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Fair Work Act 2009                                                    






s.158 - Application to vary or revoke a modern award


AM2020/99 – Aged Care Award 2010 – Application by Ellis & Castieau and Others


AM2021/63 – Nurses Award 2020 – Application by  Australian Nursing and Midwifery Federation-Victorian Branch


AM2021/65 – Social, Community, Home Care and Disability Services Industry Award 2010 – Application by Health Services Union




9.30 AM, FRIDAY, 6 MAY 2022


Continued from 05/05/2022



THE ASSOCIATE:  The Fair Work Commission is in session in matters AM2020/99, AM2021/63 and AM2021/65, Aged Care Work Value Case for hearing.


COMMISSIONER O'NEILL:  Good morning, everybody.  Just one matter before we start.  I understand from the President's chambers that the HSU witness statements haven't been provided yet in Word form.  So we've mentioned that a couple of times, if you can attend to that promptly, that would be appreciated.  Is there anything further or are you ready for your first witness?


MR GIBIAN:  I think we're ready for the first witness.  I think I did mention yesterday afternoon that the third witness who's on the list, Ms Wagner, is not available today and so we have the four in the morning.




MR GIBIAN:  So Mr Kent, I think, should be either available or will be shortly.  I understand Mr Kent is just having a brief technical issue so hopefully it will be resolved in a moment.  Apologies.




MR GIBIAN:  Commissioner, I understand despite this having been tested, he's having difficulty with the Teams link and he's going to phone in unless there's any objection to that course.


COMMISSIONER O'NEILL:  Are you content for that, Mr Ward, in the circumstances?


MR WARD:  I think we have to make-do, Commissioner.  Yes, I think we have to.


COMMISSIONER O'NEILL:  Mr Kent, can you hear me?  Sorry, false alarm, that was not Mr Kent that just joined.


MR GIBIAN:  Apologies, Commissioner, I don't know what is happening.  Can we just ask for a five-minute adjournment and we'll try and sort out where Mr Kent is?


COMMISSIONER O'NEILL:  Yes, we'll resume at 9.42.


MR GIBIAN:  Thank you, Commissioner.

SHORT ADJOURNMENT                                                                     [9.38 AM]

RESUMED                                                                                               [9.42 AM]


COMMISSIONER O'NEILL:  I understand you're there, Mr Kent.  Can you hear me?


MR KENT:  Yes, I can hear you perfectly.  I'm Darren Kent.


COMMISSIONER O'NEILL:  All right.  I'm O'Neill C, and my Associate's just going to have you take the affirmation.


MR KENT:  Okay.  Nice to meet you, thank you.


THE ASSOCIATE:  Hi, Mr Kent.  This is O'Neill's C Associate speaking.  Can you please say your full name and work address?


MR KENT:  My name's Darren Kent and I work at 23 Were Street, Calwell in Canberra in an aged care facility run by Warrigal.

<DARREN JAMES KENT, AFFIRMED                                             [9.42 AM]

EXAMINATION-IN-CHIEF BY MR GIBIAN                                    [9.42 AM]




MR GIBIAN:  Thank you, Commissioner.  Mr Kent, can you hear me?‑‑‑Yes, I can hear you fine, thanks.


Excellent.  This is Mark Gibian, I'm appearing for the HSU in this matter.  I don't think we've had the opportunity to speak before.  Can I just ask you to repeat your full name for the record?‑‑‑My name is Darren James Kent.


And you're employed at the Warrigal aged care facility in Calwell in the ACT?‑‑‑That's correct.

***        DARREN JAMES KENT                                                                                                                  XN MR GIBIAN


Can you just repeat the address of that facility for us?‑‑‑It's Were Street in Canberra.


I think you said - is it 23 Were Street or 43 Were Street?‑‑‑Sorry, I made a mistake.  I live at (address supplied), I won't say my address, that's my personal address, I made a mistake there but - - -


Fair enough.  Yes.  I just want to make sure the statement in the address in the statement was correct?‑‑‑Yes.


As I understand it, you've been employed at that or been working at that facility since 2015 but that it was subsequently taken over by Warrigal in 2020.  Is that correct?‑‑‑Yes.


In your first statement, in the second paragraph, you referred to yourself as being employed as head chef.  Is that the - is that the correct title or is there some other title on your employment documentation?‑‑‑Well, I've just been reviewing that now.  My correct title actually states that I am a chef but I am known and called the head chef.


Who are you known and called the head chef by?‑‑‑By the management team, by my general manager and other colleagues.


When you were referring to documentation, what was that documentation?‑‑‑That's my original contractual agreement.


Yes, thank you, Mr Kent.  Now, you've made two statements for the purpose of this proceedings.  Have you got copies of those with you?‑‑‑I do, yes.


The first of those, I think, is dated 31 March 2021.  I think there's some 110 paragraphs over 12 pages.  You have that with you?‑‑‑I do, yes.


Have you had the opportunity to review that statement?‑‑‑Yes.


Subject to that correction in relation to the job title that was in your appointment documentation, otherwise is it true and correct to the best of your knowledge and recollection?‑‑‑Yes.

***        DARREN JAMES KENT                                                                                                                  XN MR GIBIAN


That's the first statement of Mr Kent that we seek to have as part of the evidence.  It's document 165 in the digital court book, commencing at page 10434.  I think, Mr Kent, you should also have a statement that's headed 'Reply witness statement of Darren Kent', dated 21 Feb - of April, sorry, this year?‑‑‑Yes.


I think it runs over some 52 paragraphs over eight pages.  Have you also had an opportunity to read that statement?‑‑‑Yes.


Is it also true and correct to the best of your knowledge and recollection?‑‑‑Yes.


Thank you, Mr Kent. That's the second statement of Mr Kent we seek to have in evidence.  That is paragraph - sorry, document 165, 166 in the digital court book, commencing at page 10499.  Mr Kent, you can't - don't have the benefit of seeing people but the next voice you should hear is Mr Ward who proposes to ask you some questions?‑‑‑Thank you.

CROSS-EXAMINATION BY MR WARD                                           [9.46 AM]


MR WARD:  Mr Kent, can you hear me okay?‑‑‑Yes.


Mr Kent, my name's Mr Ward, Nigel Ward.  I appear in these proceedings for the employer interest, and I'm just going to ask you some questions.  If at any stage you can't hear me or you want me to repeat myself, please just ask okay?‑‑‑Yes, yes.


Do you have your first statement in front of you?‑‑‑I do.


Thank you.  Can I just start with, who do you report into at the facility?‑‑‑My immediate manager is the general manager at the facility.


I take it the general manager is the person who runs the whole facility?‑‑‑Yes.


Can I ask you to go to paragraph 4 of your statement.  Do you see that?‑‑‑Education and qualifications?


Yes, please.  Could you go to that?‑‑‑Yes.


I understand the Food Safety Supervisor Certificate, am I right that somebody has to hold that certificate where food's being provided?‑‑‑That's correct.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


And on this occasion you hold it?‑‑‑That's correct.


Tell me if I'm wrong but my understanding is, is that this is a mixture of online learning normally and practical - my understanding is it's six hours of reading and online learning and then you have to do 12 hours of practical, and most people do that over three or four shifts.  Is that your understanding of what you did?‑‑‑Yes, and you also have to get - do some practical experience in another kitchen that is - gets signed off by another chef or by another supervisor.


Yes?‑‑‑That helps - passes your certificate.


The one I'm not so familiar with is the one in (b) Food Handling Certificate.  Where do you get that one from?‑‑‑That's an online course.  You can do an online course for that or you can do a face to face learning session through that and that's also practical based as well.


And how long does the online course go for?‑‑‑That's a shorter course, that's usually two hours.  Two to three hours.  Once a year.  Once a year, every year.


And so you do that as a refresher once a year, do you?‑‑‑Yes, yes.


Do all of the people who work for you - do you require them to have the Food Handling Certificate?‑‑‑Everybody needs to have that certificate.


When you say needs to, is that Warrigal's decision, your decision, or are you telling us that legally they have to have it?‑‑‑Legally they have to have that, and that's on our food - that's on our Food Safety Guidelines as well.


Is it the same if you're working in a restaurant?‑‑‑If you work in a restaurant your staff would need to have a different certificate, but they would need to have a food‑handling certificate.  The difference between a health and restaurant would be a HLTFS course for aged care workers, and a restaurant certificate is a different certificate altogether; similar course but slightly different.


But similar in the sense they're dealing with food handling and food handling safety, are they?‑‑‑That's correct, yes.


Are they broadly of the same duration, or is one longer than the other?‑‑‑Broadly same duration, just different aspects.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


You've moved in and out of aged care – I think your statement indicates you've sort of moved in and out.  If I could take you to paragraph 13?  You talk about paragraph 13, you've left Calvary and you've gone to work for the airlines.  I take it, when you say you're a chef working for the airlines, what were you doing then?‑‑‑I was preparing food, various different foods for Qantas, for Virgin, and also for the Defence department for their planes leaving Canberra.  So it was all flights leaving Canberra, including the Defence, including the Prime Minister's private plane, and also other private aircraft leaving Canberra.


What attracted you back into aged care?‑‑‑I've always liked aged care, enjoyed it since my first job when I was working at the Aranda facility.  I was waiting specifically for a job to become available and the aged care position became available when Bupa opened up in Calwell, and I applied.


So you were keen to get back into aged care?‑‑‑Yes.


The Calwell facility, was that purpose built in 2015?‑‑‑Yes.


Is it a fairly modern facility?‑‑‑It's a new facility.


I don't know if you know this, but I just wanted to see if it was discussed.  My understanding is that the facility was under sanction.  Warrigal then took it over.  Is that your understanding?‑‑‑That's correct.


You've indicated in your statement that you're covered by an enterprise agreement, which I understand you've identified as the Bupa Aged Care Australia Pty Ltd ACT Enterprise Agreement 2018, and you've attached a schedule from that agreement with your classification on it.  Are you familiar with that schedule?‑‑‑Yes.


You're a level 7 employee, is that correct?‑‑‑That's correct.


Am I right that a level 7 employee is the top grade?  There's no level 8?‑‑‑No level 8, so that's the Bupa agreement - I now work for Warrigal.


Yes?‑‑‑There is a new agreement being commenced at the moment.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


You say you're negotiating an agreement, are you?‑‑‑Yes.  I'm not negotiating an agreement, but the agreement is run out and there's a new agreement that's being negotiated for all workers at the moment.


Your facility at Calwell, you say you've got three kitchens.  Are they three full functioning kitchens for cooking?‑‑‑We have one main kitchen where the bulk of the cooking is done, where all of the cooking is prepared and made in the main kitchen.  Then we have two main serveries and the food is distributed to the two other serveries.  We have four dining rooms in total.


Just bear with me, I just want to make sure I understand that.  So there's a main kitchen for cooking?‑‑‑Yes.


And then you have two additional areas where hot food could be moved to – placed into serveries and the service actually occurs from those places, is that what you're saying?‑‑‑Yes and no.  In the main kitchen we also have two serveries.  So we serve 72 residents out of the main kitchen, out of the two serveries.


Yes?‑‑‑So two dining rooms, two serveries in the main kitchen, and then there's two other separate serveries, which we classify as smaller kitchens, where there is no food preparation prepared, and they serve food out of those two other kitchens.


When you say 'serveries', we're talking sort of bain maries, or what are we talking?‑‑‑Well, it's a separate room with a bain marie in it, and they have their own fridges, washing machines, fridges – it's a complete separate room where an employee can work from.


So the distinction is - - -?‑‑‑(Indistinct).


Go on?‑‑‑Completely (indistinct) contained and enclosed.


So the distinction is that the cooking's done in one of them, there isn't cooking done in the serveries, but other than that they've got fridges and they've got washing machines and the like?‑‑‑That's correct.


Can I just take you to paragraph 24?  You say you've got 24 staff including yourself, and then you say you've got a cook.  Is the cook who works with you trade‑qualified like you are?‑‑‑Yes.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


And then you've got 22 kitchen assistants.  Do you know if those kitchen assistants have any qualifications?‑‑‑None of the – the catering assistants don't have any qualifications other than the food safety certificate.


Do you get to organise – are you in charge of who works for you?‑‑‑I supervise all the staff, yes.


Do you get to decide things like whether or not you employ more part‑time or more casual employees, do you get to make those decisions?‑‑‑Those decisions are made based on what the home needs and what shifts are available.  At the end of the day, most of those decisions fall on the HR department or the general manager, but yes, I do have a say.  Unfortunately we can't hire everybody on a full‑time basis, as there's only certain shifts available.


Can I take you to paragraph 28?‑‑‑Yes.


In 28(b) you say, 'A cook that comes in during the afternoon, I cook most of the meals for the day when I come in, and the cook makes sandwiches and salads.'  Is the cook you're referring to the person we spoke about earlier who's trade‑qualified?‑‑‑They're trade‑qualified, yes.


Is there a cooked meal for breakfast?‑‑‑Two days a week we have a hot breakfast, and we also do some specials throughout the week for breakfast for some residents that ask for it.


Do you cook the cooked breakfast yourself or does the other cook?‑‑‑I cook it.


Do you cook the lunch or does the other cook cook the lunch?‑‑‑I cook the lunch.


What about dinner?‑‑‑The cook assists with cooking dinner as well.  It depends on the day, every day's a little different.


So could there be occasions where the other cook cooks the dinner or you will do - - -?‑‑‑Yes.


- - - most of the cooking.  They cook?‑‑‑Yes, they do cook the dinner some days, yes.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


Is that simply because you - as I understand your evidence you sort of move between the shifts - is that because you're simply not there that day?‑‑‑No, no, we have a cook on at 10 o'clock every day of the week, and some days the cook isn't there with us, they might be sick or they might not be here.  On those days the chef in the morning would cook all meals.  The cook at 10 o'clock makes sandwiches, a salad and prepares for dinner as well with the assistance of the chef.


Okay.  You then in paragraph 29 talk about your on the job training, and in (a) you talk about training on the Standards.  Is that the Aged Care Standards or is that Food Standards?‑‑‑Both.


Do you run those training programs yourself or does somebody else?‑‑‑We have somebody else come in and train us with both, and we have modules and books to research it.


And you do those, what, once a year?‑‑‑Once a year, yes.


And again what's the typical duration of those?‑‑‑It could be two to three hours.


You do hygiene and infection control, what sort of program is that?‑‑‑That's an online module that's given to us by our employer.


Okay.  And again is that a once a year thing?‑‑‑That's a once a year thing.


And is it a couple of hours, half an hour, how long does that take?‑‑‑Usually about half an hour.


And then you've got aged care training on aggressive resident behaviour and residents with dementia.  Is that face to face or online as well?‑‑‑That's an online module supplied to us by our employer.


And how long does that take to do?‑‑‑Maybe another half an hour.


Sorry, I should have asked, is there a test at the end of it or is it just you sort of have to do it?‑‑‑There's a test at the end of all the training modules that we do.


Thank you, Mr Kent.  Thank you, that's very helpful.  And again you do that once a year?‑‑‑Yes.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


And when you say training on policies and procedures is that procedures like manual handling, work health and safety, those types of things?‑‑‑Yes.


At paragraph 30 at the end you give us some observations from your experience about the quality - I'm going to use the phrase quality of some workers.  You say:


The absence of more qualified people in aged care puts  pressure on qualified workers such as chefs.


So it's yourself, Mr Kent.  What more qualified workers - what qualifications do you want your workers to hold they don't have?‑‑‑Experience.


So it's not necessarily Certificate IIIs or something like that, you would just be more keen about more experienced people?‑‑‑More experienced people, and most definitely if there were more staff that held a Certificate III that would be very helpful, absolutely.


And just for my benefit, Mr Kent, what is it that you believe the Certificate III gives you?‑‑‑Commercial cookery experience.  It also gives you hospitality experience, which is what we do inside the aged care as well.


So those experiences from the commercial sector are very transferable into aged care?‑‑‑They're very beneficial.


In terms of experience, I think you say later on in your statement that you think for a cook to be up and running and really going you need four to five years experience.  What sort of experience do you really need as a kitchen hand, a support person, to really be able to do the job?‑‑‑It can take quite some time to train a staff member up if they haven't worked in aged care, in the aged care industry before in one of our kitchens.  It can - it can take a number of months to get them up to speed and to learn all the aspects of dealing with the elderly with special diets, reading up all - understanding all of our forms, and knowing our residents.


So in the case of the kitchen hand you're talking months, but in the case of the cook you're talking years?‑‑‑Yes.


Okay.  At paragraph 31 you say:

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


Generally the hourly rate for an aged care worker is less than someone can get working at a hotel or restaurant.


Are you just making a personal observation there about aged care workers; are you not talking about yourself?‑‑‑I'm talking about myself and other - other workers.


So when you're comparing yourself to working at a hotel or restaurant are you talking about any particular hotel or restaurant?‑‑‑I'm talking from prior experience.


And you're talking there about the actual rate the hotel or restaurant would pay?‑‑‑Yes.


And that rate might be an enterprise agreement rate or it might just be a market rate?‑‑‑Mostly market rate.  Enterprise rate would be completely different to a market rate.


You're saying the market rate would be higher?‑‑‑Yes.


Yes, okay.  Could I take you to paragraph 34?‑‑‑Yes.


I just want to walk through some of your duties if I can.  I just want to try and clarify a few matters.  In (a) when you say, 'Ensuring sufficient food is available to feed the residents', is that making sure that you're actually putting out enough meals for those who want them?‑‑‑Yes, enough meals and making sure that the food is in the facility that we can service.


So that's ensuring that if you have to move to a particular servery for a particular dining room that it's there when it's required?‑‑‑That as well, and also making sure that the food is in the facility so that we can use it.


I see.  In terms of making sure you've got the right stock to make the food in the first place?‑‑‑Yes.


Yes, okay.  You then talk in (b) that you - ordering food for residents of the facility.  I take it that's your meats, your dry goods, is that what you're referring to by ordering food?‑‑‑Yes.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


I will just pause there.  Can I just jump ahead in your statement to when you talk about menus.  I might deal with that now.  Bear with me, Mr Kent.  Could I ask you to go to paragraph 83.  In paragraph 83 you say:


When it comes to meal planning I work off menu templates that are provided by Warrigal.


It's not a phrase I'm familiar with, Mr Kent.  What do you mean by a menu template?‑‑‑Menu templates are (audio malfunction).  They're created from a variety of different meals that help us choose what we can provide, and we make a menu from this template that is a nutritionally balanced weekly diet.


Just bear with me - - -?‑‑‑It helps - it helps - the menu template helps us create a menu that's balanced throughout the week.


So you're not provided with a structured menu plan from Warrigal head office, you don't get that?‑‑‑No, we have a template which we can choose particular meals from, and we have to create our menu from those meals that we can choose from.


Okay.  So the template might say here are four pork meals or here are three beef meals and these are the ingredients and you get to decide whether or not next week we're going to do the pork or the beef.  Is that what you're telling me?‑‑‑That is correct.


You might not know this, if you don't say so, but are the templates put together by nutritionists and dieticians?‑‑‑They are, yes.  And they're constantly changing.


And then if they change a template they send it down to you and that allows you to work out what you want to do?‑‑‑They can constantly change and we also have constant feedback from residents, and we can make personal changes as well.


When you say personal changes, do you mean you can decide from the template that you'll serve this but not that, or do you mean you give feedback to the nutritionists and feedback to dieticians that something's not going down very well?‑‑‑We get feedback from menus - from residents - from our resident meetings.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


Yes?‑‑‑And we create our menus from feedback given to us from our residents.  So, some of the templates may not work very well and our residents will give us some feedback and that's where the chef or myself would need to make changes and change the menu or change the template.


If you do change the template, does that changed across the whole of Warrigal?‑‑‑No.


Just for your facility?‑‑‑Yes.


Okay.  If you want to change a template, does the nutritionist or dietician have to say that's okay?‑‑‑It depends on if it's a permanent change.  Some of the changes are not permanent, it's a - the changes are made from resident feedback.


Could you give me an example just to help?‑‑‑So, we have - each menu runs for four weeks and we have four - and we create four different menus throughout the year.  So the idea of a template is to give our residents variations throughout the year and so we don't have the same meals for the residents for the entire year.  So, we have four complete menus, one for each season of the year.  Residents give us feedback as to what they would like to see on these templates and we can make changes to add those particular dishes onto the menus and templates from resident feedback.


Let's say that the residents said they wanted a beef ragu put on the menu for autumn, does a dietician or a nutritionist have to say yes, I'm comfortable with that going on the menu?‑‑‑As long as it fits - as long as it fits into the menu's balanced weekly meal.  So if there's chicken allocated on a Tuesday, we have to make sure that we allocate a chicken dish for that particular day.


So you get - - -?‑‑‑So as long as - so as long as the protein is the same, we can make a menu change.


So, you'll have some rules around the protein or possibly the vegetables, but within that you get to exercise your skill and your craft to decide whether or not you serve the chicken a certain way or a different way?‑‑‑That's correct.


Yes, okay.  In terms of the ordering of stock, are you the person who orders the stock for the kitchen?‑‑‑Yes.


Is that ordering done from pre-arranged stockists that you go to?‑‑‑Yes.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


I take it that the prices of the stock are already negotiated by Warrigal.  You're not involved in negotiating price?‑‑‑I can sometimes, yes.


When would you do that?‑‑‑When there's - when we're trying to source a new product or a new meat or a new cut, we can - we can ask for prices and cost the prices and we could then negotiate with our supplier as to the price of that product.


Do you have the authority to say yes to that price or does somebody else have to approve that?‑‑‑I have authority.


Okay.  Can I just take you to 34(h).  In 34(h) you say:


Being responsible for the safety of food prepared and served within the facility including keeping daily records for food safety checks.


I understand that particularly when you're serving hot food there's very clear rules about the temperature of the food.  Is that right?‑‑‑Yes.


If it goes below a certain temperature there's rules.  It's 60 degrees or something, isn't it?‑‑‑That's correct, yes.


When you're talking about food safety checks there, are you talking about things like that?‑‑‑Yes, and also time.


So, could you just explain to me what you mean by time?‑‑‑Well, we're only allowed to keep a cooked product for 48 hours if it's made on-site.  So, that's in our food guidelines, food safety guidelines.  We're also only allowed to have inside of the fridge for a total amount of four hours.


And when you say you have to keep daily records, do you have to keep daily records of what you've just described to me?‑‑‑Yes.


Where do you record that?‑‑‑On our food safety forms.


It's just like a check sheet is it?‑‑‑A little bit more involved than a check sheet.  There's also areas where you have to write down times, time guidelines and temperature variations.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


Who does that go to?‑‑‑Food safety supervisor signs off at the end of each day or at the end of each week, and then we - then we keep it on-site.


In case you get inspected?‑‑‑Yes.


I think you said earlier that - are you the food safety supervisor?‑‑‑Yes.


In paragraph 35 you talk about the Aged Care Quality and Community Commission doing an assessment.  How often do they come out to you?‑‑‑They can come out whenever they like.


Yes, but how often do they come out?‑‑‑Well, they could come out whenever they like.


When's the last time they came out?‑‑‑At the least once a year but they could come out whenever they like.  So, it's always once a year and they could come out, you know, without, you know, warning.


I understand what they can do.  So, have they been - have they been out in the last 12 months?‑‑‑Yes.


Was that their annual one or did they just drop in on you?‑‑‑No, they dropped in on us.


When they came, what were they looking - what did they look at?‑‑‑They looked - they looked at - went through all or paperwork, made sure that it was all in line with the standards.  They asked various questions.  They also interviewed residents to see - ask for feedback as well, and wanted to have a look at menus, procedures, paperwork, make sure that we were following all protocols.


When you say they looked at your paperwork, are you talking about the sort of paperwork you and I talked about earlier about temperature control and all of those matters?‑‑‑They look at those too, yes.


What other paperwork were they looking at?‑‑‑Complaints and resolutions.


That's complaints about the food that you've received?‑‑‑Yes, yes, and how we handle it.  They look at our food meeting agendas.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


And I take it you take the lead in that conversations do you?‑‑‑Yes.


Not your general manager?‑‑‑Only food related.


Okay, so you're taking the lead on the food related stuff because you're running that part of the facility?‑‑‑Yes.  Yes.


Can I take you to paragraph 40, sorry, 39, sorry?‑‑‑Yes.


You say:


Working in a kitchen in aged care is fast-paced and often stressful.  It's certainly not for everyone.  Everything is structured around timing for the residents' meal and schedules.


Is it more akin to large scale catering than working in a commercial restaurant?‑‑‑Can you rephrase the question again, sorry?


Well, no, I'm just asking you this because of your background because you've done your catering work at the airport and you seem to have worked at restaurants.  At a restaurant you don't quite know how many people are going to be eating, you've got a rough sense, you've got a staggered sense.  In a catering situation you normally know how many meals you've got to actually prepare.  So I'm just trying to understand, is it more like working in your catering activity at the airport rather than working in a restaurant?‑‑‑No, working in an aged care kitchen is large-scale catering.


Yes?‑‑‑You're correct in saying that we do the same amount of meals each day.  They can still vary on the day as to what particular meals the residents have asked for though.


So you're giving them a choice, aren't you?‑‑‑Yes.


Tell me if I'm wrong but it's like you can have the fish or the pork, and they get to choose that?‑‑‑There's other options other than just the two as well.  There's also quite a few specials.  If they don't want the chicken or the pork there are other options that we can provide for them as well.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


No, that's all right, I wasn't trying to say you were wrong.  It's not like an a la carte restaurant, though, is it?‑‑‑It is leading that way at the moment.


Is that your facility is trying to move to an a la carte arrangement?‑‑‑No, there seems to be a lot of residents currently at the moment that enjoy the options that we provide and there's also quite a few residents that ask for meals that are not on our current menu.


That's a service you provide at this facility, is it?‑‑‑Yes.


Could I ask you to go to paragraph 50?  You talk in paragraph 50 about:


Food is ordered on paper-based forms.  These forms are printed from a computer-based system.  The forms are specific for each resident and include their name, room number, allergies and dislikes.


It's my understanding that their likes and dislikes, their allergies and also their IDDSI index number, that's normally on the resident's care plan.  Is that your understanding?‑‑‑It was on the care plan and it's also on our order form sheets as well.


Some other people have said they keep an allergy book in the kitchen, itself, as a sort of back-up.  Do you keep that?‑‑‑We have an allergy book.  We also have allergy on the residents' forms as well.


When they're actually ordering their preference for the day, that's a triple safeguard that it's actually on the form?‑‑‑Yes.


Yes and then on paragraph 51 you talk about changing food to meet the IDDSI index.  Am I right that let's say you were cooking pork, am I right that you would – and the resident wants pork, they would get the same pork but depending on where they sat on the IDDSI index you might serve it up to them slightly differently?‑‑‑Yes.


I haven't asked anyone this before.  Do you learn about the IDDSI index in your certificate 3 in commercial cookery or is it something you learned afterwards?‑‑‑It's something that you learn afterwards.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


The actual techniques of things you would have learnt in commercial cookery, you would have learnt techniques about pureeing and mincing and things like that, wouldn't you?‑‑‑The IDDSI level is completely different to what you would learn in commercial cookery.


In what way?‑‑‑In commercial cookery you don't learn about cooking for aged care residents.


No, sorry, I might not have been very clear.  You learnt how to puree something when you were doing your commercial cooking, didn't you?‑‑‑You can puree food in commercial cooking, yes.


Yes and if I asked you as a commercial cook to mince something, you would know how to mince it, wouldn't you?‑‑‑You'd still need to do some form of – you would still need to do some training to be able to understand the differences between each level in the IDDSI.


What training did you do?‑‑‑On the job training.  It took me some time to fully understand.


You didn't do - - -?‑‑‑It's not just one resident that you're doing this for.  There's, you know, quite a number of residents that you have to meet the IDDSI levels for and they're all very quite different.


You were taught on the job by somebody else, were you?‑‑‑I was – in my personal situation I had to learn on my own on the job.


You were self-taught?‑‑‑Yes.


Just bear with me a minute, Mr Kent.  Could I ask you to go to paragraph 88?  You talk about the Aranda facility, I think that's where you - is that where you originally started in aged care?‑‑‑Yes.


How many residents did that facility have?‑‑‑This was quite some time ago now but it was over 100.


Did it have three kitchens as well?‑‑‑No.


Did it have one?‑‑‑It had one main kitchen.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


How many dining rooms did it have?‑‑‑It had one main dining room and it also had room service.


You might not recall, I don't know, but were you part of – did they have 24 people in their catering department?‑‑‑It would have – it was some time ago, I wouldn't – couldn't accurately give you a number of how many staff were in that kitchen but it still ran seven days a week, it still had two rostered schedules.  We still had a number of casual staff there as well, so numbers may have been very similar.


You talk about in paragraph 86, you talk about your bible?‑‑‑Yes.


All professions have a book that could be called that.  We have one in our profession.  Is that an off-the-shelf book or - - -?‑‑‑No.


Is that something you've put together over your years of experience?‑‑‑Every site has their own individual bible that is site-specific that you need to follow.


That would be - - -?‑‑‑Not every home would be identical.  So some of the bibles might be slightly different.


Every facility is going to have its own food safety guide and that's going to be similar but it might be different if I went to another facility's kitchen?‑‑‑Yes.


Has there been a food safety guide for as long as you've been in aged care?‑‑‑Yes.


Can I take you to your second statement, Mr Kent, if I could?  Do you have that, Mr Kent?


Can I ask you to go to paragraph 45?  You talk there about GSOs.  That's not a phrase you use in the first statement.  Can you tell me what a GSO is?‑‑‑General service officer known as the kitchen hand.


Okay?‑‑‑So a kitchen assistant.


Did they get a name change, or is there any reason why you didn't use it before?  Is that the proper name?‑‑‑That's the proper name.


Okay?‑‑‑Each employer might call them slightly different.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


It says, 'GSOs now have to remember each and every resident's preferences.'  Are these the preferences that are in the care plan?‑‑‑Yes.


And they're the preferences that are on the order sheet?‑‑‑Yes.


Then in 46 you say, 'The amount of documentation kitchen staff, including GSOs, are required to deploy(?)', and it goes on.  I understand the paperwork you do, Mr Kent.  What's the paperwork the GSO does?‑‑‑The paperwork the GSO does is also at the end of their shift, they fill out the pre‑safety paperwork as well.  They have their own little timelines and temperatures that they need to take also during the meal service time for their particular servery.  They also have to clean their kitchens and sign off on their kitchens being cleaned as well.  The paperwork that they also do and fill out on a daily basis is ensuring that the residents get the correct meals, so they read off their sheets and they tick off that the resident has received their meal.


If I can just go through those one-by-one, so if I'm at a particular servery, I'm a GSO at a servery, am I making sure that those temperature guidelines are followed?‑‑‑Yes.


And I have to fill out some paperwork to confirm – do I have check that, what, every hour or something like that?‑‑‑You check it before service, then after service.


Then there's a form I have to fill out to say I've done that, is it?‑‑‑Yes.


And I'm not being rude, Mr Kent, but I take it that's a form that simply says yes, I have done it?‑‑‑It says yes, I have done it, and there's also sections there to write times and temperature variations in it as well, and a personal signature.


If I had observed that the temperature had fallen below 60 degrees I'd have to record that, would I?‑‑‑You'd have to record it and notify somebody, yes.


Notify you?‑‑‑Yes.

***        DARREN JAMES KENT                                                                                                                XXN MR WARD


And then you said they have to confirm in writing that they've cleaned their kitchen.  Again, I'm not trying to be rude – is that to sort of tick the box to say I've done this cleaning and I've done that cleaning?‑‑‑Yes.  So the GSOs also count their numbers of variants of different meals that they need as well, and notifying me.


So that would be saying I need six of these or four of those?‑‑‑That's correct, yes.


Sorry, is that – I'll just make sure I get the timing of that right.  I've given the resident their menu form, which has their preferences on it; the resident fills it out.  The GSO then has to tell you, having had those filled out I need four pork, six chicken – is that the timing of that?‑‑‑Very similar.  In some instances residents are unable to fill out their own paperwork, so kitchen staff and/or care staff also assist the resident in meal choices as well and help them fill forms out.


Thank you.  Mr Kent, thank you for your evidence.  No further questions, Commissioner?‑‑‑Thank you.


COMMISSIONER O'NEILL:  Any re-examination, Mr Gibian?

RE-EXAMINATION BY MR GIBIAN                                               [10.35 AM]


MR GIBIAN:  Yes.  Thank you, Mr Kent.  Can you hear me again?‑‑‑I can, yes.


There were just a few matters I wanted to clarify.  Firstly, you were asked some questions initially about the qualifications you have, including the food handling certificate, and Mr Ward in particular asked you whether that was the same certificate in aged care as in restaurants more generally, and you indicated there was a different certificate in aged care, and I think you mentioned the code for that certificate.  Was that right?‑‑‑I did, yes.


Are you able to repeat that?‑‑‑So the code for the aged care certificate is a HL for health, FS food safety - yes, HLTFS for health food safety.


Secondly, you were asked quite a number of questions about the menu templates and the extent to which you're able to offer specific meals or change the templates based upon feedback from residents.  I just wanted to ask you if you could indicate how is that, the feedback from residents, communicated to you?  Is it directly through meetings. or some other mechanism?‑‑‑The residents can offer various different ways to give me feedback.  They could come up to the servery window and see a staff member or myself, because all of our kitchen serveries are all open to the dining rooms.  So residents can give back feedback all the time, whenever they like, and also they can give feedback through our resident meetings, and they can also give feedback through our food focus group meetings.

***        DARREN JAMES KENT                                                                                                               RXN MR GIBIAN


With the food focus group meetings, can you describe what those meetings are?‑‑‑In the food focus group meetings, we notify residents when there's going to be a menu change, and residents have an option to indicate whether they accept the menu or they can offer ideas to implement new dishes into the menu, and we create menus that way as well.


Are they conducted with any regularity, that is, every few months, or is there any pattern?‑‑‑There is a pattern.  We have food focus group meetings every season, at the beginning of every season and at the beginning of every new menu, and if there's a request or a need to have a food focus group meeting we will also do that too.


You also gave some evidence about there being requests for specific meals on specific days, in addition to feedback on the menu more generally.  How does a resident communicate, and when does a resident communicate that they want a particular meal on a particular day?‑‑‑Our residents are quite – there's a lot of residents that are very verbal and can speak to us through the serveries, and they can notify myself or the kitchen staff as to a particular meal that they would like to have for that particular day and we'll try to meet their needs.


And they can do that at any time, can they?‑‑‑They can do that at any time, yes.


You were then asked some questions about documentation, food safety documentation that you're required to keep, and in answer to that question you said that the documentation is then retained in case you get inspected.  You were then asked some questions about the inspection by the Aged Care Quality and Standards Commission, and you gave some evidence about those inspections.  Are there separate food safety inspectors, separate from the Aged Care Quality and Standards Commission?‑‑‑Yes.  So there's the food safety inspection, which is very different to the Aged Care Commission inspection.  Food safety look at our kitchens, our cleanliness, the way we provide our service to see whether we provide food in a safe manner, and to also check over our kitchens to make sure that our kitchens are cleaned correctly as well.


And how regularly do you receive visits from food safety inspectors?‑‑‑A food (indistinct) must come once a year and just - however, they can also come in at any time as well.


You then were asked some questions about the inspections by the Aged Care Quality and Safety Commission, and you gave some evidence that they check through paperwork and the like and that you speak to those, the assessors from the Commission at least about food matters.  Do they also speak to other staff to your knowledge?‑‑‑Yes, they speak to everyone as well.  Yes, they get feedback from everyone, so, yes, they do.

***        DARREN JAMES KENT                                                                                                               RXN MR GIBIAN


And with residents as well?‑‑‑And with residents as well.


Yes, thank you, Mr Kent.  Thanks so much for your evidence?‑‑‑Thank you very much.


COMMISSIONER O'NEILL:  Thank you, Mr Kent, you're now excused and free to go?‑‑‑Thank you.

<THE WITNESS WITHDREW                                                          [10.41 AM]


COMMISSIONER O'NEILL:  All right.  Do we have Purden?


MS DOUST:  Commissioner, I understand he's attempted to log in and he might be waiting to be admitted.


COMMISSIONER O'NEILL:  Mr Purden, can you hear me?


MR PURDEN:  Hello.  Good morning.


COMMISSIONER O'NEILL:  Good morning.  I'm Commissioner O'Neill and my associate is just going to have you take the affirmation.


MR PURDEN:  Yes.  All good.  All good, yes.


THE ASSOCIATE:  Mr Purden, can you please say your full name and work address.


MR PURDEN:  Full name and address - Michael William Purden, (address supplied).

<MICHAEL WILLIAM PURDEN, AFFIRMED                              [10.41 AM]

EXAMINATION-IN-CHIEF BY MS DOUST                                   [10.41 AM]




MS DOUST:  Mr Purden - - -

***        MICHAEL WILLIAM PURDEN                                                                                                        XN MS DOUST




MS DOUST:  That's quite all right, Commissioner.  Mr Purden, can you hear me, it's Lisa Doust speaking?‑‑‑Sorry, who am I talking - sorry - yes, sorry.


Can you hear me okay, Mr Purden?‑‑‑I'm having - it's not very clear, let me just try and turn that up a little bit - okay, try now.


Okay.  Can you hear me better now?‑‑‑I can hear you better now, yes.


Okay, great.  Can you please state your full name for the record?‑‑‑Michael William Purden.


All right.  Are you employed by South Eastern Community Care as a community care worker?‑‑‑Yes.


And, Mr Purden, have you prepared a statement for the purpose of the matter that's before the Commission?‑‑‑I have.


Do you have a copy of that in front of you?‑‑‑I do, yes.


I understand there's a couple of corrections that need to be made to that document, and for the record that's document 203 in the digital court book at page 11,283.  Can I ask you to go, Mr Purden, to paragraph 14?‑‑‑Yes, I've got it.


Am I right in understanding the figure that appears there should be $25.37 rather than 26 cents?‑‑‑That's correct.


And in the following paragraph the figure should be $29.12, not $29.90?‑‑‑That's correct.


And in paragraph 16 you refer to a figure of $4.64 an hour and give a percentage.  In fact the figure there should be $3.75 an hour?‑‑‑That's correct, yes.


Can I ask you just to go ahead in the statement if you don't mind to paragraph 40?‑‑‑Yes.

***        MICHAEL WILLIAM PURDEN                                                                                                        XN MS DOUST


You refer there to a client with dementia.  Is it the case that in fact that client suffers from a brain injury?‑‑‑That's correct.  That's right.


All right.  Subject to those qualifications is the statement true and correct to the best of your belief and knowledge?‑‑‑So then if you go - so leading further on from number 40, number 45 refers to the same client.  So that's a brain injury.


All right.  So again where that refers to dementia you're referring to that client suffering a brain injury?‑‑‑That's correct.


All right.  But subject to those corrections and qualifications is the statement true and correct otherwise?‑‑‑It is true and correct, yes.


Thank you.  I read that, Commissioner.


COMMISSIONER O'NEILL:  All right.  Mr Ward?

CROSS-EXAMINATION BY MR WARD                                         [10.45 AM]


MR WARD:  Thank you, Commissioner.  Mr Purden, can you hear me?‑‑‑I can, yes, thank you.


My name is Nigel Ward, Mr Purden, I appear in these proceedings for the employer interests.  I'm just going to ask you some questions, sir.  If at any stage you can't hear me just let me know, okay?‑‑‑Okay.


Do you have your statement in front of you?‑‑‑I do, yes.


Is South Eastern Community Care normally just called South Eastern, what do you normally call it?‑‑‑South East (indistinct) for short, yes.


Okay.  Well, I'm going to call it South Eastern.  It might be easier.  You say in your statement at paragraph 6 that you completed your Certificate III in aged care before commencing work in the home care sector.  Did you make a decision to try and get into the home care sector and that's why you did it?‑‑‑I got made redundant in the workforce that I was - in the line of work that I was in, and so I decided on a change in career if you like and went down that path.

***        MICHAEL WILLIAM PURDEN                                                                                                       XXN MR WARD


Okay.  What were you doing before?‑‑‑I was in credit control, if you like, or debt collection I was into before, (indistinct) telephone calls.


So quite a career change?‑‑‑Quite a career change, yes.


Can I just start with a little bit about how South Eastern set up around you.  In your statement you talk about case managers, you talk about care coordinators.  Who do you work for, who's your boss?‑‑‑Well, I wouldn't consider the case managers or coordinators bosses as such, they're the people we refer problems to as far as our clients are concerned.  I have a direct manager that's above that level if you like, and that's - - -


That's fine.  What's their title?  What's their title, Mr Purden?‑‑‑I'm not sure what the title is.  I don't know.  Yes, good question.


There's somebody you work for?‑‑‑Yes.  There's a manager that works - that deals with, directs all the office staff and the carers too.  That's someone that I would report too, but (indistinct) on a day to day basis deal with clients or something like that we would report to, directly to that person, manager, as far as (indistinct) who manages their cases.


So that's what you call a case manager, is it?‑‑‑That's right, yes.


So if you're with a client and you've got a problem with a client your first point of contact is the case manager?‑‑‑That's correct, yes.


Do you know if the case managers are registered nurses?‑‑‑No, they're not.


Do you ever get involved with getting a registered nurse in to help a client?‑‑‑I wouldn't do that, but if there's any issues our (indistinct) the first - first thing to do would be to call an ambulance if there is any medical issue.


So if you were with a client and that client was starting to be short of breath your procedure is to simply call triple 0 and get an ambulance to them?‑‑‑That's correct.

***        MICHAEL WILLIAM PURDEN                                                                                                       XXN MR WARD


Now, when a client is set up, so let's say that I want to become a client with South Eastern, who does the initial assessment, is that the case manager?‑‑‑That's the way it used to be when I first started there.  I'm not sure, because I know some of them say that they don't get out and make personal calls any more.  I don't know if that's still the case, but that's how it used to be, that they used to go out and it's the person who assessed them, yes.


Okay.  So they used to do that, but you're not sure if they still do it?‑‑‑Not 100 per cent sure, no.


But it's not you?‑‑‑No.


Do you know - when a client is first taken on do you know if they do a risk assessment at the home to make sure the home's safe?‑‑‑That's how it used to be.  That's my understanding.  Now, that's, yes, that's how it happened.  I'm not aware of current procedures but I know that's how it used to be when I first started.


But you don't have any reason to believe it's changed, do you?‑‑‑No reason to believe them to be changed, no.


Right?‑‑‑If there were any risks, we're also trained to look for any risks or anything like that within the household and important things that might be of risk when we – we'll agree to go into the house as well.


Could you give me an example of that?‑‑‑An example of a risk or - - -


An example where you might have gone into a house and identified a risk that you'd reported back?‑‑‑There's one.  There was a house that I went to that was cluttered up.  They were hoarders, if you like, and it was a fire hazard and also a risk.  There was no clear avenue to get out of the house.  It could (indistinct) these old – I reported that.


Was that fixed up?‑‑‑Well, I never went back there.


You never went back, okay?‑‑‑The last time that I went to there.


It was fixed up for you?‑‑‑Indeed.


It was fixed up for you.  Am I right in saying that you don't get involved in medication?‑‑‑I don't have the certificate for medication so, no.

***        MICHAEL WILLIAM PURDEN                                                                                                       XXN MR WARD


No, that's okay.  When is the first time you would see the client's care plan?‑‑‑When was the first time I would see?


Their care plan?‑‑‑Basically the information we have is on our work file.  So when I get my roster for the fortnight, the details are on the app - - -


Okay?‑‑‑ - - that's I've got on my phone.


That's good and can I just take you to paragraph 25.  You say in paragraph 25:


Over time I've gradually built up regular clients.  Now 90 per cent of the clients I see week-to-week are regular clients.


Do you see that?‑‑‑Yes, yes.


You know week-to-week where you're going and who you're going to see?‑‑‑The rosters come out each week on the phone, so I get the roster, like, a week in advance, yes.


Those 90 per cent, you know when you're going to see them?‑‑‑I've seen them the week before, some of them, I get them on a regular basis would be what I'm saying.  So, yes, not necessarily that I'm going to get them for that following week but what I'm saying is when the roster comes out, on that roster most of those times I see on a regular basis.


On a regular basis.  You've developed some familiarity with those people in terms of what their needs are?‑‑‑That's correct.


I take it that from time to time you get asked to go and see a client who you don't regularly see?‑‑‑Yes, just for one-offs where people are away sick or, yes, there's roster changes for that reason, yes.


Can I ask you to go to paragraph 39?  You say in paragraph 39:


I think the biggest challenges that come with the job involve handling abuse from clients and their families, dealing with client behaviour issues, particularly the dementia patients.

***        MICHAEL WILLIAM PURDEN                                                                                                       XXN MR WARD


Mr Purden, what skills did you learn in your certificate 3 that help you with that?‑‑‑Dealing with dementia and I think most of the training there is not too – you go along with the clients as much as possible.  You go along with the story that they've got and not challenge the story.  And if they want to do something, to try to redirect their interest, yes, rather than just say straight out no.  So more a way – a different way of saying no or a different way of disagreeing with them or something like that so it doesn't cause triggers basically as far as our dementia clients are concerned.


Yes, what about general behaviours?  Did you learn anything in your certificate 3 in how to manage general difficult behaviours?‑‑‑I think that's all along the same - - -


The same line?‑‑‑The same sort of lines.


I think they're called de-escalation strategies, aren't they?‑‑‑I couldn't honestly tell you if that's what it is.


It's been a while, has it?‑‑‑I don't know what it's called, no.


That's fine.  Have you ever found yourself in a situation where you personally thought you were unsafe?‑‑‑Yes.


Is there a procedure in your – in South Eastern is the procedure that you're to remove yourself from that unsafe situation?‑‑‑Yes, I – yes, and I did remove myself from that situation and reported it immediately.


When you reported it, does that go back to the case manager?  Who are you reporting it to?‑‑‑Well, it was an after-hours situation so I reported it to the people dealing with the after-hours.  There's an after-hours number that I rang and they would have reported it back from there.


When you've done a session with a client, do you do a write-up?  Do you write any progress notes in relation to what you've done?‑‑‑Whenever we see a client, there's a book in the - that we complete of the times we were there and we write progress notes before we leave.

***        MICHAEL WILLIAM PURDEN                                                                                                       XXN MR WARD


Could you give me an example of what you might write in that book?‑‑‑A lot of times they're usually just mundane notes as far as – especially if you're just cleaning their house or something like that.  Most of it is fairly mundane but, I mean, the reason for those notes my understanding is if there is any concerns, anything to pass onto the next carer that might walk through the house, there's notes there telling them, you know, what's happened on the previous shift.


It could be as simple as, 'Clean the bathroom'?‑‑‑Yes.


Or it could be, 'Clean the bathroom.  Nigel's not himself today'?‑‑‑That's it.  It could be as simple as that, yes.


Just a minute, please.  Mr Purden, thank you very much for your evidence, sir.  I wish you well?‑‑‑Thank you.

RE-EXAMINATION BY MS DOUST                                                [10.57 AM]


MS DOUST:  Mr Purden?‑‑‑Yes.


It's Lisa Doust again.  Can I just take you back to the question you were asked about a situation where you found yourself unsafe?‑‑‑Yes.


Can you just describe the circumstances where you've felt that you were unsafe?‑‑‑It was actually with a brain injury client.


Yes?‑‑‑She's – I was there looking after her while I opened (indistinct) was out and she said, 'I don't need you anymore, you can leave now.'  And I had – I have to stay there for the full term of the shift, and she became quite volatile, if you like, as far as wanting to remove me from the house.


Is this what you describe, Mr Purden, at about paragraph 48 of your statement?  Is it that situation?‑‑‑48.  I would imagine – yes, that's the one, yes.  Yes, that's right, yes.


Could I also ask you to go back to where you were being asked about whether or not you believed there might be something in the home that gave rise to a risk to health and safety?‑‑‑Yes.


You referred to something, I didn't quite catch it, you were talking about there being a fire hazard or no clear avenue out of the house?‑‑‑The house was very cluttered up, the hallways and there was no spare space in the house anywhere.  It was that – a total fire hazard.  There was only one – the back entrance was blocked off with boxes and items, and there was only one entrance.  The front door was the only way in and out.

***        MICHAEL WILLIAM PURDEN                                                                                                      RXN MS DOUST


Are you talking about a client who was a hoarder?‑‑‑Yes.


Was there anything about the material in the house that caused you concern?  Was that flammable as well, was it?‑‑‑Yes, boxes and cardboard boxes, et cetera, there, yes.


You were also asked earlier on about your Cert III training?‑‑‑Yes.


As to whether or not your Cert III training assisted you to deal with handling abuse and difficult behaviours?‑‑‑Yes.


Is the Cert III training the only thing you draw upon to deal with those things?‑‑‑When I say we dealt with as far - we dealt with the dementia side of things as well as dealing with the behavioural issues with dementia clients.  I can't - I can't say that (indistinct) other than that.  So, no, the Cert III mainly (indistinct) not abusive clients in general, no.


Is there anything else you draw upon when you're dealing with those situations?‑‑‑Common sense I think is what you draw upon a lot.  (Indistinct) respect and how you treat other people (indistinct) is what I draw upon.  My life experience.


All right.  And part of that experience has been as a debt collector over some years.  Is that right?‑‑‑That's right, yes.


Thank you.  Nothing further, Mr Purden.  Thank you?‑‑‑Thank you.


COMMISSIONER O'NEILL:  Mr Purden, thank you very much for your evidence and you're now excused.  You're free to go?‑‑‑Thank you.

<THE WITNESS WITHDREW                                                          [11.01 AM]


COMMISSIONER O'NEILL:  All right.  We're going to take a short break and resume at 11.10.  The Commission is adjourned.

SHORT ADJOURNMENT                                                                   [11.01 AM]

RESUMED                                                                                             [11.10 AM]

***        MICHAEL WILLIAM PURDEN                                                                                                      RXN MS DOUST


COMMISSIONER O'NEILL:  The Commission is now resumed.  Do we have Ms Field?


MR GIBIAN:  I understood she was waiting to be admitted.


COMMISSIONER O'NEILL:  Ms Field, can you hear me?


MS FIELD:  Yes, I can hear you.


COMMISSIONER O'NEILL:  Lovely.  I'm O'Neill C and my associate is just going to have you take the affirmation.


THE ASSOCIATE:  Ms Field, can you please say your full name and work address?


MS FIELD:  Anita Field, and my work address is 12‑18 Leigh Avenue, Roselands.

<ANITA FIELD, AFFIRMED                                                             [11.10 AM]

EXAMINATION-IN-CHIEF BY MR GIBIAN                                  [11.11 AM]


COMMISSIONER O'NEILL:  Mr Gibian, is it?


MR GIBIAN:  Yes, it is.  Ms Field, can you see and hear me?‑‑‑Yes, I can.  Thank you.


This is Mark Gibian, so you know, for the HSU.  Can you just repeat your full name for the record?‑‑‑Anita Field.


And I think you actually have two jobs.  So you're a laundry hand at the Leigh Place Aged Care?‑‑‑Yes, and Australian Unity.


And also chef for Australian Unity?‑‑‑Yes, that's correct.

***        ANITA FIELD                                                                                                                                  XN MR GIBIAN


I think you've set out in your statement the hours, but you're ensured work Saturday, Sunday, Monday at Australian Unity, and Wednesday, Thursdays at Leigh Place.  Is that still the arrangement?‑‑‑Yes.  Currently at the moment I have been injured, and nothing to do with the workplace but by travelling there.  So I'm on a CTP claim at the moment, so unwell to return back to work until I get well, but until then my job is there.


So your hours haven't changed, you're just off work as a result of the injury?‑‑‑Yes.


You've made a single witness statement for the purpose of these proceedings that's dated 30 March 2021.  Do you have that with you?‑‑‑Yes, I do.


I think it runs to some 44 paragraphs.  Have you had an opportunity to read that through again?‑‑‑Yes, I did, but at the moment my brain is a bit short‑circuit, so I have to just remember a few things again.


Of course.  Having read it through, were there any corrections you wanted to make to it?‑‑‑No.


Is it true and correct to the best of your knowledge and recollection, with that updating in relation to your present work situation?‑‑‑Actually the hours has changed, sorry.  Where I used to start from 7 am in Leigh Place, 7 am to 4 pm, now the hours have changed to 7 am to 3 pm.


All right.  Well, with that correction, is it otherwise true and correct to the best of your knowledge and recollection?‑‑‑Yes.


Thank you.  That's the statement of Ms Field we wish to have admitted into evidence.  It's document 191 in the digital court book commencing at page 10910.  Ms Field, I think on the screen one of the boxes has Mr Ward in it.  He's just waving now?‑‑‑Yes.


He's proposing to ask you some questions now?‑‑‑Yes, sure.

CROSS-EXAMINATION BY MR WARD                                         [11.14 AM]


MR WARD:  Ms Field, can you hear me okay?‑‑‑Yes, I can.  Thank you.


Thank you, Ms Field.  My name is Nigel Ward.  I appear in these proceedings for the employer interest and I'm just going to ask you some questions.  Do you have your statement in front of you?‑‑‑Yes, I do.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


Can I just start with your duties as an assistant in nursing that you've identified in paragraph 8?  Could you go to paragraph 8 for me?‑‑‑Yes.


Can I take you down to paragraph 8(f), if you could go there?  In 8(f) you talk about 'administering medication, Paracetamol and vitamins.'  Do you see that?‑‑‑Yes, I do.


I'm just going to jump forward a minute into another part of your statement.  Could you go to paragraph 29(b)?‑‑‑Yes.


You're talking in 29(b) about working as a chef, but you also say there – you talk about 'starting your medication rounds.'  Do you see that?‑‑‑Yes.


I just want to talk about what you actually do on medication rounds, and if it used to be different in the past to what you do now you'll need to let me know.  When you say in paragraph 8(f) you were administering medications, and you say in brackets, '(Paracetamol and vitamins)', at that stage when you were working was it only Paracetamol and vitamins?‑‑‑To correct that, that I used to do that only in retirement village, not in nursing AIN.  In AIN nurse in Leigh Place is full on with the Webster‑pak.


So that was where you used to be, but in Leigh Place you would use the Webster‑pak medications?‑‑‑Yes, Webster‑pak medication that's what we use in Leigh Place, but in aged care retirement village – sorry, in retirement village in Australian Unity we have very limited, because you don't really need a certificate to work in retirement village, because it's a low care facility, and so when we give the medications we only give sort of, like, vitamins and Paracetamol, that's all; very low – so we don't use too much medications in Australian Unity.


I'll come back to Leigh Place in a minute.  Let's leave that one where it is.  That's fine?‑‑‑Okay.


If I can take you to paragraph 21?‑‑‑Yes.


You say in paragraph 21, 'I got my catering certificate?'  Can you see that?‑‑‑Yes.


Could you explain to us what your catering certificate was?‑‑‑I got Certificate in – sorry - - -

***        ANITA FIELD                                                                                                                                 XXN MR WARD


That's all right.  Take your time?‑‑‑As – working as like a chef, so it was Certificate IV - - -


Certificate III or IV?‑‑‑Certificate III actually in catering where you can – I could even have my own, like, restaurant and everything else as well.  So I can work as a chef, but mostly in (Indistinct) Village in Australian Unity we use – there's staff there that don't even require a certificate to work as a cook.  So you know, so you can still cook there, but you don't need a certificate, but I ended up getting that extra so that I can get employed in case they need extra, you know, sort of, like, certificate, like, say, RCT and RCA, so that's the certificate I ended up getting.


If I can just put that back to see if I understand it.  I think what you're saying is you've got your Certificate III in Commercial Cookery, but where you work as a chef you're not required to have it.  Is that what you're saying?


COMMISSIONER O'NEILL:  Ms Field, I think you might have frozen.  Can you still hear?  Mr Gibian, is there someone that can just be with Ms Field?


MR GIBIAN:  There is someone who's there with Ms Field and we'll just make a telephone call now to see if they can re‑join.


I understand they're reconnecting now.


COMMISSIONER O'NEILL:  Welcome back, Ms Field?‑‑‑Sorry about that.


No, no, that's fine.  All right.  Mr Ward, you might just repeat your question.


MR WARD:  Thank you, Commissioner.  I think, Ms Field, I was asking you this question.  Is what you just tried to tell me that you've - you went and got your Cert III but your employer doesn't require chefs, cooks, to have a Cert III?‑‑‑(No audible reply)


COMMISSIONER O'NEILL:  I think Ms Field's frozen again.


MR GIBIAN:  It does look that way.  We'll make another telephone call. Shall we have one more attempt at this and then maybe resort to the telephone if that's once more unsuccessful?

***        ANITA FIELD                                                                                                                                 XXN MR WARD


COMMISSIONER O'NEILL:  Well, it might be easier to go straight to the telephone, I suspect.


MR GIBIAN:  Yes.  Yes.  Okay, we'll endeavour to arrange that.


COMMISSIONER O'NEILL:  All right.  Just while that's occurring.  Mr Gibian, I might have missed something on the way through but my tally of the remaining HSU witnesses, I'm not - I understand there's six witnesses that will need to give evidence if you wish to rely on their statements that haven't been scheduled; Mr Mills is scheduled for Monday but on my tally there's Mr Barnes, Ms Kelly, Ms Sharlia, White, Wagner and Whyte spelt with a 'y'.  If you could just have a look at that.




COMMISSIONER O'NEILL:  And let me know sort of later today.


MR GIBIAN:  Yes, I was going to give you an update later in the day.  There are a small number that we will need to try and accommodate sometime next week and we'll communicate.  There was Ms Kelly who contracted COVID and was unable to give evidence at the time that she'd been scheduled, and a couple of others.  There are a small number, it's either three or four, who we've simply been unable to arrange for various personal reasons that attach to those people in the time that are available, and we won't frankly be able to do so in the time that is available.  What we had intended to do with respect to those individuals is to explain, at least in brief terms, without going too much into their private circumstances, the circumstances, and we did propose to seek to rely upon the statements, notwithstanding that we haven't been available(sic) to make them available for cross-examination.


Obviously, if that effects the degree of weight that can be attached to their evidence then so be it, but given that there were - it's not simply that we're not producing them, but that there were particular circumstances which have resulted in that situation.  That was the course that we were proposing at least, and Mr Ward can consider his position in that respect.




MR GIBIAN:  I understand we're trying to arrange the telephone connection to be made.  Again, apologies, this is perhaps the reality of these hearings from time to time.

***        ANITA FIELD                                                                                                                                 XXN MR WARD




MR GIBIAN:  Just while we're waiting also, is Mr Ward able to give any estimate as to how long Ms Field might be once we do get her connected again, so we can try and have Ms Heenan waiting and ready at that time as well.


MR WARD:  Mr Gibian, I was genuinely optimistic I would hit my half hour mark.


MR GIBIAN:  Which is probably another 20 minutes or so.


COMMISSIONER O'NEILL:  Are you similarly optimistic about Ms Heenan?


MR WARD:  I have no optimism with Ms Heenan because I'm not doing Ms Heenan, Commissioner.  I'll just ask.  We think 30 minutes will be fine for her.  Can I just say, Mr McKenna will be (indistinct) for me to say this, I'm hoping to catch up with the ANMF witnesses this afternoon.


COMMISSIONER O'NEILL:  All right.  Welcome back, Ms Field?‑‑‑So sorry about that.


No, no, it's not your fault.  All right.  Mr Ward.


MR WARD:  Thank you, Commissioner.  Ms Field, I think I simply asked you were you saying before you dropped out, were you saying that you have your Certificate III but your employer doesn't require chefs and cooks to have a Certificate III.  Was that what you were trying to tell me?‑‑‑Yes, that's correct.  That's in Australian Unity, yes.


Yes, okay.  That's fine.  Can I take you then to your laundry work?‑‑‑Yes.


If I can take you to that.  I think it starts at paragraph 27 and I might try and do this a little quicker than I was proposing to do to sort of catch up with some time?‑‑‑Okay.


The laundry in the facility?‑‑‑Yes.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


Do you have to go and collect the laundry from around the facility, or is the laundry brought to the laundry?‑‑‑No, there's only one laundry person in the laundry, that's myself or whoever's working there.  Their job is to go and collect the laundry from every houses, every rooms and put it in a big container so the load would be no less than 30 kilos.


I'll come back to that if I can.  So, you go and collect the laundry from?‑‑‑The residents' rooms, yes.


The residents' rooms.  And by residents' rooms, are you indicating that you strip their beds personally?‑‑‑No, the cleaners do that now.  So - yes.


So you would go into each room and what, pick up the laundry bag would you?‑‑‑Yes.


Would the personal clothes be separated from the sheets and towels?‑‑‑No.


So, your facility they're altogether are they?‑‑‑Yes.


If there is soiled linen, is that placed into a plastic soluble bag at your facility?‑‑‑Yes.


Go on?‑‑‑It's the red contaminated bags.


If there is anything that's infectious, is that also then placed into a red bag plus then a yellow soluble bag?‑‑‑Well, it's only in the yellow bags and - - -


It just goes in the yellow, it doesn't go in the red and then into the yellow.  Just the yellow?‑‑‑Just the yellow.  Infection ones are just yellow.


Yellow.  When you go and collect the laundry from the facility, that's the stuff you need to wash, you put it in a trolley?‑‑‑Yes, it's a big trolley because individual bags, the big bags, that goes in the trolley and then I push the trolley to the laundry and then that's where I sort them out in another container and then in individual ones, they go in the machine according to the loads, yes.


That's okay and we've seen in some facilities they have these trolleys that have spring-loaded floors, so as you take stuff out the floor of the trolley goes up.  Do you use those?‑‑‑Just one but - - -

***        ANITA FIELD                                                                                                                                 XXN MR WARD


You use that inside the laundry, do you?‑‑‑Yes, that's only for inside the laundry.


You go and collect things from the ward in a big trolley, bring them to the laundry?‑‑‑Yes.


You said you sometimes have to carry over 30 kilograms.  Is that true?‑‑‑Yes, sometimes it's over 30, yes.


Your employer doesn't have rules around safe handling?‑‑‑We do get training for the safe handling but what they say and what they do is two different things.


They have a rule but they break it, do they?‑‑‑Yes.


Do you know what their rule is for what you're meant to lift?  Is it 10 kilograms?‑‑‑Actually now I'm not too sure.  They say up to 15 but I'm not too sure, yes.


So they have a rule it's 15 kilograms but, unfortunately, the rule gets broken?‑‑‑Yes.


How many washing machines do you have?‑‑‑One small, one medium, one large.


Just bear with me, are the medium and large industrial washing machines?‑‑‑Yes.


Is the small one a domestic washing machine?‑‑‑No, they're all industrial but they - - -


Industrial, yes?‑‑‑It comes in different sizes, yes.


Is there a reason why they're different sizes?‑‑‑The small one is mostly for where contaminated washing is supposed to go in.


Yes?‑‑‑And the medium one is for the – does the normal clothing and the big loads should be for the linens and all that.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


I take it that when you get the washing into the laundry you move it into the trolley with the floor that rises, you take that to the washing machine then, do you?‑‑‑No.  The same trolley that is – the one that we got the spring is only for the folding.


Okay?‑‑‑So all the other ones are just normal, not - - -


You take the trolley you've collected in straight to the washing machine, and you'll move the washing from that trolley into the washing machine itself?‑‑‑Sometimes, yes.  Sometimes there's another – we've got about four trolleys so there's – I make sure there's another one empty there.  So I empty in that and then sort it out.


You actually have to sort the personal clothes from the bed sheets and the towels?‑‑‑Yes.


Your washing machines, are the detergents automatically put into the washing machines?‑‑‑Yes.


Do you have to refill where the detergents and chemicals are?‑‑‑Yes, when they're empty we refill that, yes.


Are the refills in canisters?‑‑‑Yes.  Actually we refill the whole bottle, so, yes, so we don't sort of divide it or anything.  If the content is empty, we just get new ones and put it on.


The dryers, are they big industrial dryers too?‑‑‑Yes.


I take it once it's dried you put it into that trolley we talked about?‑‑‑Yes.


You move it to your folding table and then you'll fold?‑‑‑Yes.


I don't think you do any ironing anymore.  I think that's what you said?‑‑‑Yes, we don't do ironing anymore.


But you might have done it at some stage?‑‑‑Yes, we were doing it all the time before.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


But you've stopped now?‑‑‑Yes, due to there's too many washing and we're running behind and can't do it on time, yes.


It's not something you do?‑‑‑No, no.


Excuse me?‑‑‑It's okay.


Can I take you to – excuse me, Commissioner.  Sorry, sorry, Commissioner?‑‑‑That's okay.


Ms Field, can I take you to paragraph 28?  Paragraph 28, I think it's on page 4.  Do you see that?‑‑‑Yes.


You say - - -


COMMISSIONER O'NEILL:  Are you all right, Mr Ward?  Do you need a few moments?


MR WARD:  I wouldn't mind a moment if I could have one, Commissioner.  Is that all right?




MR WARD:  Thank you.  Thank you very much for the indulgence, Commissioner.  Thank you.


Ms Field, if I could take you to paragraph 28(q)?‑‑‑Yes.


You say:


I have to change the amount of chemicals for a heavy wash.


When you say you have to change the chemicals, what are you actually referring to when you say that?‑‑‑This is two years ago, that was totally different than what they do now.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


Okay?‑‑‑So sometimes, like, and before the chemicals that the – from the soiled – once we use this soaker, like, the powder ones.  So that's still – we still do that.  So what I mean, if there is a soil, so what – when we're talking – like, when I take the washing out of the machine wet and there's still soil in it, like the stains and all that, so I have to soak them in the bucket of water, the hot water.  Mix the – this soaker, like bleach, and make sure that it is a right amount and then sort out the colours and that.  So we have to do sometimes, like, a handwash to remove the stain.  So we have to use the chemicals and stuff, so we have to just see if it's a right chemical that we're using for the right things.  Sometimes we have to use the stain remover, spray, or sometimes we use the soaker that they have, they provide us, so it's all depending.


Those sprays are stain remover sprays or they're powders or detergent for heavy soaking, are they?‑‑‑Yes.


I'll leave that.  Could I ask you to go to paragraph 29?‑‑‑Yes.


This is Australian Unity.  As I understand it, this is your weekend work, is it?‑‑‑Yes.


I wouldn't mind just going to (b) first, if we can go to (b)?‑‑‑Okay.


You talk in (b) about doing medication rounds?‑‑‑Yes.


I take it this is because you are both a qualified cook but you're also an assistant in nursing that you're able to do these things?‑‑‑That's right, yes.


So, all your skills are being used by Australian Unity on the weekend?‑‑‑Yes.


In terms of the medication round, I think we talked earlier about Webster-paks?‑‑‑Yes.


So, I take it these would be scheduled for medications, not Schedule 8?‑‑‑Yes.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


And let me explain to you how I understand it might work and you can tell me if I'm wrong.  The Schedule 4 medications will be in a locked medicine trolley or possibly a locked cabinet.  Is that what happens in your facility?‑‑‑Not really in this - in this condition, because some of the residents they've got medication in their room which sometimes I have to go in there and just to supervise them taking it.  And there is other ones that we've got in the kitchen area that is always in like a pantry, so it's locked - it's not locked but it's a container that we store the medications in that container and it stays away from the residents.


So, can you just help me out.  When a resident might have their own medications, what might those medications be?‑‑‑They might be the ones they're usually taking like their blood pressure tablets or their sugar tablets or there's some other complex - you know, just to - because we are a low facility and they are independent and they're taking it, we just have to ensure that they are taking it on time, because they forget sometimes, or sometimes they don't want to take it.  Like, today I miss or tomorrow I'll take it.


Okay.  So, they're low needs residents?‑‑‑Yes.


And they can manage that themselves but you occasionally just have to remind them to take it?‑‑‑Yes.


Okay.  In that situation, are you actually charting and documenting they're taking the medication or do you not do that?‑‑‑Yes, we do that.


You still do that.  Okay?‑‑‑Yes.


I take it with the Webster-paks the people who have the Webster-paks, you would take their medication to their room?‑‑‑Yes.  There's two residents that we take it to the room and there's - the other two is - so it's about roughly five or six residents that we medicate, because it's a low facility.  Yes.


In relation to those residents, you would remove the medication from the Webster-pak?‑‑‑Yes.


I take it you would - you would verify that the medication's correct?‑‑‑Yes.  Still using the six method, how to administer the medications, like identify the residents, check the medication, count the medication and if the medication's missing so we hold it, ring the chemist, find out if they - we can continue to give that medication or they want to give us another lot or something like that.  So, we still do all that, yes.


But you check to make sure the pills are the right pills?‑‑‑Yes.


I take it that - can all of your - can all of your residents swallow the tablets whole?‑‑‑Yes.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


After you've seen them take it, you put on their chart that they've had it?‑‑‑Yes.


Do you have a - as a low needs facility, low acute - do you have a resident nurse on hand or - - -?‑‑‑No.


So, if you have an issue, where do you go to?‑‑‑Well, on the weekends I make the decision because the cook is in charge, and they are more qualified than the other carers, so I make the decision as whether - if there is any complications like with the - if there is a medication or anything with the residents, I ring around to the chemist or the doctor's.  I still do all that.  If it is beyond my hand, then I contact the manager.


If something goes really wrong do you just ring Triple 0 and get an ambulance there?‑‑‑Yes.


I think you say in your statement that there's 40 residents in the wing you look after.  Is that - is that who you're cooking for?‑‑‑Yes.


You also say there's a set menu.  Is the menu developed by Australian Unity and given to you or are you free to make the menu up?‑‑‑It goes both ways.  It's resident's choice as well because as I'm cooking the residents do mention sometimes they would like this or they would like that, so I do pass it onto the manager and then when manager is making the menu and then she decide whether she do it, you know, within a week or two weeks time. And then so she continues, yes.  Menus (indistinct), yes.


So, the manager's in charge of designing the menu, is she?‑‑‑Yes.


You might suggest that a resident would like Chicken Kiev on the menu and - - -?‑‑‑Yes.


- - - the manager will make a decision as to whether or not we put Chicken Kiev on the menu?‑‑‑Yes, that's right.  Yes, when to put it on, yes.


When you're doing the cooking, are you doing breakfast, lunch and dinner?‑‑‑On Saturday and Sunday, yes, but Monday and Tuesday, no.


Is it a cooked breakfast?‑‑‑No, it's continental.

***        ANITA FIELD                                                                                                                                 XXN MR WARD




When you cook for lunch, is it one lunch or do they have options?‑‑‑It's one lunch.


It's the same for dinner?‑‑‑No, dinner is different. They choose, like, we've got four different varieties and they choose out of the four, two items.  Like, they can have - if it's winter they can have soup and main or they can have sweets and main, or they can have, you know, sort of like - they can choose, you know, out of the four.


But the main course itself would be the same main course?‑‑‑Yes.


Do you have any residents who need their food prepared a certain way, pureed or chopped up?‑‑‑No, not in that facility, but what do happens is they - sort of there is the fussy eaters or they got likes and dislikes, so if I'm making say, for example, grilled fish and somebody doesn't like grilled fish, I have to check who doesn't like it and who does.  So I have to prepare something else for that particular resident so they can have the meal.


In Australian Unity, have you been shown the residents care plan?‑‑‑Yes.


Does the care plan have their preferences on it?‑‑‑Yes.


Does it also have their allergies on it?‑‑‑Yes, they hardly got allergies but there's about two residents which - and because I have worked there for that long and I remember by heart like which resident doesn't like what.  So, even I'm off work there is some of the staff members do ring me and ask me Anita what this resident's have this or this resident has that, and how do you prepare it.  Because we try to do our best for the residents.  So we try to communicate with the staff members together to see if I'm not there or whoever's there, how to prepare the certain resident's menu.


Are you the food safety officer?‑‑‑We get trained for it but we're not sort of like an officer.  There's no one there apart from the manager that's food safety officer.


Do you hold a - bear with me, sorry Ms Field, my apologies?‑‑‑That's all right.


Do you hold a Food Safety Supervisor Certificate?‑‑‑Yes. Yes.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


You do that have?‑‑‑Yes.


Are you the only person at the facility who holds that?‑‑‑There's four of us.


So, all four of you - - -?‑‑‑Yes.


Do they have the Food Handling Certificate or the Food Safety - - -?‑‑‑Yes.


The Food Handling?‑‑‑Yes, Food Handling, yes.


And do you have to do any paperwork in relation to food safety?‑‑‑Yes, it's all in the - in the pantry it's all listed there that - how to handle and also where the - we have the – all the products and it's written there that how to handle what, and on the fridge as well it's written the temperature, how to handle, how to keep it safe and how to serve and all that, yes.


After you've cooked a meal do you have to fill out any extra paperwork?‑‑‑Yes, we do.


What do you fill out?‑‑‑We fill out the before and after serving.


Right?‑‑‑The temperature and what we have cooked and what was the heating and storing and all that, so - - -


That's about the food safety?‑‑‑Yes.


Can I ask you to go to paragraph 32.  Paragraph 32 starts with this, it says:


She checks on the chemicals and stock and that staff members are on duty.


Is, 'she' – does that mean the manager?‑‑‑Sorry, what was the question again?


I might, let me try and be fair with you.  Paragraph 31, you were - - -?‑‑‑Yes.


You were talking about the operations manager, do you see that?‑‑‑Yes.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


In paragraph 32 where you say, 'She checks on the chemicals and stock', is that the operations manager?‑‑‑Yes.


Am I right that the operations manager is ordering stock for the kitchen?‑‑‑Yes.


The operations manager is delivering the chemicals to - - -


MR GIBIAN:  Sorry, just I think these questions may have commenced with a misapprehension.  I understood this part of the statement to be referring to the laundry work rather than the kitchen work.


THE WITNESS:  Yes, it's the laundry work, yes.


MR WARD:  Let me ask you a different question then.  Thank you, Mr Gibian.  Who orders the stock for the kitchen?‑‑‑The manager does as well but we have to write it down.  I have to check it if we're going low or anything like that.


Yes?‑‑‑So there is an ordering book, so we write it down in the ordering book.  So, for example, my manager's name is Kathy, so I have to write it down and say, 'Kathy, we've got only four left', or 'two left', and then she knows when to order.


Yes?‑‑‑So it write it down, yes.


Does the same operate for the chemicals in the laundry?‑‑‑No.


Do you order those?‑‑‑No, the manager orders that but sometimes she miss it and then that's when I have to ring her and say – the laundry manager is Terry, so I say, 'Terry, we don't have this', or, 'We don't have that.'  And then she will sometimes tell me, 'We are on a low budget, we have to wait', or something like that.  Or she will say, 'Well, I forgot.'  So just have to be reminding her.


Yes?‑‑‑But she does the ordering, yes.


When you say in paragraph 32, you say:


She checks the chemicals and stock.

***        ANITA FIELD                                                                                                                                 XXN MR WARD


By stock are you referring there to things like towels and sheets, are you?‑‑‑Yes.


If you're seeing some towels are looking a bit shabby, you would tell the laundry manager that you need to buy some more towels?‑‑‑Yes.


You'd tell them how many you think they need and they would make that decision?‑‑‑They make that decision.  I do suggest that, sometimes I would say, 'We need this much or that much', but the laundry manager will decide whether – it's up to her, like, and up to the manager – management, that how much they can afford or what they can do.


You've just described something that's not in your statement, you talk about a laundry manager?‑‑‑Yes.


Is the laundry manager different to the operations manager?‑‑‑It's the same thing, sorry, but it just - - -


They're the same person?‑‑‑Yes, same person.


No, that's all right?‑‑‑Sorry.


That's all right?‑‑‑Yes.


I thought we'd found somebody we didn't know anything about?‑‑‑No, no it's the same person but different name.


Just a moment, if I can.  Just lastly, if I can, Ms Field, you say, this is paragraph 35?‑‑‑Yes.


This is the operations manager:


When I started she used to visit three or four times a day to check on me but now I don't see her.  I don't see her if I don't call her, if there's a problem.



***        ANITA FIELD                                                                                                                                 XXN MR WARD


I take it that you've got your routine pretty well worked out?‑‑‑Yes.  What actually happens, like sometimes, like, when I started working in the laundry she used to make rounds to check how things are going and all that, and nowadays when I was in the laundry she hardly comes around to see what's going on or how's things getting solved or anything like that.  So I have to make my own decision.


Yes?‑‑‑On the spot to see the – yes.


When you say, 'if there's a problem'?‑‑‑Yes.


What sort of problems would you contact your manager about?‑‑‑When the machine breaks down.  That's when I contact her.


If the machine breaks down you'd contact the manager?‑‑‑Yes.


And say, 'We need to get the maintenance people out to fix it'?‑‑‑And also when I get – during the COVID actually there was issues that the staff don't put it in a correct order and then I receive the infection clothings in the normal bags.  So I call the manager and notify her that this is the condition that I'm receiving the laundry and that's up to her how she's dealing it on – behind the back.


But other than that, day-to-day you're quite confident in using the machines, the washing machine and the dryers?‑‑‑Yes.


You're quite confident doing that by yourself?‑‑‑Yes, yes, that's right.


Ms Field, thank you very much for your evidence.  No further questions?‑‑‑No problems, thank you.


COMMISSIONER O'NEILL:  Any re-examination, Mr Gibian?


MR GIBIAN:  I think just one thing.

RE-EXAMINATION BY MR GIBIAN                                               [11.57 AM]


MR GIBIAN:  Ms Field, just the operations manager who you were just asked about?‑‑‑Yes.

***        ANITA FIELD                                                                                                                                RXN MR GIBIAN


Her name is Terry, is that right?‑‑‑Yes.


Is that person's responsibility, does she just work at the same facility or is it across a number of facilities?‑‑‑No, just the one facility, yes.


Thank you, Ms Field.  Thank you for assisting us?‑‑‑Thank you.


COMMISSIONER O'NEILL:  Thank you for your evidence, Ms Field, you're now excused and free to go?‑‑‑No worries, thanks.

<THE WITNESS WITHDREW                                                          [11.57 AM]


MR WARD:  Commissioner - - -


COMMISSIONER O'NEILL:  I think we have – sorry, Mr Ward.


MR WARD:  Could I be allowed to withdraw temporarily while Ms Rafter is here?




MR WARD:  Thank you, Commissioner.


COMMISSIONER O'NEILL:  I think we have Ms Heenan ready to commence.  I have spoken too quickly.  Ms Heenan, can you hear me?


MS HEENAN:  Yes, I can.


COMMISSIONER O'NEILL:  Are you able to turn your camera on, please?


MS HEENAN:  My camera is on.


COMMISSIONER O'NEILL:  Just we can't see you.


MS HEENAN:  I did a practice run this week and it was all working.

***        ANITA FIELD                                                                                                                                RXN MR GIBIAN


COMMISSIONER O'NEILL:  That's all right.


MS HEENAN:  I don't know why.  I'm so sorry.


COMMISSIONER O'NEILL:  No, that's all right.  Ms Rafter, do you have any difficulty if we proceed without seeing Ms Heenan?


MS RAFTER:  No difficulty, Commissioner.


COMMISSIONER O'NEILL:  All right.  Ms Doust, is it?


MS DOUST:  Ms Heenan, it's Lisa Doust here.  Can you hear me?  I'm sorry, does the witness need to be affirmed first?


COMMISSIONER O'NEILL:  Yes, that's a very good idea.  Sorry, Ms Heenan, I'm Commissioner O'Neill, my associate is just going to have you take the affirmation.


MS HEENAN:  Okay, then.


THE ASSOCIATE:  Ms Heenan, can you please state your full name and work address?


MS HEENAN:  My full name is Therese Eileen Heenan and I work for Warramunda Village and – in Kyabram and they're - just Warramunda Drive in Kyabram.

<TERESA EILEEN HEENAN, AFFIRMED                                      [12.00 PM]

EXAMINATION-IN-CHIEF BY MS DOUST                                    [12.00 PM]




MS DOUST:  Thank you, Commissioner.  Ms Heenan, can you please just state your full name for the record?‑‑‑Teresa Eileen Heenan.


Are you employed by Warramunda Village as a home care employee?‑‑‑I am.

***        TERESA EILEEN HEENAN                                                                                                            XN MS DOUST


And have you prepared two statements for the purpose of the proceeding before the Commission?‑‑‑Yes, I have.


Is the first one a statement that's dated 20 October 2021?‑‑‑Yes, it is.


And just for the record that's document 207 at page 11,446 of the digital court book.  Ms Heenan, did you prepare a second statement described as a reply statement dated 20 April 2021?‑‑‑Yes, I did.


For the record that's document 208 at page 11,474 of the digital court book.  Ms Heenan, since you prepared your first statement is it fair to say there's been slight variations in the particular clients you have and the hours that you see them, but that it truly and correctly described your work at the time you made it?‑‑‑Yes, that's - - -


Are your statements otherwise true and correct to the best of your belief and knowledge?‑‑‑Yes, they are.


I read them both, Commissioner.


COMMISSIONER O'NEILL:  Yes.  All right, Ms Rafter.

CROSS-EXAMINATION BY MS RAFTER                                      [12.01 PM]


MS RAFTER:  Hi, Ms Heenan, my name's Alana Rafter and I appear for the employer interests in these proceedings.  I just want to ask you some general questions about your work with Warramunda just to get a feel for the team that's there.  So my understanding is as a home care employee you report to a team leader?‑‑‑Well, that's what I call her, yes.


And is the team leader a registered nurse?‑‑‑I'm not - I think Marissa is.  I know that there are other registered nurses in the admin team.


So if you needed to talk to a registered nurse you might not call the team leader, but you might contact a registered nurse directly?‑‑‑That is correct.


Thank you for that.  And I understand there's also at Warramunda there's a village hostel which you would call after hours instead of the team leader, is that right?‑‑‑Yes, but they don't have access to the client's details.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


That's right, they don't have access to the care plan.  I believe you say that later in your statement?‑‑‑That's correct.


The hostel, if I can shorten it that way, that's different to the on-call phone that you would use?‑‑‑During the day  on-call is - on-call isn't during the day, it's after hours.  So, yes, I can - I've tried to send a text after hours to on-call, but they haven't necessarily had the phone with them.  So I have tried to call the hostel after hours to be sort of told that really they can't do much to help me.


So I take it you're not too pleased with these two after hours options, but they are two separate after hour options, the hostel and the on-call phone?‑‑‑Yes, I would say that.  Sometimes it's diverted to - yes, it diverts to the hostel.  Now, I just want to clarify, on the weekends I can send a text to on-call and I will get the home care person, on the weekends.


Just to help me out who is the home care person?  When you say home care person who are you referring to?‑‑‑Well, that may be whoever is on from the home care admin team.


And are there also - are there client case managers as well, but would you be dealing with them?‑‑‑Yes, they're mainly the registered nurses.


Okay.  Thanks for that.  So I take it the client case managers, the registered nurses, they would be the ones involved in the initial assessment of a new client?‑‑‑Correct.


Do you have any involvement in that process?‑‑‑No.


Okay, that's separate.  And then once that interim - initial assessment happens and a care plan is made when do you first see the care plan for a new client, at Warramunda as well, (indistinct), we're still on Warramunda?‑‑‑Well, it's sort of they will put notes onto our roster system, and if we want to we can request to look at the care plan.


And this roster system, is that accessed by your phone?‑‑‑That's correct.


So it may include progress notes left by another carer?‑‑‑No, they don't really have progress notes.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


Okay.  So the notes that you said that might be in that roster system are they summary notes of the care plan?‑‑‑Just summary notes about the client, very brief.


So could you give me an example?‑‑‑This client - say, you know, to pick up a newspaper and take it to the client and to support them with making their breakfast.  The client likes to, you know, just sit on the couch, or to have her breakfast and to check that the medications have been taken.


Okay.  So you read those notes and it gives you a little bit of an idea of what you're going to be doing when you attend that client's.  You're going to pick up a newspaper on the way in, help make them breakfast, you know her seating preference, so the carer is informed about that?‑‑‑That's correct.


Excellent.  Thanks for that, it's very helpful to get that picture in my mind.  I would now just like to take you through your history in the aged care just to confirm.  So you started off in aged care as an enrolled nurse, and you say at paragraph 6 of your first statement that this was around 40 years ago?‑‑‑Yes, that's correct.


Then after your time as an enrolled nurse I believe you spent around two years - you moved down to Melbourne to work at the Heidelberg Repatriation Hospital?‑‑‑That's correct.


That would still be as an enrolled nurse?‑‑‑Yes.


Thank you for that.  Then I understand you took a bit of a break and turned to some admin roles and spent 11 years working at Telstra?‑‑‑Yes, that's correct.


In 2006 you returned to the aged care sector and you're doing - you started as a home care worker at Southern Cross Care?‑‑‑That's correct.


And whilst you were with Southern Cross Care you undertook - you did two - I'm just making sure - you did a Certificate III?‑‑‑Yes.


And that was the Certificate III - just making sure - that was the Certificate III in home and community care, is that correct?‑‑‑That's correct.


And I understand that after you worked - so you worked at Southern Cross for three years and then you've moved up to Kyabram in 2010?‑‑‑That's correct.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


And you then picked up two permanent part-time jobs?‑‑‑That's right.


The first one is at Tongala at District Memorial Aged Care Service as a personal care assistant?‑‑‑That's right.


And I understand at that facility you primarily worked at the ten bed facility for the people with dementia.  Would that be fair to say?‑‑‑That's correct.


And in that facility as a personal care assistant would your duties include giving medications or no?‑‑‑No.


Not for that one.  Could you briefly talk about what you would do there as a personal care assistant?‑‑‑Well, I would mainly work afternoon shifts, so I would be responsible for preparing the afternoon tea, assisting anyone who needed help with eating and drinking.  I would assist people with having to go to the toilet or incontinence issues.  I would get things ready, you know, the beds ready for them to be settled for the night.  Sort of just try to, you know, put on some music or TV or have a bit of fun, like, with the balloon tennis or things like that.  Tea time would come and I would have a support worker bring the tea trolley up.  So together we would work with getting all the meals out, assisting those who needed help with eating and drinking.


I note – I'm not meaning to interrupt so if you're still going feel free to finish your answer?‑‑‑Well, this is the sort of thing I would do.  This would be a typical shift and then I would be responsible for getting everyone into bed, plus doing the floors and mopping and reports and written reports.


At paragraph 16 you talk about calling on the RN for assistance where necessary?‑‑‑Yes.


Could you give an example of what you mean by when it would be necessary to call the RN?‑‑‑Well, I had a client who had a fall and, you know, sort of I would have to call her to come up to help assess or she may say, 'Look, just take the observations', you know, blood pressure and temperature.  And depending on the situation sometimes it would be that someone with dementia who I just could not get to stop standing and I knew they were at a falls risk, and I just couldn't attend to the other clients, the other residents on my own, so I had to see if someone could come up to help.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


Thank you for that.  At paragraph 19 you talk about the Ashby Memory Method, a course you did through Alzheimer's Australia?‑‑‑Yes.


My understanding is that's an online course that you do at your own pace?‑‑‑Yes, I did, yes.


Then at the completion of it you do a multiple choice quiz, would that be correct?‑‑‑That was right, yes.


Then in the next paragraph at 20 you talk about taking on volunteer work so that you could put what you had learnt during that AMM course into practice.  Do I take it that you couldn't incorporate what you learn into your work as a personal care assistant?‑‑‑No, not really.  I did – in my – with the volunteer times, part of that too was to do a life story and in my own time I did do – I did all the residents, worked out sort of what they did in their childhood, what their favourite sport was, their siblings, their parents, where they grew up, and then I put it all into a format so that the other staff could access that information and that way we can sort of get people engaged and talking and, yes, we always had something sort of we would say, you know, 'When you were younger you used to do such-and-such', and get them talking and - - -


You're building a – I don't mean to oversimplify but you're building like a little profile of that resident?‑‑‑Yes, yes, making it easy to read than what's in a care plan because it was all just words, whereas I used to do little diagrams and - - -


Okay?‑‑‑That's okay, I enjoyed doing it but they didn't take it up and that was the way it was.  With the Ashby Memory Method it really was too late to be using it once people had gone into a nursing home.  They were too advanced.


Then in 2010, so you're still at Tongala, you've taken up a disability support worker position with Country Care?‑‑‑That's right.


You were with them for about five years?‑‑‑Yes, they finished, the company closed down.


I understand.  Then between 2018 and '20 you're working at Tongala as a personal care assistant.  You were working at Community Living as a disability support worker and doing some work with Warramunda as a home care employee?‑‑‑Yes.


Thank you for that.  Then there was a little bit of a gap in 2020 and during that time you acquired your certificate 4?‑‑‑Certificate, yes, I did my certificate 3 in disability and aged care, and then I commenced sort of doing the certificate 4 in disability as well.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


So the two - - -?‑‑‑When that was sort of all finishing.


You did your two certificate 3s first and then after that you returned to do the certificate 4 in dementia?‑‑‑Yes.


Thank you for that?‑‑‑No, no, sorry, I beg your pardon.


No, you're right?‑‑‑Certificate 4 was disability.  I had done the certificate 4 in dementia practice quite a few years before that.


Yes, I see at 37, in 2016?‑‑‑Yes.


That was my mistake, so thank you for that.  I'd like to take you to – bear with me.  With your certificate 3s that you did in 2020 did you attend classes with that?‑‑‑In the beginning before COVID hit, so that was in Echuca.


Yes and then due to COVID I take it you then had to finish off the theory component online?‑‑‑Yes, we had Zoom meetings.


Thank you for that.  Going back to Warramunda, you do additional annual training at paragraph 42 of your first statement you refer to that?‑‑‑Yes.


My understanding is that these online training modules may include some videos or may just be content that you read, is that correct?‑‑‑A bit of both.


A bit of both?‑‑‑Mainly videos.


Mainly videos and are you prompted to do a quiz at the end of it?‑‑‑Yes.


They vary in duration, I take it some may be 30 minutes, some may be an hour?‑‑‑Or longer.


Or longer?‑‑‑Medications take a lot longer as well as infection control and, you know, because you want to make sure you understand and you're doing it all right because you need to get, you know, 100 per cent really for that.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


Staying with this medication, I understand you do medication prompts as part of your work at Warramunda.  Is that correct?‑‑‑Correct.


Prior to you doing that, did you receive training from the RN at Warramunda?‑‑‑It was an RN-trained teacher, yes, and plus I have done the medication training through Community Living as well.


With the Warramunda one, was it in a classroom like setting?‑‑‑Yes, it was at one stage before COVID.




I take it was it around 30 minutes with the registered nurse?‑‑‑I honestly can't remember now, I'm sorry.


No worries.  There was some type of RN where they walked you through how to do a medication prompt.  Do you recall the RN then assessing you as a client to make sure you were doing it correctly or how was it addressed?‑‑‑No.


You just completed the training and they didn't see you, watch you do it or act it out, even act it out during that session?  There was no assessment?‑‑‑Heavens, I don't think so.  I think with Community Living I would have yearly – I would have a yearly catch-up with my team leader and she'd ask me, you know, what are the 10, you know, the prompts and things like that.


Thank you for that.  I'd now like to take you to paragraph 55 of your first statement.  There you refer to doing a lot of additional unpaid work in your own time and you refer to case reports and composing emails?‑‑‑M'mm.


What do you mean by case reports?‑‑‑Well, I – depending on the client, okay, so this – some of the things I'm referring to with Community Living, so - - -


(Indistinct)?‑‑‑ - - - (indistinct) in this.  And like, in particular I have had a very high complex needs client, and so I need to go into great detail about, you know, sort of certain behaviours, or you know, perhaps needing more support.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


And that's been the context of your – is it - for community living for your disability for your clients as a disability support worker?‑‑‑Yes, except for recently when I had the client who I had to call the ambulance for, and you know, plus – there have been other times too going to this client, where there's been other issues with him that I've put into an email, or I've had to hand‑write out - - -


And I – sorry, I'm not meaning to cut you off.  Sorry, because I can't see you sometimes I may accidentally cut you off, but go on?‑‑‑No, that's it.


I just want to draw a line for the case reports and composing emails, that unpaid work you refer to.  Is that referring to the community living work as a disability support worker or also your work and home care worker?‑‑‑And home care.


I understand you don't do case reports for your home care clients?‑‑‑Well, if you're meaning, like, going into their files - - -


No, I'll clarify that for you.  I'm looking at your wording in 55, just trying to marry up the case reports and composing emails, if they're both applying to both jobs or if you're referring to one in particular, and I understood the case reports - - -?‑‑‑A bit of both.


A bit of both?‑‑‑Yes.


I'm going to separate and focus on Warramunda just to make sure it's clear.  After you do an appointment with a client, earlier you said it wasn't practice to do progress notes.  Was that correct?‑‑‑No – well, they were – originally we used to have to do handwritten progress notes for NDIS clients, but that isn't happening at the moment.  If I go to an aged care client, they seem to – I'm putting a lot – doing texts, because that's what they seem to use more of that as well with Warramunda, whereas community living they don't use texts so much.  So as well as emails - -


(Indistinct) - - -?‑‑‑ - - - I do texts (indistinct) - - -


When you say texts, you mean, like, on the mobile phone?‑‑‑Yes, correct.


You're texting your team leader?‑‑‑Yes, or one of the RNs.


Or one of the RNs?‑‑‑Yes.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


Would these texts for Warramunda to your team leader, would they be at the end of an appointment you might text everything you did, or would you only text certain types of tasks?‑‑‑That's correct.  If everything flows smoothly there's no need to do a text.


So you'll only use a text if there was, say, something different, something out of the ordinary?‑‑‑Yes, such as I delivered a meal the other night and the lady was very confused and complained of not feeling well, and so that's why, you know, I sent the text, because I didn't know whether or not anyone would still be in the office, but was, and they were then able to deal with it from their end, so I didn't have to do anything.  If I was really concerned with the lady I would stay with her.


You also mention texting an RN.  Would an example of this be if you noticed a client of yours had a new bruise.  Would it be common for you to take a photo and text it to the RN?‑‑‑I'm not meant to take photos.


So you just text the RN that the client is presenting with a bruise?‑‑‑Yes, I will give a description of what the bruise looks like and where it is.


Now I'll go back to paragraph 60 of your statement and where you're talking about medication prompts, and you also refer to measuring blood pressure.  Are medication prompts and measuring blood pressure, are they both done at the delegation of the registered nurse?‑‑‑Sorry, the medicate – what - - -


I'll withdraw that.  I'll separate them.  So for measuring blood pressure, how do you know you're going to need to measure blood pressure?‑‑‑Because it's in the notes.  That's why - - -


It'll be on the care plan.  And prior to being able to measure blood pressure for Warramunda, do you have to be assessed by the RN or trained how to do it?‑‑‑Oh heavens, I've been doing - - -


I understand you've been doing it when you were an EN as well.  I'm just seeing if Warramunda also double‑checks - - -?‑‑‑I don't know.  Honestly I can't remember, sorry.


That's fine.  I'm not going to ask you to guess, or if you ever can't remember something, that's perfectly fine by me.  I'll now take you to – I want to walk through a medication – the process with medication prompts as I understand it.  So in your statement you say that Warramunda don't use medication charts as such?‑‑‑That's correct.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


But they have the blister, the Webster-paks for the clients that have medication?‑‑‑Correct.


So when you are doing a medication prompt and you're picking up the Webster‑pak, is the only way of checking if an earlier dose has been given by reference to the Webster‑pak itself?‑‑‑Correct.


If you were doing a dose for lunchtime, for example, but the morning dose was still there, in that instance and it looked like a medication round may have been missed, would you typically notify the team leader of that?‑‑‑Definitely.


And would you do it immediately?‑‑‑Yes.


And then once you've done that check, you would pop the pills out, I take it, into a cup?‑‑‑Well I try to get the client to do it.


Yes?‑‑‑But as I said, some of them have arthritis and are unable to do that.  So I have it right beside them and – yes, so I pop it into a cup and I count the tablets, then make sure it's the correct amount.  There have been times when there's been either one missing or an extra one.  Most times the clients will say, no, something's not right.  So I try – I work out, you know, which one's missing and I inform the RN.


You inform the RN?‑‑‑Yes.


And with that medication appointment, you'd only be sending a text or making contact with the team leader or RN if there's a problem?‑‑‑That's correct.


But if it goes smoothly there's no need to add a note or text someone?‑‑‑No.


I'll now take you to paragraph 72 of your statement?‑‑‑Yes.


At 72 you describe the purpose of your work is to enable the independence of elderly people, and I believe you gave an example with giving them the Webster‑pak and getting them to pop the pills out if they can.  Could you tell me how your Certificate III helped you with skills in that respect?‑‑‑Heavens, it just – which Certificate III?

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


That's right, you have about three.  I'll make it a bit clearer.  I'm talking about the Certificate IIIs you obtained in 2020, so the ones to do with individual support for ageing and disability?‑‑‑Okay.  How did it help me?


Yes?‑‑‑Well, some of it just validated what, you know, I was already doing, and a lot of it too just gave me a different aspect about care, and it was great to hear from what other people were doing as well and different experiences.  Yes, it just broadened by knowledge.


When you say a different aspect about care, did you learn new strategies by doing these certificates?‑‑‑I would say yes.  I mean I learn each day with my work as well, but it is good to be with other people who are doing similar, but not the same sort of work, and - yes, or just to find out some better ways of doing things as well.


And where you say validated am I right in saying - because I note some of the units looking at - you were provided a record of your results with your statement, and in the Certificate III in individual support it refers to a unit 4, 'Support independence and wellbeing.'  So when you say validates as in it's recognising that purpose you refer to in 72?‑‑‑Yes, it validates that I'm - you know, I'm on the right track and (audio malfunction) things I'm doing (indistinct).  So it (indistinct) and validates that what I'm doing is right.


So the skills that you're employing when you're prioritising the independence of your clients and seeking to empower them?‑‑‑Yes.


That's the validation.  So you're using - it recognises those skills are an important part of the care and it helps you with that?


MS DOUST:  I object to the question for this reason; I'm not sure it's clear from the question what the 'it' is.


COMMISSIONER O'NEILL:  Perhaps if you can just rephrase it, Ms Rafter.


MS RAFTER:  Yes, I might withdraw - I withdraw that last question where I said 'it', and I think I will move on from that question.  If I could take you to paragraph 75 of your statement, the first one?‑‑‑Yes.


And here you're talking about a client who was resistant at first, but he ended up - out of fairness I should walk back to - - -?‑‑‑Making a bowl of porridge?

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


Yes, I should give the context.  This is where you're talking about making the porridge, and you say he was resistant at first, but ended up doing it and was chuffed with himself.  Could you explain how he was being resistant?‑‑‑He was - he was testing me saying, 'No, I can't do that.  I can't do that.'  And I said, 'Yes, you can, I'm sure you can.  You just watch what I'm doing, and, you know, this is what you do.  You know, you tear open the packet and pour it in the bowl.'  And took him through it step by step, and then once he had done it he was so proud of himself.


And that process you walked through, that engagement with that client to make them feel comfortable and act independently, is that reinforced by in your Certificate III course?‑‑‑Is it reinforced?


The skills that you used there were you taught to use skills like that during - to use communication?‑‑‑Yes, communication is very important.  I mean - yes.


I was trying to clumsily ask if you were taught about - during your Certificate III they teach you communication skills?‑‑‑Yes, I feel that they did, yes.


And if I could take you down to paragraph 77?‑‑‑Yes.


Bear with me.  Actually I will take you to paragraph 78.  Now, here you're referring to care services have become quite rushed, and could you give an example of what you're referring to there?‑‑‑Mainly like in the hostel, like at Tongi, there were so many tasks to get done.  So, yes, we would be trying to get through everything and you just feel as though - you're feeling, you know, pressured because you want to be able to spend time with the residents, but then you know that you've got all these other things to do as well.


Now, I will take you to paragraph 82 of your statement, and on that page there's a little bit of a paragraph I want to take you to at the end of 81, but if you're on 82 you will be able to see it, and you talk about how you identified a safety hazard with a client regarding having a shower in the bath because the shower was over a bath and that client would have to step over, and you were aware he had giddy turns and nearly had a fall.  So you identified that as a safety issue?‑‑‑Yes.


And you reported that to your team leader.  I wanted to understand what happened next, because in paragraph 82 you talk about how it was modified, that care was now provided on some days as a sponge bath.  Does that need to be - did that require a change to the care plan for that to happen?‑‑‑The team leader handled that change.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


Okay.  So you reported it to the team leader, and then the team leader would have made sure a change occurred for the care plan?‑‑‑Yes.


So if a carer was filling in for this client of yours they would see that they shouldn't be showering this resident in the shower over the bath?‑‑‑Yes.


Thank you for that.  Now, I take you down to paragraph 85?‑‑‑Yes.


And you talk about you're going to an appointment to prepare the breakfast for a client?‑‑‑Yes.


And during that appointment you also mended some clothes for him?‑‑‑M'mm.


Is the mending the clothes part of the domestic care on the care plan, or is this an additional task not on the - within the scope of the care plan?‑‑‑I don't know.  I just saw that he - he showed me a loose button had come off and so I made sure I had needle and thread and while we were, you know, just sitting and while he had his breakfast I sewed the buttons on.  I mean I don't know if it was part of the care plan or not, it was just something you did, because it was quite simple.


Simple you knew how to do it, so you thought you'd help him out because you could?‑‑‑Yes.


No worries, that's fine?‑‑‑The same for, you know, the hem coming down.


Now, I will take you to paragraph - bear with me one moment - I wanted to take you to paragraph 94, and I note that you're talking about there was some urgency getting the safety alert device fixed?‑‑‑Yes.


But I wanted to talk about emergency situations in general, and I understand if there's a protocol in place.  If there is an emergency, a client has a fall during your appointment, I take it you would call the ambulance?‑‑‑That's correct.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


And if the client - is it then a judgment call - for this emergency you took a different course, could you explain why for this emergency you chose to try contacting the team leader?‑‑‑Well, this wasn't - sorry, this at 93, this was just that he identified that there was a problem with the alert device.  There wasn't an emergency.  I was wanting to make sure it was working properly in case when he was on his own he needed to press it.  It was just when he put it in the charger in the morning it would - you know, talks about and says this is charging, and it was really faint, and so - and because he has hearing difficulties I was concerned that if he did have to press it on his own he wouldn't understand what they were saying to him, and so that's why, you know, I did some investigating to make sure it did get repaired.


If I could take you to paragraph 103 of your first statement?‑‑‑Yes.


You refer to that you spent unpaid time writing lengthy emails to team leaders in Warramunda?‑‑‑Yes.


Would this be when a particular issue arises that you would be writing a lengthy email?‑‑‑Yes.


And I should clarify, 'issue' meaning, as you said before, if something happens out of the ordinary, or different, or something goes wrong, that's when you would take the time to write an email to your team leader?‑‑‑Yes.


But these lengthy emails wouldn't be after every appointment?‑‑‑No.  No, no.


I might now take you to your second statement?‑‑‑Okay.


At paragraph 8 you refer to when a client is in a wheelchair there are still physical demands on the worker, and that is greater – worker that are greater than a client who does not have a wheelchair?‑‑‑Correct.


Would it be fair to say that for clients that need wheelchairs, so they have mobility issues, the wheelchair does help with moving them around?‑‑‑Yes.  Of course it does, yes.


I'm not meaning to be rude by that question.  I mean if there was no wheelchair there'd be very much increased difficulty in moving a person with that level of immobility?‑‑‑Yes.


I wasn't meaning to be rude with you there?‑‑‑No, that's okay.


At paragraph 9 you talk about using slings?‑‑‑Yes.

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


And slings to guide the client's movement?‑‑‑Yes.


In your experience, has the use of – and I note that there are some limitations now, as you refer to in your statement – but in your experience with slings, do they make the movement of the client a safer task?‑‑‑Yes.  I haven't had to use a sling for quite a while.  When I was at Tongala, yes, that was wonderful to be able to have a sling to be able to move them.  I mean, pushing a machine, you know, the lifting machine, which they had – they didn't have overhead machines - so that was hard on your back, and then trying to put the sling behind them if they're in an armchair, and then to get them into a standing position, and they're putting their feet up on the lifter and – yes.


Just a general question about Warramunda for your home care clients, is it your understanding that Warramunda organise a risk assessment of the house before you go to a client's house?‑‑‑Yes, I would say that they would when they do the assessment at the beginning, and then they have 12‑monthly ones where we take a form out and we have certain things to check off, such as, you know, power points and leads and - - -


Would you be checking the shower potentially?‑‑‑Yes.


And different things in that home environment that a carer might have to be involved in?‑‑‑Yes.


No further questions, Commissioner.


COMMISSIONER O'NEILL:  Any re-examination, Ms Doust?


MS DOUST:  No re-examination, thank you, Commissioner.


COMMISSIONER O'NEILL:  Thank you very much for your evidence, Ms Heenan.  You're excused and free to go?‑‑‑Thank you.

<THE WITNESS WITHDREW                                                           [12.44 PM]


COMMISSIONER O'NEILL:  All right.  I understand that the next witness is the ANMF witness, Ms Bayram, is that right?

***        TERESA EILEEN HEENAN                                                                                                        XXN MS RAFTER


MR McKENNA:  That's correct, Commissioner, and I understand Ms Bayram is currently being contacted and hopefully will pop up in the waiting room momentarily.




MS RAFTER:  And Commissioner, may I just be excused to get Mr Ward?


COMMISSIONER O'NEILL:  Yes, of course.  Ms Bayram, can you hear me all right?


MS BAYRAM:  Yes, I can.


COMMISSIONER O'NEILL:  I'm O'Neill C.  My associate is just going to have you take the affirmation.


THE ASSOCIATE:  Ms Bayram, can you please say your full name and work address?‑‑‑Lisa Marie Bayram, 1A Leslie Avenue in Cowes.

<LISA BAYRAM, AFFIRMED                                                           [12.46 PM]

EXAMINATION-IN-CHIEF BY MR MCKENNA                            [12.46 PM]




MR McKENNA:  Thank you, Commissioner.  Ms Bayram, my name is Jim McKenna.  I appear on behalf of the ANMF.  Can you see and hear me okay?‑‑‑Yes, I can.


Could I ask you to please state your full name again?‑‑‑Lisa Marie Bayram.


And you are a registered nurse and you work at the Grossard Court facility, is that correct?‑‑‑Yes.


Can you give the address of that facility, please?‑‑‑1A Leslie Avenue in Cowes.


You have prepared a witness statement for the purpose of this proceeding?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                           XN MR MCKENNA


Do you have a copy of it with you today?‑‑‑Yes, I do.


It's a statement dated 29 October 2021?‑‑‑Yes.


92 paragraphs over 19 pages, is that correct?‑‑‑Yes.


And hopefully three annexures to that statement?‑‑‑Yes.


I understand that since you made that statement there have been a couple of changes that are relevant to its contents, the first of which is I understand you've had surgery on your leg and you're not currently working?‑‑‑That's right.


And the other is, I understand that there have been some staffing changes at Grossard Court, is that correct?‑‑‑Yes.


Commissioner, I've got express instructions on these.  Would it be convenient for me to lead the witness through them, or I can ask non‑leading questions if that's of assistance, but I don't understand it'll be - - -


COMMISSIONER O'NEILL:  No, you can lead the witness through them.


MR McKENNA:  If the Commission pleases.  Ms Bayram, I understand that there have been changes to staffing structure relating to provisions in the enterprise agreement which identify for there to be two registered nurses rostered in the facility at all times.  Is that correct?‑‑‑Yes.


And I understand that it is now intended that for each shift, including the PM shift that you're normally on, there will be two registered nurses?‑‑‑It's for the out of hours shifts, for the PM shifts and night shifts and the weekends.


Yes, sorry.  I understand that the implementation of that change has begun, but it is not fully implemented so far as you know?‑‑‑That's right.


I also understand that the new roster when fully implemented will have real implications for you and your team and the care of the residents on the shifts where you have worked?‑‑‑That's right.

***        LISA BAYRAM                                                                                                                           XN MR MCKENNA


And the structure will provide for the after hours coordinator, which was the role that you fill, to be supernumerary, that's correct?‑‑‑Yes.


It provides for a grade 2 registered nurse to be the third team leader on the floor?‑‑‑Yes.


And on shifts where that has been possible to date, you have mostly had time to provide the high level care needed, including time for families managing extensive documentation requirements, care assessments, implementation of changes in care plans for upcoming care?‑‑‑Yes.


Thank you.  Now, subject to those qualifications - I'll withdraw that.  Have you had a chance to read your witness statement in its entirety recently?‑‑‑Yes.


Are there any other changes, corrections or clarifications you'd wish to make to it?‑‑‑No.


And so subject to those two qualifications we've discussed, are the contents of your witness statement true and correct?‑‑‑Yes.


Ms Bayram, you hopefully also received an email recently from Mr White attaching a number of additional documents.  Have you received that?‑‑‑Yes, I have.


Thank you.  For the benefit of the Commission, Ms Bayram's witness statement is in the electronic court book, document 223, page 11,859, and that is relied upon by the ANMF.  Ms Bayram, hopefully you can see Mr Ward on the computer on the screen in front of you?‑‑‑Yes.  Hello.


He's waving his hand.  Mr Ward will have some questions for you?‑‑‑Sure.


Thank you.

CROSS-EXAMINATION BY MR WARD                                         [12.51 PM]


MR WARD:  Am I pronouncing it right, is it Bayram?‑‑‑Yes.


Thank you, Ms Bayram.  Can you hear me okay?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


Ms Bayram, my name's Nigel Ward and I appear in these proceedings for the employer interest.  I'm just going to ask you some questions in regard to your statement if I can.  Do you have your statement in front of you?‑‑‑Yes.


Thank you.  I appreciate you're highly qualified.  In paragraph 7 you talk about when you received a Bachelor of Nursing, which as I read it was back in 1994.  Is that correct?‑‑‑Yes.


Do you recall back then whether or not the Bachelor of Nursing had any elements dealing with aged care?‑‑‑No, it didn't.  Not specifically, no.


Not specifically.  And if I could ask you to turn to paragraph 10?‑‑‑Yes.


You talk there about continuing professional education, you discuss a dementia essentials program, you also discuss comprehensive assessment of the older person in aged care.  Was that part of your professional - was that part of your necessary professional development as a registered nurse?‑‑‑Our necessary education - - -


Your 20 hours a year.  Your 20 hours a year?‑‑‑Yes, we have to do 20 hours a year but it's anything that we choose.


Yes?‑‑‑And I chose to do those things, so yes, they did exceed the 20 hours.


Okay, that's okay?‑‑‑Considerably.


They were part of your professional development requirements?‑‑‑Yes.


Is the same the case for the program you did in paragraph 12?‑‑‑Yes.


Can I ask you to jump all the way to paragraph 27?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


Paragraph 27 you talk about having an enrolled nurse and two personal care attendants on the afternoon shift, and you discuss that a little bit further on.  What activities does the enrolled nurse do at Grossard Court, that the personal carer assistant doesn't do?‑‑‑So, the enrolled nurses work as a team leader, as the - in charge of the ward.  They are responsible for the medication rounds. They're responsible for anything that we call clinical care or complex care needs.  So, wounds, oxygen therapy, CPAP machines, blood glucose monitoring, anything that's got to do with the illnesses or comorbidities that the residents have.  They're responsible for providing leadership for the PCAs.


Yes?‑‑‑And organising the workload for the shift.


Can I just go through a couple - - -?‑‑‑And anything - and anything that the registered nurse asks them to do.


Anything extra that the registered nurse is comfortable to delegate?‑‑‑Yes.


MR GIBIAN:  I'm sorry to interrupt, Commissioner.  As you may hear in the background there is an alarm going off here, and (indistinct).


COMMISSIONER O'NEILL:  Thank you for that, (indistinct).


MR GIBIAN:  It is almost lunch time.  I think we might have to request that we adjourn for lunch if that's not a problem.


COMMISSIONER O'NEILL:  I think so.  We'll do that.  Ms Bayram, we are going to have to interrupt, I'm afraid?‑‑‑Sure.


So, we will break for lunch.  You'll remain under affirmation so you can't discuss your evidence with anyone over the lunch break and we'll resume at 2 pm?‑‑‑Okay.  Right.


The Commission is adjourned until 2 pm.

<THE WITNESS WITHDREW                                                           [12.55 PM]

LUNCHEON ADJOURNMENT                                                          [12.55 PM]

RESUMED                                                                                                [1.59 PM]

<LISA BAYRAM, RECALLED                                                             [1.59 PM]



COMMISSIONER O'NEILL:  The Commission is now resumed.  Ms Bayram, thank you.  Mr Ward, back to you.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


MR WARD:  Thank you, Commissioner.  Ms Bayram, can you hear me again?‑‑‑Yes.


Thank you very much.  I think before lunch we were just - I was asking you some questions about the distinction between the enrolled nurse role and the personal care attendant?‑‑‑Yes.


And you had listed for me team leadership, complex matters, you talked about wound care, oxygen saturation, medications and leadership?‑‑‑Yes.


Can I just explore a couple of those quickly with you if I can?‑‑‑Sure.


In your facility do the enrolled nurses do all the Schedule 4 medication?‑‑‑Yes, they do in their sections, yes.


So the personal care attendants don't deal with Schedule 4 medications in your facility?‑‑‑On very infrequent occasions they do, but only if we don't have a nurse available.  Yes.


Would they be required to hold a particular competency to do that?‑‑‑Yes.


Do you know - would you know off the top of your head which competency that might be?‑‑‑No, we just - we just say they're medication competent.  I don't know what that is.


That's fine, that's fine.  And you talked about wound care?‑‑‑Yes.


Can you - as best as you can, could you try and describe for me what a personal care attendant might do with a wound versus an EN, versus an RN?‑‑‑Sure.  The personal care attendants don't have responsibility for the management of wounds. There are some residents who might have a dressing taken off before they go into the shower and the water's allowed to go over the wound.  That would be the extent of their responsibilities, was to do the showering and the ENs would then come and manage the wound, put the dressings on, take the photos, do the documentation.  The PCAs are though expected to observe the patients when they're caring for them.  When they're showering, when they put them to bed, when they're changing their aids, and if there's anything wrong with the patient's skin, their responsibility is to refer that to the nursing staff.  Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


So, if I was a PCA at your establishment and I noticed the bruising, it's my job to come and see the EN or the RN and say look, I've observed this?‑‑‑That's right, yes.  There would be some instances if someone had some excoriation on their skin and the protocol was just to put some barrier cream on or something like that, then the PCAs would do that during their hygiene work.  But, yes.


Yes.  And it might be difficult to answer this but is there a distinction between the role of the EN and the RN when it comes to things like wound care?‑‑‑We use protocols to assist with the management of wounds but if – the ENs are always required to report to the RNs and the RNs still oversee the management and would make the changes that were required.  The ENs wouldn't make a change to a wound protocol without consulting the RNs.


The framework within which the wound is managed would be consistent but the individual RN might delegate certain activities to an EN because they believe they're competent to do that?‑‑‑Yes.


Could I take you to paragraph 43?‑‑‑Yes.


If you could sort of turn to page 8 or turn over the page, at the very end of paragraph 43 you're talking here about residents arriving?‑‑‑Yes.


You talk about the fact that historically they would be fully admitted before they arrived and that's not always the case now, and right the end you say:


We no longer have an admissions nurse on site, the function is managed by head office.



***        LISA BAYRAM                                                                                                                               XXN MR WARD


Could you just explain to me when you say the function, do you mean the function of filling out admission forms and those types of things?  What do you mean by the function?‑‑‑So in this case actually finding residents who are going to come and live at the facility, so from the hospitals or from the community and doing the initial organisation for them to come in.  So when that happens that's about as far as it goes.  There is no extensive conversations with the family, there's no visit to hospital to see the resident, to see what their needs really are.  And so that impacts on the care that we give because we might just have a diagnosis and nothing else and we need to start from scratch.  In other instances we get a diagnosis and it's actually not right or we're told that the residents have been living at home and they just need some help, and when they arrive they have, you know, severe co-morbidities and extensive needs.


In the circumstance where the resident is sort of just dropped on you - - -?‑‑‑Yes.


- - - I take it at that stage there isn't a care plan for the resident?‑‑‑No, so the only information that we would have to go on is a brief handover from the hospital or what the families have told us.


You've said that that's an increasing phenomena.  How often does that happen?  What percentage of residents might just be dropped on you from, say, hospital or something like that?‑‑‑It's pretty normal.  We don't get a lot of information.


So more often than not that would be the case, would it?‑‑‑Yes.


That's fine and I take it when that happens one of the first activities for the registered nurse is to actually work with the resident and the family to establish the care plan?‑‑‑Yes, that's right.


You've mentioned in your evidence about a clinical care manager?‑‑‑Yes.


I think you've said your clinical care manager is an RN.  Have I got that right?‑‑‑The clinical care coordinator - - -


Coordinator, my apologies?‑‑‑ - - - is an RN, yes.


An RN, okay, and just can you tell me what the distinction in role is between you as an RN and the clinical care coordinator?  What do they do different to you in the facility?‑‑‑The clinical care coordinators have responsibility for, I guess, the day-to-day running of the organisation and the care of all of the residents.  They have other roles as well, administrative roles.  They have reporting roles, they have links back to the organisation. The after-hours coordinators, their nominees when they're not there.


Okay?‑‑‑So we're responsible for the facility and all the care that's given and everything that happens on our shift but we – the clinical coordinator is still our boss.


I'm not trying to be clever when I ask this question?‑‑‑No, no.


So when you're there - - -?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


- - - you're responsible for the clinical care in the facility?‑‑‑Yes.


Or if the clinical care coordinator is there, do they actually have that primary responsibility?‑‑‑They do but because of their other responsibilities they delegate all of that down.


Delegate.  No, I understand.  Okay, I understand, I understand?‑‑‑Yes.


I'd be right in saying that if the clinical care coordinator wasn't an RN, then that accountability would sit with you or people like you all the time?  The responsibility for clinical care?‑‑‑Yes, but I can't imagine a situation where we didn't have - - -


That there would be - - -?‑‑‑ - - - a clinical care coordinator.


Who was an RN?‑‑‑That's right.


No, that's fine.  That's fine?‑‑‑Yes.


We've just talked about care plans.  Earlier on today I sent a version of a care plan to you?‑‑‑Yes.


I appreciate it's a Friday afternoon but I don't know, have you had a chance to peruse that?‑‑‑I have, yes.


I just would like to know if possible is that similar to the care plans you use in terms of the headings and the content?‑‑‑Yes, it is.  I think ours is probably more extensive than that but that's the same sort of thing, yes.


That's okay.  What I'd be interested to hear is when you say it's more extensive, is it more extensive as in detail or subject matter?‑‑‑Subject matter, I think.


I guess what's missing from here is the complex nursing needs and the palliative care needs which, unfortunately, in aged care we try and distinguish between care and complex clinical care.


Just give me a moment, I'm just going to make a note?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


Ms Bayram, I apologise, you're my first registered nurse up, so you're copping the brunt of me, I apologise?‑‑‑Sure, that's okay.  So the complex care needs are really the things that the nursing staff are qualified and responsible for.


Yes?‑‑‑They're over and above things like the things that the PCAs do with oversight like hygiene, meals, social interaction.  They're activities of daily living, is an old-fashioned expression for those sorts of things.


Yes?‑‑‑And the complex care needs are the nursing staff looking after the disease processes or the injuries, that sort of thing.


Commissioner, just for your reference, I'm taking the witness to the care plan which we provided earlier in the proceedings.  I think we've already said we'll rely on that.  Can I just see if I can understand an example of that?‑‑‑Yes.


If you look at that care plan, at the very beginning it's got medical history, diagnosis, osteoporosis, chronic lower respiratory diseases, high cholesterol.  So those are the clinical conditions that the nursing staff, the RNs, the ENs, are focusing on?‑‑‑Yes, on top of everything else.


Everything else?‑‑‑Yes.


No, no.  Yes, I wasn't trying to diminish their role.  No, that's okay.  That's okay.  No, thank you for that.  My understanding is, is that the PCA obviously is making daily observations - - -?‑‑‑Yes.


- - - of the resident.  The PCA is making progress notes in relation to what they're observing?‑‑‑M'mm.


If they observe something serious, we've already agreed that that would be referred to the EN or the RN such as bruising or a wound or something like that.  I take it that those observations are reviewed by the RN on a regular basis to determine if the care plan should be changed?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


Is it the RN who has the authority to change the care plan?‑‑‑There is some documentation that the PCAs are able to do but they wouldn't do that without discussing that with the RN first and with the sheer volume of documentation that needs to be done, we're trying to upskill the PCAs to be able to take on some more of that with the nursing staff oversight.  So if they did something like if they thought that the continence care for a resident needed to be changed, they could discuss that with me.  I would say yes or no, that's what we should do and then the continence assessment in the care plan, they would then be able to go in and make some changes to that, and then I could sign it off.


Okay.  So, you could listen to what they're suggesting based on their observations, you could make a decision to proceed.  To save you time they could manually change to the care plan and then you would sign a new one off?‑‑‑Yes.


I take it the same - the same occurs with the enrolled nurse?‑‑‑The enrolled nurses do a lot of the assessments.


Okay.  That's fine, that's fine.  Can I just jump a little bit if I can.  Can I just talk about adverse events?‑‑‑Yes.


And bear with me.  My understanding is that if there's a skin tear or there's bruising observed, there's now a requirement to log that, notify the next of kin and to notify the GP.  Have I got that right?‑‑‑Yes.


Where's that normally logged?‑‑‑The clinical system that we use has - where all our assessments are that make up our care plan, has a new assessment in it for resident incident.  We did do this reporting previously but it's much, much bigger and more extensive than it used to be.  So that document is in the clinical system.  And they - - -


Yes.  So, it'll be - it'll be on that resident's file?‑‑‑Yes.


Yes, okay.  My understanding is that in the past you would log it?‑‑‑Yes.


But you had a discretion as to whether or not you notified the next of kin and the GP and now you don't have a discretion.  Is that right?‑‑‑It's mandatory now.  We used to do that but we are now required to do that and there's - the difference now really is the open disclosure component.


To the family?‑‑‑There is an onus on having a frank discussion with the family, documenting the discussion and the outcome of the discussion.


Who documents that discussion?‑‑‑In our facility the nurse who's the team leader or the registered nurse who would be having that conversation with the family.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


Now, my understanding is that that's a little different to SIRS.  I can almost guarantee that I can't find the piece of paper.  And - - -?‑‑‑That's a requirement of SIRS.


My understanding though and tell me if I'm wrong, my understanding is that in terms of incident reporting related to the SIRS legislation?‑‑‑Yes.


That arises when the bruising or whatever falls into one of a number of categories, and my understanding is that the categories are these; unreasonable use of force?‑‑‑Yes.


Unlawful sexual contact?‑‑‑Yes.


Unexplained absence from the facility?‑‑‑Yes.


Unexpected death?‑‑‑Yes.




Emotional or psychological harm?‑‑‑Yes.


Stealing or coercion of funds by a staff member?‑‑‑Yes.


And lastly use of restrictive practices without informed consent?‑‑‑Yes.


So, I take it that where bruising or something arises because of one of those, that triggers the SIRS notification process?‑‑‑That's right.


Is it the registered nurse whose responsibility it is to complete the SIRS notification?‑‑‑So, when an incident happens, the person who - the person who witnesses the incident does the first part of the report. Then the nurses in charge of the ward does the second part of the report, and then the third part the registered nurse is required to do that and part of that third section is to decide whether it is a SIRS reportable incident, or not.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


Okay?‑‑‑So, the way our system is set up, once you click on that button to say yes, it is and if it's a priority 1 or a priority 2 that sends messages off to the managers and head office to say that we've got a SIRS reportable incident and then the registered nurses do as much of that reporting as they can there, and then the clinical care coordinator and the residential manager will come in and continue from there.


Sorry, I should know this.  When you finished that report, where do you report to?‑‑‑So, the actual submission of the SIRS report - - -


Yes?‑‑‑ - - - is compiled by our residential manager and our clinical care coordinator, that goes to our central office and we have a person at Blue Cross who's responsible for SIRS reporting.


Reporting?‑‑‑And they send that.  And there's a - there's a log of all the incidents that go into the system.


I take it from the evidence you've just given that you've got a computer system that helps with the workflow of that?‑‑‑Yes.


Okay.  Does that system work okay?‑‑‑From my perspective it does and I - - -


Only from - yes?‑‑‑And I have had a conversation with the lady who does the SIRS reporting, and she - we still - everybody still needs education about how to do this but the system flow that we've got is working.


Just for the Commission's benefit, can you just explain the distinction between priority 1 and priority 2?‑‑‑Priority 1 incidents have to be reported to the Commission within 24 hours, and priority 2 it's in 30 days.


Is there - I would assume that there is a need for palliative care at your facility?‑‑‑Yes.


Is anybody in particular trained or specialising in palliative care?‑‑‑We have one registered nurse who has in the past worked in a palliative setting.


Yes?‑‑‑But no, as far as I know the other RNs don't have a qualification in palliative care, neither do I.


That's okay.  Are there any particular skills that are needed when you're working in that environment?‑‑‑There are lots.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


That's okay.  Well, let me ask it a different way.  Are there any skills distinct from the skills you use outside of that environment?‑‑‑The care plan is different for someone who's dying.  So, you actually have to have a  knowledge of the dying process and what the likely scenarios are and have the skills to manage the patient's care.


By skills, you mean the clinical skills or - - -?‑‑‑The clinical skills.


Yes?‑‑‑But you also need to have communication skills, empathy, understanding, you need to be able to listening, you need to be able to explain things to people, explain scenarios that some of them have never ever heard of and never dealt with in their lives before.  You need to be able to deal with people who are in distress.  But even people who aren't distressed, like family members who have an understanding of what's happening and what the outcomes are going to be, they still need care and compassion.  You need to sometimes change the language that you use and the most important thing is being able to guide family members to make good decisions when they're in distress.


You've used some phrases like empathy and compassion?‑‑‑Yes.


Would I be right in saying - which I've always thought it's difficult to teach empathy.  Are some people better at managing palliative patients than others, because of the fact they have qualities like empathy and compassion?‑‑‑Yes, but I think that they're things that you can learn from experience, not necessarily from books, and the more you do it the better you get at it.


Yes?‑‑‑Even I guess one of the skills is being able to present and be productive and effective irrespective of your individual traits.


Do you think additional formal training on palliative care is useful if somebody is going to be involved in that?‑‑‑Absolutely.  I think it should be.  I was looking at that other document about the units that the PCAs are trained in and palliative care was an optional extra.


An elective.  Yes, it's an optional?‑‑‑I've only done small amounts of palliative care training, short courses, and I've learnt amazing amounts just in a couple of days but I think it's essential.


I'll come back to the cert 3 in a moment, if I can?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


You've worked in a big hospital, haven't you?‑‑‑Yes, mostly.


Mostly, that's okay.  I'm just trying to get a frame of reference.  The paperwork requirements in aged care for a registered nurse versus the paperwork requirements for a registered nurse in a hospital, can you explain to me how they're distinct?‑‑‑I haven't been a registered nurse on a ward doing that sort of paperwork for 20 years, so - - -


Okay, it's not exactly - - -?‑‑‑ - - - it's changed enormously but - - -


No, it's an unfair question?‑‑‑But, from my perspective, the amount of documentation that's required in aged care is huge.  It's a burden, it's a real burden.  I understand why most of it's required but there's double-ups and triples, and, I don't know, I think we could do it better.


From a kind of broader industry perspective we could do it better?‑‑‑I think so.


Can I take you back to your statement?‑‑‑Yes.


I might just start with paragraph 59, if I can and in 59 you're talking about catheters and colostomy bags?‑‑‑Yes.


How many people at your facility have a catheter in at the moment?‑‑‑One, two – I think five, yes.


Who's competent to put the catheter in?‑‑‑Well, we've got one – no, she's gone.  None of us.


None?‑‑‑It depends on the sort of catheter.  If it's a - - -

***        LISA BAYRAM                                                                                                                               XXN MR WARD


Help me out.  Help me out with that?‑‑‑Yes.  So there are two types of catheters.  There's what's called an in-dwelling catheter that goes into the urethra.  And there's a catheter that goes into the bladder through the abdomen wall.  Usually we use the latter because they're better for long-term management.  Less infections, easier to look after.  Most of the registered nurses would be able to put in the other sort of catheter in a female resident but not a male resident because it's extremely difficult and usually male residents who have a catheter have problems, so that just makes it even more difficult to put in.  The suprapubic catheters, we did have an RN who was capable of reinserting one of those if it fell out.  So what we do is we use the in-reach nursing service from the local hospital and those nurses come every six weeks and they change the catheters for us.


Just bear with me?‑‑‑Yes.


Those nurses, do they have some particular qualification that allows them to do that?‑‑‑I would imagine that they've got a hospital-based competency that they get signed off on, yes.


Once the catheter is in, what's involved in maintaining the catheter in situ?‑‑‑The site needs to be kept clean.  The suprapubic catheters – the abdomen ones have a small gauze dressing put on them and you just have to have good hygiene practices when you're disconnecting it and changing the bag and emptying it and things like that.


The PCA is competent to change gauze and disinfect around the catheter?‑‑‑The catheters usually wouldn't need disinfection.  They would just get washed when the patient is having their shower or their wash.


Yes?‑‑‑If there's nothing wrong, the PCAs can put the gauze on there but the nursing staff would be checking that every day to make sure that there wasn't an issue with the skin.


Yes?‑‑‑And the PCAs are competent to change the bags over.  They change the bag at night-time and then they put a clean bag on at the – each week, and they empty the catheters, you know, a couple of times a shift.


If I can just understand, the bag is where the urine collects?‑‑‑Yes.


I take it there's like a little clip or something, you clip that bag off and then you clip a new bag on?‑‑‑Yes.


Then the bag, I presume, is disposed of appropriately?‑‑‑Yes.


Yes, yes and that's what the PCA does in your establishment?‑‑‑Yes.


Then you talk about colostomy bags.  How many people have you got with colostomy bags at the moment?‑‑‑I think we've only got one at the moment.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


What is the care regime around somebody in your facility who's got a colostomy bag?‑‑‑So they – the care plan would depend on the type of stoma that the resident has and the type of bags that they need, what's wrong with their skin.  There are a multitude of different sorts of bags that can be used.  The PCAs are able to change the colostomy bags.


Is that similar to how I described the catheter bag before?‑‑‑No.  So the appliance, is the word I should use, sticks onto the skin, onto the abdomen and there's different sorts.  There's ones that you can open and empty and there are ones that when they're full you can take them off and you put a new one on.  They have different sorts of connections and different sorts of sticky stuff but all of that stuff would be decided with the registered nurses in conjunction with the stomal therapy nurse at the hospital about what sort of appliance to use, how often to change it and all that sort of thing.  That would go into the care plan and then with assistance, education and oversight, the PCAs would be able to do that.


They're involved in the emptying process, they're not involved in the broader management of the actual fixture to the body, are they?‑‑‑Yes, yes, they would be.  So if the residents got a bag that gets taken off and thrown out and a new one put on, they would do that.


They would do that?‑‑‑Yes.




If I can take you to paragraph 83.  I'm close to finishing, I promise, Ms Bayram.  Paragraph 83 you say:


I would say that while there are still gaps in PCA education, there wouldn't be a PCA employed across (indistinct) who doesn't have a certificate 3 or certificate 4.


Do you see that?‑‑‑Yes.


Earlier today, and I think you've had a bit of a look at it, I think you've outlined for the certificate 3 and individual support?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


I don't know if you've seen this document before.  In fairness to you, have you seen it?‑‑‑No, I haven't, but I have read those pages of what the units are that make up the course.


If I just ask you to turn to page 4 of 8, at the top of page 4 of that is the mandatory electives – it's a strange phrase – the mandatory electives if you want to do ageing?‑‑‑Yes.


Which includes, 'Facilitate the empowerment of older people', 'Provide support to people living with dementia', 'Meet personal support needs', and so forth, and then I think as you've identified, on the next page there's a very long list of electives that one can take a choice from?‑‑‑Yes.


In the context of having read that, I wonder if you could tell me, when you say there are gaps in PCA education, could you explain to me personally where you see those gaps?‑‑‑We've had some fairly new PCAs come and work with us in recent months, and I also note that the amount of work that this course takes is 120 hours, so that's three weeks of study.  There are – the general daily work is not understood, so how the facility runs, what our processes are, how to manage our time, how to group activities, how to get their work done throughout the day, is something that they need to learn when they come.  There's a focus on task completion and not holistic care with most of the PCAs.  But there are things listed in this group D section that I think should be things that PCAs know before they come to work, so things like falls prevention.  Falls prevention is an enormous component of what we do.  As people get older and frailer and sicker, they tend to fall over, but there are lots and lots of strategies that you can use to help prevent that.  Foot care is really important.  Loss and grief should be something that is at least introduced, because we deal with it every day, and that's not just about people dying; that's about people leaving their homes and coming to live in aged care.  It's about people whose spouses have died or whose children are away; have lost their independence, who can't see their friends, all of those sorts of things.  What else is in here?  I think perhaps there should be a little bit of information about dealing with mental health issues, because we have a lot of residents who have a history of depression or anxiety, not just residents who have, you know, well‑known diseases like schizophrenia; there are lots of people dealing with depression, particularly in this age group.  Palliative care, an introduction to palliative care should be a baseline component.  There's one here that says, 'Assist with monitoring modification of meals and menus according to individualised plans.'  That's really important, because the nursing staff don't have the time to supervise the dining rooms.  So the PCAs and the kitchen staff are the ones who are watching what goes on to the table, what actually gets consumed, what's not wanted, who's feeling sick, who's not eating today, who's coughing and wasn't coughing yesterday, are they not swallowing properly.  The PCAs are the ones who see all of that.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


They're the observers?‑‑‑Yes, and that's – meals is really important, because it goes to general health; it goes to weight loss; it goes – it's related to diabetes management; it's related to general health and your skin and your frailty, your muscles; choking hazards, and just generally how people feel.  So that's something that needs to be learnt right at the start.


So a PCA who came to you with all those competencies would be more effective than one who didn't?‑‑‑Absolutely, yes.


Can I take you - - -?‑‑‑The other one that's in here is oral hygiene, and that's something that's really underestimated.  If people haven't got good teeth or they've got a sore mouth and nobody's noticed, then they can't eat.


Can I take you lastly to paragraph 89?‑‑‑Yes.


You're talking here about physical infrastructure of facility, I presume your facility?‑‑‑Yes.


You say, 'While physical infrastructure has improved enormously, the layout has made it hard to deliver care.'  I just want to explore that with you if I can?‑‑‑Mm‑hm.


My understanding - and this might not be your facility, so you might need to tell me it's not - but my understanding is that if the room's bigger, you've got more capacity to move around the resident and help the resident rather than being in a small room?‑‑‑Yes.  That's right.


My understanding is that these days most of the rooms have electronic beds that sort of help you move the bed up and down?‑‑‑Yes.


And I would presume they're of assistance?‑‑‑Yes, certainly.


And bigger rooms means that you normally have access to both sides of the bed as well?‑‑‑Yes.


And it also means that you have a better ability to move wheelchairs around?‑‑‑Yes.


My understanding, and I'm thinking about what we saw in the inspections, is that you've got these much larger bathrooms now, which have got doors wide enough for the wheelchair or a frame to go through?‑‑‑Yes.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


The toilets seem to be positioned so that you can actually assist the resident from either side?‑‑‑Ours aren't.  Ours are only accessed from one side, which is – it would be great if you could go on both sides.


But yours is a one‑sider?‑‑‑But the bathrooms fairly large and fairly easy to access.


Does that make it easier to move somebody into a shower and move them out?‑‑‑Yes.


When you say the layout's harder to deliver care, is that more about the fact that people are just further away from each other physically?‑‑‑Yes.  So we've got some long corridors, and we've got some little nooks, and so if residents are in their bedrooms they cannot be observed, and they wouldn't be heard if they didn't have their call bells.  So even though we've got – everyone's got a single room and they've all got an ensuite, which is essential, with the number of staff who are in the building at any one time, half of the residents can't be seen.


I'm not trying to be facetious - I take it, if we wind the clock back to when people were in sort of multi‑person wards and the nurse was sitting at the end, it was just simply a lot easier to observe them?‑‑‑Yes.


(Indistinct) - - -?‑‑‑There's not a lot of dignity and - - -


No, (indistinct) - - -?‑‑‑ - - - (indistinct), but I come from a hospital setting where people were in two bedrooms and four bedrooms, and it is easier to deliver care to multiple people if they're in a smaller space, but as I said, if you've got a long corridor and then you've got to go around the other side of the building to another long corridor and that's your ward, that's an awfully long way to go to have safe observation of the people that you're looking after.


We had at least one witness talk about the fact that they have to run between rooms?‑‑‑Yes.


I could imagine if there was an emergency, one might have to move fairly quickly if there was a fall.  Would I be right in saying that it would be unsafe to have people running around your facility?‑‑‑It's never ideal to have people running around where there are people who are at risk, but I have run from one end of the facility to the other on numerous occasions.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


And was that because there was an emergency in play?‑‑‑Yes.


And I imagine it's all hands to the wheel if there's an emergency and you just have to get there?‑‑‑Yes.


Okay.  And just lastly if I can, on the issue of emergencies if somebody has a fall what's the role of the PCA in your establishment versus the role of the EN versus the role of the registered nurse?‑‑‑The PCAs are usually the first people to know that something's happened.  I would expect them to stay with the resident, keep them comfortable, pull the alarm bell so that the nursing staff come.  The ENs if they get there before the RN make an initial assessment, but they would wait for the registered nurse to come to decide what's going to happen, and that's even from whether or not we're going to move the person or not.  The PCAs then provide assistance.  So if I decided that we needed - if someone was stuck in the bathroom and we needed to get them out I would say we've got to get them out.  The PCAs would be the ones who would help me do that.  They would get the equipment, they would give me some advice on their way to manage that, and then once we had made the person safe the nursing staff would take over making - the decision-making, and the PCAs would just follow my directions.


The PCA might be the best person placed to actually work the hoist to pick them up?‑‑‑Yes, definitely.


If the decision is made that they have to go to hospital is that made by the RN?‑‑‑Yes.


And is the RN the one who liaises with the hospital?‑‑‑Yes, and actually when you ring triple 0 they ask if a registered nurse has authorised the transfer.


Just a moment, Ms Bayram, if I can?‑‑‑Sure.


Thank you very much for your evidence.  No further questions?‑‑‑Thank you.


COMMISSIONER O'NEILL:  Mr Gibian, do you have any questions for this witness?


MR GIBIAN:  I do not, thank you.

***        LISA BAYRAM                                                                                                                               XXN MR WARD


COMMISSIONER O'NEILL:  All right.  I will adopt the same approach with you, Mr Gibian, with the ANMF witnesses, if you just flag with any witness if you do have any questions.  Otherwise, Mr McKenna, any re-examination.


MR McKENNA:  Three matters, Commissioner.

RE-EXAMINATION BY MR MCKENNA                                           [2.45 PM]


Ms Bayram, you were asked questions, you were asked about the distinction between enrolled nurses and registered nurses with regard to wound care, and in answer to that question you referred to - you said, 'We use protocols to assist with the management of wounds', and I got your answer?‑‑‑Yes.


Can you explain what you mean by protocols in that context?‑‑‑We've actually got a folder with - that's been designed by a wound care consultant for Blue Cross, and when the nurse looks at the wound they have to make an assessment as to what type of wound it is.  So if it's a skin tear there are four different categories of skin tears and we have to decide what it is, and then this book of protocols you can look into it and it says for a skin tear 2B, and they give you a photo of what it looks like, this is the regime that you should use.


Thank you.  You were also asked some questions about palliative care at the facility, and you were asked are there any skills required for palliative care and I think your answer was, 'Yes, there are lots.'  You then listed a number of those skills and you refer to empathy and compassion and you ask some further questions about the skills of empathy and compassion.  Having particular regard to those skills, empathy and compassion, are they skills that are limited only - that are required only by registered nurses in dealing with palliative care?‑‑‑No, everybody who works in the facility needs to have them.


And what about the other skills that you refer to with respect to palliative care?‑‑‑What were they?

***        LISA BAYRAM                                                                                                                        RXN MR MCKENNA


Yes.  No, it's probably - rather than take you through I'll move on to the last point?‑‑‑So listening, making decisions under duress with people who are distressed, leading families who are in situations where they're not familiar and they're anxious and they don't know what's going to happen and trying to get the best outcomes for them and for their loved ones, and the information that you provide and the leadership and the guiding people through the process.  That's the really important stuff that everybody needs to be better at, and that you really, really need experience, and mentoring to learn that stuff.  Everybody can learn how to fix the bed, do the mouth care, put on the nice music, talk nicely to the families, but that other stuff takes a long time to learn, but it's essential.  If you haven't got people who can do that then you can't provide good palliative care.


When you say everyone needs to be better at that are you referring specifically to registered nurses, or more broadly?‑‑‑Registered nurses take a lead when we're looking after someone who's actively dying.  The other nursing staff are heavily involved, but the PCAs are still the people who are actually doing the care.  So they're the ones who go into the room and they do the mouth care, they turn people over, they manage their continence.  If they're still drinking they give them drinks.  They make the cups of tea for the families, they're the ones who are actually changing the bed, turning the lights on and off, putting the music on, doing all of those things, and they have to have some of those skills as well.


Thank you.  And finally you were asked - you were taken to the Certificate III in individual support documentation, and your comment, your statement, in your witness statement that there are some gaps in PCA education, and you referred to some new PCAs who had started at Grossard Court in recent months, and by my notes you said that some of them need to learn how the facility runs, how to manage time, how to do group activities and how to get work done.  Can I ask, you've said that those are things that they need to learn, in your experience are those things that are learnt?‑‑‑They're learnt when you're working.  So I guess what I was suggesting was there needs to be - so the PCAs when they do their course they do their education hours and they have a placement.  So they come to an aged care facility and they work for a week or something like that, and they double with the PCAs and they - I guess there needs to be more of that, it needs to be extended or we need partnerships or something so they get some more of that experience before they come to work, because if there's only two PCAs in a ward and one of them is brand new it's incredibly difficult to get the care delivered well, timely and effectively if you've got a new PCA.


Do I take it from that answer and your reference to a new PCA that those are skills that will develop on the job?‑‑‑They do develop in most PCAs, but I think they need a better grounding before they come.


Thank you, Ms Barham.  I have no further re-examination.  Might the witness be excused?


COMMISSIONER O'NEILL:  Yes.  Ms Barham, thank you very much for your evidence and you're excused?‑‑‑Thank you.

<THE WITNESS WITHDREW                                                             [2.52 PM]

***        LISA BAYRAM                                                                                                                        RXN MR MCKENNA


MR McKENNA:  And, Commissioner, I will hand over to Mr Hartley for the next witness.


COMMISSIONER O'NEILL:  All right.  That's Ms Hewson.


MR WARD:  Sorry, Commissioner, I apologise, I know we're running behind, could I just have a two minute break?


COMMISSIONER O'NEILL:  Yes, of course.

SHORT ADJOURNMENT                                                                     [2.52 PM]

RESUMED                                                                                                [2.54 PM]


COMMISSIONER O'NEILL:  Good afternoon, Ms Hewson.  I'm Commissioner O'Neill and my associate is just going to have you take the affirmation.




THE ASSOCIATE:  Ms Hewson, can you please say your full name and work address?


MS HEWSON:  Yes, my full name is Suzanne Claire Hewson and my work address is the Royal Adelaide Hospital, Port Road, Adelaide.


THE ASSOCIATE:  Thank you.

<SUZANNE CLAIRE HEWSON, AFFIRMED                                   [2.54 PM]

EXAMINATION-IN-CHIEF BY MR HARTLEY                               [2.54 PM]




MR HARTLEY:  Thank you, Commissioner.


Ms Hewson, can you see me?  I'm the man with the beard?‑‑‑Yes.

***        SUZANNE CLAIRE HEWSON                                                                                                    XN MR HARTLEY


Thank you.  I'm Jim Hartley for the ANMF.  Can you just restate your name?‑‑‑Yes, my name is Suzanne Claire Hewson.


Thanks very much.  Have you made a statement in this proceeding dated 29 October 2021?‑‑‑Yes, I did.


Is that it sitting on the table in front of you right now?‑‑‑Yes, this one, yes.


Is that a statement of 32 paragraphs over eight pages?‑‑‑Yes.


For the Commission's assistance, that's tab 231 in the court book at page 12,050.  Ms Hewson, could you have a look at paragraph 5 of that statement and just read it to yourself?‑‑‑Certainly.  'I'm currently working in aged care.'  Is that the one?


Yes, that's the one.  Just read that to yourself and then also paragraphs 6 and 8.  You don't have to read it out loud?‑‑‑Yes, I've read those.


Can you have a read of paragraph 32 as well?  It should be in the very last paragraph above your signature.  Ms Hewson, can you see that?‑‑‑Yes.


Yes, great, thank you.  What you say in those paragraphs is that you were considering leaving aged care.  The position is that you have now, in fact, left aged care.  Is that right?‑‑‑That's correct.


Can you describe what it is that you're doing now?‑‑‑Yes, I'm enrolled nurse in mental health.


As far as the rest of your statement is concerned, that's to be understood as a statement that was accurate as at the time that you made it but now things have changed, is that right?‑‑‑That's correct, yes.


Understood in that way, the statement is true and correct to the best of your knowledge and recollection?‑‑‑Yes.  I do have an error on page 4 of that statement and it is, 'At 10.40, an unpaid 10 minute tea break.'


Yes?‑‑‑The tea breaks are paid.



***        SUZANNE CLAIRE HEWSON                                                                                                    XN MR HARTLEY


Thank you, Ms Hewson.  With that correction the statement is true and correct to the best of your knowledge and recollection?‑‑‑That's right, yes.


Thank you, Ms Hewson.  You'll see Mr Ward in one of the other squares on the screen, he's now going to ask you some questions?‑‑‑Okay.

CROSS-EXAMINATION BY MR WARD                                           [2.57 PM]


MR WARD:  Ms Hewson, can you hear me okay?‑‑‑Yes.


Ms Hewson, my name is Nigel Ward.  I appear in these proceedings for the employer interests.  You have your statement in front of you, don't you?‑‑‑Yes, I do.


Ms Hewson, I'm only going to ask you a few questions so I won't be keeping you here for very long.  Can I ask you to go to paragraph 10 of your statement and I'm going to see if I've got this right.  You got a certificate 3 in aged care in 2014 and then you proceeded to obtain your diploma of nursing after that, is that correct?‑‑‑That's correct.


I wonder if you could share with me what did the diploma of nursing teach you that the certificate 3 didn't?‑‑‑It was much more involved.  You had to do anatomy.  You had to know much more legal and ethical areas of responsibilities of being a nurse.  I had to do the drug calculations.  I had to know how to do drug calculations and what the tablets were for.  I had to study that information as well.  I had to know how to approach people, how to do a handover, how to do observations, learn how to do blood pressures, manual.  I had to learn how to do vein puncture, stitching wounds.  I had to do wound care.  I had to understand about pressure injuries.  I had to understand about deteriorating conditions in elderly people.  I had to know the vital signs and what areas of concern would be.  I had to have an idea of dementia.  I had to an idea of other illnesses that the elderly have.  I had to have an understanding of mental health.  I did a mental health placement.  Plus I had to have information about acute wards and what would happen in a hospital setting as well.  It was far more details.  It was fulltime study over an 18 month period and that didn't include the placements that you have as well.

***        SUZANNE CLAIRE HEWSON                                                                                                       XXN MR WARD


What was the extent of the placement you had when you did your diploma?‑‑‑I had a two-week placement in aged care but we weren't allowed to administer any medications in that placement because I hadn't done the medication part of it.  So that was mainly the fact that I've got experience in wound care.  A lot of people did not have experience as a carer so they didn't understand how to shower people, so they had to learn how to do all of that and what basically the routine is in an aged care facility.


Keep going?‑‑‑I was involved in the opioid drug rounds so that I understood all the procedures and practices in that which is quite strict.  I also learnt the difference between what happens in the morning shift and what happens in the afternoon shift in aged care.  I had to learn – I learned how to do progress noting and how to write that succinctly and functionally and what they actually required to do.  That was two weeks.  Then I had a six-week placement in an acute ward.


I won't ask you to go into that because I appreciate you've had it but our case is about aged care so I might pause you there.  I might pause you there.  When you finished your diploma of nursing you were competent to administer medications?‑‑‑Yes.


But you weren't competent when you had your certificate 3?‑‑‑No.


Okay?‑‑‑Yes, I was but when I changed to be a home support worker.


Bear with me?‑‑‑Yes.


After you finished your certificate 3 did you do an additional competency for medications?‑‑‑No.  Because I worked in an aged care facility that was different and when I changed positions, when I left Bupa and worked for Southern Cross Care as a home support worker I had to have a six-hour training course on administering medications.


That was overseen by a registered nurse?‑‑‑Yes.


Can I just take you to your statement, then, just to clarify some points around medications if I can.  I think it's paragraph 17(j)?‑‑‑Yes.


You say in paragraph 17(j) that you checked that opioid pain patches are on residents, all residents currently have these.  I'm entirely ignorant of this, bear with me.  Is an opioid pain patch a Schedule 4 or a Schedule 8 thing?‑‑‑It's a Schedule 8.


Are you qualified to actually put them on or are you qualified to do something else?‑‑‑No, I'm qualified to put them on and take them off, yes.

***        SUZANNE CLAIRE HEWSON                                                                                                       XXN MR WARD


Do I need a diploma in nursing to do that?‑‑‑Yes.


So, a personal care worker couldn't do that?‑‑‑No.


No, that's fine, that's fine.  Later on in (r) and (s) where you talk about the drug round, you see that?‑‑‑Yes.


Are you talking there about Schedule 8 or Schedule 4?‑‑‑No, that's Schedule 8, yes.


Schedule 8.  And are you authorised to do Schedule 8 drugs?‑‑‑Two people have to do Schedule 8 drugs.  One has to be a registered nurse.


So - go on?‑‑‑And the facility that I worked at it was an enrolled nurse as well.  And if there's - if there's any calculations required such as in palliative care, there must be two nurses, yes.


I think this is what you've just told me.  That the registered nurse is the administer of the drug and the enrolled nurse is the person who confirms that the right drugs being given to the person.  Is that right?‑‑‑That's right, yes.


Could I ask you to go to paragraph 22.  In paragraph 22 you say:


In addition to my duties outlined above, I am also the dementia and palliative care champion.


Do you see that?‑‑‑Yes.

***        SUZANNE CLAIRE HEWSON                                                                                                       XXN MR WARD


I wonder if you could tell us what the dementia and palliative care champion, what's that role?‑‑‑That role was given to me by the RSM of the aged care facility and that entailed me to attend.  Because I was very good at my job, they asked me to be the dementia and palliative care champion for the site.  So I attended training sessions specifically for those two areas that you deal with in aged care, which I got paid for, so that was in work but in the interim because there was such a big interest in dementia, I did a lot of work on my own dealing with Dementia Australia and I was at this part called the Communities of Practice, so I would have Zoom meetings with people with an interest in dementia and how we could best serve people in aged care facilities with dementia, and that practices worked, how we could improve, they had guest speakers.  It really was quite excellently run.  I also did a special training just on dementia itself which is part of the dementia training that they had, so I had another bow up my sleeve, plus I attended all of the things that Southern Cross paid for, plus I also did the University of Tasmania mocks, which are like 20 week training courses, which go right through and give more detailed information on dementia.


This is - you learnt skills about palliative and dementia care beyond your diploma course?‑‑‑Yes.


And I take it, does that mean that you're now the sort of - sorry, this will sound crude.  Does that mean you're the go to person if somebody's got a problem in that area?‑‑‑Well, I was.


You were, okay.  Sorry, yes, you've left?‑‑‑Yes.


But you were.  Sorry, you were.  That's fine.  Now, if I could take you down to paragraph 24(a), you're talking here about medications?‑‑‑Yes.


You say:


A new EN would find it difficult to do the job safely and efficiently.


Could you help me out.  What do you mean by that, a new EN?‑‑‑If you've just graduated as an enrolled nurse it's quite overwhelming, especially in aged care with the amount of residents you're looking after in a drug round.  So, the timing and everything is really quite tight, especially given the shortness of the shift that I had.  If it's a shift that's a seven and a half hour shift, you've got a bit of lee-time so that you can actually - if you can't finish the drugs that need to be administered by a certain time, like Panadol and Panadol Osteo, you have a four hour window.  A lot of people are having Panadol four hours, four times a day and a lot of people have Panadol Osteo are having Panadol Osteo every six hours, so that's three times a day.  So you need to be quite specific in the timeframe so that you have something that the afternoon staff can adhere to their schedule, so that the people's pain relief has been resolved in an appropriate manner.  And - - -


So, this is - sorry, when you give this evidence, this is about medications specifically is it?‑‑‑Yes.

***        SUZANNE CLAIRE HEWSON                                                                                                       XXN MR WARD


No, that's fine, that's fine.  And how long - in your experience, how long does the EN need to be able to do the job safely and efficiently?‑‑‑It depends on the amount of residents you're actually looking after.  You know, I have done - I've looked after 35 residents and that's extremely difficult, even for an experienced enrolled nurse.  That's quite challenging.  But, you know, in reality I think it would take at least a year for the enrolled nurse to become reasonably capable but, you know, you're still constantly learning because there's different drugs being put on the market all the time.  So, you need to keep your skills up and you need to ensure that you know what you're administering.  Some people don't have the same impetus that I have, that I want to make sure I'm doing the best job that I possibly can.  So I probably research things and ensure that I'm fully aware of what I'm actually administering, whereas other people don't have that.


Can I just ask a few more questions on that.  We've had some evidence in the case already about Schedule 4 drugs, and that when people validate that they've got the right drugs they use, like, picture charts of the tablets.  Is something similar like that used to validate Schedule 8 drugs, or is it just you're looking at the name of the drug?‑‑‑With an electronic drug chart you can have photos but you don't have photos of all the tablets that are there, so you do need to know what the tablets look like.


Okay.  And you gain that through experience, I presume?‑‑‑Yes.


No further questions.  Thank you very much.  Thank you?‑‑‑Thank you.


COMMISSIONER O'NEILL:  Mr Hartley, any re-examination?

RE-EXAMINATION BY MR HARTLEY                                            [3.10 PM]


MR HARTLEY:  Yes, very briefly, thanks, Commissioner.  Ms Hewson, you were asked some questions about paragraph 10 and you were listing a large number of skills that you thought were required of a person in your position.  One of the things that you said was how to approach people.  Can you just explain what you meant by how to approach people as a skill?‑‑‑Yes. People with dementia, you need to be quite careful on how you approach them.  You need to be openly engaged.  You need to ensure that you are speaking to them clearly and concisely and that you need to show that you're listening as well as speaking to them.  I feel that some people don't have the skills to be able to manage what you call chitchat, being able to say to them good morning, how's such and such.  How are you going today?  Did you have a good sleep?  Is there anything else I can help you with?  Or you ask some questions about their family, did you have a good visit with them yesterday?  So that you're interacting with them constantly and making the visit more personal to them.  And I always used to try to make it so that they knew that I was interested in them as a person and yet aware of what was happening around them as well.  And I think that's a skill that is learnt.

***        SUZANNE CLAIRE HEWSON                                                                                                 RXN MR HARTLEY


Yes, thank you.  Another skill that you identified that you learnt while doing your diploma was, I think the word you used was venepuncture.  Is that the right word?  And what does that mean?‑‑‑It means taking blood.


Thank you.  You I think were commencing to describe a placement that you did on an acute ward.  Do you remember that evidence that you were starting to give?‑‑‑Yes.  Yes, that was six weeks and that was - - -


I have a question about that if you don't mind.  The question is was the placement that you had on the acute ward, did you find that what you learnt in that placement was useful for your later work in aged care?‑‑‑To some extent I was.  I was with Disability SA and we don't have people on ventilators in aged care but we do have people with multiple sclerosis and other illnesses that was – so that was very relevant, yes.


Were there any other respects in which your acute ward placement was relevant to the work that you carried on in aged care?‑‑‑I think it's mainly – well, there it was how to observe people, ensuring that all my observations were correct and then making good clinical reasoning on what I was doing or what should be done or how I could improve that person.  Noticing pain, in particular, with people and how that's really important.  And I also, through that also learnt how to communicate non-verbally with people because a lot of them were non-verbal.  They had brain injuries, I had to learn how to ask questions so that they could respond by lifting one eyebrow up.  So it was very handy in that way of how to do – how to make more of your communication skills on a whole in that regard.  And then after that I did a two-week mental health placement as well which gave me all over some more information about mental health issues in aged care because 80 per cent of the residents there have – suffer from depression.  We also look after a lot of people that do have mental health conditions and that's not really recognized very well, that people have schizophrenia or bipolar.  So that was really useful as well.


The last question that I have for you, Ms Hewson, is you were asked some questions about paragraph 22.  That's the one where you referred to being the dementia and palliative care champion.  I think you gave an acronym, you said that your RSM named you the champion at that time.  What is an RSM?‑‑‑Residential Service Manager, so that's the person in charge of the aged care facility.


Yes, thank you, Commissioner, that's the re-examination.


COMMISSIONER O'NEILL:  Ms Hewson, thank you very much for your evidence this afternoon.  You're excused and free to go?‑‑‑Thank you.

***        SUZANNE CLAIRE HEWSON                                                                                                 RXN MR HARTLEY

<THE WITNESS WITHDREW                                                             [3.15 PM]


MR WARD:  Commissioner, can I offer some – no, you can go, Ms Hewson, it's fine, you can go.  Commissioner, could I offer some good news?


COMMISSIONER O'NEILL:  Always welcome.


MR WARD:  We won't be requiring Maree Bernoth.  I hope I've pronounced that name correctly.


COMMISSIONER O'NEILL:  All right.  Do we have Ms Mashford?  I think she's waiting to be admitted.  Ms Mashford.


MS MASHFORD:  Yes.  Am I joined?


MR McKENNA:  Speak up a little.


MS MASHFORD:  Hello, can you hear me?


COMMISSIONER O'NEILL:  Yes, yes, I can.  We're just seeing the side of you, the camera is facing the other – is it the front of the room.


MR McKENNA:  Yes, everyone's trying to work out the camera.


COMMISSIONER O'NEILL:  Ms Mashford, I'm Commissioner O'Neill and my associate is just going to have you take the affirmation.






THE ASSOCIATE:  Ms Mashford, can you please state your full name and work address?


MS MASHFORD:  Virginia Laura Mashford, Preston Road, Wynnum West.

***        SUZANNE CLAIRE HEWSON                                                                                                 RXN MR HARTLEY


THE ASSOCIATE:  Thank you.


MS MASHFORD:  I'm not sure of the number.

<VIRGINIA LAURA MASHFORD, AFFIRMED                               [3.17 PM]

EXAMINATION-IN-CHIEF BY MR MCKENNA                              [3.17 PM]


THE ASSOCIATE:  Thank you.




MR McKENNA:  Thank you, Commissioner.


Ms Mashford, my name's Jim McKenna, I appear on behalf of the ANMF.  Can you see me?‑‑‑Yes, I can.


I take it from your answer you can also hear me, that's a good start.  Could I ask you to please repeat your full name?‑‑‑My full name is Virginia Laura Mashford.


You are employed as an assistant in nursing with Regis Aged Care in Wynnum, that's correct?‑‑‑That is correct.


You were asked a minute ago for the address, I think you couldn't remember the number but aside from that could you just please repeat the address of that facility?‑‑‑It's Preston Road, Wynnum West, Queensland, 4178.


Thank you very much.  Ms Mashford, have you prepared a witness statement for the purpose of these proceedings?‑‑‑I did prepare a statement, yes.


Have you got a copy of that with you today?‑‑‑Yes, I have.


Can I just ask to confirm with you that it's a statement dated 29 October 2021?‑‑‑M'mm.


Hopefully you'll find the date on the 13th page?‑‑‑29 October 2021.

***        VIRGINIA LAURA MASHFORD                                                                                                 XN MR MCKENNA


Whilst you're there can you confirm that the statement runs to 69 paragraphs over 13 pages?‑‑‑Correct.


For the benefit of the Commission, it's found at document 232, page 12,058 of the electronic court book.


Ms Mashford, have you had a chance to read that statement recently?‑‑‑I've read it a couple of times today, yes.


I understand there are a number of corrections that you'd like to make to it?‑‑‑Yes, I sent in corrections which I've got on the front here.


I'll just take you through them so that everyone knows precisely what they are.  Is the first of those at paragraph 21?‑‑‑Correct.


At paragraph 21 you talk about the morning shift?‑‑‑Correct.


I understand that there's been some changes to that shift, you don't work the morning shift.  So I understand that in terms of corrections to make to paragraph 21 should we delete subparagraph (a) and (b) and perhaps the word 'namely' in the main part of the paragraph?‑‑‑I'm assuming you're talking about what I originally put in, yes, and I would prefer just not to comment about the morning shift because I don't work on the morning shift.


The paragraph would read:


The morning shift for AINs goes from 0630 to 1430 hours.  During that time there's a number of different AIN shifts in each of the Stradbroke and Bribie wings.


And it would stop there, is that correct?‑‑‑Correct.


Thank you.  Then 22 would also be removed to the extent that that deals with the different shifts on morning shift?‑‑‑Correct.


Thank you.  Then with respect to paragraph 23, that is talking about the afternoon shift and that's a shift that you work?‑‑‑Correct.

***        VIRGINIA LAURA MASHFORD                                                                                                 XN MR MCKENNA


I understand that there are a number of changes that have occurred to that shift since your initial statement?‑‑‑Correct.


One being the removal of the medication competent AIN.  Is that correct?‑‑‑Correct, yes.


In paragraph 23 you would remove the reference there to the medication competent AIN and the paragraph would read:


For the afternoon shift there are three AINs in each wing.  The AIN shift times can be –


and then (a) and (b).  Is that correct?‑‑‑Correct.


Then with respect to (c) there are some changes to the third of the shifts and rather than being from 1630 to 2030, it would be from 1500 hours to 2100 hours, is that correct?‑‑‑Correct.


Then the reference in subparagraph (d) to the medication competent shift would be removed?‑‑‑Correct.


Then in paragraph 24 there are now no longer two RNs rostered together, is that correct?  So that the paragraph should read:


Again, there is generally one RN and one EN, sometimes two ENs in charge.


And so on?‑‑‑Correct.


I probably haven't read that very clearly, Commissioner, I'm not sure if that needs to be clarified.


COMMISSIONER O'NEILL:  Look, I think we'll keep adopting the same approach which we'll deal with the changes here but you can file a corrected statement for the hearing book.


MR McKENNA:  Yes.  I think the only other change – no, sorry.  Paragraph 60.  No, in paragraph 26, subparagraph (n) you there refer to:

***        VIRGINIA LAURA MASHFORD                                                                                                 XN MR MCKENNA


AINs are also required to clean the pan rooms and remove laundry to the main laundry area in another part of the facility.


Would you also add to that subparagraph the fact that AINs are required to restock linen cupboards?‑‑‑During the COVID lockdown outbreak that we had at our facility, that was the case.


You would add the words, 'and during the COVID lockdowns would restock linen cupboards'?‑‑‑Yes.


Thank you.  Then I think finally in paragraph 60 – hang on, pardon me.  At 28 at the end of the paragraph, you would add the words:


More recently there has been an increase of agency staff causing to cover staffing shortages but we are still often short-staffed.




I'm also reminded that I missed a change to paragraph 26, subparagraph (e) and (f), I'm sorry.  In 26(e) the reference there to the AIN starting at 1630 would be changed to 1500.  Is that correct?‑‑‑Yes.


I'm sorry and subparagraph (f) would be removed?‑‑‑Correct.


Then I've said this a few times but I think the final change would be to paragraph 60 and you would add at the end of that paragraph a further sentence saying:


This has improved over time as more thoughtful and compassionate policies have been implemented.


Is that correct?‑‑‑Correct.


Thank you, Ms Mashford.  Subject to those changes, are the contents of your witness statement true and correct?‑‑‑Yes.


Ms Mashford, you should see on the screen that you're looking at, the face of Mr Nigel Ward as well who's now waving to you?‑‑‑Yes.

***        VIRGINIA LAURA MASHFORD                                                                                                 XN MR MCKENNA


Mr Ward has some questions for you.


COMMISSIONER O'NEILL:  Just before you do, Mr Ward, I've just got a technical glitch on my computer that's just going to take me a moment or two to address.  I'll just deal with that.  I'll be back in a moment.


That's all right.  We're back.  I just got an alert to say I had three per cent battery left but I've resolved that.  Ms Rafter, are you taking the cross-examination here or - - -


MS RAFTER:  No, apologies, I was just going to ask the Commission for an indulgence of a couple of minutes, please, just for Mr Ward.  He just had to step our urgently.


COMMISSIONER O'NEILL:  Yes, no trouble.

<THE WITNESS WITHDREW                                                             [3.25 PM]

SHORT ADJOURNMENT                                                                     [3.25 PM]

RESUMED                                                                                                [3.26 PM]

<VIRGINIA LAURA MASHFORD, RECALLED                              [3.26 PM]

CROSS-EXAMINATION BY MR WARD                                           [3.26 PM]




MR WARD:  Sorry, Commissioner, I seem to be marginally unwell this afternoon, apologies.


Ms Mashford, am I pronouncing your name correctly?‑‑‑Thank you.


Ms Mashford, my name is Nigel Ward.  I appear in these proceedings for the employer interests and I'm just going to ask you some questions.  Do you have your statement in front of you?‑‑‑I do.


Could I ask you to start at paragraph 22?‑‑‑Yes.

***        VIRGINIA LAURA MASHFORD                                                                                                     XXN MR WARD


Now, I'm not sure if this is one of the paragraphs that got amended but in my version it reads as follows:


There is usually two registered nurses, RNs, and one RN and one endorsed enrolled nurse, EEN, in charge of the shift across the three wings.  Sometimes this role is filled by two EENs.  There are also two clinical care coordinators who do the clerical administrative work during office hours.


I just want to pause there.  Who are the clinical care coordinators?  Are they registered nurses themselves?‑‑‑Correct.  They do the clinical care coordination and clerical and they are on staff, though they don't work on the floor.


When you say they do the clinical administrative work, could you describe for me what the clinical administrative work is?‑‑‑It is the overview of the clinical needs of each resident, sorting and coordinating care needs of the residents.  It's beyond my scope of practice and I am – I just have a general view of what their workload is.


When you say clinical administrative work, that's just your general understanding of it but you don't know the specifics?‑‑‑Correct.


That's fine.  That's fine.  Can I ask you to go to paragraph 26(f)?‑‑‑Yes.


You talk in paragraph 26(f) about a medication competent AIN.  Do you know what the qualification is that's required to be a medication competent AIN?‑‑‑You have to have a certificate 3 or equivalent qualification and you have to have work experience within the organisation and you have to pass some sort of test, I'm not medication competent so I haven't sat the test.


You're not familiar with what that test is about?‑‑‑No, I haven't sat that test.


No, that's fine.  That's fine.  Are you aware do medication competent AINs simply distribute Schedule 4 medications?‑‑‑Yes, they would distribute the pre-packed medications.


In the Webster packs or the blister packs?‑‑‑Correct.


Could I ask you then to go to paragraph 26(m), M for Michael?‑‑‑Yes.

***        VIRGINIA LAURA MASHFORD                                                                                                     XXN MR WARD


In this part of your statement I think you're listing what you do in your day-to-day job?‑‑‑Correct.




Documentation is completed when staff have the time to sit down, so mostly done at the end of the shift.


Could you tell me what documentation you do at the end of your shift?‑‑‑I fill in bowel sheets, I fill in food imbalance charts, I document progress notes, complex plan – I have to fill in complex pain charting.  I have things like massage and so forth that – those sort of charting.  And sometimes there's ag fee which is or was method that determines the funding for the organisation, we have to fill out those sort of things like continence care and so forth.


Can I just go through a few of those just to understand them better.  When you say progress notes, that's the observations you've made on the people in your care?‑‑‑Correct.


That might involve making a note about how you've observed their behaviour change.  It might involve a note about observing a skin lesion or something like that?‑‑‑Correct.


You talked about, I think you said, complex pain?‑‑‑Correct, that's where we have to chart whether the person is – I don't have any – I don't determine the pain levels or anything, I just note that pain is present and I note that on pain charts.


Bear with me, is that simply ticking a box that pain is present?‑‑‑Yes, yes, yes.  There's – it's just an observation.  I have no skill level there at all.


That's okay.  That's okay but you would have obviously sufficient skill to observe somebody is in pain?‑‑‑Correct.


Would you normally do that by asking them?‑‑‑I ask somebody, I observe their responses to questions, I look at their behaviours and so forth.


Do you chart things like fluid output, bowel motions, things like that?‑‑‑Correct.

***        VIRGINIA LAURA MASHFORD                                                                                                     XXN MR WARD


Again, for a bowel motion, would that be simply noting the time that it occurred?‑‑‑No, you have to note the amount of bowel motion, whether there's constipation, whether the person was continent or incontinent in that process.


In terms of these charts that you're doing, are these charts paper charts or are they on an iPad or - - -?‑‑‑They're in the computer system.


They're in the computer system.  So at the end of your shift you go somewhere in particular to use the computer?‑‑‑At the nurse's station there's a computer that AINs use to do their charting.


I think you mentioned ACFI?‑‑‑Correct.


Is that on the computer as well?‑‑‑Yes, but I'm basically doing tick sheets and making small observations.  I put - I input the information and somebody processes the information.


When you say 'I do tick sheets' can you just give me an example of a tick sheet?‑‑‑Sorry, I've just had a complete blank.  Just go back to the - - -


Take your time, it's fine?‑‑‑Right.  So when you go into - you have to go to the (indistinct) sheets.  You then have to choose the resident, then you - you can either just generically put in the time, which you just tick the top box and that generically fills it in, or you can individually do those - those charts.  It's relatively easy and straightforward and simple, but it's time consuming.


I understand.  How long do you normally spend at the end of your shift doing that?‑‑‑It depends on the complexity of the shift and the time - sometimes if I'm really tired I do it as quickly as I possibly can.  Other times I put more time and effort and (indistinct), and I write more individual progress notes about the residents and so forth.  So it varies, it really does vary from one shift to the next.


So it could be 20 minutes or it could be two hours?‑‑‑Never two hours, but certainly 20 minute, half an hour, sometimes it can take me longer, especially if I'm tired and I'm fighting with the computer system.


Thank you.  Can I ask you to go to - bear with me - 36(c)?‑‑‑Okay.  Yes.


36(c) says:

***        VIRGINIA LAURA MASHFORD                                                                                                     XXN MR WARD


Many of the residents have special food, nutrition or hydration needs.  Some residents are gluten free, lactose intolerant, some need different textures of food.


Am I right that that will all be contained in the care plan?‑‑‑There's a care plan on the computer system and there's a care plan in the bedrooms which tell you about the physical care of people.  In the kitchen there is charting which I look up each time if I'm uncertain about a person's - a person's new or they've had illness or there's been a change of status, and we can look that up, and if I'm still unsure I can go to the registered nurse and ask - - -


Ask the registered nurse.  Can I just understand the distinction of what you've just described.  You said there's a care plan in the computer.  I assume that that's their full care plan?‑‑‑Yes.


And then you said there's a care plan in the room about - - -?‑‑‑And that's about mobility and toileting and things like that.  It tends not to be about food, it tends to be about mobility and toileting and transferring from bed to chair or hoist, et cetera.


Is that sort of drawn out of the big care plan on the computer?‑‑‑Yes, although (indistinct) they're sort of parts, so they're in the various areas that you need them.


Okay.  And the one in the room as you've just described it's about how you physically assist the resident in the room?‑‑‑Correct.


That might for instance discuss how you need your certain hoist to life them or things like that?‑‑‑Whether it's a two person, whether you need two people to assist the individual what particular resource, like hoist or the slide sheets that you can stand transfer someone.  There's a variety of different - - -


Could you help me, what is a slide sheet, it's the one thing I haven't asked so far?‑‑‑Okay.  A slide sheet is a very large piece of nylon and it's slippery and you use friction.  So you double it over and you use one piece of sheet over the other to put the person on top, we move them that way.


It creates less friction - - -?‑‑‑Yes.


- - - so they are easy to move?‑‑‑Yes.

***        VIRGINIA LAURA MASHFORD                                                                                                     XXN MR WARD


Do you use that to move them around the bed or - - -?‑‑‑Yes, correct.


So if you were repositioning somebody who was heavy you might use that?‑‑‑Yes, definitely.  Absolutely.


Can I take you to 44.  Sorry, my apologies, Ms Mashford, can I take you to 44?‑‑‑Yes.


Sorry, my apologies.  You say:


During my time working at (indistinct) I've noticed that the regulation requirements have increased.  At Regis Wynnum I have noticed an increase in the accountability placed on staff with documentation requirements.


And I will just pause there.  Is that a reference to the documents you and I talked about earlier that you do at the end of your shift?‑‑‑Yes.  There's far greater input from staff like myself.  It's just (indistinct) inputting into the computer system.  Once upon a time it used to be the registered nurses who'd do those - that sort of documentation, and AINs would just basically pass the information on, but it's now - and I suppose that's the accountability part where, you know - - -


The accountability part is the fact that you're now entering that into the system?‑‑‑Yes.


No, I understand.  I'm right, aren't I, that those things that you're charting, those things that you're observing, they all come out of your skillset that you learn in your Certificate III?‑‑‑Correct.


But then you go on to say:


I have seen RNs spending more and more time documenting and less time being available to provide direct care.


I think what you're saying there is they're in the office more than on the floor, is it?‑‑‑It's like a nurses station, so it's - - -

***        VIRGINIA LAURA MASHFORD                                                                                                     XXN MR WARD


Sorry, I said the nurses - - -?‑‑‑And it's always accessible.  Yes, RNs do spend more time collating information.  So the information that I'm putting in and sharing it then goes to the registered nurse and I suppose they also take information from other professional people providing care within the organisation, and there's any amount of different care professionals.  There's dieticians, there's optometrists, there's podiatrists, there's physiotherapists, et cetera, et cetera.


That's part of that liaison role that the registered nurse is playing?‑‑‑Yes, and there's pulling and collating the information, and then it goes to the clinical care coordinators who then put these things together and then it goes through the bureaucratic process of getting funding I'm assuming.


Now, I don't want this to sound unfair, so bear with me.  I take it you don't know specifically what the RN is spending more time on, you just see them spending more time on it?‑‑‑Correct, it's an observation.


No, that's fine.  Just a moment if I can.  Ms Mashford, thank you very much for your evidence.  Commissioner, we have no further questions.


COMMISSIONER O'NEILL:  Any re-examination, Mr McKenna?


MR McKENNA:  There is not, Commissioner.  Might Ms Mashford be excused?


COMMISSIONER O'NEILL:  Indeed.  Ms Mashford, thank you very much for your evidence, you're excused and free to go?‑‑‑Okay.  Thank you so much.

<THE WITNESS WITHDREW                                                             [3.42 PM]


COMMISSIONER O'NEILL:  All right.  We have Ms Nasemena?


MR McKENNA:  Yes.  Commissioner, it is the screen with Lee Hubbard in it that Ms Nasemena - that's where she will be appearing.


COMMISSIONER O'NEILL:  All right.  The camera's not on at this point.


MR McKENNA:  I think Mr Hubbard might be there and he might see to that.




MR McKENNA:  There we go.

***        VIRGINIA LAURA MASHFORD                                                                                                     XXN MR WARD


COMMISSIONER O'NEILL:  Good afternoon, Ms Nasemena.  Have I pronounced your name correctly?




COMMISSIONER O'NEILL:  And you can hear me.  I'm O'Neill C and my Associate's just going to have you take the affirmation.


THE ASSOCIATE:  Ms Nasemena, can you please state your full  name and work address?


MS NASEMENA:  My name is Rose Nasemena.  My work address is BUPA Aged Care, Bonbeach, 53-59 Broadway, 3196, Victoria.

<ROSE NASEMENA, AFFIRMED                                                       [3.44 PM]

EXAMINATION-IN-CHIEF BY MR MCKENNA                              [3.44 PM]




MR McKENNA:  Thank you, Commissioner.  Ms Nasemena, my name's Jim McKenna, I am the barrister or one of the barristers for the ANMF in this proceeding.  Could I please ask you to again state your full name?‑‑‑My full name Rose Nasemena.


You are employed as an assistant in nursing by BUPA at BUPA Bonbeach.  Is that correct?‑‑‑Yes.  Yes.


You've just given your address at that facility.  Could you please repeat that for the Commission?‑‑‑53-59 Broadway, 3196 Bonbeach, Victoria.


Thank you.  It might be that that's the hardest question that some of the witnesses are asked in this proceeding.  It's sometimes difficult to remember our work address.  Ms Nasemena, have you prepared a witness statement in this proceeding?‑‑‑Yes.


Do you have a copy of it with you today?‑‑‑Yes.

***        ROSE NASEMENA                                                                                                                   XN MR MCKENNA


Is it a statement of 59 paragraphs over 10 pages, with one annexure?‑‑‑Just one minute.  Can you repeat?  Is it 59 paragraphs?


If you go to page - the second last page, you will hopefully see there that there's a statement 57 paragraphs long?‑‑‑Yes.


And it's dated 29 October 2021?‑‑‑Um - - -


Hopefully on that page 10?‑‑‑Page 10.


Just after 57 paragraphs?‑‑‑Yes, I can see now, yes.


It's important to know that we're working off the same document.  And for the benefit of the Commission and the transcript it is document 228 at page 11,987 in the electronic court book.  Ms Nasemena, have you had a chance to read that statement recently?‑‑‑Yes, I, yes, went through.


I understand there are a couple of corrections you'd like to make.  The first of which is at paragraph 4.  Is that correct?‑‑‑Paragraph 4.


Is it correct that you have now resigned - - -?‑‑‑Yes, paragraph 4, yes, I put my resignation letter on 7 April.  My last day of work will be tomorrow.


Thank you.  And so, to clarify paragraph 4, would you add that you resigned from your position with effect on 7 May 2022, to take time out?‑‑‑Yes.


Thank you.  And then in paragraph 8 you did some bed numbers?‑‑‑Yes.


Now, you say Bonbeach is a 100 bed facility, with about 90 residents currently.  And I understand that you changed the numbers of beds in Parklane from 32 to 13.  Is that correct?‑‑‑No, the bed number from Parklane - Mayfair it's a dementia unit, it's 14 beds.


Right, so Mayfair instead of 12 it'd be 14?‑‑‑Yes.


Park Lane we currently say 32?‑‑‑Yes.

***        ROSE NASEMENA                                                                                                                   XN MR MCKENNA


Should that be changed?‑‑‑Yes.


Is that correct, that - sorry?‑‑‑No, no, Park Lane unit now it's 33 because at Park Lane unit it's break up to three section.  We call team A, team C - team A, team B and team C.  Team C is dementia unit, yes.


So, should Park Lane refer to 32 beds in Park Lane.  Is that correct?  Thirty-three, I'm sorry?‑‑‑Thirty-three, yes.


Thank you.  And then for Lodge, how many beds should there be there?‑‑‑In Lodge I don't really work in that area.  It's 47 beds.  Yes.


Thank you for that.  Are there any other changes, corrections or clarifications you wish to make to the statement?‑‑‑No.


Subject to those changes, are the contents of your witness statement true and correct?‑‑‑True.


The one annexure that you've got which I think is a pay slip, that's a true copy of the document that you refer to in your witness statement?‑‑‑Yes.


Thank you, Commissioner.




MR McKENNA:  Yes.  Ms Nasemena, you should see Mr Nigel Ward on a screen on the - in a box on the screen in front of you?‑‑‑Yes.


Mr Ward will have some questions for you.  Thank you.

CROSS-EXAMINATION BY MR WARD                                           [3.50 PM]


MR WARD:  Ms Nasemena, can you hear me okay?‑‑‑Yes, I can you clearly.


Thank you very much.  My name's Nigel Ward, Ms Nasemena, and I act in these proceedings for various employer interests.  I'm just going to ask you some questions.  Do you have your statement in front of you?‑‑‑Yes.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


I wonder if we could just start right at the beginning of the statement.  You describe your role as a senior carer.  Do you see that?‑‑‑Yes.


Can you just explain for me what the role of a senior - does senior mean something particular at BUPA?‑‑‑Yes, being a senior carer I have actual responsibility and been working there for 13 years, which the head nurses, the registered nurses there rely heavily on me.  So, I believe I'm a senior carer there with like additional responsibility, assisting the clients with their medication, yes.


And I take it that there are some people employed at BUPA who are just carers rather than senior carers?‑‑‑Yes.


Yes.  Could I ask you to go firstly to paragraph 10.  If you could turn to paragraph 10, please?‑‑‑Yes.


Now, you say in paragraph 10:


I did the Certificate IV in Aged Care.


I'm right that you've got both a Certificate III and a Certificate IV in Aged Care aren't I?‑‑‑Yes.  Yes.


You say:


I did the Certificate IV in Aged Care to help learn more about aged care, especially the documentation at ACFI.  BUPA was helpful and encouraged us to do the Cert IV.  I have also undertaken courses, assist clients with medication and recognising healthy body system in a healthcare context.


Can you just explain to me the course Assist Clients with Medications.  Was that a course run by the employer or is that a TAFE course?  What sort of course is that?‑‑‑It is a - I can say from the memory it is a course run by the RTO.


Right?‑‑‑Yes, so they bring a tutor from the RTO.  They bring it into the facility to actually run the course.  Like, that course for us to go through with assisting the clients with the medication, the Webster-pak medication, yes.


Is that the course you did to become qualified to do medications?‑‑‑Yes.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


And I think you said it was – was it a full day course or - - -?‑‑‑It is a full day course.


Is it run by a registered nurse, or who ran it?‑‑‑A registered nurse, is a two time, yes.


The other course is, 'Recognising health body systems in a health care context.'  Was that also run by a registered training organisation?‑‑‑Yes.


How long was that course?‑‑‑That was a day course as well too.


Am I right in saying there was an assessment or test at the end of the courses?‑‑‑Yes.


In terms of medications, am I right that you are limited to Schedule 4 medications?‑‑‑Yes.


Just bear with me, I just want to see if how I understand that works is how it worked for you.  You're able to do Schedule 4 medication rounds in the facility, is that correct?‑‑‑Yes.


I assume your facility normally keeps its Schedule 4 medications locked away somewhere?‑‑‑Yes.  Okay, Schedule 4 medication, it's dangerous drug, isn't it?  It is.


Yes?‑‑‑So, okay, this is only handled by the registered nurse.  Yes, the carers, we are more – we're doing our Webster‑paks.


Let's say I'm the resident you're looking after; you would take the Webster‑pak to my room, you'd check the medication – the tablets to make sure they're the right tablets, and do you do that using a picture chart?‑‑‑Yes.  We have the iPad.


And it's on the iPad, is it?‑‑‑Yes, it's on the iPad, called the Leecare.  We've got to be – I've got to be very careful if there are two residents in the room and they have the same surname.


So you have to check the right person and the right tablets, yes?‑‑‑Yes.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


Does the iPad tell you how you have to give the tablet to the resident, whether or not it needs to be crushed or something like that?‑‑‑Yes.  Yes, they have the history of the, you know, medical condition and all this, so we have to read all this.  And then we've got to check against physical Webster‑pak - we've got to check against what's on the iPad.


After you've done that you would – let's say I needed my medication crushed and placed in custard, you would do that as part of the process?‑‑‑Yes.  If a client finds it difficult to, you know, the swallowing, the swallowing problem, we will have to communicate with the registered nurse, and yes, if tablets are not to be crushed it has to be dissolved in the, you know, water or something – yes, in the water, yes.


You've given me my tablet, I take it that you would record on your iPad that I've taken it?‑‑‑Yes.  Yes, (indistinct) tablet and then we record it.


If there's a problem, let's say when you check the pills they don't look like the right pills, who do you go and talk to?‑‑‑To the registered nurse and she follow up with the responsible pharmacy, who dispensed the medication, yes.


Now, you did your Certificate III in 2009, and then you did your Certificate IV in 2015.  Could you just share with us why you went on to do your Certificate IV?‑‑‑Okay.  Certificate IV was – it was the organisation that I work with, they thought it's compulsory for the carers to, you know, extend their knowledge.


And - - -?‑‑‑Because you have to acquire the knowledge to work with the clients, the residents, yes.


What extra skills did you learning doing the Certificate IV that you didn't have when you had the Certificate III?‑‑‑Okay, Certificate IV was longer period than Certificate III.  Certificate III is for me to get into the workforce, so they just run it through only in three months, so that I go on the floor and I learn the job on my own, yes.  And Certificate IV, it's theory, which I'll learn about how to communicate with the client, both in the nursing home and in the home care as well, and with the individual support care as well, and basically it touch on, you know, how to deal with the client with the mental health and physical health, and we studied their vital signs and how we do the documentation, like we report to the nurse and, yes, stuff like that.  So it's more depth than Certificate III, yes.


Can I ask you to go to paragraph 24?  You say, 'I do documentation on personal hygiene and care throughout my day by entering it in the progress notes'?‑‑‑Yes.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


Are your progress notes on the iPad, or are they physical paper?‑‑‑Two years ago - iPad was just introduced, yes, two years ago, so basically we do paperwork, yes.


So you don't put your progress notes into the iPad?‑‑‑Now we do it into the iPad now.


You do it now into the iPad?‑‑‑Yes.  So we have the residents list.  So the residents list, each resident they have there, you know, are scheduled, like, which day or in the afternoon or AM, or night staff they do the progress note for the individual work(?), you know – day‑to‑day living.


So when you write a progress note on a client, I assume that you would be writing about observations you've made while you've been with them?‑‑‑Yes.


And those observations might concern whether or not they're eating, yes?‑‑‑Yes, eating.


They might relate to whether or not they're sleeping more than normal, or whether or not they're in a bad mood or something like that?‑‑‑Yes, all the same – yes, observation like – yes, it's about toileting or their changes, in their physical changes, and their mental changes as well when they're like – their communication changes, all these observations.  So we do the progress note and then – yes, we - - -


When you say toileting, you're making observations about bowel movements or urine input/output?‑‑‑Yes, bowel movements, yes.


When you say 'physical', is that more about whether or not their mobility is changing?‑‑‑Yes, mobility is like walking, standing, sitting, all this.


I take it that those progress notes, then the registered nurse has access to those?‑‑‑Yes, they have access to those.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


You also say in paragraph 24, 'Anything clinical we write it down and pass it on to the RN.'  What do you mean by clinical?‑‑‑Okay, clinical is on, like, the medication, like – okay, clinical, medication like when – when the doctor comes in and makes some changes, changes on the tablets, say, for example, if I'm not on that shift and I come in and open a resident's cupboard and then I find extra, you know, sachet pack or extra tablet, I write it down, or I have to call the RN, can you explain it to me, or something like that before I, you know, assist the client with his or her normal medication.


If you observed a client and they had a cut or something like that, would you tell the RN straightaway?‑‑‑Yes, and then the falls as well.


Sorry?‑‑‑The falls, if the client falls.


If the client falls, you tell the RN straightaway?‑‑‑Yes.


What about bruising on a client, would that go straight to the RN?‑‑‑Bruising, bedsores, anything, we go to straightaway; straightaway call the RN.


Could I ask you to go to paragraph 29?  You say in paragraph 29:


We have one 83‑year‑old resident who is a former footballer and is still in very good shape.


Hopefully I will be at that age.


He is very strong and lashes out.  His wife couldn't cope with him at home.  He likes female company.  We keep him busy pushing the tea trolley around, helping us in the kitchen.  If we don't keep him busy and calm he can become aggressive, so that times time and energy.


Am I right in saying that you learnt strategies in your Cert III and Cert IV about dealing with behaviours and aggression in clients?‑‑‑Yes.


Can you just share with me the sorts of things you learnt in your Cert III?‑‑‑Yes.  Cert III we are - it comes down - once I am on the floor I learn about dealing with different clients, you know, with their like behaviours and all these, yes.


And did you learn anything extra in your Cert IV?‑‑‑Yes, Cert IV is more depth that I learn in Cert IV, yes.


If you go to paragraph 32 you say this right at the end of it, you're talking about dealing with certain residents, you say:

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


So it needs a combination of technical skills as well as empathy and using an appropriate tone of voice and physical approach.


Is empathy an important quality to have?‑‑‑Yes, it is.


How does it help you?‑‑‑I have to be special in this area, especially with dementia section.  It's a very challenging area, so it comes to - I've got to work around mentally to deal with the situation with different dementia patients.  So, yes, it's all about calmness and - - -


When - sorry, go on.  I interrupted you, I'm sorry?‑‑‑It's all about calm and the tone of my voice, how I approach each of them, yes.


When you say you need to take a different physical approach what do you mean by different physical approach?‑‑‑How do I put it, like we call (indistinct) like a personal touch.  Personal touch, like give them comfort, you hold their hands, something like that, yes.


And then in 33 you talk about, 'During meal times we also have to be very conscious of choking risks.'  I am right, aren't I, that choking risks is a topic covered in the Certificate III?‑‑‑Yes.


Now, can I then take you - just give me a moment.  Sorry, Ms Nasemena, just give me a moment.  Can I take you to paragraph 35 you say:


In my role I help less experienced and less trained staff learn what is needed in the role.  This is always the way with new casual or agency staff.  Some staff do not seem to have received very good quality training, or it isn't in depth enough about dementia and pain and diabetes and so on.  We are working with the most vulnerable people, but when people come out of their course they have not done enough practical training.  Much of what is learnt is learnt on job.


I take it when you're saying that you're happy with their theoretical training, but you're not happy with their practical training, is that right?‑‑‑Yes, especially coming to manual handling.  I guess in that manual handling area we only have only one (indistinct), like manual handling, but basically I think we should have more on manual handling training.  This is really part of our caring role, is manual handling, yes.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


And by manual handling you mean - - -?‑‑‑Transferring - - -


- - - transferring?‑‑‑Lifting.


Two people lift, so all of those things?‑‑‑All of those.


And the people you were seeing coming into the industry, that you've seen, you don't think they have got enough practical understanding of that?‑‑‑Yes, practice - yes, practical understanding of how to move a sick elderly - a sick elderly they have fragile skin and we just have to be very, very careful on how to moving them, and, yes - - -


Then in 36 you say, 'When I am partnered with someone who is inexperienced I teach them routines.'  By inexperienced are you referring to what we've just talked about?‑‑‑Yes, yes, and also the routines of like I have the residents list and I have to tell them who to do next, but first of all we've got to do this, you know, room first, and then we move into that room, and so we go after dinner, before dinner always, because that time who's got to go to bed first.  Yes, so - - -


Okay.  I take it that's part of the role of being a senior carer, is it?‑‑‑Yes, giving direction.


Yes.  Can I take you if I could to paragraph 43.  It says in 43, 'We do a lot of the eye care, mouthwash oral care.'  I will just pause there.  Do you see that?‑‑‑Yes.


Again am I right that those are things you learn in your Certificate III?‑‑‑Yes, Certificate III those sort of things we learn, yes.


You then say:


I also monitor the stomas.  We have one resident, and assist with changing them.  We have several residents with catheters which I change and empty the catheter bag.


Am I right when it comes to the catheter bag you're taking the full bag off and putting the new one on?‑‑‑Yes.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


With the stoma how is that being emptied?‑‑‑Okay.  The stoma we've got to check.  If the bag is full - if the bag is full - the particular resident he can tell us the same, because he goes rubbing his bag, that he's not comfortable.  So I know that the bag is full, so then I assist him, I take him to the restroom to take off the bag, clean it, and then put a clean stoma bag on.  Yes.


Then can I take you to 51.  I think it's (d), but bear with me, it might not be.  If we can start with (d), you talk there about moving to computers for all other care such as bowel charts, fluid charts and progress notes.  Is that what you meant when you said, 'We move then onto the iPad'?‑‑‑Yes.


And then in (e) you said, 'The increased number of high care residents will fall risks that require constant monitoring.'  Can you just explain in a little bit more detail what you mean by constant monitoring?‑‑‑Constant monitoring is - I'll just give an example.  In the dementia section it's full on.  It's full on, so basically I can say that I have to have like four eyes, like I have to make sure I look here, look there and, you know, one will just open the door and just run out to the garden or banging on the door.  They go from room to room, you know.  Yes, so it's all different behaviour, it comes on (indistinct) times, yes.


So with the dementia clients I take it some are not ambulatory, but some are quite ambulatory?‑‑‑Yes.


Is it more the case that the ones who aren't ambulatory could fall more regularly?‑‑‑Yes.


And you have to be on the lookout for that?‑‑‑Yes.


Okay.  If there is a fall is the procedure if there's a fall to go and get the registered nurse straight away?‑‑‑Yes.  I've got the pagers, I just call her straight - - -


Okay.  And you say there's a fall and the registered nurse drops what they are doing and comes and helps?‑‑‑Yes.  So basically we don't - we're not going to touch and push them.  We just stand there and then the registered nurse comes in and do the observation.  After observation we may move, touch or transfer.


And the registered nurse will make that decision?‑‑‑Yes, she makes all the decisions, like she comes and do the touching and pushing and moving around.


Thank you.  Just a moment, please.

***        ROSE NASEMENA                                                                                                                        XXN MR WARD


Ms Nasemena, I wish you well.  Thank you very much.  No further questions, Commissioner.


COMMISSIONER O'NEILL:  Any re-examination, Mr McKenna?


MR McKENNA:  Thank you, Commissioner.

RE-EXAMINATION BY MR MCKENNA                                           [4.13 PM]


MR McKENNA:  Ms Nasemena, you were taken to paragraph 35 of your statement in the questions, and that paragraph provides as follows:  'In my role I help less experienced and less trained staff to learn what is needed in the role.'  In respect to that paragraph, you were asked, or it was put to you that much of what you learn you've learnt on the job, and then I think a question regarding the training that you have and the Certificate III and Certificate IV.  It was put to you that you're happy with the theory but not the practical components of that training, and in answer to that you said, 'Yes, especially in relation to the manual handling', and then you said there was only one of something with manual handling, and I'm sorry, I missed that.  Can you just explain what your answer to that was?  There was one something about manual handling?‑‑‑Manual handling?


Yes.  You were asked questions about that paragraph and you were asked questions about your training, and it was put to you that you felt that there was a difference between the practical component of your training and the theoretical component, and you said yes, one of the practical components that you weren't satisfied with was with respect to manual handling?‑‑‑Yes.


And you said there was only one of something, and I'm sorry, I missed what that one thing was?‑‑‑In the manual handling we need more training on that, because when, like, the new staff are coming in they're less experienced, so they need more training on how to move, push, always, yes.  And transferring clients, all this, yes.


And so you'd say that that is something that should be dealt with more comprehensively in a Certificate III or Certificate IV?‑‑‑Certificate III.


Thank you.  I have no further re-examination for Ms Nasemena.  Might the witness be excused?

***        ROSE NASEMENA                                                                                                                 RXN MR MCKENNA


COMMISSIONER O'NEILL:  Yes.  Thank you very much, Ms Nasemena, for your evidence, and you're excused and free to go?‑‑‑Thank you.  Thank you so much for inviting me over.  This is my first experience.


You've done very well?‑‑‑Thank you.

<THE WITNESS WITHDREW                                                             [4.15 PM]


MR McKENNA:  Commissioner, we have Ms Christine Spangler available now.  If it is possible to deal with her today, that would be our preference.


COMMISSIONER O'NEILL:  All right.  Mr Ward, do you have any problem with that?  It seems perfectly reasonable to me.


MR WARD:  Well, let's press on.


COMMISSIONER O'NEILL:  There was also a document I think in relation to Ms Spangler's evidence, is that right?


MR McKENNA:  Yes.  I'll defer to Mr Hartley on that, Commissioner.


COMMISSIONER O'NEILL:  Yes, it's in relation to the enterprise agreement.


MR McKENNA:  It's the new enterprise agreement, yes, that's right.




MR McKENNA:  Can I say as well while I'm on my feet that - - -


MR HARTLEY:  (Indistinct) was going to be next.  She's actually had to start a shift, because her facility was short‑staffed, so we'll have to bring her back another day.


COMMISSIONER O'NEILL:  All right.  Ms Spangler, can you hear me all right?


MS SPANGLER:  Yes, I can.


COMMISSIONER O'NEILL:  I'm O'Neill C and my associate is just going to have you take the affirmation.


THE ASSOCIATE:  Ms Spangler, can you please state your full name and work address?


MS SPANGLER:  My name is Christine Marie Spangler.  My work address is 224 Piper Street, Broken Hill.

<CHRISTINE SPANGLER, AFFIRMED                                             [4.17 PM]

EXAMINATION-IN-CHIEF BY MR HARTLEY                               [4.17 PM]




MR HARTLEY:  Thank you, Commissioner.  Ms Spangler, it's Jim Hartley for the ANMF speaking.  Can you see and hear me?‑‑‑Yes, I can.


Thank you.  Could you just restate your name, please?‑‑‑Christine Spangler.


And your occupation?‑‑‑I'm an AIN in aged care.


Could you say your address one more time?‑‑‑My work address is 224 Piper Street, Broken Hill.


Ms Spangler, you've made a statement in this proceeding dated 29 October 2021?‑‑‑Correct.


Do you have a copy of that with you?‑‑‑Yes.


For the Commission's benefit, that's tab 215 commencing at page 11611.  Ms Spangler, can you look at paragraph 9 in that statement, please?‑‑‑Yes.  'I work part‑time.'


Yes, that's the one, and you'll see that on the second and third lines you identify an enterprise agreement which ends the numbers, 2017 to 2020.  Do you see that?‑‑‑Yes.


Is it the case that you're now covered by the Southern Cross Care (Broken Hill) Limited NSWNMA and the Broken Hill Town Employers Union Enterprise Agreement 2021 ‑ 2024?‑‑‑Yes, that's correct.

***        CHRISTINE SPANGLER                                                                                                            XN MR HARTLEY


And is your base rate of pay now $28.60 per hour for night shift?‑‑‑Correct, yes.


If you look at paragraph 14, you say there that you only work night shifts.  That remains the case, doesn't it?‑‑‑It does, yes.


Updated to the present date in the way that you've just done, is that statement true and correct to the best of your knowledge and recollection?‑‑‑It is, yes.


You'll see Mr Ward in another one of the boxes on the screen.  He's now going to ask you some questions?‑‑‑Okay.

CROSS-EXAMINATION BY MR WARD                                           [4.19 PM]


MR WARD:  Ms Spangler, can you hear me okay?‑‑‑Yes, I can.


Ms Spangler, I'm not going to keep you very long.  I've got a couple of questions for you if I can.  Just so you understand, I'm appearing in these proceedings for the employer interests.  Do you have your statement with you?‑‑‑Yes.


I'm just going to jump around a little bit, but can we just start at paragraph 30, is that okay?  Could you go to that?‑‑‑Yes.


Tell me when you're there?‑‑‑Getting there.


That's okay?‑‑‑Yes.


You say in paragraph 30, you say this:


When I first started at St Anne's, they asked whether I had done my Certificate III or had an intention of doing one.  That does not happen anymore.  There is now no expectation to have a Certificate III to work in aged care at St Anne's.  The staff now have less formal training.


I'm going to pause there.  Is it the case that at St Anne's the employer doesn't want Certificate III; it's not asking for them?‑‑‑Well, you don't have to – well, it's not required to have one anymore.

***        CHRISTINE SPANGLER                                                                                                               XXN MR WARD


Was it required before?‑‑‑They preferred you to have one.


Okay.  All right?‑‑‑Yes, preferred.  It was preferable, thinking you had more knowledge to go in, because you've already done your certificate.


You've done your Certificate III, haven't you?‑‑‑Yes.


Now, if you can't answer this question don't, but do you think somebody needs a Certificate III to do the job properly?‑‑‑Yes, I do.


If I could take you then right back to the beginning of your statement?‑‑‑Yes.


You sort of win a prize.  Nobody's done as much inhouse training as you in this case.  You've listed on my count, and I reckon my count might not be quite right – I've listed 42 things you've done?‑‑‑Yes.


Does that sound about right?‑‑‑Well, yes, that's over a year.  You get that over a year to do.


So you're saying you do these courses each year every year, do you?‑‑‑Yes, for refreshment courses.  You have to keep up‑to‑date with these trainings.


How long do these courses go for?‑‑‑One session can go for 30 minutes.


Yes?‑‑‑And one could be 20 minutes.  We usually have two to four to do each month, and they prefer it if it's done at work.


Yes?‑‑‑Which is not always the case that that can happen.


Are these on a computer, or are these - - -?‑‑‑Yes, on a computer.


Have you always been required to do so many?‑‑‑We used to have in-house training, like a full-day training but then we had to be paid for it.  So now they've decided that you may now do these at work on the computer and a lot of staff haven't even started to do them.

***        CHRISTINE SPANGLER                                                                                                               XXN MR WARD


Are they a new thing, are they?‑‑‑Well, they've been in force for about the last six months.


If you don't know the answer to this, don't answer it but do you know why they've been introduced?‑‑‑I think it's to reduce maybe payments because if you have in-house training you have to pay the staff on their day off to train.


Is it possibly because people don't have a certificate 3?‑‑‑It could be possible, yes.


So you'd have to do all of those each year, that's your understanding now?‑‑‑Yes.


Could I ask you to go to paragraph 17.  Just tell me when you get that?‑‑‑I'm there.


Thank you.  You talk about a typical night shift, you say in (a):


I look after the residents, answer call bells, take them to the toilet and make sure all out of bed alarms are on for safety.


Are the out of bed alarms pressure mats on the floor?  How do yours work?‑‑‑Ours are on the floor.  So if a resident gets out of bed and their feet touch that mat, an alarm goes off, yes.


You'll know that the resident is getting out of bed, so you can attend to it?‑‑‑Yes, yes.


Then bear with me.  Then in (d), you say:


We assist the RN to sign out Schedule 8 drugs if required.




What do you mean by sign out?‑‑‑Well, all drugs, like, have to be signed into a medication S8 books, which S8 drugs are drugs of, like, oxycodone.  Anything of high powerful pain relief.

***        CHRISTINE SPANGLER                                                                                                               XXN MR WARD


Yes?‑‑‑And they're all - so they have to be counted out and then you have to go with the RN to watch them give that medication out.


Your role is to observe what the RN is doing?‑‑‑Yes and sign that they've – there was 10 in a packet, we've taken one out, that leaves nine.


Nine, okay?‑‑‑And you sign the book.


Did you need to do special training to do that?‑‑‑No.


You were just picked to help the RN?‑‑‑Yes.  Usually they will pick someone that's been there a long time, of experience.


Could I ask you to go to paragraph 24?‑‑‑Yes.


You're talking in paragraph 24 about wound care?‑‑‑Yes.


You talk about what you would do, what the registered nurse and the enrolled nurse would do, and in the last little part it says:


If it is more complex they will do it.


I'm assuming that you mean the RN or the EN?‑‑‑Yes.


What does complex mean?‑‑‑If the resident has had a really bad fall and, like, has split their head open, they will attend to that.  There might be steri strips goes onto that wound and sometimes even an ambulance has to be called as we wouldn't have the things to dress it in our nursing home.


Can I take you to paragraph 26?‑‑‑Yes, yes, I've got that.


Are you there?  At the end of 26 in the last sentence you say:


We only have more time with the residents if there are more staff.


Do you see that?‑‑‑Yes.

***        CHRISTINE SPANGLER                                                                                                               XXN MR WARD




The RNs and ENs have to do a lot of documentation like risk assessments, skin assessments and the documentation involved in admissions.


Do you see that?‑‑‑Yes.


Can you just tell me in your facility what's the paperwork they do related to admissions?  I'm sorry, I can't hear you?‑‑‑Sorry.  I've got a very croaky voice, sorry.  Full admissions would be everything like if you're being admitted to hospital.


Right?‑‑‑Like I'd like to know your preferences, what your eating habits are, what your preferences are for showering, your mobility, your continence, and all these sort of things of their daily living tasks.


When you use the word - - -?‑‑‑Allergies.


Go on.  You go on.  You go on?‑‑‑Yes.  Allergies and anything that would help you to help them in their daily living.


When you say admissions do you mean admissions into your facility or do you mean admissions from your facility to a hospital?‑‑‑No, into our facility.


I take it that those things you've just talked about, they go into the client's care plan, don't they?‑‑‑That's right, yes.


You also talk about risk assessments?‑‑‑Yes.


What do you mean by risk assessments?‑‑‑Well, it can be falls risk assessments and plus there's pain assessments.  You have to do a lot of paperwork just for a resident to get an S8 drug and if they are a high falls risk they have to – you have to have everything in place for that falls resident.  You know, you've got to make sure all the safety procedures are in place.


Just a moment.  Ms Spangler, thank you very much, have a good weekend.  Commissioner, no further questions?‑‑‑Okay.  Thank you.

***        CHRISTINE SPANGLER                                                                                                               XXN MR WARD


COMMISSIONER O'NEILL:  Mr Hartley, any re-examination?


MR HARTLEY:  I have one question.

RE-EXAMINATION BY MR HARTLEY                                            [4.30 PM]


MR HARTLEY:  Ms Spangler, the very last answer that you gave you referred to having to have everything in place for a falls resident?‑‑‑Yes.


What are some of the things that you would have to have in place for such a resident?‑‑‑Well, if they're in bed you have to make sure the out of bed alarms are in, their floor mats are on.  And for an example, I asked a staff member to check those and they didn't know what they were.  So then I had to educate the person, if they're not on then this person gets out of bed, anything could happen.


All that work that you've just described is that work that you do or is that work that the nurses do, setting up floor mats, checking that they're turned on, that sort of thing?‑‑‑We all – well, the nurses do it, yes.


Do you also do it or only the nurses?‑‑‑No, I do it.


Yes?‑‑‑My RN always says, 'I want you to check each time you come on all those safety and the floor mats are on and connected.'


Yes?‑‑‑So I do.


Thank you, Ms Spangler.  That's the re-examination, Commissioner.


COMMISSIONER O'NEILL:  Mrs Spangler, thank you for your evidence, you're excused and free to go?‑‑‑Thank you.

<THE WITNESS WITHDREW                                                             [4.31 PM]


COMMISSIONER O'NEILL:  That's the last witness for today on my count.


MR WARD:  Yes.

***        CHRISTINE SPANGLER                                                                                                         RXN MR HARTLEY


COMMISSIONER O'NEILL:  Are there any matters either party wishes to raise before we adjourn?


MR WARD:  Not for us, thank you, Commissioner.


SPEAKER:  No, Commissioner.




MR GIBIAN:  No, thank you, Commissioner.


COMMISSIONER O'NEILL:  We're adjourned and we will see you on Monday morning.


MR GIBIAN:  Thank you, Commissioner.


COMMISSIONER O'NEILL:  The Commission is adjourned.

ADJOURNED UNTIL MONDAY, 09 MAY 2022                                [4.32 PM]



DARREN JAMES KENT, AFFIRMED............................................................ PN7312

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN7312

CROSS-EXAMINATION BY MR WARD....................................................... PN7331

RE-EXAMINATION BY MR GIBIAN............................................................. PN7517

THE WITNESS WITHDREW........................................................................... PN7531

MICHAEL WILLIAM PURDEN, AFFIRMED............................................... PN7539

EXAMINATION-IN-CHIEF BY MS DOUST.................................................. PN7539

CROSS-EXAMINATION BY MR WARD....................................................... PN7560

RE-EXAMINATION BY MS DOUST.............................................................. PN7612

THE WITNESS WITHDREW........................................................................... PN7628

ANITA FIELD, AFFIRMED.............................................................................. PN7636

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN7636

CROSS-EXAMINATION BY MR WARD....................................................... PN7650

RE-EXAMINATION BY MR GIBIAN............................................................. PN7840

THE WITNESS WITHDREW........................................................................... PN7845

TERESA EILEEN HEENAN, AFFIRMED...................................................... PN7866

EXAMINATION-IN-CHIEF BY MS DOUST.................................................. PN7866

CROSS-EXAMINATION BY MS RAFTER.................................................... PN7876

THE WITNESS WITHDREW........................................................................... PN8022

LISA BAYRAM, AFFIRMED............................................................................ PN8030

EXAMINATION-IN-CHIEF BY MR MCKENNA.......................................... PN8030

CROSS-EXAMINATION BY MR WARD....................................................... PN8058

THE WITNESS WITHDREW........................................................................... PN8081

LISA BAYRAM, RECALLED........................................................................... PN8081

CROSS-EXAMINATION BY MR WARD, CONTINUING........................... PN8081

RE-EXAMINATION BY MR MCKENNA...................................................... PN8247

THE WITNESS WITHDREW........................................................................... PN8257

SUZANNE CLAIRE HEWSON, AFFIRMED................................................. PN8266

EXAMINATION-IN-CHIEF BY MR HARTLEY........................................... PN8266

CROSS-EXAMINATION BY MR WARD....................................................... PN8284

RE-EXAMINATION BY MR HARTLEY........................................................ PN8323

THE WITNESS WITHDREW........................................................................... PN8331

VIRGINIA LAURA MASHFORD, AFFIRMED............................................. PN8347

EXAMINATION-IN-CHIEF BY MR MCKENNA.......................................... PN8347

THE WITNESS WITHDREW........................................................................... PN8401

VIRGINIA LAURA MASHFORD, RECALLED............................................ PN8401

CROSS-EXAMINATION BY MR WARD....................................................... PN8401

THE WITNESS WITHDREW........................................................................... PN8467

ROSE NASEMENA, AFFIRMED..................................................................... PN8478

EXAMINATION-IN-CHIEF BY MR MCKENNA.......................................... PN8478

CROSS-EXAMINATION BY MR WARD....................................................... PN8508

RE-EXAMINATION BY MR MCKENNA...................................................... PN8597

THE WITNESS WITHDREW........................................................................... PN8604

CHRISTINE SPANGLER, AFFIRMED........................................................... PN8619

EXAMINATION-IN-CHIEF BY MR HARTLEY........................................... PN8619

CROSS-EXAMINATION BY MR WARD....................................................... PN8633

RE-EXAMINATION BY MR HARTLEY........................................................ PN8696

THE WITNESS WITHDREW........................................................................... PN8704