Statement to ABC TV 7.30 Program
AACQA audit of Pioneer Lodge (December 2017 – January 2018)
Blue Care’s number one priority is the wellbeing and safety of our residents and we take all matters that relate to the quality of care and service we provide very seriously.
When Blue Care was notified by the Australian Aged Care Quality Agency (AACQA) earlier this year that our Pioneer facility had not met several quality standards between December 2017 and January 2018, we immediately took action to implement a comprehensive remediation plan at Pioneer in full consultation with the AACQA - who have been visiting Pioneer regularly since that time.
Blue Care has sincerely apologised to Pioneer residents, their families and the community of Bundaberg for the quality and practice failures identified at Pioneer during the AACQA audit and we are continuing to work collaboratively with the AACQA to ensure Pioneer swiftly returns to delivering the high standard of care that residents and their families rightly expect from us.
Blue Care senior management and staff have been working closely with external advisers to implement numerous improvements to systems, processes and practices at Pioneer, including the engagement of a senior industry nurse adviser.
As 7.30 has noted, one of the findings of the ACCQA report related to Pioneer’s inability to demonstrate residents’ nutrition and hydration needs were being consistently met. Following the audit we immediately addressed this by strengthening our nutrition and hydration monitoring mechanisms.
Our comprehensive remediation action plan at Pioneer has been underway for several months and is now very well progressed, and feedback from Pioneer residents and their families has been positive. Auditors from the AACQA revisited Pioneer on Tuesday 27 March and provided very positive feedback on the improvements we have made.
Staffing levels at Pioneer Lodge
The intensity of nursing care required by residents, also known as ‘acuity’, varies greatly between individual residents and facilities, and constantly fluctuates; therefore Blue Care must apply flexible staffing models that can deliver an appropriate skills-mix for the changing occupancy levels and changing needs of residents at each individual site.
As part of this process of continuous review and adjustment, we reduced the number of nurses employed at our Pioneer facility by three in August of 2017 (representing a 4% reduction in Pioneer’s total number of 76 employed care staff at the time). The mix of care staff employed at Pioneer at the time of the AACQA audit in December 2017 and January 2018 included a mix of Registered Nurses (RNs), Endorsed Enrolled Nurses (EENs), Enrolled Nurses (ENs), Assistants in Nursing (AINs) and Personal Carers (PCs).
While the number and mix of staff employed at Pioneer has always been in line with Australian aged care sector averages, the AACQA audit identified that rosters were not being managed in a way that ensured Pioneer’s available skill-mix was being deployed to consistently meet the needs of Pioneer residents; these management and rostering issues have since been swiftly addressed. Supervisory nursing staff (Registered Nurses and/or Clinical Nurses) are now rostered on to all shifts at Pioneer.
The concept of mandated staff ratios in residential aged care has been circulating for many years, however there remains no substantive evidence that they achieve better health outcomes for residents.
The Productivity Commission has also previously noted that “while there are superficial attractions to mandatory staffing ratios, there are also downsides. An across-the-board staffing ratio is a fairly ‘blunt’ instrument for ensuring quality care because of the heterogeneous and ever changing care needs of aged care recipients - in the Commission’s view it is unlikely to be an efficient way to improve the quality of care. Because the basis for deciding on staffing levels and skills mix should be the care needs of residents, it is important that these can be adjusted as the profile of care recipients’ changes (because of improvements/deteriorations in functionality and adverse events, etc).”
Medication and Personal Carers (PCs)
As is standard practice across Australia’s aged care sector, our personal carers assist with non-complex and low-risk medications, which is permitted under federal and state legislation and regulations that govern the administration of medication. Our Registered Nurses (RNs) have special responsibility for the administration of complex and high risk medications.
Janice Williams’ mother
Regarding the claims put to Blue Care by 7.30 on behalf of Janice Williams, Blue Care greatly sympathises with Ms Williams regarding the passing of her mother, however refutes any suggestion that the actions of Blue Care Pioneer staff contributed to her mother’s death.
Upon admission to our Pioneer facility in 2016, Ms Williams’ mother had high clinical care needs due to multiple pre-existing medical conditions.
Following observation and advice from Blue Care Pioneer nurses, Ms Williams’ mother was admitted to hospital to treat an infection where she received care for several days prior to her passing.