TWO and half years of hearings before the Royal Commission into Aged Care have exposed shocking stories of neglect and abuse inside Australia’s residential aged care facilities – but perhaps the most shocking detail was left for last.
Almost 50 sexual assaults occur in care facilities across the country every week, senior counsel assisting, Peter Rozen, told the royal commission during his lengthy closing submission last week.
“Commissioners, this is a national shame,” Mr Rozen said.
“Many witnesses have explained they placed their loved ones into residential aged care because they felt it would be safer for them or because safety was a concern.
“It is therefore entirely unacceptable that people in residential aged care face a substantially higher risk of assault than people living in the community.”
Mr Rozen said the estimated number of incidents of “unlawful sexual contact” in 2018–19 was 2520, or almost 50 per week, including resident-on-resident assaults which were not reportable.
A 500-page report from the counsel assisting team outlines an ambitious plan for aged care that would abandon much of the current, broken system and build a new one.
It contains 124 recommendations including calls for a new Aged Care Act that would promise older Australians a right to safe and quality care
It proposes lifting the quality of staff in aged care through improved pay and providing more funding for education and training.
IT also demands a return of nurses to nursing homes – recognition that currently, most facilities aren’t required to have a minimum number of nurses on staff.
One registered nurse would be required on site per residential aged care facility during the busy daily shifts that make up 16 hours of each 24-hour cycle.
It also recommends mandated staffing ratios requiring registered nurses, enrolled nurses, and personal care workers for at least 215 minutes per resident per day.
There is also a proposal to replace the existing regulator with a new and independent Aged Care Commission.
The royal commission was in part sparked by the appalling treatment of residents at Adelaide’s now closed Oakden nursing home, but it opened a can of worms about conditions in every state.
As Prime Minister Scott Morrison warned when he launched the commission inquiry in September 2018 that we “brace ourselves for some pretty bruising information about the way our loved ones have been treated”.
As well as physical abuse, there were many instances of cruelty, neglect and simply poor care.
The commission heard testimony on chemical restraint in aged care, of the overuse of anti-psychotic drugs and in some instances, lack of accountability in prescribing them.
“In the future the system should never again be involved in this apparent resort to antipsychotics in place of proper care of people showing so-called challenging behaviour,” counsel assisting Peter Gray QC told the commission.
The recommendations include that only a psychiatrist or a geriatrician should initially be able to prescribe this class of medication before a GP could then provide repeats.
The state of the nation’s residential aged care crisis became clear as COVID-19 spread and those in nursing homes accounted for the highest proportion of sick and dying from the disease.
The media honed in on the distress of older Australians and their families as they were physically cut off and family visits banned.
In September, 83 residential aged care facilities in Victoria were active with COVID-19 cases.
A month earlier, in August, the royal commission heard that more than 1000 aged care workers in Victoria had tested positive to COVID-19, that masks were being kept in locked boxes with only one allowed for workers per shift, and that some providers didn’t have soap.
Overall the royal commission received more than 10,000 submissions from residents, their families, staff, providers and government agencies across Australia.
Some of Australia’s largest aged-care providers submitted tens of thousands of incident reports of abuse, neglect and poor care.
The commission has also heard from 641 witnesses, including 113 with direct experiences.
“We salute the courage of these witnesses for sharing the most intimate details of their lives to inform this inquiry,” Mr Rozen said.
He said at least one in five people receiving residential aged care had experienced substandard care.
“We submit that the evidence before the royal commissioners supports a finding that the level of substandard care being delivered in the current aged care system is far too high,” Mr Rozen said.
The commission’s council assisting recommended a radical overhaul aimed at lifting standards.
Part of the proposal is that specialised aged-care GPs should be created to visit older Australians at home or in care, with doctors opting to receive an annual fee instead of Medicare’s existing fee for service.