With the aged-care watchdog looking into the Covid-19 cluster that has claimed 16 lives at Newmarch House in Sydney’s west, systemic flaws are being exposed. But what comfort is that to the distressed families of residents? By Rick Morton.
The Newmarch House Covid-19 cluster
It began with a single careworker with a “scratchy throat” and swiftly morphed into a Covid-19 cluster that has killed 16 people, infected at least 68 all up and necessitated the creation of an isolation chamber that has shattered families.
Newmarch House, an Anglican Community Services-run nursing home in Sydney’s west, first learnt one of its workers tested positive for coronavirus on April 11.
It had been five days since her last shift at the facility, after working back to back since the start of April.
A week later, on April 18, a 93-year-old resident at the facility became the first to die from the virus. All of those who’ve succumbed in the past month have been elderly residents.
Containment of the outbreak may have been possible, were it not for a medley of errors at all levels that expose historic, systemic flaws in the nation’s aged-care system.
“At the start, I do not think the managers wanted to believe this was happening,” a Newmarch careworker, who spoke on condition of anonymity, told The Saturday Paper.
“There was panic, but it was the kind of panic that resulted in either nothing happening or the completely wrong thing happening, which made the effort to control it worse.”
According to staff and family members, it was not until weeks after the first contact was confirmed that the notion of keeping residents who tested positive to Covid-19 separate from the rest of the facility was entertained.
Staff at the home have told The Saturday Paper that while a crackdown on relatives visiting their loved ones was instituted immediately, management missed an opportunity to quarantine residents.
Late on Wednesday this week, the aged-care watchdog threatened to revoke Anglicare’s licence to operate nursing homes if it failed to respond to a litany of “serious concerns”.
“The Commission has escalated our enforcement as a consequence of continued evidence of lack of effective infection control, and of immediate and severe risk to the safety, health and well-being of residents at Newmarch House,” Aged Care Quality and Safety Commissioner Janet Anderson said in a statement.
“The Covid-19 outbreak at Newmarch House in Western Sydney during this pandemic has been one of the most devastating in Australia, with 16 residents having lost their lives to the virus. This is a tragic situation, and the anxiety and grief experienced by residents, their family members and staff has had an impact on all Australians.”
Anglicare Sydney chief executive Grant Millard said the organisation acknowledged the commission has “taken regulatory action, including appointing an independent adviser to provide additional support to Newmarch House”.
“While the outbreak at Newmarch House has proved very challenging for all involved, the situation has substantially improved. We will continue to collaborate with key stakeholders as we work through the continuing challenges in the coming weeks,” Millard said.
Families of residents at the nursing home have agonised about their relatives during what feels to them like an information blackout.
On April 28, Scott Lardner left a message for other family members who took part in a Zoom call hoping to speak to Anglicare officials. However, the nursing home operator was not on the call, instead delegating questions to a third-party advocacy organisation.
“I was a bit taken back and shocked to hear everyone in tonight’s Zoom meeting were experiencing a similar situation with their family members in Newmarch House, approximately 58 family members with concerns and only one person with positive feedback in the current situation,” he wrote. “I actually thought the Zoom meeting was with Anglicare not just an advocacy group. I understand the advocacy group are trying their best to assist and answer family members queries, but they should not need to. Anglicare need to answer our concerns.”
Anthony Bowe, whose 76-year-old mother, Patricia Shea, was among the first residents diagnosed with Covid-19 at Newmarch, told 2GB’s Ray Hadley he knew nothing of her treatment for days.
“I’ve had no contact from any doctor to do with Mum’s treatment,” he said. “I’ve had no involvement in the treatment plan the whole way along.”
On Wednesday, the Royal Commission into Aged Care Quality and Safety released a statement saying its commissioners Tony Pagone, QC, and Lynelle Briggs are “very concerned by the reports of deaths due to Covid-19 in aged care facilities”.
“Since March, the Commissioners have been collecting information, including from submissions from the public, so that their final report may be informed by the lessons learnt from the pandemic – including the lessons from what has happened at Newmarch House, and other aged care facilities,” the commission said.
“The Commissioners may need to inquire into particular events relating to Covid-19 in particular residential facilities. However, any such inquiry must in no way distract providers from giving residents of aged care facilities the care that they need in these difficult times.”
Tensions between New South Wales Health Minister Brad Hazzard and state opposition MPs over the issue were further exposed on Thursday during an upper house inquiry into the state’s handling of Covid-19.
“Don’t you think you have a role to step in, or are you going to blame the federal government?” Labor MP Walt Secord asked the minister.
“Just to be clear, in correspondence with the opposition, your office confirmed that NSW Health is responsible for providing health-related services and support to residents at Newmarch. Are you now resiling from that position?”
Hazzard bristled, demanding to know who wrote the letter before reiterating that aged-care homes are federally regulated services.
“They are in their own home, at their house, it just happens to be an aged-care facility,” he told the inquiry on Thursday. “Individuals would generally have a GP looking after them. And GPs generally make a practice of visiting their patients in their own home. That still exists for quite a number of the residents there but obviously when things became challenging there in the early days … NSW Health was able to assist when they ran short of staff; that’s not something that they would normally do.
“NSW Health offered to put in some nurses, when they had none available. And as it has become obvious, there are other challenges. NSW Health has also offered additional services, effectively to the federal government-regulated body, by putting in infectious disease specialists, geriatricians and others to assist with the patients.”
Australian Nursing and Midwifery Federation (ANMF) federal secretary Annie Butler tells The Saturday Paper it is “disturbing” the outbreak at Newmarch House did not attract the same level of emergency intervention as the cluster at a public and private hospital in north-west Tasmania, which also sprang up in April.
“There has been a lot of bumbling by the federal government in its response,” she says.
“We did see a similar outbreak in north-west Tasmania and the Commonwealth sent in Australian medical assistance teams. Defence was sent in and the hospitals were closed.
“Why didn’t we get the same attitude and the same response in addressing the urgent needs in aged care? The health system is so well equipped but residential aged care is a completely different story. They are chronically understaffed and under-resourced.”
In many ways, coronavirus exploited an already depleted aged-care system in the grips of a staging crisis.
A new survey of 2000 aged-care workers, conducted by the ANMF and which has not yet been released, looks directly at the sector’s response to Covid-19 and has revealed startling figures about staff hours during this crisis.
Three-quarters of those surveyed said there have been no increases in staff or hours in nursing homes during the pandemic, while 20 per cent said there have actually been cutbacks to hours and staffing levels.
Fewer than 30 per cent of the respondents felt they had access to the required personal protective equipment.
In one aged-care home, The Saturday Paper understands the responsibility for screening visitors and staff each day has been given to a receptionist.
Nursing staff have been told by other aged-care operators they cannot come to work if they have a second job – a legally dubious direction from employers – because this could pose a risk to residents.
As this pandemic became more serious in March, aged-care providers launched a curious new training module that they said could pump out aged-care assistants in just 10 hours as part of a “redeployment initiative”.
The training is being offered by the peak industry body for commercial providers, Leading Age Services Australia, but it is being run by Altura Learning and the recruitment firm Dash Group.
A senior source in the aged-care sector told The Saturday Paper that it is “astonishing” that “even lower-skilled staff are being snuck into aged care under the cover of Covid-19”.
At the NSW inquiry this week, Health Minister Brad Hazzard was grilled about why he didn’t intervene sooner at Newmarch House using the powers he has under the Public Health Act.
Under the legislation, when a situation has arisen that “is or is likely to be a risk to public health”, the minister “may take such action and may by order give such directions as [they] consider necessary to deal with the risk and its possible consequences”.
Hazzard repeatedly bit back at what he considered “politically loaded” questioning, labelling it “political rubbish”. “I challenge the premise of your question,” he said in response to Walt Secord.
“Now, if mistakes have been made, who by and by what? Matters around the Ruby Princess are being looked at by the commission of inquiry and the matters in relation to [Newmarch House] are subject to investigation by aged-care quality. You have no basis whatsoever.
“There are thousands, tens of thousands of people, who have died across the world. NSW Health has done an extraordinary job and front-line staff, the public health staff and the entire system, and all I’m hearing is deprecatory comments, loaded political questions. It shouldn’t be a political exercise.”
Congratulations at a state level may well be in order but it is small comfort for families who were robbed of a chance to say a proper goodbye or to even hold the hand of their mothers, fathers and siblings who died in isolation.
This article was first published in the print edition of The Saturday Paper on May 9, 2020 as "Outbreaking point".
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