An aged care facility on the NSW south coast has come under fire this week after it was revealed that a resident was admitted to hospital with maggots in his head wound.

Bupa Aged Care Eden made headlines only weeks ago after it became the 9th Bupa aged care home to be sanctioned for failing to meet compliance standards and described by the Department of Health as a “severe risk to the health, safety, and wellbeing of care recipients.”

The Bupa Eden facility failed five of the 44 aged care accreditation standards last August, and this deterioration continued when the facility failed 22 of the necessary 44 standards.

But hopefully, this unfortunate finding will be the last, of what has been a horror eight months for the NSW facility.

As grotesque of a notion as it may be, maggots infestation of a wound, otherwise known as wound myiasis, is actually a problem that occurs from time-to-time in aged care facilities.

Catherine A Sharp, Founder, and CEO of Sydney’s The Wound Centre has over 20 years of experience dealing with wounds and shared her thoughts with HelloCare on the issue.

“I’ve seen maggots many times over the years as a wound care consultant for aged care facilities, we have big blowies (flies) in Australia and they can land on wounds and lay their eggs,” said Catherine.

“Wound management can be very complicated, it can come down to hygiene, or it can even be as simple as inappropriate dressing, often wounds are dressed with things like gauze, and flies love to land on them.”

“I can’t comment on this particular incident without knowing all the facts, but what I do know is that a number of aged care staff work in very tough circumstances and having two staff to care for 50 or 60 people is not a recipe for good overall care, and that includes wound management.”

Thoughts From The Minister

Minister for Senior Australians and Aged Care, Ken Wyatt AM, MP, voiced his concerns yesterday over the disturbing find at the Bupa facility labelling the incident as ‘totally unacceptable.”

“It’s concerning that an aged care provider who has had a visit from the Aged Care Safety and Quality Commission, should just in a short period after, have someone who has maggots in a wound,” said the Minister.

“The quality agency will certainly go back to that Bupa facility and will not allow them to provide reasons that are unacceptable for anybody to have a wound with maggots.”

“I am disappointed that they’ve allowed this to happen because if we give care and attention to an individual, then you should pick up if there is something wrong.”

“It doesn’t matter what it is, and an examination of individuals if they complain of pain or something that may vary from their normal personality on a day to day basis needs to be taken into consideration. And the causative factor then looked for and found and treated.”

The Minister also did his best to assure the media that those regulating the industry are doing their very best to arrest concerns of the quality of care that Bupa has been providing to residents.

“ The agency has been in talking to the management of that organisation on a raft of matters, I know that senior officials from the department have also met with the organisation and they have made it very clear that there are a number of concerns that we have as a government, as a department and as an Aged Care and Quality Safety Commission and we need them to address it.”

“If they fail, sanctions are applied which means they don’t have access then to Commonwealth funding and ultimately, as we have done in the past, we’ve closed facilities that have not performed as required by the Act or under the standards.”

Thoughts from the Aged Care Quality and Safety Commission

The Following is a statement from a spokesperson representing the Aged Care Quality and Safety Commission:

The former Australian Aged Care Quality Agency, and now the Aged Care Quality and Safety Commission (Commission), have been closely monitoring and assessing the compliance of Bupa Eden since July 2018 following a complaint to the former Aged Care Complaints Commissioner.

The Commission most recently visited the service between 26-28 February 2019. At this time, our quality assessors became aware that a resident of the service had been admitted to hospital with maggots in a head wound. The Commission urgently sought further advice from Bupa Eden on this matter, and is currently undertaking a full review audit of the service’s compliance with the Accreditation Standards.

Bupa Eden is also currently subject to sanctions by the Department of Health until 7 June 2019, and the approved provider is not eligible to receive Commonwealth subsidies for any new care recipients at the service.

Under the current sanctions, the approved provider status of Bupa Eden is revoked unless conditions outlined below are undertaken:

  • appoint at their expense, an adviser to assist with complying with responsibilities in relation to care and services
  • appoint at their expense, an administrator to assist with complying with responsibilities in relation to governance and business operation
  • to provide, at their expense, training for officers, employees and agents.

Sanctions require the service to remedy the issues promptly, and are intended to assist the service to implement changes so that they can maintain compliance. In the event that there is recurring non-compliance, including following a sanction, and there continues to be an inability or unwillingness by the service to address the non-compliance, the Department of Health may consider revoking the service’s approval to provide aged care. Revocation of approval to provide aged care does not preclude an aged care service operating without Commonwealth subsidy.

Where a number of services operated by the same approved provider are found to have a level of non-compliance with the applicable Standards, the Commission may seek to discuss this situation with the approved provider for the purposes of ensuring that the Board or other governing body is fulfilling its responsibility to oversee the work required to address the issues effectively and as quickly as possible.

The Commission is closely monitoring aged care residential services owned by Bupa Aged Care. The Commission uses information from a range of sources, including feedback from consumers, to target areas of highest risk. Our quality assessors undertake a number of different types of regulatory activities, including unannounced monitoring visits, re-accreditation audits and review audits. All re-accreditation audits undertaken by the Commission are now unannounced, and we are working to expand the proportion of visits undertaken out of business hours.

How Does Maggot Infestation Happen?

Flies have a keen sense of smell and can find rotting organic material from a long distance away, and the decaying human tissue found in a wound bed is the perfect breeding ground for flies that are wanting to lay eggs.

Maggots can be extremely hazardous to any open wound bed due to the fact that they can carry a large amount of disease and bacteria that can cause further complications to a wound.

There are a number of factors that can increase the likelihood of a person developing this kind of infestation on a wound, but the vast majority of them relate to conditions or circumstances that are conducive with poor hygiene.

People who have a reduced ability to clean and monitor their own wounds have an increased risk of wound infestation and unfortunately, this can relate to elderly Australians.

Elderly Australians in aged care environments are often one of a number of people who may require assistance with wounds and other medical issues throughout the day, and the growing workload of aged care employees increases the chances of issues like this occurring.

Surprisingly, maggots have actually been used to treat wounds in some instances, but this requires a very specific breed of fly called the Green Bottle fly, that only consume dead tissue.

 

If anyone has a concern or wishes to make a complaint about an aged care service, they should contact the Aged Care Quality and Safety Commission on 1800 951 822.

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