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ROYAL COMMISSION: Bad care, poor reporting and lack of dignity

The first day of the Perth hearings for the Royal Commission into Aged Care Quality and Safety is examining person-centred care and listened to a case study of bad care, lack of dignity and poor reporting afforded to an 89-year-old man and his family during his time at Mitcham Aged Care Home in Adelaide.

Ms Noleen Hausler placed a camera in her father's room for eight days and found instances of abuse and rough handling from agency staff towards her father. [Source: Aged Care Royal Commission]
Ms Noleen Hausler placed a camera in her father's room for eight days and found instances of abuse and rough handling from agency staff towards her father. [Source: Aged Care Royal Commission]

Direct evidence was heard from Noleen Hausler, the daughter of Mr Clarence Hausler, who suspected her father with dementia was being mistreated and placed a camera in her father’s room for eight days in 2015, recording terrible instances of abuse.

The Royal Commission saw some of the footage of the rough care and abuse experienced by her father including one example of a carer force-feeding him, pinning his arms down, and even holding a napkin over his nose with excessive force, all within a 25 minute period.

When Mr Hausler entered the facility in 2002, the nursing home was under the operation of another company. The facility operation changed over to Japara Healthcare Limited in August 2014.

Ms Hausler said the care given to her father before Japara took over the operation was very good and she had no worries.

“[He] was really well cared for… He had all of his activities and things available to him that he could enjoy. His actual hygiene care was done very, very well,” says Ms Hausler.

“...It was lovely, I had no concerns at all and I was quite comforted for the fact that he was in a facility that they were caring for him very well.”

Months into the new management take over, some former staff left and were replaced and the facility started to rely on agency staff, which Ms Hausler says made a difference in the care delivered.

Ms Hausler started finding pressures sores and chronic nail infections on her father, as well as unusual bruising, however, most of this was dismissed because there was no evidence of the cause.

It was when her father stopped properly communicating and no longer connected via eye contact, as he had previously done, when Ms Hausler, concerned and suspicious of one of the employees, decided to take action.

“I didn’t know whether he was actually caring for dad directly or not. But when he was around, dad seemed to have these moments of worsening, compared to other times,” says Ms Hausler.

“Initially, it was one of the male staff, and he was very good with dad. I felt that he was very caring, and he seemed to have a nice demeanour about him in caring, but over a period of time that seemed to change. 

"If I saw him in the corridor, he would sort of avoid me or, I don't know, it was a feeling I had and I was concerned that he may have been doing something that was affecting dad’s wellbeing.” 

When footage from her hidden camera validated her concerns, she sent a complaint about her concerns of silent misconduct been done to residents by staff and carers.

Ms Hausler says the facility refused to take any action without proof and didn’t seem to address the concerns.

In one instance on September 9, 2015, Ms Hausler found her father in the fetal position in tears and she knew something was seriously wrong. After viewing the footage from that day, Ms Hausler went straight to the police.

Ms Hausler says on many instances she found cases of complacency and non-compliance by staff, and when she complained about it, they considered it to be “intimidation”.

Since Ms Hausler was still concerned with her father’s safety, she continued with the cameras, despite being reminded constantly by Japara that it was against the law.

Japara allegedly also intervened in her attempt to change her father’s guardianship over to herself, she was already the medical power of attorney, through the South Australian Civil and Administrative Tribunal (SACAT).

SACAT rejected her application and Ms Hausler is still unsure why Japara was even present at the meeting.

This intervention meant that Ms Hausler could not show photos of her dad’s pressure sores, dermatitis and infections.

Ms Hausler was in tears during her final statement to the Commission about the poor quality of life her dad lived in his final days.

She says while there were wonderful staff that had helped her family and her father over the years, Mitcham’s management had a culture of risk aversion, dismissive and non-transparent behaviour and a profit-driven attitude.

Next to the stand was former Facility Manager for Japara Healthcare Limited, Rachael Musico, who was grilled by Counsel Assisting Ms Eliza Bergin about the poor reporting of abuse allegations at the facility during the time of Mr Hausler’s residence.

The report of an alleged abuse by one agency nurse was not recorded in monthly reports following 1 September 2015, when it occurred, only being properly recorded in the November 2015 report.

Ms Bergin had Ms Musico admit that the report was only made after the Aged Care Complaints Centre (ACCC) South Australia contacted her. A complaint form was then passed on to the Department of Health.

The Assisting Counsel stated that the complaint form was incorrect due to the wrong date of the assault was put on the form, November 26 instead of September 1, which Ms Musico denied since the date reflected when they were told it was a reportable assault.

When asked, Ms Musico says she wasn’t sure whether Japara would have reported the assault unless the ACCC contacted the facility, but believed it should have been reported.

Ms Bergin stated the complaint was received two months late and didn’t comply with its obligation to the Aged Care Act to report incidents within 24 hours.

Hearings will continue tomorrow, Tuesday, June 25, at 9.30am AWST in Perth, WA.

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