Showing posts with label aged care. Show all posts
Showing posts with label aged care. Show all posts
Monday 26 August 2019
Morrison Government's understanding of human rights and aged care appears flawed
"Restrictive practices can elicit concern for a number of reasons. Fundamentally, they impact on the liberty and dignity of the care recipient. In circumstances where they are not absolutely necessary, their use is likely to sit uncomfortably for many. Their use without lawful consent may infringe the resident’s legal rights and constitute a civil or criminal offence, such as assault or false imprisonment, although there are very few cases in Australia where a criminal or civil complaint has been pursued to challenge the use of a restraint in an aged care setting. Physical and chemical restraint can have significant adverse effects on a resident, both physically and psychologically. There are also fundamental questions about their effectiveness." [Royal Commission into Aged Care Quality and Safety, Background Paper 4, May 2019]
9 News, 20 August 2019:
The Commonwealth government recently introduced changes aimed at limiting the use of restraints in residential facilities.
But experts believe the regulations have created many more problems than they solved.
They are urging the Commonwealth to scrap the regulations and start again from scratch.
Queensland's public guardian Natalie Siegel-Brown said the changes placed her agency and the community in a "really compromising" position.
"Unfortunately in their current form, the principles actually regress the recognition of human rights of people living in aged care, particularly with respect to chemical restraints," she told the committee in Sydney on Tuesday.
"But the entire suite itself lacks any monitoring, enforcement or oversight in any event, and this can lead to greater problems."
Colleen Pearce, from the Victorian Office of the Public Advocate, said aspects of the regulations were flawed and ambiguous.
"We consider the principles are inconsistent with people's human rights (and) would preferably be contained in legislation,"
Dr Pearce told the committee. "(The principles) introduce, in the case of physical restraints, a new flawed and ambiguous substitute decision-making regime, provide virtually no regulation of chemical restraint usage, and lack the safeguards of other restrictive practices regulatory schemes."
Joseph Ibrahim, the head of the Health Law and Ageing Research Unit at Melbourne's Monash University, described the regulations as stupid.
"There is no monitoring mechanism, there are no sanctions associated, there is no way of implementing or making sure the law comes into effect," Professor Ibrahim said.
A group of advocates believe the government should be prohibiting the misuse of restraints and over-medication, rather than regulating them.
They argue medication should only be used for therapeutic practices and be administered with a patient's free and informed consent.
The group includes Aged and Disability Advocacy Australia (ADA) and Human Rights Watch, both of which addressed the hearing on Tuesday.
"Older people in nursing homes are at serious risk of harm if this new aged care regulation is allowed to stand as is," ADA chief executive Geoff Rowe said.
"Australia's parliament should act urgently to ensure that everyone, including older people, is free from the threat of chemical restraint.".....
The Canberra Times, 21 August 2019:
New rules on the use of restraints in aged care could lead to more elderly residents being sedated, a parliamentary inquiry has heard.
The regulation is also unenforceable, and does nothing to relief the staffing pressures that have led to the use of restraints, expert witnesses have said.....
Professor Joe Ibrahim from Monash University's Health Law and Ageing Research Unit said the regulation also did not recognise the pressures within aged care that forced staff to use restraints.
"Staff restrain residents to get through their day because they don't have enough hands to get through what's needed or they don't have the skills, knowledge, ability to assess why a person has responsive behaviours or unmet needs to address that," Professor Ibrahim said.
"A law that isn't monitored, has no sanctions, no way of checking, it will drive practice underground."
Queensland Nurses and Midwives Union professional officer Jamie Shepherd said he knew of a case where one registered nurse had to administer medication to 166 residents on night shift, and management resisted rostering on an enrolled nurse to help until the RN threatened to call an ambulance each night to assist.
Australian Nursing and Midwifery Federation federal professional officer Julie Reeves said through a recent member survey, she learnt of an aged care home where there were just six staff rostered on overnight to look after 420 residents.
"We cannot always effectively manage challenging behaviour issues for dementia residents while at the same time caring for others who have very complex health issues.
We receive little to no support from management when things don't go as planned," she quoted the member as saying.
Australian Human Rights Commission president, Emeritus Professor Rosalind Croucher said while parts of the regulation had merit, it should not be allowed to proceed unless there was a mechanism for independent oversight. "If it's a choice of it or nothing, nothing might be better than it as it is," Professor Croucher said....
Physical restraining devices currently allowed in Commonwealth-funded aged care facilities are:
Bed rails
Chairs with locked tables
Seat belts other than those used during active transport
Safety vests
Shackles
Manacles
[my yellow highlighting]
Chemical restraint is any medication or chemical substance used for the purpose of affecting a person's behaviour, other than medication prescribed for the treatment of, or to enable treatment of, a diagnosed mental disorder, a physical illness or a physical condition.
Use of chemical restraint is specifically excluded from assessment in the National Aged Care Mandatory Quality Indicator Program. [See p.15]
BACKGROUND:
Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019
Monday 22 July 2019
What many frail aged Australians can expect if they enter a nursing home - maggots, rotten food and a starvation diet
ABC
News,
16 July 2019:
PHOTO:
Pictures supplied to ABC investigations as part of a crowdsourcing
project on food in aged care. (Supplied)
…..Cutting corners
Earlier,
a roundtable of three chefs with almost 100 years of experience in a
range of aged care services and kitchens between them suggested an
answer to why food standards were so poor.
The
commission heard the quality of aged care menus — described by one
panellist as "the one thing [residents] get to look forward to"
— came down to what the facility paid per resident.
For
$16 a day, the residents of the unnamed facility Lindy Twyford
manages were served salt-and-pepper squid, fillet mignon, and
occasional portions of frozen but high-quality produce.
At
the other end of the spectrum, a home spending $7 would rely on
secondary cuts of meat and mass-ordered vegetables, some of which
would be thrown out at the expense of serving sizes.
"You're having to cut corners, you're having to use frozen foods, you're having to use processed foods just to feed residents," chef Nicholas Hall said.
Mr
Hall said food costs at some facilities he formerly worked at were
inflated by an ordering system beyond supermarket prices, in one
instance by as much as 100 per cent.
Chef
Timothy Deverell raised concerns about the lack of training to create
texture-modified foods, menus that had no input from residents until
they complained, and food served on open-air trolleys that was often
cold by the time it reached some residents.
Some
homes would place food orders using a "restrictive" system
in which a drop-down box offered just a handful of options, Mr Hall
said.
Facilities
would opt for finger food platters because they were "low-risk",
cheap, and didn't require a chef.
Some
meals would be repeated up to three or four times a week as providers
made a bid to reduce costs.
"They're racing to the bottom to see who can feed for the lowest amount of cost," Mr Hall said
Maggots, rotten food
The
commission was also told of one "upmarket residential aged care
facility" which had a maggot-infested rubbish store between
service trolleys and a nearby fridge containing enough rotten food to
fill a trailer.
"[I've
seen] reusing food that's already been out, served to residents and
come back to the kitchen," Mr Deverell said.
"They
use that for texture-modified diets."
Mr
Hall said food safety audits were too infrequent and services were
given advance notice, meaning extra cleaners could be hired to bring
facilities up to scratch.
He
said nutritionists failed to properly engage with residents and their
needs…..
Labels:
aged care,
elder abuse,
food,
human rights,
royal commission
Tuesday 4 June 2019
The National Disability Insurance Scheme continues a bumbling problem-filled roll out during which its clients suffer
Newcastle
Herald Sun,
31 May 2019:
AT least 3000 NDIS
recipients from regional NSW and Victoria will have to find new care providers
after mutual company Australian Unity decided to cut back on disability
services to concentrate on aged care in Sydney.
Australian Unity
confirmed the decision after concerns were raised with the Newcastle
Herald by the Public Service Association.
It did not dispute an
assertion by PSA regional organiser Paul James that the decision was a
consequence of the financial pressures facing NDIS providers.
The decision comes just
three years after Australian Unity bought the NSW Government's Home Care agency
in February 2016, picking up 4000 former government employees and 50,000 aged
care and disability clients.
Australian Unity said it
would "work closely" with the National Disability Insurance Agency
(NDIA) to ensure NDIS participants found "another service provider of
their choice".
It said 57,000 clients
on aged care packages would not be affected.
It did not expect the
NDIS decision to cause job losses but Mr James questioned how this could be.
"Even if they say
the majority of their clients are unaffected, there's still 3000 people in
regional areas who will have to find new providers," Mr James said.
"The NDIS was
originally supposed to be helping people with disabilities into work, but
instead it's become an opportunity for the states to ditch their
responsibilities for disability services."
Australian Unity said
the decision to "scale down" its NDIS services came after a review of
its "Home and Disability Services" business - as it renamed the
former Home Care agency.
According to
the Dept.
of Human Services (recently renamed Services Australia) In NSW as of 31 March
2019:
101,963 people
have a NDIS service;
4,219 initial
plans have been approved; and
34,397 people
will be receiving services for the first time.
While according
to the National
Disability Insurance Scheme (NDIS), 12 April 2019:
There are now 250,000 participants nationwide;
Almost one in three of these participants are receiving
disability supports and services for the first time; and
Costs to NDIS clients for individual service delivery have
risen between 10.9 per cent and 20.4 per cent from 1 July.
This price rise will include a minimum rise of almost $11 per hour for therapists, and up to a 15.4% price increase to the base limit for attendant care and community participation and appears to be driven by the demands of service providers.
The number of NDIS participants is set to rise to 460,000 at full roll-out in 2020.
This price rise will include a minimum rise of almost $11 per hour for therapists, and up to a 15.4% price increase to the base limit for attendant care and community participation and appears to be driven by the demands of service providers.
The number of NDIS participants is set to rise to 460,000 at full roll-out in 2020.
…delays
in the rollout of NDIS plans, the bureaucratic maze that even the most capable
of carers or people with disability struggle to get through, and the
difficulties that people with plans have in accessing services that are not
there have
resulted in long wait times and crisis intervention is virtually non-existent.
Due to the
demand for home care packages, for most people, the expected wait time for
approved packages is:
www.myagedcare.gov.au |
The expected wait time for the level of interim package you agree to receive (while waiting for your approved level to be assigned) is:
www.myagedcare.gov.au |
The conclusions drawn was that the NDIS scheme was administratively under-resourced for the rollout task, however there were a number of areas where NDIA could improve its administration of participant-initiated reviews. Otherwise the review process would remain unwieldy, unapproachable and the driver of substantial complaint volumes.
If you are in New South Wales and have a complaint about a support or service you have received under the NDIS, you can contact the NDIS Quality and Safeguards Commission.
Monday 8 April 2019
The Morrison Government's Budget 2019-20 appears to be fooling very few
By 26 August
2018 North
Coast Voices was posting this……
On this
list are individuals who have:
* not yet
been approved for home care;
* been
previously assessed and approved, but who have not yet been assigned a home
care package; or
* are
receiving care at an interim level awaiting assignment of a home care package
at their approved level.
Waiting
time is calculated from the date of a home care package approval and this is
not a an ideal situation, given package approval times range from est. 27 to 98
days and the time taken to approve high level home care packages is now [more] than twelve months - with actual delivery
dates occurring at least 12 months later on average….
By June 2017 New South
Wales had the largest number of persons on the home care waiting list at
30,685.
Given the high number of
residents over 60 years of age in regional areas like the Northern Rivers, this
waiting list gives pause for thought.
This was the
Morrison Government announcement of 17 December 2018 reported online…….
Community
Care Review
magazine, 17 December 2018:
The federal government
has announced $553 million in aged care spending including the release of
10,000 home care packages and increased residential supplements for the
homeless and people in regional areas.
The splash-out is a
centerpiece of the federal government’s Mid Year Economic and Fiscal Outlook,
which forecasts a return to budget surplus and a raft of new aged care spending
initiatives.
The new high-care home
care packages will be available within weeks, Prime Minister Scott Morrison
said. Funding will be split across 5,000 level 3 and 5,000 level 4 care
packages, providing up to $50,000 per person in services each year.
This is the Morrison
Government pretending that the 10,000 aged care packages it announced last year
are a new round of age care packages in Budget 2019-20……
Budget Papers 2019-20:
To support older
Australians who choose to remain in their own homes for longer, the Government
is providing $282.4 million for 10,000 home care packages….
However, not everyone
was fooled……
The
Conversation,
2 April 2019:
In aged care, the government
will fund 10,000 home care packages, which have been previously announced, at a
cost of $282 million over five years, and will allocate $84 million for carer
respite. But long wait times for home care packages remain.
Tuesday 12 February 2019
The lies Liberals tell on the subject of aged care
The
Australian, 7
February 2019:
Aged Care Minister Ken
Wyatt was handed a departmental briefing report showing the “winners and
losers” from the Coalition’s $2 billion savings drive in the aged-care sector
shortly after Scott Morrison announced a royal commission and denied funding
cuts.
Documents obtained by
The Australian under Freedom of Information laws show the proportion of
“losers” almost tripled to 53 per cent following the budget savings revealed in
late 2015.
In the three-year period
to 2018, aged-care services that had been classified as “winners” almost halved
to 47 per cent, according to the brief sent to Mr Wyatt.
A series of “hot issue
briefs, question time briefs and general briefs” sent to Mr Wyatt last year
acknowledged the budget hit to the Aged Care Funding Instrument — which is the
basic taxpayer care subsidy paid to all nursing homes — together with
“increasing cost pressures will be putting pressure on the sector”.
Mr Wyatt was also made
aware of reports of “cut backs to staffing”. At a press conference announcing
the royal commission into aged care in September, the Prime Minister was questioned about two cuts to the
ACFI in the 2015 mid-year economic update and the 2016 budget but denied any
had been made.
“No, no, the Labor Party said that. I don’t accept that,”
he said.
Two days later, a question time brief prepared for Mr Wyatt offered advice on
what to say if asked about funding cuts to ACFI.
The ministerial brief
also contains a breakdown of funding changes by domain, revealing that average
annual taxpayer subsidies per resident increased by just $400 between 2016-17
and 2017-18 despite the growing frailty and complexity of Australians as they
enter residential aged care older than ever before.
For the first time,
funding for the two areas that provide extra boosts for nursing home residents
with significant behavioural problems and complex healthcare requirements went
backwards by $300 a person.
The peak body for
aged-care providers, ahead of the April 2 budget, has urged the Coalition to
include an additional payment of almost $700 million each year.
“This estimate reflects
a range of factors, including the value of foregone indexation (through ACFI),”
Leading Age Services Australia (LASA) says in its pre-budget submission, seen
by The Australian. “This is approximately a 5.2 per cent increase in
residential care funding in 2019-20, noting that this is difficult to calculate
as forward estimates for residential and home care are no longer separately
reported.” LASA said it considered the money to be a “down payment” and a
notably larger funding boost might be needed following the findings of the
royal commission.” The commission, which is due to release its interim report
in October and the final version by the end of April 2020, has already
highlighted the widespread industry practice of “doping” nursing home
residents, which doctors, nurses and consumer groups attribute to overworked
staff. [my yellow highlighting]
Friday 1 February 2019
Scott Morrison and his cronies want to buy your vote ahead of the May 2019 Australian federal election
Despite there being a growing urgency to invest in the full range
of climate change mitigation measures, in the face of evidence
that it is going to take billions of dollars to step back from the developing
environmental, social and economic disaster developing in the Murray-Darling
Basin, regardless of constant cost cutting in the welfare
sector leading to a fall in services for older Australians and those
with disabilities, while all the while failing to confront a growing
public debt which now stands at est. 679.5 billion, the Morrison
Lib-Nats Coalition Government intends to try and buy votes ahead of
the May 2019 federal election.
Brisbane
Times, 28
January 2019:
The Morrison government
is now more focused on protecting its electoral chances than the nation's
finances with claims it is going on a pre-poll spending spree based on a
short-term boost in tax collections.
Deloitte Access
Economics said in a quarterly report out on Tuesday that Scott Morrison is
looking to buy back disappointed voters, with the government sitting on $9.2
billion worth of tax cuts and handouts that were included in the December
mid-year budget update but not announced.
Deloitte Access partner
Chris Richardson said the government had promised $16 billion in extra spending
and tax cuts in the past six months, the biggest short-term spend by a
government since Kevin Rudd in 2009 in the depths of the global financial
crisis.
He said with the budget
in a reasonable condition on the back of strong global growth and a surge in
company tax profits, the Morrison government had made a decision to woo back
voters with taxpayers' cash.
"Of late, the
government has been busily taking decisions that add to spending and cut taxes,
thereby worsening the bottom line rather than repairing it," he said.
"After all, they've
got the dollars to do it, they're behind in the polls and the election is just
around the corner.
"That powerful
combination of motive and opportunity means that the government's focus has
shifted to shoring up its electoral standing rather than shoring up the
nation's finances."
News.com.au, 24 January 2019;
Pensioners and some
families could receive one-off cash payments from the Morrison government in a
pre-election sweetener.
Senior advisers are
looking at two one-off payments that could be included in the April 2 budget,
the Australian Financial Review reported on Thursday.
If the government
decides to go ahead with the plan, the payments could be distributed before the
federal election, which is due by mid-May.
The first option is a
one off handout to age pensioners and the second is a cash injection for
families.
It’s believed the single
payments would be aimed at luring those who won’t directly benefit from the
Coalition’s $144 billion personal income tax cuts being phased in over the next
six years.
Monday 21 January 2019
Australian Royal Commission into Aged Care Quality and Safety now underway
Commencing in
2016-17 when Australian Prime Minister and Liberal MP for Cook Scott Morrison was then just the Federal
Treasurer he cut $472.4 million from Aged Care funding over four years, then
followed that up with a $1.2 billion cut over the same time span.
When deteriorating
conditions in nursing homes around the country began to be reported in the
media and the Oakden scandal came to light in 2017, concerned citizens began to call for a royal commission.
The Liberal
Minister for Aged Care and Liberal MP for Hasluck Ken Wyatt was of the opinion that such an inquiry would be “a waste of time and money”.
Once Scott
Morrison realised that ABC Four Corners was about to air an exposé on aged care provision he quickly changed his mind and announced the Royal Commission into Aged Care
Quality and Safety on 16 September 2018.
The Royal Commission
into Aged Care Quality and Safety was established on 8 October 2018
by the Governor-General of the Commonwealth of Australia, His Excellency
General the Honourable Sir Peter Cosgrove AK MC (Retd).
The Honourable
Richard Tracey AM RFD QC and Ms Lynelle
Briggs AO have been appointed as Royal Commissioners…
The Commissioners are
required to provide an interim report by 31 October 2019, and a final
report by 30 April 2020…
The Commissioners were appointed to be a Commission of inquiry, and
required and authorised to inquire into the following matters:
a. the quality of aged care services
provided to Australians, the extent to which those services meet the needs of
the people accessing them, the extent of substandard care being provided,
including mistreatment and all forms of abuse, the causes of any systemic
failures, and any actions that should be taken in response;
b. how best to deliver aged care services
to:
i.
people with disabilities residing in aged care facilities, including
younger people; and
ii.
the increasing number of Australians living with dementia, having regard
to the importance of dementia care for the future of aged care services;
c. the future challenges and opportunities
for delivering accessible, affordable and high quality aged care services in
Australia, including:
i.
in the context of changing demographics and preferences, in particular
people's desire to remain living at home as they age; and
ii.
in remote, rural and regional Australia;
d. what the Australian Government, aged
care industry, Australian families and the wider community can do to strengthen
the system of aged care services to ensure that the services provided are of
high quality and safe;
e. how to ensure that aged care services
are person‑centred, including through allowing people to exercise greater
choice, control and independence in relation to their care, and improving
engagement with families and carers on care‑related matters;
f. how best to deliver aged care services
in a sustainable way, including through innovative models of care, increased
use of technology, and investment in the aged care workforce and capital
infrastructure;
g. any matter reasonably incidental to a
matter referred to in paragraphs (a) to (f) or that [the Commissioners] believe
is reasonably relevant to the inquiry.
A preliminary
hearing was held in Adelaide on 18 January 2019.
At this
hearing the Commissioner Tracy stated
in part:
The
terms direct our attention to the interface between health, aged care and
disability services in urban, regional and rural areas. These issues
necessarily arise because of Australia’s changing demography. We are also
required to look at young people with disabilities residing in aged care
facilities and do our best to deliver aged care services to the increasing
number of Australians living with dementia. Part of our task is to examine
substandard care and the causes of any systemic failures that have, in the
past, affected the quality or safety of aged care services. We will consider
any actions which should be taken in response to such shortcomings in order to
avoid any repetition. This will necessarily involve us in looking at past 25
events. There have been a number of inquiries which have considered matters
that, in certain respects, fall within our terms of reference. We are not
required by the Letters Patent to inquire into matters which we are satisfied
that have been, is being or will be 30 sufficiently and appropriately dealt
with by another inquiry or investigation or a criminal or civil proceeding. As
a general rule, we do not intend to re-examine matters which have been
specifically examined in previous inquiries. We do, however, expect to examine
the changes and developments which have followed previous inquiries, as well as
the extent to which there has been implementation of recommendations from those
inquiries. Where we have different views, they will be made known.
According to ABC
News on 18 January 2018: Out of almost 2,000 Australian aged care
providers invited to shed light on the sector ahead of the royal commission,
only 83 have been forthcoming with information, the Adelaide inquiry was told.
The
Guardian on
18 January reported: Counsel assisting Peter Gray said the
commission had received more than 300 public submissions since Christmas Eve
and 81% concerned provision of care in residential facilities, with staff
ratios and substandard care the most common themes. The
federal health department has also passed on 5,000 submissions it received
before the commission’s terms of reference were set.
Commission will continue to accept submissions until at least the end of June
2019.
Details on how to make a submission can be found here.
Labels:
aged care,
elder abuse,
Health Services,
human rights,
neglect,
royal commission,
violence
Saturday 29 September 2018
Quotes of the Week
“There are some
people who seem to find it a very funny circumstance that last week, in full
daylight, and in a main street of Cooktown, two black troopers, with their
clothes in the same condition as those of a clumsy butcher’s apprentice, fresh
from the shambles, exhibited a naked black girl, not twelve years old, as their
newly caught prize. This young slave, taken by force . . . has since been
transferred, either for payment or as a gift, to a citizen in this town, whose
property she has now become. What were the circumstances that attended, or
immediately followed, her capture we do not know, nor do we very much care to
inquire ...” [ Journalist
& author Carl Feilberg writing
in the Cooktown Courier in January 1877 ]
“Adding a new level of fear and uncertainty onto that with the findings coming out of a royal commission is going to harm the community as well as the industry,” [CEO Clarence Village Ltd Duncan McKimm acting as an apologist for the aged care industry in The Daily Examiner ahead of the Royal Commission into Aged Care Quality and Safety]
“Adding a new level of fear and uncertainty onto that with the findings coming out of a royal commission is going to harm the community as well as the industry,” [CEO Clarence Village Ltd Duncan McKimm acting as an apologist for the aged care industry in The Daily Examiner ahead of the Royal Commission into Aged Care Quality and Safety]
Labels:
aged care,
Australian society,
history,
human rights,
racism,
royal commission,
violence
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