Many of the aged care homes hardest hit by Victoria's coronavirus outbreaks were given a clean bill of health by the federal regulator only months before their first infections.
The revelation comes as new data released exclusively to The Age and The Sydney Morning Herald shows the full extent of COVID-19 fatalities in nursing homes. Fifty homes across Melbourne have recorded at least one resident death.
Epping Gardens aged care home received perfect marks in the regulator’s 2018 assessment. Credit:Eddie Jim
The highest death tolls were at St Basil’s in Fawkner, where 44 of the 120 residents died; Epping Gardens (35 of 148 residents); and Kalyna Care in Delahey (23 of 102 residents). The full list of deaths and overall cases in each aged care home appears below.
In the past eight weeks, after coronavirus escaped Melbourne's quarantine hotels into the wider community, 531 elderly Victorians have died in aged care homes. Six more deaths in aged care were recorded on Tuesday.
Since the pandemic hit Australia, all but 31 of the nation's deaths in aged care have been in Victoria.
Analysis of the accreditation process followed by Canberra’s Aged Care Quality and Safety Commission shows the Victorian homes where many coronavirus deaths and illnesses occurred passed their assessments.
One of the nation’s top experts on aged care said the commission too often worked with homes rather than as a true watchdog.
"The government, regulator and providers all understand that [shutting a home] is a problem for all concerned," Monash University's Health Law and Ageing Research Unit head Joseph Ibrahim said.
"This creates an environment where the regulator is often viewed as working in a type of partnership with the homes."
Residents and staff at 19 of Victoria's worst-affected homes accounted for more than 2000 infections.
Epping Gardens, St Basil’s and Estia Health Ardeer collectively had 583 coronavirus infections, and yet all three homes received perfect compliance ratings in audits completed by the regulator in 2018 and 2019.
The home with Melbourne’s worst aged care outbreak, Baptcare Wyndham Lodge in Werribee, has recorded 232 coronavirus cases and 18 deaths. It received a near-perfect assessment from the commission in January.
Among the federal quality standards is a requirement for homes to develop and maintain an infection control and "outbreak management" plan. Homes are required to "implement an effective infection prevention and control program" in the event of any outbreak.
Despite full marks from the regulator for most homes, coronavirus has exposed holes in those infection controls.
Analysis of the audits in 2018 and 2019 for 19 Victorian homes that suffered a coronavirus outbreak revealed that only four had less than perfect marks in the assessment criteria being used at the time. The remaining homes either had a minor area for improvement recorded or had to meet a handful of extra requirements before being allowed to continue operation.
Baptcare Wyndham Lodge received a near-perfect assessment from the commission in January.Credit:Joe Armao
Aged Care Quality and Safety Commission head Janet Anderson – paid almost $500,000 in 2019 according the commission’s annual report – was given the backing of federal Health Minister Greg Hunt last month.
He said she was "one of the toughest cops on the beat" who had been "absolutely fearless in stepping in to protect residents".
Ms Anderson said her agency held aged care providers to account for the quality and safety they provided to older people. She said that during the pandemic it had been using "the full range of our regulatory powers to ensure that providers meet their obligations … [and] mitigate the risks of transmission of the virus".
She said that in August the commission expanded its program of on-site monitoring to include unannounced spot checks of infection-control practices in aged care homes. By last week, 133 of these checks were done in Victoria.
However, information tendered to the Royal Commission into Aged Care Quality and Safety last week showed that between January and March this year, at the outset of the pandemic, the regulator visited just 29 of Victoria's 766 aged care homes.
Federal Aged Care Minister Richard Colbeck announced last week that as part of a $563 million aged care funding extension, residential providers would have to employ "a designated infection control officer on site" to continue receiving extra COVID-19 payments.
Monash University's Professor Ibrahim said this requirement came far too late.
"That should have been happening a long, long, long time ago – it’s what Hong Kong had been doing since SARS," he said.
Mr Colbeck said efforts to strengthen protections for senior Australians "remain a priority for the Australian government".
He said the commission had received millions of dollars in extra funding to help with its regulatory work.
Opposition aged care spokeswoman Julie Collins said the regulator did not have the powers and resources it needed to ensure older people received high-quality care.
"Scott Morrison and the failed Minister for Aged Care must do much more to ensure older Australians are safe and receiving high-quality care in aged care homes," she said.
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