Horrific footage of a 95-year-old woman left to languish in a Melbourne aged care facility struck by Covid-19 shows ants crawling from a wound on her leg, and the bandages around it crusted with blood.
The footage and photos, described by the federal aged care minister as “heartbreaking”, were taken inside Kalyna Care, a private residential home in Melbourne’s north-west, on Tuesday, some two weeks after the virus was first identified in one staff member.
The woman, known to her family as Milka, died on Friday morning of conditions unrelated to Covid-19.
Care staff brought into the home this week have told Guardian Australia that some residents went without food or water for 18 hours. Faeces were found on the floor. An ant infestation, which had been kept at bay, had got out-of-control in Milka’s room.
The staff say they were not given adequate facilities to change out of infection-exposed clothing and basic hygiene was said to have fallen by the wayside, with some residents not cleaned for days.
The Guardian has spoken to Milka’s family who say they do not blame the managers, staff, or the board of the home for what happened to her, and say until Covid-19 swept through she was provided with excellent care.
But once the home’s health and aged care workers began getting sick and exposed to Covid-19 and were stood down or furloughed, there was no one to fill the gaps despite repeated requests from the management to the state and federal governments for help.
The chair of the board of Kalyna Care, Halja Bryndzia, said that at one point, there was just one nurse and one personal care assistant looking after 68 residents.
“From the moment we had our first case in a staff member at the end of July we clamped down, we communicated with families, we reported the case to the health department, we did everything,” Bryndzia said.
“The whole point of asking for help from federal and state authorities was to avoid disaster like the ones we have seen elsewhere. But when we first asked for help in July, we were not considered bad enough.”
“Then, when our first few residents tested positive they didn’t have severe symptoms yet, so when we asked for them to be taken to hospital the response was again, ‘no, it’s not bad enough’,” Bryndzia said.
“The irony is although we did everything we could on our own to try to stop it getting worse, it was only when things got really bad that the state and federal governments were concerned enough to help us.
A workforce left sick and exposed
Now, more than 20 residents and about 15 staff have tested positive for the virus, Bryndzia confirmed, and many more are furloughed due to being exposed, including the entire catering team.
On Thursday the Victorian premier, Daniel Andrews, announced Kalyna was among the latest of many aged care homes battling to contain Covid-19 that the state government had immediately assumed control of.
“We’ve essentially assumed responsibility, taken over those facilities, for the purposes of the highest-quality care and to deal with challenging circumstances in each of those three,” Andrews said.
On Friday, the prime minister, Scott Morrison, said he was “deeply sorry” for failures in the aged care system.
“The sad truth is, some days, we fall short. And other days, we don’t,” Morrison said.
“On the days that the system falls short, on the days that expectations are not met, I’m deeply sorry about that, of course I am, and I know that everyone who is involved in the process who is trying to meet those expectations is equally sorry.”
But Bryndzia said she had been frustrated by both state and federal responses. “We made repeated and desperate staffing requests and we couldn’t get them, and those requests started from the end of July,” she said.
“But Victoria, generally, has a problem with infected aged care staff and healthcare workers, and so they needed to start sourcing workers from interstate. Eventually, we had people from Queensland and New South Wales come in to help us this week. In the meantime, we are a Ukrainian facility and so we called out to that community for anyone trained and willing to help. We are just one of about 100 places in Victoria that lost staff through no fault of their own.”
One interstate nurse brought in to urgently assist was so shocked by what they saw they decided to speak out.
“I’ve been into homes before I would describe as derelict, but this was so, so much worse than that,” the nurse said.
“This is a high-level care home and in normal times, you can see it would have been. But it is set up to be a residential home, not a clinical ward, and that’s what staff at the home with no experience in this kind of care found themselves trying to turn the home into.”
The first staff member was infected on 26 July, and on Wednesday the state government took over and cleaning teams swept the building.
“What happened in the interim is a mystery, and scares the hell out of me,” the nurse said. “So many of the normal staff were missing, furloughed from being exposed to Covid or because they are sick with Covid. So who was looking after the residents? Who was there to urgently fill the gap before we came in?”
Residents left dehydrated and unwashed
The nurse said they came into Kalyna Care, which caters to people from the Ukrainian and European communities, on Tuesday and noticed dried faeces on a section of the floor. Many residents of the home had dementia, they said.
“A patient had gone to the toilet on the floor in their own room, but then there were also these faeces on the floor elsewhere that were so dried that you couldn’t even get it off with detergent and scrubbing,” the nurse said.
“This was in the dementia ward, and there I saw residents confused, wandering around and tracking bacteria in and out of each other’s rooms. It was horrifying. I put my shoes straight in the wash on a hot wash.”
The nurse said Covid-positive patients also appeared to not have received basic hygiene for days. Some of them had not received their medications for up to five days.
“One of the Covid patients I went and saw had so much crust on his face from not being cleaned,” the nurse said. “This is the reality of some of those in aged care homes, and they are victims of this pandemic the public don’t always see, but need to know about.”
The nurse added that staff had not been given uniforms to wear on site. If they brought their own separate clothes to change into, they used the bathroom which was used by many people.
Residents with Covid-19 had been put into a separate area of the building with only a lounge area separating them from other residents. There was no training for some staff brought in to fill in for the more experienced sick and furloughed staff. Some of the team were not even qualified healthcare workers.
“We had a [hospitality worker] at the door keeping an eye on the doors of the Covid area, making sure the residents didn’t invade other spaces,” the nurse said.
“When I arrived at work I asked them what their qualifications and expertise were, what their job was, because I needed all the staff I could get and wanted to know how to make the best use of people.
“I told [them] not to do anything else, not to go into patient rooms, that [they were]not to do anything really. There was this mix of staff from all over the place, and some had to be trained in PPE.”
Another health worker was so shocked by Milka, who had a wound on her leg with a bloody bandage that needed changing, and ants crawling over her and the bed, that they took video and photos for evidence. Milka had been receiving palliative care at the home, and was taken to hospital after the ants were discovered on Wednesday.
Milka’s son, Rudy Kelemen, said ants had previously been an issue in her room but had never been out of control until Covid-19 infiltrated the home.
“Mum was very, very fond of the CEO of Kalyna Care,” Kelemen said. “She was in the home three years. Mum was an amazing person, she spent the last 50 years in this country and was very hard working, and she was fluent in English a couple of years after arriving from Europe. Some of my best memories are from my childhood with her, she made me feel loved and protected.
“I’m not saying the home did everything right, I’m not saying there weren’t mistakes made. But I will not be levelling any blame on the administration. I know they are caring and they were trying to get help.”
He did however say that after Milka was taken to hospital, hospital staff told him she had Covid-19, which was not true.
“I made an angry call to Kalyna asking why they didn’t brief the hospital properly, but then I found out it was the hospital that decided that they would treat every person from any nursing home as Covid-positive irrespective of the results because they didn’t trust the tests from age care, which in a way is sheer arrogance.
“So mum was being treated as though a Covid-19 patient. In the end, it didn’t matter much, because she passed away less than 24 hours later.”
Correspondence shows updates about the home and the Covid-19 situation were regularly sent out by the CEO to families, and they implemented numerous measures such as rigorous restrictions on visitors, strict screening of staff and contractors, and supplied staff with PPE [personal protective equipment].
But the nurse who spoke to the Guardian said family members of residents were often left confused as to what was happening with their relatives, and poor handover information meant there was little to tell them.
The nurse received a call from two people wanting information about their family members after they had been told by another staff member their loved one had acquired Covid-19.
“But according to the notes I had, they did not have Covid,” the nurse said. “Yet they were in a Covid ward. If they didn’t have Covid, they should have been in a different space entirely. And if they did have Covid, I didn’t have any information about it.”
The nurse said they always felt safe working at hospitals in their own state, and had worked in Covid wards throughout the pandemic. Working in aged care in Victoria, they said they had no confidence in the safety of staff and residents. Aside from a decent supply of PPE, there were very few safety procedures in place, they said.
An investigation into the incident has now been launched into Kalyna Care, a spokesman for Djerriwarrh Health Services, which has been brought in to assist the state and federal governments in managing the home, said.
The federal aged care minister, Richard Colbeck, described the images of the incident as “heartbreaking and absolutely unacceptable”.
“I have requested that the Aged Care Quality and Safety Commissioner investigate this urgently this evening,” he told Guardian Australia.
“The aged care quality safety commissioner issued a notice to agree on 5 August 2020 following concerns about the welfare of residents. This resulted in the appointment of a new manager.
“[On Wednesday] night the federal and state government took the further action of bringing a hospital manager into the facility with support staff to run the facility.”
The chief executive of Djerriwarrh Health Services, Belinda Scott, said the service was “now assisting the Department of Health and Human Services and the commonwealth government, and is on-site to provide the highest quality care to residents at Kalyna aged care in Taylor’s Lakes”.
“Dedicated care teams are moving room to room to ensure residents are receiving personal care, food and medication. All families and carers are being informed about their health status. The privacy, care and respect of residents and their families is paramount. Djerriwarrh Health Services is working with the board of Kalyna to put into place additional measures to improve the situation and ensure all residents have the best possible care.”
Andrea Pearman, the CEO of Inclusive Australia, which advocates for the elderly, said the pandemic had highlighted existing inequalities in the aged care system. “In times of crisis, we need to be investing in appropriate communication, education and safety measures as well as showing sensitivity to different cultures,” she said.