Cracks in the system – Australia’s Aged Care Facilities at Risk, What Can We Learn?

residential care for elderly covid19

The aged care sector has been under a spotlight worldwide, but we are particularly keeping an eye on Australia as Coronavirus has brought with it uncomfortable questions for operators, the solutions, however, seem to be some way off no matter which country you look at.

COVID-19 has shone a bright light on problems in the sector with understaffing and insufficient training and there has been a lot of dialogue on how it may be a case of too little too late to effect change in the middle of a pandemic.

It was clear to see from overseas how devastating the virus could be in an aged care setting. Canada, US and the UK were all showing how bad it could get, New Zealand was relatively lucky in terms of numbers affected, but those clusters of the virus in aged care facilities here did have devastating consequences.

And the warnings were plain to see in Australia too.

It's been well-documented that the aged care sector with a reliance on workers who struggle to take days off for illness or work several jobs to make ends meet in turn increase exposure and transfer risk. They can become a direct line for Coronavirus to make its way into aged care homes.

The intended proactive approach by authorities in Australia to establish a risk assessment to identify aged care facilities that are more vulnerable to an outbreak of Coronavirus seems to have missed the mark. In Victoria, the Australian Medical Assistance Team has taken on the task of a national rapid response and advisory service dedicated to the management of aged care homes. Should the Federal Government and Aged Care Quality and Safety Commission have been doing more to prepare facilities with outbreak plans and to manage homes that were known to have failures in infection control as well as staff shortages?

What about here in New Zealand? The threat of community transmission remains while we are at Alert Level 1, and the management of staffing levels is crucial to keeping the virus contained.

The quality of care of the vulnerable is paramount and with it comes the responsibility to manage training, transparency and quality controls governing the management of the facilities. Care and protocols must be consistent. With nursing staff crossing over into other homes there remains a loophole that this virus may quickly fill.

The lack of sufficient clinically trained staff in some care homes and the frustration at the way RN expertise is utilised remains a concern. Enough experienced staff, ongoing training, outbreak plans and advisory teams all have one thing in common – lack of money. The way resources are used and allocated is a question that has been raised since the lockdown. Insufficient resources including enough clinically trained staff as well as personal care workers may well have been the reason for the number of deaths here in New Zealand and the ongoing situation in Australia.

While aged care has the element of public funding, it is effectively a private service and transparency and accountability have never been more vital. Data from all providers, independents and larger groups need to focus on this new environment where the gaps in the care of the elderly have had devastating results both here and worldwide.

Perhaps most importantly, now is not the time to remove the checks on arrival for all incoming visitors to aged care facilities. After all, as we have seen overseas, a second wave can start with just one super spreader.

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