Over the past three decades, Mark Sewell has worked in disability care, child protection and now aged care.
"I've never in those 35 years seen this kind of crisis level of exhaustion and work from frontline care staff in a human service," he told 7.30.
Mr Sewell is the chief executive of Warrigal, an aged care provider with 11 homes across New South Wales and the ACT.
Prior to Christmas last year, none of those homes had experienced a COVID-19 outbreak during the two years of the pandemic.
"On the 29th of December, we had our first case and then it went berserk," Mr Sewell said.
Finance staff, members of Warrigal's HR team and even Mr Sewell himself were donning personal protective equipment (PPE) to help out at the homes.
More than 280 residents and 250 staff caught COVID-19.
Outbreak and death numbers
On January 28, there were 1,261 active COVID-19 outbreaks at aged care homes across the country, according to weekly federal figures.
Nearly 10,000 residents and more than 14,000 staff tested positive.
About 500 residents have died with COVID-19 in the first few weeks of this year.
It's unclear how many of those residents died before they had their vaccine booster, with Aged Care Services Minister Richard Colbeck telling a Senate inquiry into COVID-19 on Wednesday that "there's a time lag in receiving that data from the states".
The federal government had committed to finishing the aged care booster rollout by the end of January.
On Wednesday, the government reported 99 per cent of facilities had been visited by a booster clinic, but only 66 per cent of residents at those facilities had actually had their third dose.
Mr Colbeck told the inquiry that there were "many reasons" for that, but on Thursday, Minister for Health and Aged Care Greg Hunt said residents or their families were "making their own choice" not to get boosted.
Last week, Mr Hunt said 60 per cent of those who had died had been in palliative care, a comment aged care advocate Sarah Holland-Batt said was "disgraceful".
"It basically suggests, in some ways, that aged care residents are somewhere in between life and death."
'Assistance is slow, sluggish'
The federal government provided surge workforce funding for temporary staff during outbreaks as part of a $100 million COVID-19 aged care support package.
Seeking nurses, Mr Sewell contacted the local public health unit before a 10-day process of filling out paperwork and being bounced between state and federal departments.
A Commonwealth case manager eventually found him two nurses, but Mr Sewell says the stress for families and staff who thought their home was going to close in the meantime was "really a big worry".
"It's really very frustrating when the assistance is so slow, so sluggish. So bureaucratic," he said.
The government says its surge workforce has filled more than 78,000 shifts.
In a statement, a spokesman for Mr Hunt said additional staff would be available to aged care under an agreement with private hospitals, and there had been a successful program to bring retired staff back to the workforce.
'You will make unforced errors'
Glen O'Driscoll is a registered nurse and is currently part of a rapid response team travelling between aged care homes in NSW due to staff shortages.
"I'm part of a special crew. I get flown out to, or transported to, aged care facilities that have a COVID outbreak," Mr O'Driscoll said.
He told 7.30 that nurses and carers are struggling to cope with the extreme workload.
"You do worry. You go home and you think, 'God, I missed that. How did I miss that?' And it's because you had so many other things to attend to, that you will make unforced errors."
Conditions for workers need improvement
Chronic staff shortages were an issue in the industry long before the COVID-19 pandemic.
Last year, the Royal Commission into Aged Care Quality and Safety recommended an increase in the award wage for aged care workers to help attract and retain staff.
But the federal government has not implemented any pay rise.
Instead, it noted that the Fair Work Commission is currently considering a case brought forward by the unions to increase workers' pay by 25 per cent, or around $5 an hour. A verdict is not expected until July this year.
Aged care advocate Sarah Holland-Batt says more immediate action is required.
"If people are going to be attracted to work in aged care, the conditions need to improve. It's as simple as that," Ms Holland-Batt said.
"They need to be paid way more than $23 an hour. We need to see career pathways, we need to see less casualisation and more job security."
Workers like Glen O'Driscoll agree.
"A lot of the care staff are frustrated, to the point where they're just saying, 'I've had enough, I'm out of this industry, it's not worthwhile," he said.
According to a survey conducted by the NSW Nurses and Midwives' Association, 22 per cent of aged care workers plan to leave the industry within the next 12 months.
Another 40 per cent plan to quit within the next five years.
Lockdowns ongoing
Glenna Cluff's sister Ruth McNee is in an aged care home in Sydney, where 21 residents and 36 staff had COVID-19 during a recent outbreak.
Required to follow local public health directions, Ruth's home, Adventist Aged Care Kings Langley, was locked down for 23 days during the outbreak, meaning she was largely confined to her room.
"During that time, the standard of care was slipping," Ms Cluff said.
"[She was] not able to be showered. Not able to be cleaned, because she's bedridden, lying in faecal matter for extended periods of time.
Ms Cluff is concerned about the mental health impacts of frequent, long lockdowns on aged care residents.
"[During the lockdown] she was just lying there, crying on the phone for hours because she's so distressed," she told 7.30.
"This is her home. And it's treated like a prison."
Ms Cluff and her other sister are worried that staffing during outbreaks, and consistent and transparent lockdown rules, don't seem to have been ironed out two years into the pandemic.
"We're really concerned that these lockdowns can happen again at any time," she said.
In a statement, a spokeswoman for Adventist Aged Care Kings Langley said all shifts had been filled during the outbreak and residents had received the levels of care they needed.
"At all times we followed the directives of the NSW Public Health Unit, which included the restriction of visitors onto the site."
The statement said on average, residents received 208 minutes of care a day.
Three weeks ago, Mr Hunt and Mr Colbeck tasked two advocacy groups with creating a national proposal to reduce the mental health impacts of lockdowns on residents.
Neither minister responded to questions about when that would be delivered, but 7.30 understands a paper was finalised by the groups over a week ago.
In a press conference on Thursday, Mr Hunt acknowledged the tension between the need for health restrictions and the impact such restrictions in aged care facilities had on quality of life.
"We do have to be honest that those two things come together and they come together with the fact that that which helps protect the health, can significantly diminish the quality of life," he said.
"That’s why we’ve asked AHPPC (Australian Health Protection Principal Committee) to specifically review the question of lockdowns, and the extent to which they have are having an impact on the emotional health and the mental health."
