Families’ dismay at aged care staffing

dsc_0156Major under-staffing issues at the Bupa Aged Care Facility in Tumut are seriously impacting both residents and staff, community members say.

The Times spoke to former Bupa staff members and family members of residents at Bupa, who reported medications being mixed up, residents not being fed, food going cold by the time it is brought out, buzzers going unanswered, inexperienced staff members unable to cope with high-care patients, unclean facilities with sticky floors and dusty surfaces, and nurses being punished by management for speaking out.

Sources paint a picture of hard-working staff who are trying to do the best they can for the residents, but are simply unable to do so due to their heavy workload.

“Those girls are really under a lot of pressure – there’s been times I’ve gotten up and helped out [during dinner],” said Linda Candotti, whose mother and father are both in Bupa.

“The staff are just wonderful but there’s not enough of them. Morale is very low, and I think it’s a combination of being overworked and also having no leadership.

“Without the staff that place would be atrocious, because it’s the staff that are keeping people happy. I get concerned about them because honestly they don’t have the time to even sit and have a conversation sometimes.

“I’m not blaming them, but it’s very frustrating as a carer and a family member when sometimes you’ll go in there and there’s no one to be seen. The place is deserted. If you ring up, it often rings out – that’s really frustrating.”

According to the NSW Nurses and Midwives Association (NSWNMA), Bupa Tumut has been short-staffed every week for seven weeks.

They have also cut down other services, such as occupational therapy, physiotherapy, and massage. At the same time, their fees have gone up.

Ruth Deaner was employed by Bupa for her aromatherapy and massage services for over 13 years until she was cut this year.

“They’ve cut as much as humanly possible. They’ve cut it to the bone,” she said.

“I seriously think that Bupa is just about the money. They don’t care about the residents at all. It’s not the staff, the staff are doing the best they can, but when they’re underpaid and understaffed, what can they do?

They’re in a very insecure environment – they don’t know when another one of them is going to be cut.”

Mrs Deaner said that when residents and family members asked why she was no longer employed by Bupa, management told them she had voluntarily resigned.

Another woman, who preferred to remain anonymous due to fears of retaliation, said that when she complained to management about her mother’s care, her mother was moved to another room away from her friends – which she believes was a response to her outspokenness.

She too had complained about the lack of staff at the centre, noticing that her mother’s buzzer would take a minimum of twenty minutes to be responded to, and that particularly on weekends and evenings the staff on were incapable of meeting all of the patients’ needs.

“Bupa advertises 24/7 care – it’s not 24/7 care,” she said.

“Why are there so many falls? There’s accidents and things, sure, but up there someone falls basically every day. There’s too many falls for 24/7 care.

“They’re neglected – a lot of the accidents up there could have been prevented.”

There is currently no regulation in place specifying staffing levels in aged care homes in Australia. Commonwealth legislation states that “an adequate number of appropriately trained staff” must be rostered on in aged care facilities, but it is up to providers such as Bupa to decide what an “adequate number” of staff is, and what level of training is “appropriate”. For this reason there are massive disparities in staff-to-patient ratios in aged care homes across Australia.

At Bupa, a full staffing roster (as of two years ago), means ratios between a high of one staff member to approximately five patients in the high care sections on weekday mornings, to one staff member per fifteen patients in the mixed care Alpine wing. In the Snowy wing for dementia patients there are two staff members for approximately eighteen patients, along with an Endorsed Enrolled Nurse, until 10pm, and at night there are four staff members and one registered nurse for the whole facility. The Times is not aware if these numbers have changed recently.

According to the NSWNMA Bupa Tumut has not been meeting their own staffing goals.

Former nurses at Bupa also said that over the past two years the structure at Bupa has become increasingly top-heavy, with more managers and less staff working on the floors. There have been four changes in the care manager position in the past two years, which has reportedly had a disruptive effect and lowered morale. Wings which were previously divided into low-care and high-care residents have become mixed, without corresponding changes in staffing to meet changes in need.

As a result, upwards of ten nurses have moved from Bupa to Blakeney Lodge in the past two years, where the pay is $1.22 to $1.82 an hour higher depending on experience and training and staffing levels are higher.

A Bupa spokesperson attributed the alleged issues at the home to teething issues.

“We are very open to feedback from our employees, residents, their families and the community in general regarding how we can deliver the best level of care at Bupa Tumut,” they said.

“Over the past few years, we have implemented an industry leading model of care across our homes that increases the quality and access to clinical care for our residents and creates more career progression opportunities for our team.

“Our home in Tumut recently implemented this new model of care which has resulted in some changes within the home, all focused on delivering better health outcomes for our residents.

“We acknowledge with the changeover in leadership in the home, that our communication during the rollout of our model of care could have been better and we are committed to open and clear communication in the future.”

They said Bupa is aware of the importance of adequate staffing levels in their facilities.

“We have recently matched staffing levels to occupancy rates in some areas of the home and have increased clinical oversight as we know this is the best way to provide quality care for our residents. We have registered nurses available on a 24-7 basis, team members are trained in our model of care and we review the staff allocations daily to ensure the skill mix is appropriate for the care required,” they said.

Tumut residents Sue and David Smart have been lobbying Bupa locally to put more staff on.

They say they have seen the care level significantly diminish since they first moved Mrs Smart’s mother into the facility three years ago. (Her father is also now a resident.)

“[My parents’] circumstances changed so that they needed more care, and the staffing didn’t change to reflect that,” Mrs Smart said.

“I have written letters, I’ve had meetings, but nothing happens. Afternoons are a blackspot, weekends – they certainly don’t need less care on weekends, but there’s less staff.

“We’re not critical of the staff, it’s the system that’s letting the staff and the patients down.”