When a new carer arrived at Anna’s* front door a few weeks ago to help with the care of her father, the first thing she asked him about was his qualifications.

“I have none,” the carer replied.

Confused for a moment, Anna asked, “Do you mean you have the minimum, just Certificate III?”

“No, I’m training on the job,” he said, adding that due to COVID-19 all training had been moved online.

Incredulous, Anna asked about the carer’s background, thinking perhaps he meant his qualifications had expired.

“I used to work at Woolies”, he said.

“I said, ‘you’re kidding me’,” Anna told HelloCare when we spoke this week. The gentleman had “no experience in the field whatsoever”. He was attending online classes, but was completely unsupervised – no buddy shifts, and no one assessing him. 

“This guy was working at Woolies one day and doing an online course and entering people’s homes the next,” she said.

The gentleman tried to reassure Anna that he was able to call the provider’s office to ask for help if needed, but otherwise he was in the community, performing a range of home care duties including administering medication.

Anna told the gentleman he was not to administer any medication to her father, including medication in Webster packs and liquid Panadol. The carer suggested he could “prompt” her father to take the medication himself.

Horrified, Anna told the gentleman her father is living with advanced dementia and any medication he takes has to be administered to him. 

Anna made it clear to the carer she would administer all medication to her father during his shifts.

Anna contacted the Aged Care Quality and Safety Commission, who suggested she make a complaint and write about her experience to the Royal Commission into Aged Care Quality and Safety. 

An experienced carer herself

Anna understands the rights and responsibilities of aged care consumers and providers. She used to work in aged care herself, and before caring for her father these last three years, she spent 17 years caring for her late husband. Both her husband and her father developed dementia, as well as other serious illnesses.

Anna has a professional set up for her father, with a hospital bed, air pressure mattress, and commode. “I’ve got everything,” she said. “I knew what to get.”

A veteran, Anna’s father is ”blessed” to be entitled to the Department of Veterans Affairs services. 

Anna self-manages his care package because it entitles her to more hours of care; they receive “more bang for their buck”, she said.

Staff must be qualified to do their job

The Department of Health issued a statement to HelloCare, stating that, “Members of the provider’s workforce must have the qualifications and knowledge to effectively perform their roles.”

A statement from Janet Anderson PSM, Aged Care Quality and Safety Commissioner, said in most states and territories some care workers are able to administer medication, and it’s up to the aged care providers to ensure they comply with the relevant laws.

Ms Anderson said all aged care providers, including home care providers, are legally required to comply with the Aged Care Quality Standards, which covers the administration and management of medication.  

Standard 3 (3) (b) requires “effective management of high-impact or high-prevalence risks associated with the care of each consumer. This includes managing medications safely.”

And Standard 8 (3) (e) requires aged care providers to “develop a clinical governance framework”. 

“A provider’s clinical governance framework is expected to refer to policies and protocols to manage the clinical risks associated with medication management,” Ms Anderson’s statement said. 

Aged care providers are also expected to have policies to “monitor” risks related to medication management, including “policies that identify those medicines the service provider does not authorise staff to administer”. 

When assessing aged care providers’ compliance with the Quality Standards, the Commission looks for evidence of “adequate medication administration and management including appropriate identification, handling, timing, and management of medication”.

For more information about home care medication management

Earlier this year, the Commission began the ‘Better Use of Medication in Aged Care Project’ which aims to reduce (and ideally eliminate) the inappropriate use of medicines in aged care settings. Click here to find out more.

The Department’s Guiding principles for medication management in the community’ provides information about the “quality use” of medicines and medication management in aged care the community. 

Further information is also available on the Department’s website to help consumers to understand the medicines they are taking and how to use them correctly. Click here to find out more. 

“I’m peeved off”

Anna said she complained to the regional provider who insisted the carer is in training, and in their view that was adequate. Her complaints to the provider in the past have not been taken seriously, with the provider turning them around to be a negative reflection on her.

Anna said she has strong medication in the house, and it frightens her to think what might have happened if the carer had administered medication and given her father the wrong drug.

“Imagine what would have happened if I hadn’t been here,” she said.

“I’m really peeved off,” she said. “I don’t want him back here, but they say they can’t provide the care without him.”

If you are concerned about an aged care service, you can make a complaint to the Aged Care Quality and Safety Commission through their website or by calling 1800 951 822.

* Name has been changed.

Image: byryo, iStock.

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