Carers told not to speak to residents to save time and residents left in bed all day because of lack of staff are among issues which suggest the aged-care sector is in crisis and urgently needs regulation, a report released yesterday says.
The sector's issues are "chronic and widespread" and required urgent attention, according to the report, which is based on a review by Green Party MP Sue Kedgley and Labour MP Winnie Laban.
"We found a sector fast reaching crisis point, struggling to meet the growing needs of an ageing population and residents' rising [disability] levels.
The result is that many older New Zealanders are receiving substandard care," it said.
The MPs, supported by lobby group Grey Power, carried out the review after Government MPs did not support a health select committee investigation.
More than 450 submissions were received from unions, the aged-care industry, family members and workers, many anonymously, to protect employment or care arrangements.
However, Health Minister Tony Ryall said, when contacted, the Government was tackling problems in aged care not addressed by the previous Labour administration.
It was introducing stricter auditing, increased oversight and greater transparency in the sector.
"This report is two years too late and actually should be an apology from Labour for their neglect of aged care."
The report advocates a move away from residential care towards supported living at home, recognising older people's increasing independence.
It recommends setting up an aged-care commission, an aged-care strategy, government-funded training, stricter auditing and a publicly available system rating facilities.
"We find it astonishing that no one agency is tasked with ensuring the safety and well-being of the thousands of residents in aged-care facilities.
Instead, a number of disconnected agencies are involved in the provision of care ..."
The sector lacked the accountability expected of public hospitals, both in reporting "adverse" care incidents and how it spent the annual $800 million taxpayer funding.
A gulf between the daily operating cost ($78.70) and the government subsidy ($109) for funded rest-home residents raised the question of where the extra money was being spent.
Some providers made "substantial returns" for shareholders of 14%-16%.
At the same time, some caregivers were paid the minimum wage of $12.75 per hour, even after more than a decade at the same facility.
Caregivers lacked training opportunities but many were expected to assume the responsibilities of nurses or other qualified practitioners.
A lack of regulation regarding minimum ratios of caregivers and nurses to residents meant heavy and often unsafe workloads.
"A Dunedin caregiver told us there were two caregivers on duty at night in the home she worked in looking after 75 residents."
Some caregivers were instructed not to speak to residents to save time while, at weekends, residents at some facilities stayed in bed all day because of a lack of staff.
Presbyterian Support Otago chief executive Gillian Bremner took issue with some aspects of the report, particularly the gap highlighted between the rest-home subsidy and operating costs.
The significant cost of building and upgrading facilities accounted for the difference, she said.
Some recommendations, such as exploring innovative ways to keep people at home, were happening, supported by district health boards.
However, staff training and wages were major issues.
Qualifications were increasingly recognised, but caregivers often footed the bill for them, and they were not always recognised in pay rates.
Otago-Southland Aged Care Association board member Malcolm Hendry questioned how the abuse claims were substantiated.
He believed few of the negative reports came from Dunedin.
The concerns:
Issues raised in a review of the aged care sector include:
• Some caregivers instructed not to speak to residents to save time.
• Residents of some facilities stayed in bed all day at weekends because of a lack of staff.
• Incontinence pads rationed to save money, sometimes leading to urinary tract infections when not changed often enough.
• Dehydration and malnutrition, poor food quality, residents being rushed through meals.
• Anti-psychotic medication over-used to help staff manage residents.
• GP appointments restricted to save money.
• Lack of proper medical treatment for urinary tract infections, dehydration, bedsores, skin tears and falls.
• Residents not being walked, and losing mobility, or not being taken to the toilet, and becoming incontinent.
