scone.com.auEditorial: Finding the Best Option for Care
MANY changes are occurring in the Aged Care sector and more will no doubt follow in the wake of the Royal Commission.
It is becoming more difficult with legislation and accreditation constantly evolving and in country areas staffing is a key concern.
Within the industry there is a move to require a registered nurse (RN) to be on site at all times, if this was introduced then smaller aged care homes across the country would have to close – it is something which may be an election issue and one to watch in communities like ours.
At Gummun Place they were unable to attract an RN to be on staff, much less have an RN on site at all times, but after Council brought in local consultant Jo Bailey from Quality Care, they were able to access RN coverage and in part under their expertise were able to ensure they kept accreditation. See story: Merriwa Aged Care Under Council Cloud.
The facility had been advised they may be sanctioned which is not to be taken lightly, it means the accreditation body has stepped in because the facility is not meeting aged care standards after three occasions and they will be sending in an administrator to take over.
During a sanction the facility is not allowed to take in any more new patients, but must maintain all services, which in a small facility with a thin operating budget can quickly become financially unviable. Thankfully under the guidance of an aged care specialist and access to a registered nurse, the facility achieved the accreditation needed.
The Staff
The staff at Gummun Place have worked hard to ensure their small facility was accredited.
Elizabeth Flaherty, editor of scone.com.au. Photo: Amanda Gaffney-Ray.
The people who work in aged care are an especially caring breed. The staff at Gummun Place are undoubtedly passionate people who work hard everyday to ensure the best care for our elderly. The bonds they form with residents is like no other in a health care setting with patients. Those bonds are arguably even stronger in aged care in small communities where there are many ties that bond them together.
Added to that the staff who work in these small local facilities can be there for decades, a rare find nowadays and it only builds on the strong relationships they form with the residents.
The recent pending sanction would have been incredibly distressing and under the leadership of a local private consultant brought in by Council, they rose to the challenge to ensure the facility remained accredited after the last inspection by assessors.
This would have been no mean feat for a small team. In large tertiary hospitals with plenty of staff they stress and struggle with the onerous demands of accreditation, so for a small team with the added stress of sanction their dedication is remarkable and they deserve praise.
Not for one moment should the staff members expertise and deep commitment to the residents and the facility be questioned.
But failures at the facility do rest somewhere and ultimately that is with the operator. It was after the private consultant was brought in to assist staff that they were able to get the facility back on track. Part of this assistance was access to a registered nurse, which is critical to provide the expertise in aged care that is needed. So, I question if a more formal arrangement should be made to have this expertise in place to support staff at all times, not just when there is a failure to comply.
Council’s approach
Council is the current operator of the facility and they have otherwise no expertise in aged care to support staff at the facility and clearly no first hand understanding.
I was staggered at a Council meeting in October last year when Cr Sue Abbott asked why there had been seven medication errors in one month at Gummun Place and even more gobsmacked by Cr Ron Campbell’s response a few months later that it was nothing serious just that sometimes patients don’t take a Panadol on time!
For anyone who works in health this rings HUGE alarm bells. Seven incidents at a 16 bed facility in only one month is significant, but moreover the flippant response by Cr Campbell, who has no expertise in health was extremely concerning. Justifiably Cr Abbott asked for specific reports on the medication errors, which should be readily available, to see the nature of the incidents but it was never tabled. After the question from Cr Abbott, the listing of incidents at the facility were noticeably missing in all future reports.
The downplaying of the pending sanction was also a serious concern.
Having the facility stay in government hands is fine if it is the NSW Department of Health or the Federal Department of Health, but our local Council with no expertise is a huge concern.
Alternatives
In speaking with Gummun Place board member Edith Shipway, who was imminently sensible in her approach to the future of the facility, she said the main focus was ensuring the facility remained open well into the future and that Council needed to be open with the community about all options.
While there are cases where small facilities are taken over by a large private operator and the care decreases, there are also cases where the private operators can turn facilities around.
In the case of Gummun Place it was when Council brought in such an operator, to provide expertise the Council does not have as the current operator, that they were re-accredited.
Perhaps the best alternative for Gummun Place is to find a proper aged care operator to run the facility completely and Council retain ownership of the building.
If the primary concern is the care of the elderly in our community and ensuring they can stay in their home town, then the best operator for that should be found and since Council as the current operator was nearly sanctioned it has to be questioned if they are the best option.
Interestingly Council came out publicly to say they have no plans to privatise the facility, but if they are considering the best future for Gummun Place, have put a draft plan out to the community for submissions and industry experts have said they should consider all options, then why have they ruled it?
Perhaps it was a knee jerk reaction in fear of public backlash with change?
The primary concern should be the best option for our elderly and there should be strong leadership that is prepared to put all options on the table and then discuss and weigh those options with the community.
Edith Shipway, a board member on Gummun Place has been vocal in making sure the whole community is aware of possible changes and it is the Merriwa community which has shown the most leadership in this process, they identified the advice from the industry expert to look at all options and realised the gravity of those few lines in a report, and they have rallied to hold Council to account and remain open minded on how the facility may run in the future, but completely committed to making sure it is in the best interests of local residents.
It is heartening to see the Merriwa community passionately supporting Gummun Place and the best interests of the residents.
I hope that the Council will take the opportunity to methodically explore all options for the facility and meaningfully engage with the community to make the future of the facility the best it can be for the residents.
Submissions on Gummun Place close on April 4, if you want a say on it’s future make a submission: Draft Aged Care and Disability Plan.
Elizabeth Flaherty
Editor, scone.com.au
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