An aged care facility where a carer allegedly strangled a resident was given an audit exemption by the federal regulator just one month earlier, despite previous non-compliance with patient care standards.
Multiple Aged Care Quality and Safety Commission (ACQSC) reports seen by the ABC showed Baptistcare Bethel in Albany, about 420 kilometres south-east of Perth, had gaps in medication management and wound care and had failed to use appropriate restraints in some instances.
But despite issues being flagged in past inspections, the facility was given an exemption as part of a scaling back of audits around the country during the pandemic.
Just a month later, shock waves were sent through the facility in December, when police charged a 19-year-old man with the murder of 70-year-old Monica Mary Stockdale.
Jacob Anthony Hoysted was a carer at the nursing home in Yakamia, where police alleged he strangled Ms Stockdale on November 28.
The police investigation began after autopsy results were received.
The accused is due back in court on January 18 and is yet to enter a plea.
Audit skipped
ACQSC reports showed Baptistcare Bethel was given an exemption for its most recent audit on October 28.
The inspections are intended to ensure that patient care at elderly homes around the country is compliant with health and safety standards.
The exemption was granted due to "exceptional circumstances" related to the COVID-19 pandemic.
Baptistcare's acting joint chief executive Amanda Vivian said it was the ACQSC's decision to postpone the check and the facility was not advised when its next full audit would occur.
ACQSC commissioner Janet Anderson said the commission had been on-site this month to support the provider.
She said some audits were deferred so the commission could examine "on the ground" infection control practices during COVID-19.
Ms Anderson said Baptistcare Bethel's accreditation would expire in May and the facility should expect to undergo a "comprehensive, unannounced accreditation site audit" in the next four months.
Federal Aged Care Minister Anika Wells would not comment on whether she thought audits paused during the pandemic should return to normal, but said Ms Stockdale's death was a tragedy.
"The alleged incident is deeply concerning; as this is a police matter we are unable to comment further," Ms Wells said.
The ABC is not suggesting the absence of an audit of Bapistcare Bethel contributed to Ms Stockdale's death.
She 'loved being happy'
Ms Stockdale's son, Matt, said his mother's death was heartbreaking.
"[Mum] was always smiling, always happy. You could walk down the street with her and she'd even say hello to people she didn't know," he said.
"She was bubbly and loved being happy. She was amazing."
He said his mother was diagnosed with dementia about a decade ago and had been living at Baptistcare Bethel for the past five years.
Mr Stockdale said it was hard enough to get the phone call saying his mother had died, but the second call following the autopsy was even more traumatising.
He described the audit exemption given to the facility as "upsetting" and said aged care homes needed to be checked as often as possible.
"It's a big concern. It's your loved ones and they're unable to look after themselves," Mr Stockdale said.
"If anything slips under the radar and it's found out that it could have been prevented, then I think that's a big issue.
"We need to know that they're [aged care homes] doing everything right by the books."
Mr Stockdale said he would support an aged care register for workers run by the government.
"Whatever it takes, they shouldn't be cutting corners … now would be the best time [to implement a register]," he said.
Mr Stockdale urged people to report any concerns they had about their loved ones in aged care.
Poor assessment in 2021
Baptistcare Bethel's most recent audit on March 15, 2022, showed it was compliant in personal and clinical care, but previous audits flagged issues at the centre.
But an overall assessment on March 9, 2021 found the centre was non-compliant and that consumers did not receive safe and effective personal care that was in-line with best practice.
The document detailed how one resident had a four-day period with blood glucose levels repeatedly outside of the acceptable level, but staff "did not adequately" manage the situation in accordance with the organisation's policy.
The assessment team also identified two people who were high-risk for developing pressure injuries, but staff "failed" to identify the injuries in their early stages.
Baptistcare Bethel said it would implement further training to be completed by all staff.
In an earlier report from 2020, the centre was unable to demonstrate that it used best practice in relation to the appropriate use of chemical restraints.
The report said a dementia patient had been chemically restrained in a way that was not best practice and that the service could not demonstrate that it was being used as a last resort or that other pharmacological strategies had been trialled prior to its use.
The service was also found to not have effective processes in place to ensure expiry date checking of medication.
Glucagon kits, used to treat severe hypoglycaemia, had expired – something the report said "could put a consumer's life at risk".
Other issues flagged included incorrect treatment and assessments of pressure injuries and some staff not receiving handovers at the beginning of shifts.
Additional training was provided to staff following the findings.
Ms Vivian said the facility was found to be fully compliant in its last audit, but admitted it was still "finding it challenging" to fill registered nurse positions.
Accused with police clearance
Ms Vivian said the accused had provided a police clearance and declared he had never been convicted of an offence.
She encouraged all staff to report any work concerns so they could be addressed as quickly as possible.
"If team members see or hear something that does not align with our values, we ask them to speak up without fear of retribution," Ms Vivian said.
She said Baptistcare supported the push for the federal government to establish a registration scheme for workers.
"The health and safety of Australia's most vulnerable seniors depends on a comprehensive and robust national registration scheme that immediately alerts aged care organisations to employees with pending criminal charges and convictions," Ms Vivian said.
Ms Vivian is holding a meeting for residents and their families this Wednesday.
She said counselling was still being offered to those affected.
