Five years after the event, Victorian State Coroner, Judge Helen Coate, has released the findings of the inquest into the deaths of four residents of the aged-care home, Broughton Hall.

Most of us can remember very well the Broughton Hall gastro outbreak. Not only did four residents die but many other residents became very ill. The outbreak occurred on the weekend. The written guidelines for managing infections were locked in a cupboard and no-one notified health authorities for several days.

When investigators from the Department of Health and Ageing conducted their investigation of the outbreak, they relied on paperwork for their information. The investigation largely took place in the office. Family members and residents claimed that they were not interviewed.

The Coroner has found that there was a lack of 'readiness and procedure' at Broughton Hall. She has recommended that the Department of Health should order aged-care homes to report an infectious disease outbreak within 72 hours - if there is unexplained vomiting or diarrhoea in two or more residents or members of staff.

A further recommendation is that every facility should have a designated infection-control manager. These are hardly world-shattering proposals and are ones that you might expect every aged-care home to do anyway.

But, then again, given the dire staffing situation in many of our homes, it might actually be quite hard to find a designated infection-control manager. After all, these days there doesn't even have to be a registered nurse on site at high care homes only one on call. Often residents are transferred to hospital for relatively minor illnesses as many staff do not have the skills to care for them.

Most of the problems in our aged-care homes get back to staffing issues. Yet the 2011 Productivity Commission Report, 'Caring for Older Australians' focussed far more on structural issues than on the critical matter of how to staff homes with adequate, skilled health professionals. However, Minister for Mental Health and Ageing, Mark Butler, recently announced the appointment of Fair Work Australia Commissioner, Anne Gooley, as the Chair of the Aged Care Strategic Workforce Advisory Group. She is to lead the development of an Aged Care Workforce Compact.

Mr Butler, stated that "The Compact will help the aged care sector attract and retain staff through higher wages, improved career structures, and enhanced training and education opportunities.'

We can but hope!

Date: 27 Feb 2008

Can you believe it? It has come to light that the officials investigating the deaths of five residents in a Melbourne nursing home NEVER LEFT THE FACILITY'S OFFICE!

They checked the paperwork but didn't talk to the recipients of the care.

Even worse, it seems that one resident (who subsequently died) was CALLING OUT FOR HELP during the visit but his cries were not heard because all the action was in the office!

What is going on here? Have those involved in monitoring our homes for frail older people become so desensitised or brainwashed that they really think that looking at paperwork and chatting in the office tells you all you need to know about the quality of care received by residents? OR that it tells you all about the efficacy of the infection control?

This Column has long decried the emphasis on paperwork at the expense of on-the-ground care. Almost every staff member I know talks about the ridiculous nature of the current documentation requirements. But no-one is listening.

Ministers for Ageing come and go and nothing happens, nothing changes. And hard-pressed staff continue to spend precious time in the office when sick, frail people are calling out for help. How we all must hope that we are spared this fate when our turn comes.

Justine Elliot, the current Minister for Ageing, says that guidelines for those investigating clinical care in nursing homes are being revised. It is hard to think that it takes new guidelines to ensure that those checking on our homes actually talk to residents and their families - but if that's what it takes!!

Prime Minister Rudd is holding a 2020 talkfest up in Canberra soon. He says he wants bright people with bright ideas to help move us all into the future. So far I haven't seen any mention of aged care as one of the pressing issues needing new ideas. But then you don't need to be all that bright to know that writing down everything doesn't mean that it gets done - or that aged care needs a complete overhaul.