The latest Consumer reveals some disturbing statistics about our rest homes. Out of the 287 homes audited over the past year, only 14% fully met the services delivery standards and over half couldn't even meet the "safe and appropriate environment" standards. These are especially appalling statistics considering the concern expressed by both the Health and Disability Commissioner and the Auditor General back in 2009 when both voiced serious misgivings about the quality of the oversight for rest homes.
Due to increasingly common media reports of inadequate care in rest homes and the cost cutting restrictions being placed on home care, some focussed research on the issues was jointly organised by the Green and Labour Parties (National refused to participate). Green MP, Sue Kedgley, and the recently retired Labour MP, Winnie Laban, toured the country last year and met with those directly affected by aged care services. The interest in the tour was such that in Invercargill alone over 200 people turned up to share their frustrations and disillusionment.
Sue and Winnie's report revealed a changing culture in the area of aged care. Most elderly prefer to stay in their own homes as long as possible and reliable and quality home care is an essential factor in supporting this. It then stands to reason that those who are in residential homes are generally beyond any level of independence and are therefore in need of much higher levels of care.
Whether it be residential care or home support, most providers operate as businesses and need to be financially viable. The main cost is staffing and if staffing is kept at minimum levels and unqualified staff are employed on low wages it ensures greater financial returns. Most complaints and audit failures are around low staffing levels and the inexperience or the limited knowledge of staff. Concern around shifting funding away from staffing was mentioned in Sue and Winnie's report:
"However, we believe it is vital that there is greater accountability and monitoring of the taxpayer funding in the sector, and evidence of how public funds are currently being spent, before additional funding is given to the sector. For instance, the Thornton Review states that operating costs per resident per day is $78.70, yet the subsidy is $109 (p.9). This begs the question, where is the extra money being spent?
The Nurses Organisation say they have been told by District Health Boards that providers are not supposed to use taxpayer funding for capital development. However, in their negotiations with providers they have frequently been told that extra money will not be spent on extra wages because the money is needed for refurbishing residential homes or for building new facilities."
There are publicly available audit reports on certified providers but useful detail is lacking and Consumer recommends mandatory reporting on key indications of care - such as staffing levels and infection rates etc. Commercial sensitivities should not be a factor when health and welfare of residents should be the prime concern. Consumer also called for a central agency with a responsibility for the aged care sector, a little like the Education Review Office (ERO) they could provide good oversight and public transparency around the performance of individual rest homes. We not only need an independent authority but we also need tougher regulations around staffing and the ability to enforce them.
It is a matter of shame that New Zealand has an appalling international record for the health and safety of our children (ranked 29 out of 30 in OECD) and the way we care for our elderly isn't much better.