Awake at 4 a.m.: Complaints about rest homes reveal staff shortages, alleged neglect

Research has revealed staffing shortages in retirement homes, residents leaving dirt behind, and facility problems, including no hot water for showers.

The details of complaint findings, obtained by the Weekend Heraldinclude elderly residents of an institution who are woken up at 4 a.m. to be cleaned and changed, reportedly due to a lack of employees.

There are 12 complaints about rest homes that are fully or partially substantiated, according to information released by the Ministry of Health under the Official Information Act.

That is a small part of the country’s 650 retirement homes.

However, the problems are more widespread – a web of organizations are involved in overseeing aged care, which means that the ministry is not informed of all complaint findings.

Over the past 12 months, retirement homes themselves have issued thousands of separate ‘Section 31’ reports, warning that staffing levels were too low to ensure the safety of residents.

The sector is short of around 1,200 nurses, and some homes struggling to work shifts have halted admissions or even closed completely. Last year there were 1260 bed closures in more than 20 facilities.

“Staff shortages across the industry have impacted care outcomes for older New Zealanders,” said Simon Wallace, CEO of the Aged Care Association, which represents most facility owners.

That crisis led to “bed locks” in public hospitals, Wallace said, as older people who would normally be discharged to aged care facilities found no beds available.

“This creates overflow in acute and emergency departments.”

The ministry declined to release the full findings of complaints filed since January 1, 2022, instead providing a brief summary of each investigation.

Six branches turned out to have insufficient staff.

Investigators acting on a July 2022 complaint about Bethany Hill Dementia Care, a 30-bed facility in Whangateau, Northland, between Matakana and Leigh, confirmed a lack of staff and the lack of a full-time cleaner.

In the same month, a complaint was made about Parklands Hospital, part of a retirement home in Christchurch run by Bupa, one of the country’s largest operators.

According to the ministry’s summary, this concerned “concerns about staffing and shortages affecting residents’ care (residents are awakened at 4am to begin morning care, continence management – delay in changing continence pads )”.

Residents were woken up early for morning care, a study confirmed. Concerns about continence management were unfounded.

(A spokesperson for Bupa said the early awakening was a “one-time miscommunication,” and “support and education has since been provided to staff to ensure it doesn’t happen again.”)

In June last year, a complaint was made about Ranfurly Residential Care Centre, which is located in Feilding in the Manawatū and provides medical, geriatric, rest home and dementia care.

According to the ministry, the complaint related to “concerns about heating issues (no heating, cold showers), poor Covid-19 infection control practices (entry/screening, management of positive cases in the facility and spread), lack of care (resident dirty abandoned, resident found on the floor, health deterioration during lockdown)”.

The ministry said the complaint was well founded. However, a spokesperson for the facility said “not all elements” of the complaint were fully substantiated or could be verified.

Nevertheless, Ranfurly Manor had apologized to the complainant, completed an assessment and made changes “in addition to those recommended to improve communication and reporting and ensure the best possible patient care”. The facility was recently recertified by the ministry for four years, the spokesperson said, showing it meets and exceeds service standards.

Another substantiated complaint was made in May 2022, following a physical altercation between two residents with “significant cognitive decline” at Bruce McLaren Village, in Howick.

One resident sustained bruises. An apology was issued to the resident’s family and an action plan was established with Counties Manukau Health.

“[This] included some additional staff training around how to handle behavioral incidents involving residents with severe cognitive decline, better management of medications and communication with family and primary care physicians on admission,” said a Ryman Healthcare spokesperson.

The elder care workforce crisis has led to recent government action, including funding $200 million a year for equal pay between elder care nurses and those working in public hospitals, who have earned significantly more.

Wallace said wage parity funding is not enough and a wage gap persists.

“Nurses in aged care are still being poached by Te Whatu Ora to work in public hospitals for better pay. The disparity is due to several factors, including the fact that elder care is not funded for fines or overtime rates.

Minister of Health Dr. However, Ayesha Verrall said the pay parity funding would mean more than 8,000 community nurses will receive a base pay increase of up to 15 percent starting next month.

“Most will now receive basic wages from about 95 percent of hospital colleagues,” Verrall said.

“The government is committed to ensuring that nurses are paid fairly and given equality with others doing the same or similar work, especially given the current cost of living pressures faced by workers and their families.

“This is a substantial step in that direction.”