A Newcastle nursing home has been deemed noncompliant after auditors found 90 per cent of its residents received psychotropic drugs without written consent.
- Anglican Care has been found noncompliant in personal and clinical care at its Greenmount Gardens facility
- Auditors found 35 out of 39 residents were given psychotropic drugs without written consent
- Anglican Care says there were verbal consents
An audit team from the federal government’s Aged Care Quality and Safety Commission did a site inspection at the Greenmount Gardens, Mount Hutton, home in April.
It is run by Anglican Care and operated under the Diocese of Newcastle.
A performance report has since been completed and it found the home failed one of eight standards that related to personal and clinical care.
As a result, the government-funded My Aged Care service has deemed the home noncompliant in that standard.
The audit team highlighted concerns about the use of psychotropic drugs.
The Aged Care Quality and Safety Commission psychotropic medications are “any drug capable of affecting the mind, emotions, and behaviour”.
They include antipsychotics, antidepressants, and benzodiazepines to manage anxiety and insomnia.
Auditors said they found nine out of 10 residents at the Mount Hutton home had received the drugs.
“The assessment team received a psychotropic register, which indicated that 35 [out of] 39 consumers are receiving psychotropics at the service,” the audit report said.
Need for informed consent
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) said there were special rules for using the drugs in aged care.
“Information about the options, risks and benefits of prescribing a medication to a person with dementia must be conveyed to the person or their substitute decision-maker.”
Anglican Care has issued a statement and outlined how the medicines were prescribed.
“Anglican Care takes all reasonable steps to obtain a follow-up written consent from either the resident or their nominated representative.”
The ABC asked Anglican Care if the verbal consent had been documented.
It replied via a follow-up statement.
“The resident’s treating practitioner [the prescriber] must obtain consent from the resident or nominated representative,” it said.
“Anglican Care’s policy and practice ensures that the follow-up written consent is obtained as soon as practicable.”
As part of its privacy responsibilities, Anglican Care could not comment on particular events or residents.
RANZCP said verbal consent was only appropriate in the event of an emergency.
“In an emergency, when the safety of the patient or others is at immediate risk, a doctor can act in the best interests of a patient unable to provide valid consent to their own treatment,” it said.
“When psychotropics are prescribed in such circumstances, informed consent should be obtained as soon as practicable.”
Anglican Care said changes had been made.
“Anglican Care has engaged a senior clinical pharmacist to assist in ensuring that medications are reviewed, monitored, and consents provided that are consistent with its responsibilities,” it said.
Nursing home ‘regretful’
Greenmount Gardens executive director Andrew Wind wrote to residents and their families about the failures in its care.
The Anglican Bishop of Newcastle Peter Stuart was also briefed, as he is the chairman of Anglican Care’s board.
The ABC has obtained the letter.
“I am disappointed to be writing to you about our failure to meet two areas of the Aged Care Quality Standards for your home,” Mr Wind said in the letter.
“We are expected to meet high standards of care. I regret that we did not.
“All remedial action is already in progress.
“The work underway includes improvements to care planning, staff education, and improved processes around the prescription and administration of medication.”
Aged care advocate concerned
The Royal Commission into Aged Care Quality and Safety was told about the perceived overuse of psychotropic medication in nursing homes.
Experts said the drugs were being inappropriately used to manage symptoms of dementia.
The commission was told that when psychotropic medication was used to manage behaviour, it may be classed as chemical restraint.
Professor Joseph Ibrahim is the head of the Health Law and Ageing Research Unit at Monash University.
He said the Mount Hutton case was a concern.
“The problems have been well known for over 20 years now,” Professor Ibrahim said.
“It is disappointing and distressing to hear there was only verbal consent and typically you would expect verbal consent to be documented in the notes to say that was taken.
“What we know is it is widespread, it is not any particular home or any particular doctor. It is through the whole sector.
“The rules that have been put in place are just not effective, nor are they consistent with respecting the human rights of an older person with dementia.”
The Aged Care Quality and Safety Commission said Anglican Care Greenmount Gardens remained subject to compliance monitoring.