Amid a royal commission into the aged care industry, Mudgee’s Pioneer House is supposedly failing to adequately provide for its paying residents.

It is believed that it was Pioneer House staff who first raised concerns about failing to meet accreditation standards.

These failures have led to the drastic implementation of sanctions on the aged care provider by the Department of Health.

In February, Members of the NSW Nurses and Midwives’ Association (NSWNMA) raised concerns for the welfare of residents, as well as their own personal safety while on-shift at Pioneer House.

The NSWNMA issued a press release with comments from General Secretary of the NSWNMA, Brett Holmes, where he said the facility has an important duty of care.

“Residents with high care needs, and their families, deserve to know whether or not they are receiving the high level of care they require,” he said.

“It’s disappointing local management chose to cut an Assistant in Nursing position from all morning and afternoon shifts, without taking into consideration the concerns of our members for the delivery of care to residents,”

“This has only exacerbated the current workload issues being experienced at the site. Unsafe workloads, a lack of support from management and fears around resident safety are a recipe for disaster in any aged care setting.”

The press release further listed some of the comments they had received from members at Pioneer House.

“When we have fewer staff the buzzers go unanswered for longer… We’re worried that the residents aren’t getting proper care.” one person said.

“When we don’t have enough staff on the morning shift, it can be quite late by the time we get residents out of bed. This has serious impacts for their ability to socialise with other residents.”

“I leave work worried that I haven’t done a good job. I think about leaving some days because it’s so bad.”

“Even before the cuts they weren’t replacing staff. We worry that now with even fewer staff it’s only going to get worse.”

The NSWNMA said they filed a dispute to the Fair Work Commission against Pioneer House for failing to consult over its staffing restructure.

Brett Holmes, General Secretary of the NSWNMA said this highlights the issues with inadequate staffing

“Residents in aged care are missing out in all parts of NSW, due to inadequate staffing," he said.

“The NSWNMA is disappointed the concerns of our members were ignored for so long. In many instances aged care nurses are ‘the canary in the coalmine’ given the number of times they have raised concerns about unsafe staffing levels, working in isolation and missed care,"

“Management has a duty of care to ensure the safety of the residents. The best way to ensure proper care is extended to all residents is to introduce mandated ratios in aged care.”

A letter obtained by the Mudgee Guardian was distributed to residents and people connected to residents in early March from the Department of Health.

The letter states:

Between 20 and 21 February 2019, the Aged Care Quality and Safety Commission (the Commission) visited Pioneer House Aged Care and found that it is not providing care consistent with the Accreditation Standards.

As Pioneer Aged Care has failed to meet the Accreditation Standards, I have imposed sanctions that require Pioneer House Living Limited (the organisation that own Pioneer House Aged Care) to make improvements which ensure that these failures are fixed.

The letter details the sanctions, which include that Pioneer House will not receive any payments from the Australian Government for new residents until August 27 this year, which limits the number of residents that can be accepted into care.

It also says that an adviser ‘must be appointed by March 5’ to assist Pioneer House in meeting their ‘clinical responsibilities.’

Finally, Pioneer House must provide training to all staff to address any skill gaps identified by ‘the Commission.’

A meeting was held at Pioneer House on Thursday, March 14 to 'provide information to all residents, relatives and representatives about the sanctions and to answer any questions...'.

The Mudgee Guardian fielded numerous calls from concerned family members and staff, all which asked to remain anonymous, that say they feel angry and frustrated with the lack of transparency and asked the Mudgee Guardian to ask questions of the board and CEO on their behalf because they either couldn't attend the meeting or were afraid of being singled out.

The Mudgee Guardian entered Pioneer House with the aim of covering the meeting and asking questions but were asked to leave before the meeting started.

It was stated that the meeting was private and that we could email the CEO, Fran Trisley with any questions.

Pioneer House CEO and Director of Nursing, Fran Trisley was contacted for comment by the Mudgee Guardian. Her response is in full below:

A comprehensive improvement process is underway at Pioneer House in response to the Department of Health’s findings that our home has not met all of the requirements under the government’s aged care accreditation standards.

Our team is treating this matter with the utmost seriousness. As a not-for-profit, community-founded and run organisation we exist only to provide the highest quality care for the seniors of Mudgee and district, as we have done for more than 50 years.

We are immensely disappointed that in this instance we have not met all of the accreditation standards.

While we continue to work on our improvement program, some of the actions we have already put in place include engaging an independent clinical nurse adviser to provide additional oversight and support in this critical area; and commencing a review of staff training, with a view to delivering additional training as soon as possible.

We are keeping residents and their families and staff fully informed. Our focus remains on continuing to deliver quality care to our residents.

The Mudgee Guardian also spoke to several people attending the meeting at the entrance to Pioneer House and via phone calls. 

One woman who spoke asked to remain anonymous because they were afraid of their mother being singled out.

"That’s everyone’s concern I think, no one wants to speak out for fear of what’s going to happen to them when we’re not here. Is there going to be retribution?" she said.

"I’m here because mum wants me to be here with her when I take her to the meeting. She’s afraid of speaking up."

When asked what they hoped came of the meeting, they made their expectations clear.

"I’d like some answers as to how we got into this position in the first place. That's the starting point. It’s all overwhelming, it was such a well-regarded establishment in the community and now not so much."

Another family member who also wished to remain anonymous detailed instances of neglect told to them by a relative who is a resident.

"I’m hoping they will put more staff on. My brother is on full-time oxygen and the other day he needed a nurse to set him up and she didn’t even know how to turn the oxygen bottle on,"

"They’re not all trained in simple things. Sometimes he doesn’t get a shower for days and days,"

"I think that they might come in and ask and he says ‘not now, because it takes him a while to get ready for it’ and they never come back,"

"Whether they get caught up with something else and forget because they’re understaffed, I’m not sure."

Another resident asked for help going to the bathroom and was allegedly told that they'd need to get themselves to the bathroom because there were no staff on hand to assist. The resident was unable to and subsequently soiled themselves before help arrived.

The Mudgee Guardian has again reached out to the CEO and invited her to answer further questions.