Carol Altmann – The Terrier

I know we are all still digesting the distressing fact that Lyndoch Living has slipped further in its duty of care to look after the elderly, but this is important:

Before breaking that story yesterday, I had planned to post these roster shortages for the Audrey Prider Centre and Lake Lodge – the two, high-care areas that make up what is called the “nursing home”.

These are the very same areas that were the focus of yesterday’s bombshell that Lyndoch had failed four more national standards of care.

These are the areas that were found by the Aged Care Quality and Safety Commission to be under stress from severe staff shortages.

That was based on the commission looking closely at Lyndoch in September.

September.

Yet here we are, and nothing has changed. These are the shift shortages for the past couple of days: it is dire.

So if things were grim in September, I can only imagine what the commission would report if it turned up now.

And I hope they do turn up, unannounced, very soon because this cannot wait until the reaccreditation at the end of February. The commission has the power to do this. It can apply sanctions at any time.

Our local Federal member Dan Tehan gave a statement to the local paper today which says the commission is still deciding what to do in response to the latest failings.

I hope they intervene, because these rosters show that we cannot hope that things will miraculously improve. They won’t.

A stream of experienced staff have gone on sick leave, stress leave or resigned since the commission’s last audit in September. They want to work at Lyndoch, but they can no longer tolerate what is going on.

This has nothing to do with national staff shortages, Covid, or the Royal Commission. It has everything to do with the Lyndoch culture and priorities.

We know it, the staff know it, and surely the commission is starting to catch on.

Yet while the walls crumble around them, Lyndoch once again shows no contrition or remorse for these failings. It once again tells the paper that it has “an action plan”. It said the same thing earlier this year.

Clearly, that action plan is not working and Lyndoch is going backwards, from failing one standard, to now failing four.

My hope is the commission does not wait for it to deteriorate even further before taking action, because at the centre of all this are real people, elderly, vulnerable people, beautiful people from our local community, who are not able to smile and laugh for the Lyndoch Facebook page, but who are instead in need of our help. We are there for them, and those who care for them.

Thankyou to every single one of you who is prepared to stay the course and fight this fight.

Exclusive

Carol Altmann – The Terrier

The Lyndoch Living nursing home has again failed a string of care standards set down by the national aged care watchdog.

In another damning report released online today by the Aged Care Quality and Safety Commission (ACQSC), the nursing home has again failed to meet key measures in personal care and clinical care, staffing, and also governance. [Download the report here.]

The nursing home area is made up the two high-care units: the Audrey Prider Centre, for dementia residents, and Lake Lodge.

An ACQSC audit from September 8 to 15 revealed poor wound management, poor pain management, a lack of monitoring and documentation after resident falls, and inadequate staffing, with unfilled rosters, and remaining staff being unable to cope with the workload.

The extent and impact of understaffing at Lyndoch is graphically highlighted by the report.

It found the nursing home is unable to demonstrate that its current mix and qualifications of its workforce could deliver and manage safe and quality care and services.

“Rosters evidence that not all care shifts are filled when staff are deployed elsewhere within the service or when staff call in sick,” the report says.

“Personal care staff interviewed advised they do not always complete all tasks allocated to them.”

The report says Lyndoch management described how they are in the process of recruiting more nursing and care staff to cover current vacancies, but this has done little to address the concerns of residents and their families.

“Whilst the service was able to evidence improvements, four out of five consumer representatives expressed ongoing dissatisfaction with staffing levels within the service,” the report says.

Short staffing was also raised in regard to poor wound and pain management.

“(Lyndoch) did not demonstrate best practice clinical care in relation to wound and pain management,” the report says.

In particular, the commission found:

– Wound management plans did not always reflect wound reviews including dressing changes, photography and measurements.

– Inconsistent wound photographs and wound measurements are taken and recorded.

– The healing progress of each wound is not clearly demonstrated.

Nursing staff told the commission that staff shortages limited the ability of staff to attend to wounds as required, and to reposition residents to reduce pressure.

“Clinical staff described how wound care is impacted by staff shortages including delayed dressing and repositioning of consumers,” the report says.

The report also outlines failings in monitoring residents who had suffered falls.

Unwitnessed falls were not always documented in reports and a sample found that three out of four residents who had fallen were not effectively monitored afterward, including neurological observations and pain monitoring.

Not surprisingly, the nursing home also failed on risk management.

“The service did not demonstrate systems are in place to prevent harm from high impact or high prevalence risks such as falls,” the report says.

Despite hiring an adviser to help with its governance activities, the service “has not demonstrated current systems and processes are adequate in identifying and managing high impact or high prevalence risks”.

It is the second time this year that the Lyndoch nursing home has failed a ACQSC audit.

In July this year May Noonan Hostel in Terang, bought by Lyndoch in 2018, also failed seven out of the eight aged care standards.

The ACQSC is the peak federal body for assessing and accrediting aged care homes.

I will seek comment from Lyndoch this afternoon and update this story if or when a comment is received. In the meantime, I stand with the care staff and the poor residents.

Carol Altmann – The Terrier

UPDATE:  Another one down. The third and final clinical leader in the Lyndoch Living hostel area is now on sick leave.

This means there are no clinical leaders left in an area of up to 128 residents.

All three leaders have gone on sick or stress leave in the past eight weeks and between them have 30 years, another 30 years and more than 10 years experience.

They are unlikely to return under the current management.

This part of Lyndoch, which includes the new $13m Swinton Wing and Riverside, now has nobody formally in the role of clinical leader – skilled nurses who work closely with the Nurse Unit Managers on administering medication, and implementing and monitoring the care plan for each resident.

They also work closely with the Personal Care Workers.

Now they are all gone. 

The two experienced Nurse Unit Managers for this area are also on extended leave.

In the space of two months, this area has lost all of its leaders and mentors who have built strong relationships with each other and with the residents, who miss them and hope they are okay.

I know this, because people contact me.

So far, Lyndoch’s answer to this growing crisis is to expect other nursing staff to fill the gaps: shuffle the chairs, move the chess pieces, switch and swap, and plug holes wherever they appear.

Lyndoch called a pep-talk meeting of all the PCWs on Monday which, from all accounts, only underscored how blinded senior management are to the looming crisis.

Some staff walked out not long after the pep talk started and well before it ended: they had heard enough.

They were hoping for a plan, some reassurance that more hands on deck were coming, but they were apparently given no such comfort.

Instead, according to my ever-trusty sources, they were told if Lyndoch was to have an accreditation assessment right now, it would fail.

As we know, Lyndoch is already under scrutiny from the national aged care watchdog and failed three out of four key standards, which must be addressed if it is to be re-accredited in February next year.

Re-accrediation was due in August this year, but due to Covid was delayed by six months – the Lyndoch hierarchy must be breathing a huge sigh of relief for the extension.

And yet none of this, not a word, merits any public explanation from Lyndoch Living as to what is going on, why and what is being done to address it.

The staff exodus and the impact does not warrant a peep from the Lyndoch board.

It has also not stirred any interrogation by local mainstream media: not a single question has been asked or appeared in any stories that I have seen.

And so it just rolls on and I find that shocking.

One of the few to speak up is the Australian Nursing and Midwifery Federation which last week sent a string of questions to the Lyndoch Acting Director of Nursing that it has asked to be answered by tomorrow.

It is a glimmer of hope for at least some answers and accountability.

We shall see.

Carol Altmann – The Terrier

There is still no sign of the Lyndoch Living AGM, but the Australian Nursing and Midwifery Federation is now demanding answers around staff shortages, poor staff morale, compromised resident care, a lack of leadership and the increased risk of a clinical incident for which staff could be blamed.

In other words, the union has identified all of the critical issues that Lyndoch nursing and care staff have been trying to raise these past 18 months and which many Lyndoch staff believe are now at breaking point.

This is not scare mongering.

This is a warning to Lyndoch and its board that this is no longer a situation that can be ignored or fixed by shuffling the deck chairs.

The plain fact is you cannot lose at least a dozen of your most experienced clinical and nursing staff in a couple of months and not expect an impact.

My long held fear is that it will take a “clinical incident” to bring this to a head – it will take someone’s loved one to be the victim of what is unfolding before there is an intervention. This is my genuine fear and it is one that is now shared by the ANMF.

In a two-page letter sent last Friday, the union has given Lyndoch until the end of this week to respond to its questions, which are outlined in the attached photos, including resident numbers, staff numbers, rosters and what is being done to address the chronic shortfalls.

I am so relieved to see the nurses union now stepping in, together with work behind the scenes from MPs, residents’ families, hundreds of community members, Lyndoch staff, and others who are no longer prepared to let this go on, unchallenged.

The board and the Lyndoch executive may choose silence or spin, but the community is not going to stand for it.

As a wise person reminded me the other day, the standard you walk past is the standard you accept. When it comes to our elderly and vulnerable residents, none of us – surely – can walk past. On we press.

Carol Altmann – The Terrier

Exclusive

Lyndoch Living has failed seven of the eight quality standards for its May Noonan Centre in Terang, after an audit by the national aged care watchdog.

The audit by the Aged Care Quality and Safety Commission in April found Lyndoch was non-compliant in almost half of the 42 benchmarks that make up the eight national standards.

In one standard – ongoing assessment and planning with consumers – the May Noonan aged care home failed on all five out of five benchmarks.

The damning report – released online this week – found a string of shortfalls, including that “staff do not understand what constitutes chemical restraint and actions do not minimise the use of chemical restraint”.

It also found the service “does not effectively manage high impact high prevalence risks including in relation to falls, medication, behavioural and weight management and urinary catheters.”

The audit also found staff do not act in a timely manner to deterioration or changes to a resident’s health.

In one example, a resident had been feeling unwell for several weeks and, despite documentation recording this and the resident’s representative telling staff repeatedly, no action was taken until the resident became feverish.

Only then was the resident assessed by an external registered nurse and found to have urinary retention.

The assessment team also found some information available was out of date and/or incomplete;

instances of directives made by health professionals and not acted upon by staff;

handover information does not include risks;

charting, assessments and care plans were not consistent or current for all residents sampled.

Staff were friendly, gentle and caring, but – once again – the report reveals that there is simply not enough of them.

Staff shortages and qualifications were captured in this pithy summary: “the number and mix of members of the workforce does not enable the delivery and management of safe and quality care and services.”

And this: “The Assessment Team found the service does not demonstrate staff have the knowledge to effectively perform their roles”.

This report follows a similarly damning audit of the Lyndoch nursing home in Warrnambool, reported here in June, which found Lyndoch was non-compliant in three out of four key measures for resident care and staffing.

[From my search of the commission website, Lyndoch is the only aged care home in Warrnambool and Port Fairy to have been found non-compliant in multiple areas.]

Lyndoch Living bought the 40-bed May Noonan hostel in late 2018.

At that time, it had passed accreditation by meeting all 44 of the 44 requirements and was due for reaccreditation in July 2021.

This has now been deferred by the commission until next January due to Covid-19.

This latest report says Lyndoch appointed a new manager to May Noonan in March and that many of the issues were now being addressed, including an audit of all residents, however the assessor determined that because this remedial action was “still in progress”, the home remained in breach.

[You can download the full report here]