Residents call for change after audits delayed again in Tamworth's aged-care sector after two-year wait

Mr Prevett believes the staff might have simply forgotten to hand out the medication, or were too busy, and said it wasn't the first time the process had gone awry.

He said part of the problem was that the Tamworth facility was understaffed.

But he also claimed the Aged Care Quality and Safety Commission didn't keep a close enough eye on his aged-care home, Bupa Tamworth.

The facility hasn't had an in-person audit since March 2020, the last on-the-ground check-up in the city. That was after a November 2019 audit found the centre had put elderly residents at "serious risk".

The 70-year-old, who spoke to the Leader over the phone because he was in COVID lockdown at the time, cried as he described what he said was a neglectful service at the aged-care home.

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"I just want an end to my misery, really, and I'm probably not the only one," he said. "It's been a long battle for me."

A spokesperson for Bupa said the company was "committed to providing high-quality care to our residents and families".

Mr Prevett last complained to the regulatory body at the end of July.

A scheduled check-up of the Tamworth facility had again been delayed in June, for the third time in a row, and a new date was yet to be set. The centre has been reaccredited until December 2022.

Some of Tamworth's aged-care homes have gone as long as four years without an on-the-ground audit by the Aged Care Quality and Safety Commission, which is Australia's primary regulator of the sector.

The commission, which has the power to sanction aged-care services, came under heavy criticism in last year's damning Royal Commission into Aged Care Quality and Safety, which called for major changes to the sector and its regulator.

No less than 14 scheduled audits have been put off at Tamworth's five aged-care homes in the last two years, with the commission citing "exceptional circumstances" as a result of the pandemic each time.

Scheduled audits were delayed at Nazareth House Tamworth, Uniting Alblas Lodge Tamworth and Uniting McKay House Tamworth, all citing the same explanation.

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The last audit was rescheduled earlier this month - set for August 18 at RFBI Tamworth Masonic Village, but was put off and the service reaccredited until March next year.

All five institutions are currently operating under an "exceptional circumstances" accreditation.

Typically an aged-care home can expect to be audited every three years or so.

Residents and even some aged-care services say the lack of oversight leaves residents like Mr Prevett in the dark.

Mike Lomax knows exactly what an aged-care commission audit is like.

He's the chair of Quirindi Aged Care Services, which operates the Liverpool Plains aged-care home, Eloura - one of the handful of aged-care homes in the region that has been audited since the COVID-19 pandemic.

Mr Lomax said the audit was extraordinarily forensic and detailed, with out-of-town auditors he'd never met appearing with little warning in June 2021 to go over the place with a fine tooth comb.

The audit looked into everything, he said.

"Performance reviews of staff, that's probably one of the most important ones, through to actually asking staff if they understand a policy or procedure," he said.

"They don't only talk to staff, they talk to residents and they talk to family. They're right across the board and if there are unhappy members of the family [that can mean a black mark]."

Eloura failed the audit.

As a result, the centre has been required to undertake additional check-ups, to reinvest in the business and to await a long-delayed follow-up audit to assess its progress, which has left the centre staff on tenterhooks for months.

Mr Lomax estimates the centre has spent half-a-million dollars and sold off a pair of "non-core, non-performing assets" to fulfil their 22 unmet standards.

He said the aged-care centre likely got into trouble because it didn't use an independent auditor to perform practice audits and check systems. The centre has since employed one.

He holds no bitterness or jealousy about being one of the few homes in the area audited that year, telling the Leader that the check-up would make the home a "better place".

"It's part of the process," he said.

"We have got to recognise that auditing, particularly aged care after the royal commission, that is part of the process."

Asked if he would be comfortable if he had a family member in an aged-care home that hadn't been audited in years, Mr Lomax said "no".

"They protect lives, at the end of the day," he said.

"If a facility is not being audited then I would really question why it's not being audited.

"The residents, the family can complain to the commission ... maybe that's what happened to us, I can't say."

The Aged Care Quality and Safety Commission is supposed to be an impartial and apolitical service that independently accredits, assesses and monitors age-care services subsidised by the Commonwealth.

It can also resolve complaints about services.

But the 2021 royal commission into the sector condemned the regulator as a "light touch", and called for major reforms.

In assessing eight criteria and 42 standards, the commission can judge almost everything about an aged-care centre, from staff education, to complex clinical processes and procedures to simply testing the quality of the food.

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If a centre fails even a handful of the metrics, it can be sanctioned - like Eloura was - requiring the organisation to change how it operates.

In extreme cases it can even refuse accreditation to a centre, stop it from taking new clients, freeze its funding, or just close it down.

The commission takes a "risk-based approach" to monitoring the quality of care and services, which means some aged-care homes might be audited more frequently than others.

A spokesperson for the ACQSC said the service had "continued to reassess and adjust our regulatory response to hold aged-care providers to account in relation to their responsibility to protect consumers from harm".

"Adjustments to our regulatory response have included introducing an infection-control monitoring spot check program to ensure providers are doing everything possible to protect people in their care during the pandemic," he said.

"Since August 2020, the commission has conducted over 3775 of these site visits to aged-care services across the country.

"As we have shifted resources to focus monitoring on areas of increased risk during the pandemic, such as infection prevention and control, we have deferred some reaccreditation site audits."

The spokesperson said the commission "can and do" visit residential aged-care services within an "exceptional circumstances" period to conduct an unannounced audit or for other on-site assessments or monitoring visits.

"Site visits are just one of a number of monitoring tools available to the commission," he said.

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"Our assessment and monitoring activities, and any subsequent regulatory actions we take, are informed by a range of information.

"This can include information gathered from complaints or consumer feedback; on-site activities, such as audits or other visits, and non-site activities such as telephone assessment contacts; and compulsory reports from aged-care providers.

"Where we identify a risk to consumers, we will take action that is appropriate and proportionate.

"Bupa Tamworth is currently operating under an exceptional circumstances provision until 5 December, 2022. This means the commission will return unannounced to the service before that date to conduct a comprehensive reaccreditation site audit."

The aged-care royal commission last year criticised the ACQSA, which it said had not "demonstrated strong and effective regulation".

"The regulator adopted a light touch approach to regulation when a more rigorous system of continuous monitoring and investigation was required for aged care," the royal commission found.

The royal commission proposed that the service should be reconstituted and revitalised as an independent Aged Care Safety and Quality Authority - a "tough cop on the beat".

The ACQSA did not answer a question from the Leader as to when it would cease deferring audits as a result of the pandemic.

Former Tamworth optometrist John Galloway - a resident at Tamworth Gardens Retirement Estate - was full of praise for Nazareth House where his wife lived until she died.

"My mother was at Nazareth House and my wife was there, so I couldn't make any better recommendation than that," he said.

"I'm sure there are people who have more expectations than I do and there are people that have less expectations than I do.

"But I personally felt it was the best place they possibly could be."

Robyn Feggans regularly visits her husband William in Uniting McKay Tamworth.

She said the staff of the retirement home always keeps her informed on anything that happens to her husband "as it happens".

"As far as the staff are concerned they're second to none, in my experience," she said.

"The food is amazing. I go in there and I smell it and I wish I was getting it.

"I wouldn't want him to be anywhere else, I don't care if the floors are shinier somewhere else. It's all about the staff treating him with dignity."

Uniting Director of Ageing Saviour Buhagiar said Uniting McKay Tamworth had no idea when the next accreditation visit would come.

"We can confirm our original accreditation period has expired, but we have received confirmation from the commission that our accreditation period has been extended through to January 2023," he said.

The new federal government has committed to undertake a capability review of the ACQSA, acting on a recommendation of the royal commission.

Aged-care minister Anika Wells committed in July to appoint an independent reviewer "with the appropriate expertise and experience" to investigate the regulator.

Tamworth's aged-care homes have been criticised in recent weeks for a slow rollout of the fourth COVID-19 vaccine. At Bupa Tamworth, one-in-five residents had got their fourth jab at the start of August.

Dozens of residents have died of the virus at aged care homes in the region in the last month, according to official figures collated by the Department of Health and Aged Care.

Seven residents died at Uniting McKay, with one dying in Nazareth House and one at Bupa Tamworth, in the month of August. Four died at Eloura, in Quirindi the same month. Scores more residents contracted the disease that month.

A November 2019 audit found Bupa Tamworth didn't meet 39 out of 42 standards, including clinical care, skin and wound care, bowel and behaviour management.

In its last audit, conducted on March 17 to 19, 2020, the aged-care home failed two of eight standards.

The ACQSA conducted several rounds of assessment contact performance reports after re-accrediting the service in April 2020.

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