COVID-19 and Aged Care in Australia

RAM

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But it's really not certainty. It's a bunch of "at least until..." qualified with absurd targets. There will not be a fourteen-day window with zero infections in the foreseeable future.
Still waiting on Scott Morrison's promise made back in March - for a National Aged Care Industry Covid-19 plan - made just after Dorothy Henderson Lodge made the news.

review of dorothy henderson lodge (dhl) covid-19 outbreak
agedcare.royalcommission.gov.au › system › files › CT...

PDF
Dorothy Henderson Lodge is an 80-bed nursing home which is part of a retirement living complex operated by. BaptistCare, in Macquarie Park in northern Sydney.

Do hope it exists BEFORE I need to reside in one!
 
Then you need to read the 2 independent reports on the Newmarch house outbreak.They were asked on the first day whether they needed extra help and they said no.it wasn't until 8 days in that they asked and the position was then dire so took a little while to get the numbers.The Newmarch house on site management was replaced.Again I have previously linked to them
The earlier NSW Aged care outbreak was well managed with minimal mortality.Both were under control of the Nepean heath districts Hospital in the Home service.This was in line with the Commonwealth plan for aged care that it was the State Health Departments who should take control of the health aspects of any outbreak as they had the hospitals and staff.
The Commonwealth did contract aged care staff to help in any outbreaks.The Commonwealth also agreed to supply Aged Care PPE out of their stockpile.They provided what they thought to be a reasonable supply to Newmarch house but the Inquities were told that Newmarch were overusing PPE to the extent of 8 times over predicted needs.
Dear drron,

where is the link to the document produced by the Federal Govt setting out in detail the "Federal Aged Care Covid-19 plan & protocols"?

I have provided the links from the most up-to-date Fed Govt Dept of Health site - & there is no such document anywhere to be found.

The Fed Govt's response to the Aged Care Royal Commission is that no such document exists, but is being worked on.

The Fed Govt keeps refusing to mandate a minimum staff to resident ratio for normal times, let alone in a pandemic. Not even a requirement to have an RN on-duty overnight.

So if I am missing something, please provide the link to the many hundred page long document, "Federal Aged Care Covid-19 plan & protocols" instead of mentioning putting up links somewhere sometime in the past.

About Newmarch House & Dorothy Henderson Lodge - the Aged Care Royal Commission has both the emails & testimony that the Federal Govt had NO staff pre-arranged either at the time the statement was made by Scott Morrison nor when the requests were made. Merely it was the intention that staff WOULD be able to be sourced, they thought, if needed. The Federal Govt, in writing, admitted they did not expect that staff at any Nursing Home would need to quarantine themselves at home.

In the end NSW staff were used from the local public hospital - NO Federally sourced staff. I know this as a friend of mine was one of them (much to her family's concern).
 
Dear drron,

where is the link to the document produced by the Federal Govt setting out in detail the "Federal Aged Care Covid-19 plan & protocols"?

I have provided the links from the most up-to-date Fed Govt Dept of Health site - & there is no such document anywhere to be found.

The Fed Govt's response to the Aged Care Royal Commission is that no such document exists, but is being worked on.

The Fed Govt keeps refusing to mandate a minimum staff to resident ratio for normal times, let alone in a pandemic. Not even a requirement to have an RN on-duty overnight.

So if I am missing something, please provide the link to the many hundred page long document, "Federal Aged Care Covid-19 plan & protocols" instead of mentioning putting up links somewhere sometime in the past.

About Newmarch House & Dorothy Henderson Lodge - the Aged Care Royal Commission has both the emails & testimony that the Federal Govt had NO staff pre-arranged either at the time the statement was made by Scott Morrison nor when the requests were made. Merely it was the intention that staff WOULD be able to be sourced, they thought, if needed. The Federal Govt, in writing, admitted they did not expect that staff at any Nursing Home would need to quarantine themselves at home.

In the end NSW staff were used from the local public hospital - NO Federally sourced staff. I know this as a friend of mine was one of them (much to her family's concern).
You just love conspiracy theories don't you RAM.Many of course aren't what you think you know.Same with Newmarch house.You might want to read the Independent Inquiry report which refutes the Royal commission statement.And despite your friend knowing that there were no staff sourced from the Commonwealth that also is wrong as is well documented inthat report.
The report can be downloaded from here as well as the NSW dept. of Health answer trying to paint themselves in a better light.

A few excerpts.
On 12 April 2020, public health officers from the Nepean Blue Mountains Public
Health Unit (PHU) identified seven staff members who were close contacts of one or
both of the first two cases (one staff member and one resident) and required them
to home-quarantine. Professor James Branley, Director of Infectious Diseases at
Nepean Hospital, visited Newmarch House the same day and recommended that
residents with COVID-19 be admitted to the Nepean Hospital hospital-in-the-home
(HITH) program, in accordance with established Nepean Blue Mountains Local Health
District policy for COVID-19 patients.

Anglicare initially rejected offers to utilise the Department of Health’s surge
workforce program (via Aspen Medical and Mable®) on the basis that some of these
staff were reportedly unsuitable or that it would be able to source its own staff. They
successfully utilised several other agencies to bolster the workforce during this
challenging time. During the outbreak period, Aspen Medical and Mable® provided
less than 20% of the non-Anglicare care workforce with the remainder sourced from
other agencies, including St Vincent’s Hospital, which assisted specifically with the
provision of Registered Nurses.

Among the IPAC issues identified during this review, was the continuous,
unnecessary use of ‘full’ PPE (gowns, gloves, masks) in non-clinical ‘clean’ areas such
as the entrance foyer, offices and staff rooms and failure to change to fresh PPE on
entry to the rooms of COVID-19 negative residents. This represented a risk to other
residents and staff, if one of these residents was later diagnosed with COVID-19 and
potentially infectious, before the diagnosis was confirmed. Later when there were
shortages, full PPE was restricted to care of residents with known COVID-19. These
inconsistencies of use and the poor quality of some PPE meant that staff who had
been caring for residents, before they were diagnosed with COVID-19, were
automatically deemed to be close contacts and quarantined, sometimes possibly
unnecessarily.

Responding to initial and ongoing concerns about the outbreak at Newmarch House,
the Commission delivered a series of Notices and remedial actions under the
provisions of the Aged Care Quality and Safety Commission Act 2018. These included
an administrative direction on 23 April 2020, a Non-compliance Notice on 3 May
2020 and finally, a Notice to Agree on 6 May 2020. The second Notice outlined a
number of requirements, including suspension of the admission of new residents
and the appointment of an Adviser.

The Commission issued an Administrative Direction to Anglicare on 23 April 2020
requiring it to engage an external management team from the BaptistCare. This
team of three senior managers had had previous experience with the first Australian
COVID-19 outbreak at the Dorothy Henderson Lodge. Anglicare agreed cooperatively
to this arrangement, recognising that guidance was required and that
there was already mutual respect between the Approved Providers. The BaptistCare
team arrived the following day, on Friday 24 April 2020 and feedback indicated,
unequivocally, that this was a welcome turning point in the management of the
outbreak at Newmarch House.

Following the appointment of the Baptistcare team on 24 April 2020, one of the first
changes was to implement 12-hour rostered shifts, with the aim of limiting
opportunities for spread of COVID-19 between staff members. This new roster
commenced on 2 May 2020.

Then you might like to read this recent piece by a palliative care physician.

He is not convinced that the Royal commission is the place to work out problems in the pandemic response.
The Royal Commission into Aged Care Quality and Safety has also bought into the issues of the pandemic in aged care as though they are a stand-alone problem, and applied the inquisitorial style of interrogation of our prosecutorial/adversarial legal system to civil servants; those working within a system that they did not create and for which we are all responsible. It seems rather unfair to seek to allocate blame for immediate impacts of a pandemic imposed on the consequence of decades of poorly considered responses to a problem identified by demographers 50 years ago.
 
You just love conspiracy theories don't you RAM.Many of course aren't what you think you know.Same with Newmarch house.You might want to read the Independent Inquiry report which refutes the Royal commission statement.And despite your friend knowing that there were no staff sourced...
Dear Drron - I see you are unable to provide any link to a "Federal Aged Care Covid-19 plan & protocols" document.

Also, please do not mis-quote. It is not becoming.
In the end NSW staff were used from the local public hospital - NO Federally sourced staff. I know this as a friend of mine was one of them (much to her family's concern).
My friend was 'volunteered' in from the local public hospital as there were no medical staff able to be provided by the Federal Dept of Health when first asked for.

I prefer to believe the evidence tendered at the Royal Commission over 'independent reports'. The threat of criminal prosecution for giving false evidence at the Royal Commission tends to produce more 'accurate' memories, especially when prompted by email trails.

"Independent reports" for some reason often seem to meet the needs of who paid for them. A bit like what happened with the CSELR project in NSW - which after I presented the evidence to the Auditor General's Transportation team they decided to investigate the project.

2015 08 20 Light rail company has bribery background.jpg

Yet there were no probity issues with the company being awarded the project despite being under investigation for bribing to win transportation (light rail for example) & power projects in over 13 countries, and actually admitted to having two departments with the sole purpose of bribing Govt MPs & bureaucrats to win transportation & power projects respectively.

BTW - they agreed to pay the USD 800m criminal fine just 4 days after Gladys awarded them their second multi-billion contract. No conspiracy theory - just have to love those independent reports (if you're Alstom at least!).

Seems 48 hours of taped conversations of the Paris-based Board of Directors discussing how much to pay certain politicians & bureaucrats (sourced by one getting a choice of 'assisting with advanced investigative techniques aka wearing a wire' or 'being in Rikers Island within 20 minutes') - saw Alstom cave. Amazing what the FBI will tell you if you ring the Agent-in-charge!

For some reason all the independent reports on the CSELR were flawed but they did support the project going ahead with no risk of cost blow-outs.

With the small number of consultancies always gaining the Govt contracts it does make one wonder about:

"He who pays the piper, calls the tune."

or perhaps:

"Don't bite the hand that feeds you."
_______________________________________​
BTW in one of the links you posted, the physician makes this point:

"The scope of the Independent Review was limited to the events in Newmarch House and little mention was made of the context of the pandemic or the role of NSW Health and the Commonwealth."

Yes, that sounds like the kind of independent review set up by politicians not to look into the shortcomings of either the State or Federal Govts.

No conspiracy theory - just hard documented evidence over wishful thinking.
 
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Dear Drron - I see you are unable to provide any link to a "Federal Aged Care Covid-19 plan & protocols" document.

Also, please do not mis-quote. It is not becoming.

My friend was 'volunteered' in from the local public hospital as there were no medical staff able to be provided by the Federal Dept of Health when first asked for.

I prefer to believe the evidence tendered at the Royal Commission over 'independent reports'. The threat of criminal prosecution for giving false evidence at the Royal Commission tends to produce more 'accurate' memories, especially when prompted by email trails.

"Independent reports" for some reason often seem to meet the needs of who paid for them. A bit like what happened with the CSELR project in NSW - which after I presented the evidence to the Auditor General's Transportation team they decided to investigate the project.

View attachment 227106

Yet there were no probity issues with the company being awarded the project despite being under investigation for bribing to win transportation (light rail for example) & power projects in over 13 countries, and actually admitted to having two departments with the sole purpose of bribing Govt MPs & bureaucrats to win transportation & power projects respectively.

BTW - they agreed to pay the USD 800m criminal fine just 4 days after Gladys awarded them their second multi-billion contract. No conspiracy theory - just have to love those independent reports (if you're Alstom at least!).

Seems 48 hours of taped conversations of the Paris-based Board of Directors discussing how much to pay certain politicians & bureaucrats (sourced by one getting a choice of 'assisting with advanced investigative techniques aka wearing a wire' or 'being in Rikers Island within 20 minutes') - saw Alstom cave. Amazing what the FBI will tell you if you ring the Agent-in-charge!

For some reason all the independent reports on the CSELR were flawed but they did support the project going ahead with no risk of cost blow-outs.

With the small number of consultancies always gaining the Govt contracts it does make one wonder about:

"He who pays the piper, calls the tune."

or perhaps:

"Don't bite the hand that feeds you."
_______________________________________​
BTW in one of the links you posted, the physician makes this point:

"The scope of the Independent Review was limited to the events in Newmarch House and little mention was made of the context of the pandemic or the role of NSW Health and the Commonwealth."

Yes, that sounds like the kind of independent review set up by politicians not to look into the shortcomings of either the State or Federal Govts.

No conspiracy theory - just hard documented evidence over wishful thinking.
The Independent Inquiry was by a professor in infectious diseases with a specialist nurse in infection control.They know a little bit more than lawyers and judges in this situation.
You obviously have no understanding of the Commonwealth/State responsibilities.
It is true that the Commonwealth has controll of the funding and accreditation of Aged Care Facilities.however it is the States that have the coverage in matters of Health.They have the doctors,nurses and hospitals.If you had read the reports I linked you would see that it was the NSW Dept.of Health that had the on site control of the outbreak of Covid at Newmarch and control was given to the Infectious disease physician at Nepean hospital.The Commonwealth supervised the administration of the facility.
During the outbreak they intervened on 3 occasions first installing administrators from Bapticare who had successfully managed the Dorothy Henderson outbreak.Then they put in an Administrator from Catholic Healthcare to take over the communication with residents,families and workers.The third occasion was when they put the Catholic Healthcare administrator in charge of Newmarch.He was still in charge last week.
So what you are asking for will never happen as it is in the area of the States duties.
As to staffing levels they haven't been satisfactory for at least 50 years-as was explained in the link to the MJA article i provided.

But you are probably unaware that the Commonwealth has had a Pandemic plan since 2006.You didn't find that one did you.
 
But you are probably unaware that the Commonwealth has had a Pandemic plan since 2006.You didn't find that one did you.

Was that the Pandemic Influenza plan? Interesting to read what that says about Cruise Ships compared to reality....

That one needs an update to recognise the Influenza ain't the only pandemic....
 
The problem isn't with the plan which is constantly updated but the fact that it appears to have been forgotten.
In 2004 the world was looking at a possible Avian flu pandemic.at an International Infectious disease Conference Australia's Federal Minister for Health gave a speech that got widespread good reviews from the professionals.He then set up a process to develop our Pandemic plan.Though it is an Influenza pandemic plan a lot of it is relevant to the Covid Pandemic such as-
In the event of an escalation of human cases overseas, a move toward tighter management of passengers arriving in Australia will be considered. This will involve measures such as “positive pratique” for incoming international flights. Under positive pratique, the pilot of an aircraft is required to report on the condition of passengers and crew before landing.

Other measures include using thermal scanners to screen for fever, clinical assessment of symptomatic passengers by nurses stationed at the border, and short-term quarantine of arriving passengers potentially exposed to the virus. All passengers will be required to fill out “health declaration cards”, which will detail symptoms and request personal and contact details (Box 2). This will facilitate timely contact tracing.

And-
Since 2003, the Australian Government has developed a stockpile with a high per capita quotient of antivirals, antibiotics, personal protective equipment (PPE) for infection control, quarantine supplies, and additional ventilators for patients requiring intensive care.

In the event of a pandemic, the Chief Health Officers of the affected states or territories will request supplies through the Chief Medical Officer of the Commonwealth Government.

Plus-
The Australian Government has commissioned experts in Australia to model the effect of public health interventions on the spread of a pandemic. The results indicate that the use of quarantine, social distancing, and personal hygiene could have a significant effect in slowing and reducing the impact of a pandemic.7 The addition of antivirals greatly assists in the “ring fencing” of an outbreak. The results of this modelling have been echoed by international studies.8,9,10,11

Social distancing refers to all non-pharmaceutical methods of infection control. It includes reducing contacts in the community by not holding mass gatherings and by encouraging individuals to keep distance from others in communal settings. It also includes personal hygiene such as frequent hand washing, cough and sneeze etiquette, and reduction in close human contact (no kissing, no hugging). Social distancing is an extremely effective tool, particularly when applied both in the community and in the home.7,8

The combined effect of quarantine, social distancing, and targeted use of antivirals may allow a pandemic to be controlled or prevented from taking off in Australia for more than a year.7,8,9,10,11


And for the latest update.
 
Still no link to the promised "Federal Aged Care Covid-19 plan & protocols" document. Saying you have posted links to it that do not exist is not a good look.

The undertaking to produce a "Federal Aged Care Covid-19 plan & protocols" document was made repeatedly by various senior Federal Govt ministers including the Prime Minister. Specific Federal plans & documents on Covid-19 have been released for other industries btw.

It is yet to be fulfilled.

I am afraid the Influenza plan (last updated) 2019 does not fulfill an undertaking for Covid-19.

An undertaking that was made roughly two years after the influenza plan from 2014 was last updated in 2019.

When the long overdue "Federal Aged Care Covid-19 plan & protocols" document is released then please post the link.
 
Just to help in the search for the elusive plan.

Here's the less than a 1 page spin document presaging it & why it is needed as well as who benefits - date: March 2020


Description:
This information sheet includes:

  • why is this important?
  • who benefits?
  • how much will this cost?

Now all that is needed is the National Plan for Aged Care as announced.

Enough conspiracy theories - just the facts for a change please!
 
Well if you had followed the links in my threads you should have got to this.there is a lot that has been done.but just to restate-the commonwealth Government is responsible for funding and supoervision.The State governments are responsible for Heath and hence the treatment and hospitalisation of those in Aged Care.



 
Victoria, after allowing 800+ residents to die in a covid outbreak the state failed to stop, is now throwing it's weight around trying to tell others what to do? Maybe I am being extreme but it almost seems as though it is arrogance that permeates the state government.


Maybe you should learn some facts:
The people who died in aged care were in federally regulated aged care homes. The regulation is the responsibility of the federal government, not the state government.



State-run aged care—which operates under the Safe Patient Care Act 2015, which enshrines in law minimum numbers of nurses and midwives to care for patients—has recorded very few COVID-19 cases and no deaths. Private facilities have no such quotas.


There were no active cases of COVID-19 in residential aged care before 7 July 2020 but by 13 July 2020 there were 28 cases. By 9 August 2020, the day before our hearing commenced, this figure exceeded 1000. The first recorded death of an aged care resident from COVID-19 in Victoria was on 11 July 2020. As at 13 September 2020, there have been 563 deaths.101

During this period, both the Australian Department of Health and the Aged Care Quality and Safety Commission were active in providing advice. However, this did not extend to mandating, or recommending, the use of face masks in aged care facilities. This is despite the fact that, according to Professor McLaws, masks are ‘a very cheap and effective method’ of slowing the spread of COVID-19.
https://agedcare.royalcommission.go...0/aged-care-and-covid-19-a-special-report.pdf Quotes taken from pp15-16


The Aged Care Royal Commission was scathing about the Federal government's action (or more specifically lack thereof) re their responsibilities enforcing regulations in aged care facilities.

Oh, and the usual rejoinder here that 'the Federal government doesn't run aged care' , is a classic example of a non-sequitur response.

Finally to assert that the 'Victorian government allowed 800+ residents to die' is truly offensive. It's never been argued or asserted that anybody in the Victorian government 'allowed' people to die.
 
Oh, and the usual rejoinder here that 'the Federal government doesn't run aged care' , is a classic example of a non-sequitur response.

Ha ha. Rejoinder not needed when its right there on your mind. :)
 
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Maybe you should learn some facts:
The people who died in aged care were in federally regulated aged care homes. The regulation is the responsibility of the federal government, not the state government.







https://agedcare.royalcommission.go...0/aged-care-and-covid-19-a-special-report.pdf Quotes taken from pp15-16


The Aged Care Royal Commission was scathing about the Federal government's action (or more specifically lack thereof) re their responsibilities enforcing regulations in aged care facilities.

Oh, and the usual rejoinder here that 'the Federal government doesn't run aged care' , is a classic example of a non-sequitur response.

Finally to assert that the 'Victorian government allowed 800+ residents to die' is truly offensive. It's never been argued or asserted that anybody in the Victorian government 'allowed' people to die.
No HVR the truth is the Federal Government doesn't run health.The States do even in aged care facilities.And I have already shown you the link 3 times where the Deputy CHO of Victoria acknowledged that fact and confidently stated that Victoria had learn't the lessons of the Newmarch house outbreak in NSW.Despite the Royal Commission's findings it was the Victorian DHHS that was primarily responsible for the outbreaks in the Victorian Aged Care Facilities.
 
No HVR the truth is the Federal Government doesn't run health.The States do even in aged care facilities.And I have already shown you the link 3 times where the Deputy CHO of Victoria acknowledged that fact and confidently stated that Victoria had learn't the lessons of the Newmarch house outbreak in NSW.Despite the Royal Commission's findings it was the Victorian DHHS that was primarily responsible for the outbreaks in the Victorian Aged Care Facilities.

HVR did not say the Federal Government runs aged care, but rather that the Cth is responsible for its regulation.

The state governments and private operators are responsible for delivery, under regulation by the Cth.

Directly from the Royal Commission report at page 2:

The Australian Government is responsible for ‘aged care services’, as defined in our Letters Patent. The development and implementation of aged care policy, including advising the Australian Government, funding and administration are the domain of the Australian Department of Health. The Aged Care Quality and Safety Commission is responsible for aged care regulation. State and Territory Governments, together with the private sector, are largely responsible for the delivery of health care, including to those living in residential aged care. They also have overall responsibility for managing public health emergencies. Under the Aged Care Act 1997 (Cth), aged care providers are responsible and accountable for providing quality care in a manner that complies with the Aged Care Quality Standards set out in the Quality of Care Principles 2014 (Cth) made under the Act.​
 
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Maybe you should learn some facts:
The people who died in aged care were in federally regulated aged care homes. The regulation is the responsibility of the federal government, not the state government.







https://agedcare.royalcommission.go...0/aged-care-and-covid-19-a-special-report.pdf Quotes taken from pp15-16


The Aged Care Royal Commission was scathing about the Federal government's action (or more specifically lack thereof) re their responsibilities enforcing regulations in aged care facilities.

Oh, and the usual rejoinder here that 'the Federal government doesn't run aged care' , is a classic example of a non-sequitur response.

Finally to assert that the 'Victorian government allowed 800+ residents to die' is truly offensive. It's never been argued or asserted that anybody in the Victorian government 'allowed' people to die.
I need to be able to hit 'like', 'agree' and 'informative' buttons at the same time.
 
HVR did not say the Federal Government runs aged care, but rather that the Cth is responsible for its regulation.

The state governments and private operators are responsible for delivery, under regulation by the Cth.

Directly from the Royal Commission report at page 2:

The Australian Government is responsible for ‘aged care services’, as defined in our Letters Patent. The development and implementation of aged care policy, including advising the Australian Government, funding and administration are the domain of the Australian Department of Health. The Aged Care Quality and Safety Commission is responsible for aged care regulation. State and Territory Governments, together with the private sector, are largely responsible for the delivery of health care, including to those living in residential aged care. They also have overall responsibility for managing public health emergencies. Under the Aged Care Act 1997 (Cth), aged care providers are responsible and accountable for providing quality care in a manner that complies with the Aged Care Quality Standards set out in the Quality of Care Principles 2014 (Cth) made under the Act.​
Irrelevant as I was talking about Health in Aged Care Facilities and the Royal commission agrees.See bolded part of your quote.
 
HVR did not say the Federal Government runs aged care, but rather that the Cth is responsible for its regulation.

The state governments and private operators are responsible for delivery, under regulation by the Cth.

Exactly. If a Commonwealth regulation says (say) "Aged care homes will have two fire wardens per floor" and one such home doesn't, and there was a fire, with a fatality, is the fatality more the fault of the home or the Commonwealth? If the C'wealth didn't enforce its regulations, then it would share some fault - but the major fault should still lie with the directly negligent party.

So, with COVID, HVR's post - and a number before that - I reckon clearly implies that the deaths in Federally regulated homes are the C'wealth's fault (boo!, hiss!. the federal government!). Consider this analogy: If there is a State drink-drive law/regulation, and a drunk driver kills someone, is State government blameable because it "regulates drink drive laws" ? If it did no enforcement, then probably yes, in part. But as the cops can't breatho everyone, every day, to blame the state, or even to hint darkly that the State is somehow culpable is ludicrous. As is blaming, or linking, the C'weath for COVID deaths in aged care home because of "commonwealth regulation" of aged care homes.
 
  • Agree
Reactions: tgh
Irrelevant as I was talking about Health in Aged Care Facilities and the Royal commission agrees.See bolded part of your quote.

I read this differently to you.

The Federal Government sets the policy and makes the relevant regulations. Those running the facilities do so in accordance with the policy and regulations, set by the Cth.

So if the Cth doesn't mandate masks, either through policy or regulation, then the person delivering the service doesn't need to provide masks. Those providing the service - running the facility - only need to do so by the rules set for them.

I believe the State run aged care facilities may have gone above and beyond the policy and regulations set by the Cth... for example they have minimum staff to patient ratios. But there is no legal requirement to do so. Same with PPE.

There's a difference between compliance with the rules, and setting the rules.
 
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The Federal Government sets the policy and makes the relevant regulations. Those running the facilities do so in accordance with the policy and regulations, set by the Cth.

Ah. That's where I think you fall to the ground. Many homes do NOT follow the policy & regulations (same as many individuals and business do not follow laws and regulations). There's a large Home in Hobart which is getting pretty notorious. It repeatedly gets inspected/audited and pinged for breaches, but continues to offend. I think they are now under mandatory directives in the areas of breach. Can't close it down - too large.

Edit: its over a year now: Notices of Non-compliance, Notices to Agree and Sanctions in Bupa South Hobart | My Aged Care
 
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