Strengthening guidelines for investigation of clinical issues in aged care - post-Broughton Hall

PDF printable version of Strengthening guidelines for investigation of clinical issues in aged care post Broughton Hall (PDF 21 KB)


18 February 2008
JE08/09


The Department of Health and Ageing will strengthen guidelines on how investigation staff respond to concerns about clinical care including during serious disease outbreaks in nursing homes.

During a disease outbreak, staff will be required to check on actual nursing home residents rather than just examining documentation and meeting with management and staff.

The Federal Minister for Ageing, Mrs Justine Elliot, made the announcement in response to a report into the April 2007 gastro-enteritis outbreak at Broughton Hall Nursing home in Melbourne - under the Howard Government.

Five residents of the home died - including Mr Merson Dunstan, who died in hospital shortly afterwards.

The recommendation by Ms Rhonda Parker – who is now Aged Care Commissioner – is in a nine-month old report which the former Howard Government did not release.

Under the revised guidelines - being developed in conjunction with state, territory and local health authorities - nurses investigating concerns about clinical care will be given more specific guidance to ensure gaps in care can be identified and acted upon.

However, draft guidelines will take into account the parameters of a Commonwealth nursing officer’s clinical role as well as the clinical assessment process to be considered during an investigation.

To that end, the department will be guided by relevant health authorities who play a role in infectious disease outbreaks and managing the risks to public health. They must also adhere to their nursing registration requirements through the nursing board in their state or territory.

Mrs Elliot also apologised to the Dunstan family for the previous government's failure to keep them informed of the matter and allowing a report to languish for nine months.

In addition, the Minister tabled -- in the Federal Parliament -- the official summary investigation report into the matter by Ms Rhonda Parker.

The Parker report followed an allegation on April 17, 2007 that a staff member from the Department of Health and Ageing and/or the Aged Care Standards and Accreditation Agency who visited the home on April 15 did not respond to calls for help by a Broughton Hall resident when they were on-site.

The previous Howard Government minister, Mr Christopher Pyne, sought a report on these allegations from Ms Parker. The report was finalised and delivered to the office of Mr Pyne - but it was never released or provided to the family.

On February 7, 2008, Mrs Elliot's office contacted Ms Parker to inquire about the status of the investigation and expressed concerned about the lack of feedback to the Dunstan family. A day later (February 8), Ms Parker provided a "summary investigation report" on the actions of departmental officers and agency assessors on April 15, 2007.

Due to legal constraints imposed by the Privacy Act 1988, the full report was unable to be released publicly, however, Ms Parker was able to provide a "summary investigation report".

As part of the report, Ms Parker's investigation found that the allegation that departmental staff and/or agency assessors ignored pleas for help was not substantiated by the evidence, however, she noted: "during the course of the investigation an apparent gap in protocols came to light".

Ms Parker said the proposed protocols should ensure the task of directly observing the level of clinical care is nominated and delegated to an appropriate body or person.

Ms Parker specified that the protocol should take into account the nature of the critical incident and all relevant occupational health and safety considerations for staff delegated the task.

On Sunday afternoon (February 10), Minister Elliot hand delivered a copy of Ms Rhonda Parker’s Summary Investigation Report to the Dunstan family.

Mrs Elliot said: "While it does not bring the matter to a close, I hope it is a step forward for the Dunstan family.

"It must have been a frustrating and – indeed -- sad nine months for the Dunstan family and our thoughts are with them as they now face the Coroner’s investigation," she said.

Aged Care in Australia – the facts

The Department of Health and Ageing oversees more than 2870 accredited nursing homes with 167,070 aged care beds across Australia, providing permanent residential care each year to one in every ten Australians aged 70 or over.
There are 1.9 million Australians aged 70 years and over, comprising 9.3 per cent of the population. The average age of people entering residential care is 82.


For more information, contact Mrs Elliot's office on (02) 6277 7280