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‘Serious issues’ cause immediate closure of SA home

An independent review into The Makk and McLeay Nursing Home at the Older Person’s Mental Health Service in Oakden, South Australia found 13 ‘serious issues’ had not been addressed, causing the State Government to announce its closure immediately.

The Oakden facility is deemed not suitable to provide modern and appropriate care to some of our most vulnerable consumers (Source: Government of South Australia 'The Oakden Report')
The Oakden facility is deemed not suitable to provide modern and appropriate care to some of our most vulnerable consumers (Source: Government of South Australia 'The Oakden Report')

The facility provides care and accommodation to older people with complex mental health needs, where living in the community or mainstream Residential Aged Care, has not been a sustainable option. 

In December 2016, an independent review was commissioned to look at care provided at the Oakden Older Person’s Mental Health Service after concerns were raised by the family of a consumer about the treatment their relative received as a resident. 

Led by the State’s Chief Psychiatrist, Dr Aaron Groves the review team included a panel of mental health experts; Professor Nicholas Procter, Dr Duncan McKellar and Ms Del Thomson.

The Review makes a harrowing read. In the 187 page document, the Review found multiple clinical entries that referred to various terms such as “tends to lie on the floor”, “puts themselves on the floor” and “floor time”.

Not understanding what these were referring to, on direct questioning, the Review was informed of a very disturbing account of what constituted “Floor time”. It occurred when during staff interactions with certain consumers, the staff would leave the consumer on the floor in considerable distress if they had formed a view that intervening to assist the person was not needed immediately, for whatever reason.

In addition, the Review heard and saw examples where the care did not closely meet ten SA Health endorsed Dignity in Care principles. For example, there were consumers who were not treated with respect, left soiled and un-bathed, were not adequately fed and hydrated, confronted with a “show of force” to undertake routine tasks of daily living, mocked, ridiculed, spoken to as if they are children, dressed inappropriately, left unkempt, and treated with little personal dignity.

One family member stated in the Review: “They put him in someone else’s clothes. He was staggering around the corridor in revolting clothes. A man with mental problems- stripped of his own clothes, without his own clothes. ‘Where are his clothes?’ I would ask. ‘They are getting labelled’, was the reply. This went on for weeks. The day he left Oakden he left still wearing someone else’s clothes. He was a proud man. He was proud about his appearance”.

Other issues highlighted in the Review include a lack of clinical audits, excessive use of mechanical restraint, a staff culture characterised by conflict, poor morale and disrespect, and minimal specialist medical input into residents’ care.

The State Government has accepted all of the review’s recommendations and will transition Makk and McLeay residents to alternative mental health or aged care facilities over the coming months.

Mental Health Minister Leesa Vlahos says Dr Groves’ report is deeply concerning and the practices outlined within the report are reprehensible. It requires a swift and significant response from the State Government.

“The report makes it clear that, while recent efforts have been made to improve the quality of care provided to residents, the Oakden facility is not suitable to provide modern and appropriate care to some of our most vulnerable consumers,” she says.

Ms Vlahos confirms SA Health will now work with the families to transition their loved ones to alternative places of care. Alternative options for residents are likely to include refurbished facilities at Northgate Aged Care Services, which will be specially adapted for residents and other appropriate residential aged care homes.

Dignity Party MLC Kelly Vincent says the announcement that the Oakden Older Persons Mental Health Service will be shut down is welcome news given the rampant culture of abuse, restraint, neglect that has characterised this service for too long.

“The stories of physical restraints, overmedication, neglect, unsafe, unhygienic and confusing environments, and poor staff culture that have emerged in this report make for harrowing reading,” she says. “It is a damning indictment on our mental health system that older South Australians with mental illness and dementia have been subject to what amounts to state-sanctioned abuse, restraint, neglect and sub-standard care.”

“This report highlights all of us, as a community, must maintain a watching brief with any residential or hospital environment where people with mental illness, dementia or disability that impairs their ability to communicate, or report, abuse,” she continues.

To date, eight staff have also been stood down pending a full investigation, 21 staff have been reported to the Australian Health Practitioner Regulation Agency (AHPRA) and 3 incidents reported to SAPOL.

Ms Kelly hopes the incidents and complaints being further investigated by police and SA Health result in swift action being taken against any proven perpetrators.

In its conclusion the Review states: at the very heart of the intent of this report’s recommendations is that Oakden must close and that it must be replaced by a range of contemporary services that aspire to excellence in care to the most vulnerable people in South Australia.

“But more fundamental should be the lesson that the failings of Oakden should never happen again.”

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