Failed nursing home loses accreditation

The Ritz at Leura: Accreditation will be withdrawn on January 4 after it met only 14 of 44 criteria.

The Ritz at Leura: Accreditation will be withdrawn on January 4 after it met only 14 of 44 criteria.

The Ritz Nursing Home at Leura has failed 30 of 44 performance markers and faces closure when government funding ceases next month.

An audit found patients often don’t have enough food and water, they have been assaulted by fellow patients and don’t feel safe, medications aren’t properly monitored and many are forced to wait to be taken to the toilet.

The care at the home, which is a locked facility for 148 high-care patients, has failed those residents, according to the Australian Aged Care Quality Agency, which has revoked its accreditation from January 4.

The owner, Mrs Millie Phillips of Milstern Health Care Pty Ltd, claimed she was being subject to the actions of a “police state” and had been forced to employ an administrator and a supervisor.

The 88-year-old sole operator, who has owned The Ritz since 1978, said there was “a lot of garbage” in the audit report, and many of the complaints were resolved long ago.

Mrs Phillips said she had offered to put in a board with independent doctors to run the Ritz but her offer had been “disregarded” by the administrator.

A spokeswoman for the Health Department said it had no authority to accept or reject offers in relation to Mrs Phillips’ business decisions.

It was up to Mrs Phillips to make the improvements needed to restore accreditation. She could also run The Ritz as a private care home but would not receive government subsidies for the patients.

Mrs Philips was also responsible for finding alternative accommodation for residents if The Ritz closed down, the spokeswoman said. Mrs Phillips said she feared the high-needs patients would “end up on the streets”.

The audit, conducted in September, found flaws or deficiencies in safety, toileting, dental care, nutrition and privacy issues.

Patients and staff reported being frightened and attacked by aggressive patients, who weren’t managed properly.

The damning report painted a picture of a dirty, smelly, dilapidated home in disarray, with patients who have little say in how they are treated and what they can do.

Dental equipment wasn’t stored hygienically. No-one was doing anything to prevent falls by patients. When accidents happened, they weren’t recorded properly and nothing was done to ensure they don’t recur. There were no programs to help patients with their mobility or dexterity.

Patients complained of being treated in a way that was undignified. The report found “management does not ensure that each care recipient’s right to privacy, dignity and confidentiality is recognised and respected”.

Their emotional needs were ignored: “Care recipients’ emotional status is not assessed ongoing and interventions are not put in place to ensure their emotional needs are met. Staff do not demonstrate an awareness of care recipients’ emotional needs,” the report said.

The Ritz had “limited resources and ability to provide stimulation and activities for care recipients within the grounds of the home… Many care recipients express dissatisfaction with the activities provided by the home and indicated they are bored.”

“While management of the home explained they have an open door policy, care recipients were noted to have limited input into their care and in general regarding what happens in the home… Many said they would like to exercise choice not to live at the home.”

Even the buildings themselves were falling apart, the report noted: “Both the interior and exterior of the home have not been well maintained. The home does not provide a safe and secure environment.

“The home was observed to be poorly maintained and dirty with many malodours throughout the home.”

The home does not provide a safe and secure environment.

Audit report

The review of The Ritz took place between September 18 and 27. The audit team failed the nursing home in many areas across four broad standards: Health and personal care; care recipient lifestyle; physical environment and safe systems; and management systems, staffing and organisational development.

On the health and care of patients, the report found management could not show that appropriate care was given.

“Care plans do not always include sufficient information and are not always updated to reflect the changing care needs and preferences of care recipients. Care recipient accidents/incidents do not result in review of care and strategies to prevent or minimise future occurrences. Staff do not always respond to care recipients’ care needs.”

Patients didn’t necessarily get specialised nursing care when they need it and medications weren’t managed safely and effectively.

“Medication incidents are not routinely recorded and audits do not identify gaps in medication management. Medication charts are regularly not signed as the medication given,” the report found. “Accidents/incidents including medication incidents are not consistently documented or monitored.”

Terminally ill patients were not properly cared for and plans for their treatment and care weren’t updated in response to their changing needs.

The Ritz did not have an effective system to ensure staff had the appropriate knowledge and skills and the audit team found numerous cases where staff knowledge was deficient.

Although there had been education sessions about clinical topics, “deficits exist in staff knowledge, demonstrating that the education system is not effective”, the report found.

The complaints system was ineffective. “Care recipients interviewed indicated there is no point raising issues because they do not get addressed.”

Milstern also owns the Yagoona Nursing Home in Sydney, which in September was found to have failed 24 of the 44 criteria and will be forced to close on December 29.

Do you know more? Email jennie.curtin@fairfaxmedia.com.au.