Carol Altmann – The Terrier

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The assessment team also found some information available was out of date and/or incomplete;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

Carol Altmann – The Terrier

Tonight, two photographs.

The first was taken around 1pm last Thursday 24 June and posted to Instagram by building company Nicholson Construction.

It shows members of the Lyndoch Living executive and board whooping for joy at the turning of the first sod for the $22 million medical clinic to be built on site as of this week.

Nicholson Construction is building the clinic, which as we know, despite being a $22 million project, was not put to tender.

Instead, Nicholson was appointed automatically, having previously built the $13 million Swinton Wing extension.

The second photo captures a message sent from within Lyndoch less than three hours later.

This photo shows Lyndoch’s nursing staff pleading for help to fill shifts.

They needed help to cover not one, but 12 shifts across Swinton Wing and elsewhere. Twelve.

I don’t think Lyndoch’s nursing staff were whooping for joy.

Like them, I find it hard to celebrate the turning of the first sod on a $22 million clinic that has no discernible benefit to the  vulnerable and frail residents.

A $22 million clinic also won’t fill the empty or understaffed shifts.

This is the reality of life for so many staff at Lyndoch who are either run off their feet, or stressed out, and it’s a reality that I have been reporting on for two years.

In that time, I have watched the slow wearing down and silencing of the voices who dare to question or challenge this reality.

But there is only so much you can silence.

The consequences of these staffing issues were made brutally clear by the aged care watchdog in its report which Lyndoch perhaps hoped we would never see.

As was first reported here, the Aged Care Quality and Safety Commission spoke of residents in pain, a resident chemically constrained without consent, of falls, of wounds, and of the staff mix being “inadequate” to care for residents.

The commission was not whooping for joy.

And yet the horrors within this report have been all but buried under the first sod of the medical clinic.

This clinic will soak up millions and millions of dollars from Lyndoch and make not one squat of difference to the daily lives of residents living just 200m away.

I can’t stop thinking about the residents in that report, just as I can’t stop thinking about the scabies, or the suffering of other residents whose stories are yet to surface publicly.

This is why we must keep pressing on, in the face of mounting pressure to shut up, to stop being a spoil sport and, instead, whoop for joy.

I will whoop for joy one day: when we have all the answers to all the questions and Lyndoch is once again fully accountable to the community it serves.

Carol Altmann – The Terrier

Lyndoch Living’s failure to care for the elderly and frail was kept under wraps for more than a year, during which things didn’t improve –  but got worse.

That little bombshell was wrapped up in MP Dan Tehan’s media statement issued in response to The Terrier exclusive on Tuesday night.

Mr Tehan said the nation’s top aged care watchdog visited Lyndoch in response to a complaint way back in February LAST year.

As a result, the Aged Care Quality and Safety Commission slapped Lyndoch with a non-compliance order for Personal and Clinical Care (aka, the very reason an aged care home exists).

Never fear, Lyndoch assured the commission at the time, they had a plan!

Fast forward 12 months to January 2021 and the commission re-visited Lyndoch to find the situation was not better, but far worse.

How is that allowed to happen?

As revealed exclusively here on Tuesday night, Lyndoch failed not one, but three out of four standards, including using chemical restraint without consent, and failing to appropriately monitor residents after serious falls.

And when it came to staffing, the commission could not have been more blunt: “(Lyndoch had) not ensured the delivery of safe care and services”.

If Lyndoch can’t get this right, what is it there for? To sponsor golf and horse racing?

Lyndoch’s three-year accreditation comes around again in August.

Lyndoch told the paper (it doesn’t respond to The Terrier) that it has an “action plan”, none of which has been detailed or publicly costed.

There is no mention of it on its website.

Once again, we are kept in the dark by a board and Lyndoch executive who are failing to deliver Lyndoch’s core business.

If The Terrier had not been tipped off about this latest report, nobody would know a thing about any of this.

“This” is the neglect that follows as a natural consequence of our nursing home not having enough staff, not having enough qualified staff, getting rid of experienced staff, and staff quitting because they are physically and emotionally exhausted.

At least 120 people have left Lyndoch in recent years, from very experienced and senior operators, down to those who only lasted a year or two.

These are the ever-growing band of alumni dismissed by Lyndoch as “disgruntled workers”, when in fact they are soldiers returned from the battlefield with warnings of what lies over the horizon.

“This” is a consequence of changing priorities where Lyndoch will overload itself with executives, but can’t fix the nurse call-bell system that is still unreliable.

“This” is a culture that will happily see Lyndoch go into massive debt for a new $24 million medical clinic based on an invisible business plan, rather than hiring more hands and hearts on the ground.

This is not the fault of the nursing and care staff: the moral collapse starts with the executive and board who set Lyndoch’s vision and priorities.

Don’t just take my word for it.

Take it from former Lyndoch Director of Nursing Penny Iddon who wrote this on the Terrier Facebook page after the breaking story:

“Poor standards of care are a direct result of poor and inadequate management oversight.

“The Board, the CEO and the senior nursing staff must take responsibility for this appalling result. The Board can no longer bury their heads in the sand and the CEO can’t keep passing the buck.

“After all, what the Auditors reported on regarding poor and outdated care practices has been allowed to continue under their watch which indicates a clear breakdown of systems, protocols and values.”

We have now seen in stark detail this week how Lyndoch is breaking down.

It has broken down in its duty of care.

And there are fears if the medical clinic goes ahead at the scale which is planned, it will break down financially.

How ironic, then, to see the Lyndoch CEO listed among the guest speakers jetting off to at an aged care forum next month in Sydney.

The topic?

Attracting and retaining new talent to revitalise your workforce.

Exclusive

Carol Altmann – The Terrier

A string of failings at Lyndoch Living has been exposed in a damning report by the national aged care watchdog.

A report released by the Aged Care Quality and Safety Commission in March – but which I was alerted to only today – lays out a shocking series of inadequacies recorded after a two-day visit by the commission to Lyndoch in January.

The commission is the peak federal body for assessing and accrediting aged care homes and for handling complaints.

Its assessment team found Lyndoch was non-compliant in three out of four key measures for resident care and staffing.

A separate report released at the same time shows the Lyndoch Hostel section passed on all measures, but an 11-page report into other, unidentified, sections of Lyndoch reveals a story of wounds, falls, pain, lack of consent, outdated records and crying out for help.

The report focusses on five specific residents, and it makes for heart-breaking reading.

Here are some of its findings:

Resident one, who was living with severe dementia, experienced “breakthrough” pain levels daily for three weeks without receiving any further pain medication, pain assessment, monitoring or evaluation;

A pain assessment plan set out by a specialist team was not followed;

The specialist’s recommendation that a pain medication patch be increased was not followed;

This same resident also had several wounds which were not adequately overseen by staff;

In regard to one of the wounds, all four management plans failed to record if the wound was getting better or worse, with boxes on wound size either unchanged or left blank;

Another resident was being given antipsychotic drugs “as required” – which is defined as chemical restraint – with no proof of consent:

“The representative of the [resident] told the Assessment Team that they had not provided consent and were unaware of any potential side effects of the use of the medication,” the report says.

A third resident had a fall and was hospitalised overnight with a significant laceration but, upon returning to Lyndoch the next day, was not reviewed for pain or possible brain injury:

“The Assessment Team found that staff did not undertake a timely review of the consumer’s pain on return from hospital and did not undertake neurological observations.”

This same resident later developed shoulder pain, but an order for stronger pain relief was not processed until two days later, with a GP review three days later.

A fourth resident, who lives with dementia, had an unwitnessed fall, but was not assessed for pain or a possible head injury.

Two days later, the same resident had two more falls which “qualifies” for a CT scan, that occurred.

The report says Lyndoch refuted the assessment team’s statements about this incident and also questioned the accuracy of its findings.

The team, however, stood by its report.

It says “the key points were timeliness of pain review following a fall and whether staff undertook neurological observations. Particularly …. for unwitnessed falls where the consumer could have hit their head…”

A review of records of a fifth resident, who was on psychotropic medication, found the medication records were out of date.

As a result of these incidents, Lyndoch was found to be non-compliant in standards for Personal Care and Clinical Care.

It was also found to be non-compliant in Human Resources and had “not ensured the delivery of safe care and services”.

The assessment team said it witnessed staff rushing tasks and staff walking past a resident who was calling out for help without stopping to offer support or assistance.

A review of the roster across a two-week period found some shifts were unfilled.

It also found failings in infection prevention and control, including:

poor use of personal protective equipment by some staff;

social distancing not always being adhered to by some staff and;

not taking all reasonable steps to prevent visitors who do not meet entry requirements from entering the facility.

Staff shortages and a lack of suitably qualified staff also came under fire:

“the skills of the current mix of staff delivering the care are inadequate and are not meeting the current needs of (residents).”

So there it is in black and white: Lyndoch is failing in its core business of caring for our elderly and frail.

It is failing some of the most vulnerable people in our community and yet there are still those within Lyndoch who will deny, deflect and head to the May Races.

This is not the fault of the exhausted Lyndoch staff.

The buck does not stop with them: it stops with those who decide the priorities of Lyndoch.

Right now, the number one priority for Lyndoch is building a $24 million, 3000sq/m medical clinic with no clear benefit to the residents.

This is how disgracefully lop-sided things have become and how far Lyndoch has drifted from its core purpose.

And so we have reports of wounds, falls, pain, missing records, soreness, sadness and crying out for help.

This is not happening in a private aged care home deep in the outskirts of Melbourne: it is happening in Warrnambool, in a place owned by us, the community.

Why has Lyndoch not told us about this report, apologised for its failings and pledged to do better?

Do we simply shrug our shoulders and say “that’s how it is in aged care” and turn away?

I can’t turn away and I know you can’t too.

We have to be the voice of the voiceless and refuse to accept silence as a solution.

[The commission has set down seven areas in which Lyndoch must improve to avoid any risk to its accreditation. You can read those here. It should be noted the commission says Lyndoch has challenged or refuted many of its findings. You can download the full report here.]

Carol Altmann – The Terrier

Lyndoch Living spent $1.2 million on consultants and lawyers in 2020, and at least another $3 million on its ever-expanding administration.

A deeper dive into the 2020 financial figures reported to the Australian Charities and Not for Profit Commission show Lyndoch has spent at least $1 million a year for the past three years – a total of $3.34 million – on legal fees, consultancies and auditors.

That $3.34 million over three years is more than the food budget for the 200 to 240 residents, but more on that shortly.

Behind the scenes at Lyndoch, a steady stream of consultants has been working on the $100 million masterplan, including – as I understand it – around $99,999 and 99 cents paid to one consultant for the business plan for the medical clinic that will be built on site later this year.

We haven’t seen that business plan, but we can only trust that it’s a good one, because Lyndoch is going into the uncharted waters of borrowing big to finance the estimated $23 million cost.

At the same time, Lyndoch’s administration costs are now more than $3 million a year, compared to $2.5 million in 2015.

The admin budget is hard to follow from year to year, because it keeps bouncing around the balance sheet like a bee in a bottle.

In 2018, it was $3.3m.

In 2019, it suddenly fell to $1.94m after an adjustment or “restatement”.

In 2020, it was back up to $3.07m.

While the figures are subject to the vagaries of various accounting methods, one thing we do know is that the number of admin staff at Lyndoch has gone up.

As has already been reported here, admin staff at Lyndoch shot up from 37 in 2016 to around 60 in 2018, and several other, highly paid souls have joined since.

(Since 2018, Lyndoch no longer publishes a staff breakdown of how many people work in each area.)

In addition to these costs, just under another $1 million has been spent in the past three years on advertising and marketing, including Lyndoch’s sponsorship of the grand annual jumps race at the Warrnambool May Races.

This sponsorship, which was renewed in 2019 and now runs until 2022, was designed to promote its Waterfront Living apartments.

I am yet to hear of anyone buying one of the apartments because they were at the races, but perhaps in between punts they were persuaded.

As it happens, the last of the apartments were sold at heavily discounted prices late last year so Waterfront could finally reach full occupancy.

But enough of the fascinators and corporate suits, what of the budget for residential care?

This brings us back to the kitchen.

I always like to check how much is being spent on food, given this – unlike the races – really is the core business of an aged care home.

In 2019, Lyndoch spent $1.2m on food for around 200 residents, or about $16.50 per resident, per day.

In 2020, this had risen to $1.44m, which looks good on paper, but Lyndoch has also since bought the May Noonan Hostel in Terang, so the number of residents has also increased to around 240.

This means the food budget works out to be the same – around $16.50 per resident, per day.

That is around $6000 in food per resident, per year.

(I suspect the various legal battles funded by Lyndoch against The Terrier have cost the equivalent of that per month.)

Again, I provide this information so the community, which owns Lyndoch, can keep an eye on its direction and priorities behind the marketing and public relations. If you wander over to the Australian Charities and Not for Profit Commission, you can check it all out for yourself.

In the meantime, we keep digging.

More soon.