Aged care home used chemical restraints without consent
AN UNANNOUNCED audit off the back of complaints of poor care and understaffing at a Toowoomba aged care home found 17 dementia patients were being chemically restrained without consent.
TriCare Toowoomba Aged Care Residence found itself in the spotlight last month after a 55-year-old, terminally ill patient complained on Twitter about poor food and conditions at the facility.
Originally an overflow patient from the Toowoomba Hospital, Kylie Kilroy is now having to manage her final days in her own home hooked up to a portable oxygen tank after she was moved out of the home following her tweet.
The Aged Care Quality and Safety Commission conducted an unannounced monitoring visit at TriCare Toowoomba on Wednesday, August 5, following the furore around Ms Kilroy's treatment.
The audit found the home was non-compliant in one of the Aged Care Quality Standards.
The Commission's assessment team found psychotropic medication was prescribed for 17 residents to manage behavioural and psychological symptoms of dementia, but a review of documentation showed TriCare Toowoomba had not sought consent or medical authorisation for the use of chemical restraint.
The assessment team also found eight residents had bed rails in place and 16 residents resided in the secure unit.
"Review of documentation identified six consumers do not have consent or medical authorisation for the use of physical restraint and 14 consumers do not have consent or medical authorisation for the use of environmental restraint. This process does not meet legislative requirements in relation to the use of restraints," the report said.
Responding to the assessment team's findings, TriCare said the lack of consent and authorisation for restraints had been identified previously "and actions to rectify the deficit are included in the continuous improvement plan, with a completion date of August 31, 2020 recorded".
"Since the Assessment contact, the (TriCare Toowoomba) has sought and obtained consent and medical authorisations for all consumers requiring physical, environmental and chemical restraint," the report said.
"Care planning documents for consumers requiring chemical restraint have been reviewed and updated with guidance and direction for staff to follow in relation to the appropriate use of psychotropic medication utilised as a form of chemical restraint."
The report also found for one resident who required an indwelling catheter, "documentation does not support the catheter has been changed in accordance with medical officer directives".
The report said TriCare staff changed the catheter on the day of the visit by the commission, "following feedback from the assessment team".
The report acknowledged while TriCare had taken steps to address the deficiencies identified, "it is my decision at the time of the assessment contact (TriCare Toowoomba) did not demonstrate each consumer was receiving safe and effective care in relation to the use of restraints and catheter care".
"Therefore, it is my decision this requirement is non-compliant."
TriCare was deemed compliant with all other requirements assessed.