Workers at Bupa Aged Care Wodonga speak out about conditions

The carers - speaking anonymously for fear of losing their jobs - say they have harboured worries for 18 months but felt obligated to speak out now.

Ashley* said her message to families was, "We are looking after your loved one".

"We are doing the best we possibly can, but under the circumstances, they're not getting the care that they deserve," she said.

Rachel* hoped their story would "give power to residents and families to speak up more".

"Even though it feels like it's falling on deaf ears, that's the only way things are going to change," she said.

Bupa is the largest aged care provider in Australia and began operating aged care services in Wodonga in 2007.

The current facility opened in 2012; it was built on Melrose Drive to replace the 60-bed Osburn Lodge.

In that year, the facility met all 44 of the expected outcomes that are assessed by the Aged Care Quality and Safety Commission.

This was also achieved in 2015 and 2018.

But in 2019, five of the 44 outcomes were not met and the Commission issued a "serious risk decision".

The audit that led to this decision stated a third of care recipients and representatives interviewed were not satisfied with staffing.

"Management actions to manage staff absenteeism have not been effective, nursing agency staff are not used to replace staff on leave and staffing shortages occur," the report said.

Some staff told auditors they did not have time to consistently provide effective continence management or emotional support to residents, and the two outcomes relevant to these areas were not met.

The Commission stepped up its compliance monitoring and in October of 2019, found Bupa had made improvements and the provider met all 44 standards.

However, Rachel and Ashley detailed the ongoing strain on staff.

"It feels like we are constantly being lied to about new staff coming," Ashley said.

"People notice how little staffing we have; I have been questioned multiple times by family members, asking where everybody is.

"We're not allowed to say how many carers are on the floor."

Rachel said when they are short-staffed, rotations to prevent pressure wounds that should happen two-hourly could be delayed to four-hourly and residents "don't get taken out of bed for the day".

"Recently, we got told to leave people in bed because we were so short-staffed in the afternoon, they wouldn't be able to get them back into bed," she said.

"Their hygiene is attended to, but they are still left in the same clothes."

Of the 114 beds, which are not all occupied, about 34 are for high-needs patients including those with dementia.

Often there is only one staff member for those high-needs patients, or one registered nurse left in charge of the entire home, Ashley said.

"If you've only got one staff member coming on at 3pm, it's quite daunting," she said.

"We have the most amazing registered nurses that come through, but they can't handle the pressure.

"So when management leaves, sometimes at two o'clock in the afternoon, there's no support for them.

"Ratios will be coming in the industry - why not do so now?

"Something needs to happen for staffing to improve."

Rachel said she "knows for a fact" people have done repeat shifts that extended to 24 hours at Bupa Wodonga.

"Staff do not know how they (Bupa) passed accreditation last year," she said.

"You get anxiety before you go to work and it affects your home life."

Bupa Wodonga general manager Kerrie Myer said "no one has ever worked a 24-hour shift inside our Wodonga home" and detailed staffing challenges across the aged care industry.

"Our Wodonga home has been managing the unique challenges of operating on a state border during COVID and lockdown periods in both NSW and Victoria," she said.

"This has presented complex staffing issues.

"To ensure we have a flexible roster available to care for our residents, we have been actively recruiting with the offer to help cover housing and relocation costs and have recently widened our net to New Zealand.

"We make necessary provisions to cover gaps in our roster, including employing local community agency staff as needed.

"We are strongly committed to providing flexibility for our team members such as accommodating later starts or earlier finishes for those with school-aged children, and longer or even double shifts for those who are eager to work longer days.

"We work hard to support an open and formal line of communication with our team and do not tolerate harassment nor coercion in our workplace."

Ms Myer said there was a registered nurse available at the Wodonga home 24/7, including three during the day and one at night.

"Our Wodonga home underwent a full site audit in April 2021 and was found to be compliant to a required level," she said.

"Following this site audit, the Aged Care Quality and Safety Commission re-accredited Bupa Wodonga for two years from June 16, 2021."

All but two of the 44 outcomes were assessed as compliant during the April, 2021 audit.

Standard three, personal and clinical care, was found to be non-compliant as "the Assessment Team found deficits in care delivery in relation to wound management, behaviour management and risk management".

"Overall the needs, goals and preferences of consumers were known by staff and consumers and representatives felt informed of how care was being managed," they said in their report.

A spokesman for the Commission said Non-Compliance Notices were issued in relation to standard three and monitoring was ongoing.

"The Commission conducted an assessment contact at the service in October 2021, which found the service non-compliant with two requirements of the Quality Standards," the spokesman said.

"The Commission continues to closely monitor the service's progress to address the non-compliance. Further regulatory action can be taken."

The spokesman said Bupa Wodonga had been re-accredited but there would be ongoing monitoring.

"On June 16, 2021, the Commission made a decision to reaccredit the service until June 16, 2023," he said.

"This is shorter than the three years typically available to residential services with a strong track record of compliance and means that we will return to the service unannounced sooner, to conduct a comprehensive site audit."

The COVID-19 pandemic has only "accelerated" the problems at Bupa, Rachel and Ashley say.

They lamented a profit-focused culture.

"The managers have started to work on the floor because we're so short staffed, but why couldn't they have done that 12 months ago?" Rachel said.

"Care managers were once in the nurse's station, so they were dealing with staff and residents on a daily basis, but now, they're all in private offices, so they don't actually know their residents anymore.

"With Bupa, it's all about profits - it doesn't matter how drained the staff are."

The Border Mail revealed on Tuesday there were two residents with COVID-19 in the facility.

Eight residents and 14 team members were COVID-19 positive as of Friday; all other residents and staff were RAT tested and were all negative.

Rachel and Ashley contacted The Border Mail about their concerns before Tuesday's article was published, which detailed the concerns of a family member who raised a lack of communication about the cases.

Rachel said the problems experienced by the family at the weekend were indicative of the lack of staffing - she has often had to ring multiple times just to call in sick.

Routine asymptomatic testing of the aged care workforce had been mandated until last December - but Rachel was only tested once because she volunteered and Ashley "has never been tested at work".

"No, Bupa don't need to make a public announcement (about cases), but they do need to answer for quite a few things," Ashley said.

"Staff that are strong are breaking down."

Ms Myer said team members were being tested before they commenced their shifts.

"All of our staff are fully vaccinated and observe our strict COVID infection control protocols," she said.

"Prior to this recent outbreak, asymptomatic testing was made available to all staff at alternating dates and times."

Maria Berry, a Wodonga aged care advocate, was told by a friend with family members at Bupa that they were not notified of the COVID outbreak.

Mrs Berry shared an anecdote of supporting a family member of a resident at Bupa some five years ago.

The woman was significantly traumatised after her mother passed away in circumstances that were not managed well - the resident had pressure sores and there was evidence of a lack of dental care.

"After raising her complaint and taking it as high as she could, she was told it had all been dealt with and the complaint closed," Mrs Berry said.

Ms Myer pointed to the November staff survey at Wodonga that scored above 80 per cent in measures including well-being, fair treatment and the ability to 'speak up.'

"These numbers have increased year on year since 2019," she said.

"Our recent resident survey also found 93 per cent of Wodonga residents say the home is run well with similar numbers responding that they feel safe, cared for and respected.

"Ninety-two per cent of relatives said that we keep them informed at the desired level.

"We provide multiple mechanisms for staff to provide feedback within the home both anonymously or named.

"Our Care Managers are situated in an office in a central location so they can be easily accessed by carers and nurses to discuss work matters in a quiet location.

"We are confident that we have a strong, caring and capable team in place at Wodonga, and we will continue to work hard to lift standards for our residents and team into the future."

Mrs Berry said it was important to be mindful and respectful of staff who go to work with the right intentions, in a "broken industry".

"We need more transparency and honesty across the board with what is actually happening if we are going to find some solutions," Mrs Berry said.

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"There is a fear of staff coming forward and voicing up - there are issues of bullying.

"It is something that has happened time and time again to myself and it is not taken seriously, but the impact it has on you long term is real.

"It is time to open all the doors across Australia and address this issue as we all have a duty of care and responsibility to our older community members."