Oakden Nursing Home

Question put forward to the Hon. G.E. GAGO (Minister for Environment and Conservation, Minister for Mental Health and Substance Abuse, Minister Assisting the Minister for Health) regarding Oakden Nursing Home.

The Hon. J.M.A. LENSINK: Will the Minister for Mental Health and Substance Abuse, regarding the Oakden nursing home, advise the Legislative Council when the next visit by the aged care standards and accreditation agency is due and whether targets will be met at that meeting? Will the minister advise whether the nursing adviser appointed by the agency has in fact resigned out of sheer frustration; and will the minister confirm whether no new residents can be admitted and that therefore no additional commonwealth funding will be forthcoming until the accreditation is up to standard?

The Hon. G.E. GAGO (Minister for Environment and Conservation, Minister for Mental Health and Substance Abuse, Minister Assisting the Minister for Health) (15:50): I thank the honourable member for her question. Indeed, it is a very disappointing outcome from this particular facility; nevertheless, staff there have risen to the challenge and have put in place a comprehensive management plan to address all the issues identified by the Standards Board. The home is a 55-bed facility that provides care for residents with complex needs. It receives commonwealth funding subject to the home meeting the accreditation standards set out in the Aged Care Act 1997. The Aged Care Standards and Accreditation Agency manages the residential aged care accreditation process using those standards and, once a nursing home is accredited, the agency then continues its monitoring to ensure that high standards of care for residents are maintained. The site was audited on 20 and 21 February 2007 and the home was granted accreditation for one year until 9 May 2008.

There were five support visits from the agency between February and October 2007, and on 10 October 2007 the home was assessed as being compliant with all standards. On 10 to 14 December the agency conducted an unannounced review audit in response to a complaint made to the commonwealth investigations scheme and on 12 and 14 December, as a result of this audit, the Central Northern Adelaide Health Services, as the approved provider, received notice from the Commonwealth Department of Health and Ageing of a decision to impose two sanctions under section 67(5) of the Aged Care Act in relation to the Makk and McLeay Nursing Home. The two risk issues identified, which required immediate attention to ensure the safety and quality of care of residents, were the unreliability of the duress alarm and concerns regarding the complex management needs of residents who exhibit challenging behaviours. Whenever a serious risk is identified homes then receive daily visits from the agency until the serious risk is resolved, and this occurred at the home.

The problems have now been addressed and the serious risks mitigated by the agency. The commonwealth will cease to fund new residents over a period of six months as part of the sanctions, but the home will continue to receive funding for the provision of care to its current residents. Other sanctions relate to the appointment of a nurse-adviser, which has been completed, and there has been a restructuring of the management team. CNAHS has commenced work on a detailed action plan which is being overseen by the newly appointed director of nursing, and this plan includes initiatives such as a multidisciplinary clinical leadership group, a review of policies and procedures related to managing challenging behaviours, and immediate and ongoing specialist training for staff in the area of behaviour management.

Additionally, a new management team has been put in place to oversee the improvements made at the home, and every effort is being made to ensure that residents and relatives are kept informed through regular meetings and communications. So, as members can see, a great deal of activity has been undertaken. In terms of other issues around chemical restraint and lifestyle and activities programs, as I said a detailed action plan has been written up and a dedicated, continuous improvement action plan developed to ensure sustained and quality improvement initiatives across all the standards and issues identified by the commonwealth, with updated plans being sent to the agency on a weekly basis. A meeting occurred on 4 February between executives of CNAHS and the commonwealth to discuss progress to date and the processes over the next month, and it was acknowledged by both the commonwealth and the agency that CNAHS was working very hard to ensure compliance and that progress had been made to date.

During the support visit from the agency on 7 February, assessors noted that progress has definitely been made towards compliance, and we were very pleased to see that. There are still regular meetings by the commonwealth, as requested. Initially, they were on a daily basis. I am not too sure whether they are currently on a weekly or a fortnightly basis, but they are determined by the commonwealth, and we comply with whatever they wish us to do. We meet on a basis that they determine. I think it is reduced to a weekly or fortnightly basis by now. In terms of the nurse adviser position, which was part of putting that position in place and which was part of meeting our commitments and the requirements of the commonwealth, that position has been put in place, and we will continue to meet any and all of the requirements of the commonwealth in relation to that position in an ongoing way.