The ANMF has welcomed six recommendations outlined in a special report released by the Royal Commission yesterday calling on the federal government to urgently support the aged care sector to manage COVID-19 but says the measures fail to address chronic understaffing and skills mix and do not go far enough to protect vulnerable older Australians living in nursing homes.
The Aged Care Royal Commission’s special COVID-19 report, drawn from evidence given at a hearing held in August investigating the sector’s response to the pandemic, says residents, their families and aged care staff have suffered the most from the “greatest challenge” Australia’s aged care sector has faced.
“The Interim Report noted that the aged care workforce is under-resourced and overworked. It is now also traumatised,” the commission says.
The report found the federal government did not have a COVID-19 plan devoted solely to aged care and that the measures it implemented, on advice from the Australian Health Protection Principal Committee (AHPPC), which is chaired by Australia’s Chief Medical Officer Dr Brendan Murphy, were “insufficient” to prepare the aged care sector to respond to the pandemic.
“Confused and inconsistent messaging from providers, the Australian Government, and State and Territory Governments emerged as themes in the submissions we have received on COVID-19. All too often, providers, care recipients and their families, and health workers did not have an answer to the critical question: who is in charge? At a time of crisis, such as this pandemic, clear leadership, direction and lines of communication are essential,” the report states.
The special COVID-19 report makes six recommendations, which commissioners say need urgent implementation to support the aged care sector.
The recommendations include establishing a national aged care plan for COVID-19 and an aged care advisory body, deploying accredited infection control experts to all nursing homes, and creating Medicare Benefits Schedule (MBS) items to increase the provision of allied health services, including mental health, to people living in aged care during the pandemic.
Commissioners said evidence during the COVID-19 hearing revealed insufficient infection control training in the use of PPE was “completely inadequate” in the context of a pandemic.
Under their plan, the ideal model would involve each nursing home having at least one dedicated ‘infection control champion’.
“We heard of workers being told they could only use one glove rather than two and a guideline at a residential aged care facility that only permitted two masks per shift. This is deplorable,” the report says.
Another key recommendation calls on the Australian Government to increase funding to providers so that they can ensure there is adequate staff to maintain visits to people living in nursing homes from families and friends.
The report argues providers should not be left to divert staff from the care of activities that residents require to facilitate increased visits.
It says providers must also continually review and revise their visitation policies in line with changing circumstances and ensure residents continue to enjoy normal lives.
“They [residents] should certainly not find themselves in their more vulnerable days facing their fears of the pandemic without the comfort and support of their friends and families.”
In launching a COVID-19 aged care plan and aged care advisory body, commissioners say the plan should establish better protocols between the Australian Government and States and Territories, maximise the ability for people living in aged care to have visitors and maintain links with loved ones, and establish protocols on who makes decisions regarding the transfer of COVID-19 positive residents to hospital.
“It is critical that there is a body responsible for monitoring and planning for health emergencies as they apply to the aged care sector,” the report found.
“There is a need for a body with a particular focus on the group of people most vulnerable to this [pandemic] and other infectious diseases to provider regular and timely practical information to the aged care sector.”
While the ANMF welcomed the Royal Commission’s six recommendations, it says the measures fail to address dangerously inadequate levels of qualified nurses and care staff with the right skills mix.
“Nursing homes desperately need additional nurses and care staff to provide safe, effective care outcomes for residents, not just to enable more visitors,” ANMF Federal Secretary Annie Butler said.
“While that is critical for the wellbeing of residents, more staff are urgently needed just to meet basic needs for residents in far too many nursing homes.”
“Our members have been on the frontline during the pandemic and have witnessed how it has stretched staff and resources even further, again demonstrating the importance of having sufficient staffing levels and skills mix to cope with intensified demands and workloads.”
Ms Butler said there had been more deaths and higher rates of COVID-19 in Victoria’s privately-run nursing homes, who set their own staff ratios, than state-run facilities, which have mandated minimum staffing levels, including registered nurses on every shift.
“We welcome the recommendation for immediate additional funding but reiterate the need for greater transparency for any additional Government funding, because aged care providers must be held accountable and actually use the money for its intended purpose of employing additional nurses and carers for the depleted sector.”
Ms Butler said the ANMF especially welcomed recommendations by the Royal Commission requiring the Government to publish a national plan and establish an expanded national aged care advisory body made up of experts from the field rather than bureaucrats.
The Government has responded to the report and announced it will accept all six recommendations.
“We are pleased the Government will act on all the report’s recommendations, including the urgent need for one or more accredited infection control officers in nursing homes. The tragedies in Victorian and NSW nursing homes have sadly shown why aged care providers must have sufficient supplies of PPE and clear infection control guidance, education and supervision for all their staff, to better protect residents.”