the trust.
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"However, to date, no list of such grants has been made available and the Synod's aged-care staff are not aware of any grants to centres."
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The man who donated the money, a retired North Shore businessman, Mr Jack Richardson, has used his wealth to establish charitable trusts, including the Bicentennial Cancer Research Trust. It is believed the Aged Persons' Welfare Foundation has been housed within the same corporate structure. When contacted this week, Dr Moyes refused to discuss the foundation or anything to do with the donation.
Mystery Surrounds $12m Donation Sydney Morning Herald August 28, 1997

Nov 2000 Apalling accreditation findings -- nurse problems

FEDERAL aged care authorities took eight months to act after a serious complaint - potentially placing the lives of 120 elderly residents of a Melbourne nursing home at risk. When the home was finally inspected, it failed 43 out of 44 health and safety standards and was deemed "unsafe".
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Problems at the latest home - the 75 Thames Street Nursing Home at Box Hill in Melbourne's east - were so serious that Mrs Bishop's department slapped sanctions on it, freezing funding for new residents for six months.
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The report found:

STAFF had little or no knowledge of fire and evacuation procedures.

RESIDENTS' clinical care was incomplete.

SERIOUS risk was found in the restraint of residents, infection control, catering, cleaning and laundry services.

A LACK of dignity and comfort for the terminally ill and residents left in pain.

The Australian Nursing Federation lodged a formal complaint with the Department of Health and Aged Care on November 29, 1999, about the home.

The union complained drugs were being dispensed and administered by unqualified staff.
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The agency's 30-page report revealed a series of problems at the facility, run by Uniting Church agency Moorfields Community for Adult Care.
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It said medication management and storage was unsafe and prescribed treatment and medication was not correctly documented or administered.
Months to act on nursing home fears Adelaide Advertiser November 20, 2000

Jan 2003 Another home and hostel with serious problems

Victorian Uniting Church aged care facilities have come under the microscope for the second time in recent months, with a Melbourne hostel placed under restrictions for medication mismanagement.

The Girrawheen Community Hostel at suburban Brighton was the subject of a serious risk report after a snap inspection by the commonwealth Department of Health and Ageing found some residents were being allowed to store medication in their rooms and administer it themselves.
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The revelations followed restrictions placed on the Girrawheen Nursing Home (nearby home under the same management) in October after the home failed to meet 32 of 44 care standards.
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"I think that what happened is that people were more concerned just with caring for people and not taking enough notice of some of what seemed to be technical things, which are actually very, very important," Mr Johnson said.
Vic - Aged care facility breaches care standards. Australian Associated Press General News January 30, 2003

Jan 2003 Sanctions

The Uniting Church's aged-care program is under scrutiny, with the Federal Government imposing sanctions against a Brighton hostel run by the church.
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Staff were also failing to properly record the administration of some medication, including Warfarin, a drug used to prevent blood clotting, and Panadol.
Church under fire over homes for elderly The Age January 30, 2003

Jan 2003 "Disappointing" findings

A spokesperson for the Department of Health and Ageing said the findings of the review were "disappointing" and that the church had been reminded of its responsibilities.

The church operates 30 aged care facilities in Victoria, and more than 300 nationwide.
Hostel loses funding over breaches. The Australian January 30, 2003

Apr 2003 Decision to close the home

Troubled Melbourne aged care facility Girrawheen Community Hostel is to close.

UnitingCare today informed the residents, their families and staff the facility would close in September.

Recent government inspections of the hostel and the Uniting Church's nearby Girrawheen Nursing Home have found numerous problems with the standard of care of the residents.
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Ms Pearce said the 1960s hostel buildings required extensive and expensive renovations to meet the federal government's building certification requirements.

In the long term, she said, the building would have compromised resident safety.
Vic - Troubled aged care hostel to close. Australian Associated Press General News April 11, 2003


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Mercy Health and Aged Care

Dec 2003 Unsuitable violent residents in the home

A 91-YEAR-OLD woman who died after being assaulted in a nursing home had pleaded with her daughter to save her.

Mary Wilkinson's daughter, Val, told an inquest at Castlemaine yesterday that she feared her mother was at risk from verbal, physical and sexual abuse at Bendigo's Bethlehem Home for the Aged.

Despite repeated warnings to Bethlehem management, her concerns were realised on October 24, 2001, when Mary Wilkinson was pushed to the ground by a strong and volatile male resident.
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Ms Wilkinson said her mother lived in the nursing home happily for a year, before physically strong men with psychiatric conditions began to be admitted to her ward in 2000.

The court heard one resident's ribs were broken. Frail elderly women were subject to obscene verbal abuse and sexual harassment, despite Ms Wilkinson's request for the men to be moved.

On one occasion, Ms Wilkinson found a man with his pants down groping her terrified mother.
Elderly victim had pleaded for help The Australian December 9, 2003


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Mission Australia

Mar 2005 Poor home closed down

MISSION Australia's image is one of care and compassion -- but when it came to looking after frail residents in one of its inner-city nursing homes these values were nowhere to be seen.

Dozens of residents at the Missionholme nursing home in Redfern will be left homeless from next month after federal health inspectors decided to shut it down.

The 33 high-care residents who called the drab building home were left in conditions which the federal Department of Health and Ageing described as an "immediate and severe risk to their health, safety and wellbeing".

A snap inspection found the home failed a record 31 of 44 Commonwealth accreditation standards, ranging from poor hygiene and nutrition to patients being given the wrong medicine.

The Daily Telegraph understands the neglect only came to light because a former employee blew the whistle before quitting in disgust.

Mission Australia was given the option of fixing the problems before April 22 but decided the home was beyond repair and will now close its doors.
Nursing home shut down over health fear Daily Telegraph March 2, 2005

Apr 2005 Dreadful conditions

AN elderly resident was tied to a chair with a crocheted rug to prevent them wandering away from a Sydney nursing home where residents lived in filth.
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It was cited for leaving pet food on paper towels in the corridors for stray cats and consistently serving cold meals to the residents.

On one occasion, residents' blood sugar levels were recorded on a paper napkin in the staff room and inspectors observed several cases of residents receiving the wrong type and dosage of medication.

Another resident had plaster on an ankle requiring frequent treatment but the home's records wrongly stated "the resident is an amputee".

The report found the residents, many suffering dementia, had little to look forward to at Missionholme -- even birthdays were not acknowledged.
Old people tied up and neglected Daily Telegraph April 27, 2005


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Masonic Care

Feb 2005 Medication problems

AGED care facilities on the bayside are going through a major upheaval, with Masonic Care Queensland Sandgate Hostel currently under State Government investigation and Eventide Nursing Home moving clients to other facilities.
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The department has received reports about time-critical medication not being administered on time and staff not monitoring patients who were deemed able to administer their own medication.
Overhaul of aged services Northside Chronicle February 16, 2005


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Government Run Homes

Some government run homes have also been disappointing and Victoria seems to have been worse than others in spite of its more socially minded government. It has been tardy in upgrading its physical facilities.

As late as February 2006 Hilary Blakiston House, one of its Barwon Health high care nursing homes had the distinction of failing all but 15 of the 44 accreditation standards after the agency had overruled one of the assessors findings. The agency elected to allow it to continue operating.

What is interesting about this report is that the vast bulk of the problems related to physical facilities, education, systems, process, documentation, and staffing. Actual care and examples of failed care were seldom mentioned and when they were related to activities that were staff and time intensive. This looked like a management and staffing problem. The actual care given was seldom criticised and it looks as though the staff may have been motivated and doing the best they could. This does not seem to be "people farming" but under resourcing.

One wonders if this is representative of the difference between accreditation failure in public versus private as the public system is not competing in the same way. As far as I am aware no analysis of the differences between different types of operators has ever been done. Given the importance of this for policy this is alarming. Given any findings sensitivity in an ideological driven system it is not surprising.

Feb 2006 Management and stafffing issues lead to poor care

Following a review audit the Aged Care Standards and Accreditation Agency Ltd has decided not to revoke the accreditation of Hilary Blakiston House in accordance with the Accreditation Grant Principles 1999.
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The Agency has found that the home complies with 15 of the 44 expected outcomes of the Accreditation Standards.
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Given the widespread non-compliance against the Accreditation Standards, the Agency considered whether the home should have its accreditation revoked. However, the Agency acknowledges the immediate and effective action the home undertook to address the issues of serious risk identified on 15 February 2006. This action has immediately improved the care of residents at the home. It also has demonstrated that the home is capable of addressing the issues that have been identified and has already gone some distance toward doing so.
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There is no established system or processes of review and evaluation of organisational or site management practices and procedures; management have not identified the extensive non-compliance identified by the team.
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The team found that site meetings had not been regularly held; there were no minutes of staff meetings past 2003. There are no policies and procedures in place to guide managerial and staff practices other than outdated McKellar Centre policy documents and limited mental health policies.
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There are insufficient clinical, allied health and activity staff to meet residents’ assessed needs.
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Staff do not have the appropriate knowledge and skills in relation to resident care to perform their roles effectively. Staff have not been provided the opportunities to develop and implement contemporary knowledge and skills to effectively assess, monitor, review and evaluate residents’ complex clinical and behavioural care needs.
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The home’s medication systems and processes do not ensure that residents’ medications are managed safely and correctly. The current chart format and method of filing the charts in the medication folder create the potential for significant medication errors.
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Recommended diets are not followed by staff increasing the potential for residents to choke or aspirate.

Residents requiring re-evaluation by external health professionals are not consistently followed up by staff to ensure the reviews are undertaken.
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Observation and documentation showed and staff confirmed that staff do not provide physiotherapy or exercises for residents. Staff said that those residents who are not able to initiate walking do not have physiotherapy or exercise programs and that they do not have time to ambulate them.
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Staff commented that they lack supervision by Barwon Health and that they would appreciate more managerial support and presence from the approved provider.

Staff confirmed that they have access to supplies sufficient to enable them to do their job.
Aged Care Standards and Accreditation Agency report Hilary Blakiston House, Barwon Health February 15, 2006


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Not for Profit Representative Body

Body representing not for profit aged care providers

Aged and Community Services Australia Inc is the national peak body in Australia representing over 1,200 church and charitable and community based organisations providing accommodation and care services to over 450,000 older people, people with a disability and their carers
Aged and Community Services Australia web site
http://www.agedcare.org.au/ Sep 2006


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BUPA : A SECULAR NOT FOR PROFIT OPERATOR (Added October 2007)

In October 2007 the giant United Kingdom not for profit company BUPA became one of the major owners and operators of nursing homes in Australia. It has no religious affiliations.

It is interesting to see the way in which this company has dealt with the conflicts between its mission and the demands of the marketplace. How it has adapted and compromised its mission in order to be successful in the markietplace.

It is interesting to speculate whether being secular would make the company more reflective and so less likely to embrace the market or whether being more worldly wise would make them more welcoming of the market. On the other hand does being religious and adopting belief on faith rather than evidence require more closed minded individuals - people more likely to do what it takes and not see the consequences; or will they be more committed to a life of serving others and so more resistant?

Click Here for an examination of BUPA


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More information

For Updates:- A good way to check for recent developments in aged care is to go to the aged care crisis group's search page and enter the name of the company, nursing home or key words relating to any other matter in the search box. Most significant press reports are flagged there. The aged care crisis web site has recently been restructured and some of the older links used from this site may not work.

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Web Page History
This page created Sept 2006 by
Michael Wynne
Update Oct 2007