Over 1 million people in Australia receive aged care services, and this number is expected to rise to more than 3.5 million by 2050. Aged care homes are environments that provide a secure and safe supervised facility for elderly people to reside in, looked after by qualified and caring staff.
However, research shows abuse and violence is particularly common in nursing homes – where residents are often vulnerable and isolated, with security less than adequate in many of these facilities.
Recently the Royal Commission into Aged Care Quality and Safety Report was released, giving an overview of experiences and concerns from a range of different communities around Australia. The enquiry investigated aged care housing, in-home care and care for young people with disabilities living in residential aged care environments. Community forums provide an opportunity for Australians to tell their stories or share their views with the Royal Commission in a more accessible setting, rather than through formal hearings. Sadly, the conclusion of the report states that the national system is failing the elderly. Recurring themes and stories include:
- Substandard care – speakers gave many examples of poor care, medication misuse, adverse events, and neglect of older people’s needs;
- Serious unsafe care and “underpaid, undervalued and insufficiently trained staff”;
- The importance of maintaining dignity and respect for people in aged care, and numerous instances of disrespectful and dehumanising treatment;
- Disempowerment in the complaints process – in particular, families described numerous efforts to have care improved, their feelings of powerlessness and distress, and their frustration with the complaints process;
- Staffing issues – staffing levels, training of aged care staff, remuneration and attitudes to aged care as a career;
- Providing culturally safe care;
- Guardianship issues and enduring powers of attorney misuse; and
- Financial distress – the costs of care and difficult financial decisions arising from aged care.
Addressing these issues, there are many improvements that could be made. For example:
- Hiring qualified and security-cleared staff – security issues for residents in an aged care home occur mostly in the hiring and management of trustworthy staff. Rigorous background checks need to be undertaken before taking on any new staff, and staff ratios need to be adequate for the number of patients they are looking after.
- Looking after staff and ensuring correct ratios of staff – Within the recent Royal Commission Report, it was noted that one speaker described the risk to the mental health of nurses and the prevalence of depression after being bullied when unable to meet unrealistic work expectations. Patients can receive as little as 2 hours and 48 minutes of care per day, whereas The Australian Nursing and Midwifery Federation recommends residents receive 4 hours and 18 minutes of care per day. Perhaps employing more registered nurses who have lower levels of training could ensure these ratios are increased.
- Nurse support and supervision from management – A self-care policy with regular evaluation of staff helps to prevent potentially violent physical and emotional behaviour towards residents.
- Ensuring training is up-to-date and ongoing – Especially in regards to particular diseases, such as dementia and other mental illnesses.
Research also suggests the security of aged care facilities is lacking, making aged care facilities more vulnerable than other health care facilities. Some concerns include data security and security of the facility from the outside.
Ensuring safety and improved protection in aged care facilities is vital. Areas of concern include:
- Staff policies and knowledge of what to do in an emergency – Security policies and procedures are rarely comprehensive or relevant and they are often not complied with by staff. Security incident reporting and effects notification are often inadequate, inefficient and ineffective.
- Adequate security technology – E.g. alarms, CCTV inside and around the grounds of the facility, covering all possible entries, and ensuring these are tested and serviced regularly. Improving the landscape such as trees and other vegetation to ensure they are not interfering with lighting or CCTV camera sight.
- Visitor Control and Compliance – Ensuring everyone who passes through the facilities is a trusted individual. The current Community Visitors Scheme (CVS) volunteers are required to undergo a police check and the facility must keep a copy of this to assist with compliance requirements. This record can be stored within the Qualification Management Module of a visitor management system and automatically checked each time the volunteer signs in.
- Cybersecurity measures – Australian aged care facilities have access to extensive personal information about their residents and their families and staff. This information can put providers at increased risk of cyber crime. The information held on aged care IT systems is highly lucrative. Examples of minimising the chances of a potential cyber hack can include:
- User access policy: Ensuring access to certain information is regulated and only possible for certain workers;
- Regular password changes for all staff but even more so for those with access to key IT systems; and
- Installing software to ensure data protection.
The protection of aged care facilities is just as important as protecting our schools and hospitals and security planning should be just as strong in aged care facilities as in other health care facilities. Aged care residents can be vulnerable and isolated, which can lead to volatility and uncertainty, especially combined with mental health issues and poor employee management.
At Agilient we assist health-related organisations with both their security and risk management. Don’t hesitate to contact us today.
Author: Jasmine Harvey , Agilient Consultant.