In the wake of prime minister Scott Morrison’s announcement of a royal commission into aged care in Australia, ABC’s Four Corners program on 17 September aired the first part of an explosive exposé on Australia’s aged care system. Families and staff revealed the damning reality of day to day life in nursing homes.

Revolting food, malnutrition, neglect and dangerous understaffing were all laid bare. The revelations came as a shock to most viewers. But for those working in the industry, there were few surprises.

“I’m usually responsible for up to 12 residents, but it can be as high as 36 depending on what time of day you’re working”, Renae,* who has worked as a carer in a nursing facility in Perth for 11 years, tells Red Flag. “The manager won’t allow agency staff, even when staff call in sick. 

“We’ve been denied use of [incontinence] pads … Residents aren’t being cared for, aren’t being showered, their personal hygiene is neglected, and they’re not being fed properly. We just don’t have the time or the staff.

“They won’t roster anyone else on because they cut hours. They can still afford flash furniture and big cars and all that, but tell us we’re spending too much money on gloves, wipes, protective equipment and staff.”

Dietician and researcher Dr Cherie Hugo studied more than 800 aged care facilities. She told the ABC that an average of $6 per resident a day is spent on food. The average Australian adult eats about $17 worth of food per day. 

Nursing homes will often serve heated up frozen food like party pies or saveloys, unappetising vegetables or, for those requiring soft food, shapeless puréed blobs covered in gravy. Research published in the journal Nutrition and Dietetics found that “at least” 50 percent of residents are malnourished. 

“[Residents] don’t eat the food. They would rather go hungry. Then they lose weight, so we fill them full of high calorie food and supplements to make them gain weight”, Renae says.

“When something is served that they can’t or won’t eat, it can make people aggressive or angry, it can give them behaviour problems. They cry and call it dog food … It’s disgusting.”

In rural Victoria, John,* a registered nurse, says ratios are required only in publicly run nursing homes – a small fraction compared to the more than 700 facilities run for profit in that state.

“I have witnessed patients with oral thrush that has been allowed to develop unnoticed (or at least untreated) for so long that I noticed it leaking out of their mouth; others have been thoroughly dehydrated and treated as ‘aggressive’ residents due to the delirium they were experiencing”, he says via email.

“My current record for an aged care ratio was a colleague who had to provide oversight for 42 residents’ medications and care. As they said, ‘You’d finish your morning medications round and immediately have to start on your midday round. No time for assessments, no time for conversations, no time for anything to go wrong’.”

Since 2008, there have been at least 13 reviews or inquiries into the aged care sector. None have dampened the industry’s drive for profit. According to a survey by Bentleys Chartered Accountants, the average profit made from each resident in aged care was $6,278 in 2015. In the same year, BUPA’s CEO was paid more than $3 million. 

The Financial Review reports that in 2016, Japara Healthcare’s CEO received more than $1.5 million – a 79 percent increase from his previous annual salary.

While the royal commission is a welcome development for those in the aged care sector, royal commissions have a chequered history when it comes to delivering anything approaching justice. 

Of the more than 100 that have been conducted, few have resulted in any real consequences for corrupt business or government practices. Fewer still have dealt with the social problems they were meant to address.

Still, advocates for the aged care sector are hopeful. “I want to see quality services from well-trained staff”, Renae says. “I want ratios for staff, I’d like to see a higher rate of pay so I don’t have to work two jobs. And I want justice to be done for our elderly.”

* Workers’ names have been changed to protect their jobs.